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We provide solutions for:

. Home Oxygen Systems
. Home Medical Equipment
. Overnight Oximetry
. Aerosol Meds Program
. Spirometry
. CPAP Sleep Therapy.
. Portable Travel Oxygen.

Patient Education


If you have ever experienced difficulty breathing, or if you have lung or heart problem, you have probably wondered about using oxygen at home.

Your physician has determined, based on your symptoms, physical examination and laboratory test, that you may benefit from the use of oxygen at home.

Following are answers to some of the most commonly asked questions about the use of oxygen in the home.

What is oxygen?

Oxygen is a colorless, tasteless, odorless gas that is necessary for life. When we take a breath, we draw air containing 21% oxygen into our lungs. The oxygen passes from our lungs into our bloodstream, where it is carried in the red blood cells to all the organs and tissues of our bodies. Oxygen is needed by our organs and tissues to convert the food we eat into heat and energy, to maintain life.

How is oxygen made and stored?

There are three common methods for obtaining pure oxygen:

Air is cooled and compressed until it becomes a liquid. Then as the liquid air warms, the oxygen "boils" off and is collected. It is then re-cooled and compressed into liquid oxygen and stored in "thermos bottles" known as reservoirs.
The oxygen gas is compressed and stored in light aluminum pressurized tanks.
Room air is pumped through a fine filter that traps all but the oxygen, which is allowed to pass through. This is known as an oxygen concentrator or oxygen enricher.
How do I use home oxygen?

A small, adjustable plastic tube (called a nasal cannula), worn much as you would wear eye glasses, is placed under the nose. This tubing, through which the oxygen will flow, is attached to the oxygen tank.

How do I go about ordering oxygen once my physician prescribes it?

Your physician, respiratory therapist, social worker, or nurse may recommend an oxygen supplier to you, or you may look in the yellow pages under "Oxygen." When selecting an oxygen supplier, consider the following: ~ Will the company deliver and install the equipment?
~ Does the company have a delivery service 24 hours a day? Seven days a week?
~ Does the company provide information on the use and cleaning of the equipment?
~ Is a nurse or therapist available to answer your questions and come to your home if necessary?
~ Will the company bill Medicare or your insurance for you?


How much does home oxygen cost?
Will Medicare and/or my insurance pay for it?

The cost can vary greatly depending on your prescription. There is a variety of oxygen equipment available. Your physician decides how much oxygen you need. The supplier will help you select the most economical system to meet your needs and activities, and should be able to give you an approximate monthly cost.

Medicare will pay 80% of approved expenses. Many private insurance carriers also pay for oxygen within the limits of their policies. To be sure your policy does cover home oxygen, call your claims representative.

Why do I need supplemental oxygen?

Normally oxygen passes readily from the lungs into the bloodstream and is pumped by the heart to all parts of the body. When lung disease occurs, oxygen may not be able to pass as readily into the bloodstream. When the heart is diseased, it may not be able to pump as much oxygen-carrying blood.

Either of these situations can result in not enough oxygen reaching the organs and tissues of the body, preventing them from functioning properly. This can cause many undesirable effects, such as decreased ability to exercise, difficulty breathing, fatigue, confusion, loss of memory, etc. Breathing supplemental oxygen increases the amount of oxygen that passes into the bloodstream and is carried to the organs and tissues.

Do all patients with lung or heart disease require supplemental oxygen?

It is estimated that over 4 million patients with lung or heart problems either are benefiting or could benefit from supplemental oxygen. This is a rather small percent of the estimated 60 million Americans affected by lung or heart and circulatory disease.

How can I tell if I need supplemental oxygen?

You might suspect you need supplemental oxygen if you have one or more of the following symptoms: decreased ability to exercise, difficulty breathing, fatigue easily, periods of disorientation or loss of memory.

The only way to know for sure, however, is to measure the measure the amount of oxygen in your blood with Arterial Blood Gas or oximetry. Your physician will evaluate your test results and symptoms to determine if you might benefit from additional oxygen. If you need supplemental oxygen, your physician will prescribe the proper flow rate and duration of use.

How can I tell if I am getting enough oxygen?
Too much?

You might anticipate that some of the symptoms you had before using the oxygen will start to go away as your blood's oxygen level returns to normal. The only way to be sure you are getting the right amount of oxygen is to have the oxygen level in your blood measured while using the supplemental oxygen.

If new symptoms, such as headaches, confusion, increased sleepiness, etc., appear, you might be getting too much oxygen. Notify your physician. Do not change the liter flow or hours of usage without first checking with your physician.

Can I become addicted to oxygen?

