What to do if I have respiratory acidosis compensating for metabolic alkalosis or is metabolic alkalosis compensating for respiratory acidosis?

Difference.... If your ph in your blood is lower than normal, then you have an acidosis. If the ph in your blood is higher than normal, then you have an alkalosis. To figure out if the abnormality is respiratory or metabolic, you need to know the carbon dioxide level. An arterial blood gas test would give the information needed to diagnose the disorder, including whether or not there is compensation!