Oxygen is not addicting. We all need oxygen to live. If your lungs and/or heart are diseased and cannot supply enough oxygen to your body from normal room air, you need to breathe supplemental oxygen. Should your condition improve, you may no longer require supplemental oxygen.

Will oxygen relieve my shortness of breath?

Oxygen frequently does help, but there are reasons other than lack of oxygen for shortness of breath. In such cases, oxygen may not relieve the condition. By itself, shortness of breath is not life-threatening.

Does the need for supplemental oxygen mean that I am dying?

Patients may live for years on home oxygen. Others require supplemental oxygen at home temporarily to relieve their discomfort after being hospitalized or experiencing other stressful situations.

Do I have to use oxygen all the time?

Your physician will determine how many hours per day you should use the oxygen. Note: Be sure to follow your doctor's directions carefully for desired therapeutic benefit.

How do I get around in my home while using oxygen?

There is a variety of oxygen equipment available. Usually it will be placed where you will be using it most. Up to 50 feet of tubing can also be added to allow you to move about. Your home oxygen supplier will discuss with you the best choice of equipment for your activities.

Can I cook and eat while using oxygen?

You can carry on your normal activities as long as you use common sense while you're using oxygen - don't cook on an open flame; don't smoke; and be careful that your oxygen tubing does not come in contact with hot burners, pots, pans or anything that could cause the plastic tubing to melt.

Using oxygen while eating may well be beneficial in reducing the shortness of breath that many patients experience during and after eating.

Can I use electrical appliances while using oxygen?

Electrical appliances that get hot or spark during operations should be kept at least 5 feet away from the oxygen system.

Can I use oxygen around smokers?

Yes, as long as no one smokes within 5 feet of the equipment or the person using the oxygen.

What do I do if I want to leave my home?

There are small portable tanks that can be taken with you, some of which hold enough oxygen to provide up to 8 hours of continuous use. If you're traveling, additional, refillable tanks may be carried in your automobile. Your supplier may also be able to arrange for you to pick up oxygen en route and at your destination.

How heavy are portable tanks?

Portable tanks vary in weight from 6 to 15 pounds. These tanks may be carried in a shoulder bag during use or pull carts may also be available.

Can I drive a car while using oxygen?

Yes. Again, all you need do is use common sense. When driving, secure the oxygen unit so it will not tip over. Leave a window open slightly for ventilation so the oxygen will not accumulate in the car.

You can also travel on public transportation while using oxygen.

Be sure to make reservations early, alerting the reservations people to any special needs you may have, so they will have time to accommodate them. Your supplier can help you arrange for your oxygen en route and at your destination.

What do I do if I run out of oxygen?

You will probably feel some of the discomfort you experienced before you went on your oxygen therapy, but this discomfort should not be life-threatening. Call your supplier to replace or refill the container. You can reduce your discomfort until he arrives by placing as little demand on your lungs as possible. For example, you might sit or lie down and relax until the supplier arrives to fill your tank.

If you are with your portable tank, and it should run out, return home and continue using your oxygen.

Is there anything I cannot do while using oxygen?

You can do anything that you would normally do, except for those things that would bring you within five feet of an open flame, a burning cigarette or an electrical appliance that sparks. Actually you may find that you will be able to do some activities while using oxygen that you could not do without it.

Are there any hazards involved in using oxygen?

While oxygen does not burn, anything that can burn will do so more easily and more rapidly in an oxygen-rich environment. Therefore, do not use oxygen near an open flame, burning cigarette or electrical equipment that sparks during operation.

Do not use oil, grease or Vaseline on oxygen equipment. Should frost form on your liquid oxygen system, do not allow the frosted portions of the equipment to come in contact with your skin. Your home oxygen supplier will thoroughly explain all safety precautions related to your home oxygen therapy.

Be careful to follow your doctor's orders exactly when using oxygen, and never change the liter flow without his or her approval.

BREATHING EXERCISES

1. Pursed Lip Breathing

You have probably noticed when shortness of breath occurs to an athlete during periods of exercise, they tend to blow the air out of their mouths by puffing out their cheeks. You may have done this as well when you've exerted yourself. This is a normal response to shortness of breath, and it provides for a quick and easy way to improve breathing patterns.

What Does It Do? Improves ventilation
Decreases air trapping in the lungs
Decreases the work of breathing
Improves breathing patterns
Causes general relaxation


How? Prolongs exhalation -- slows down the breathing rate
Causes a slight back pressure in the lungs that keeps the airways open longer
Improves the movement of old air out of the lungs and allows for more new air to get into the lungs


Procedure

REMEMBER -- Exhalation must be 3-4 times longer than inhalation, so do not force the air out.

Sit down but sit up straight, relaxed
Breath in, preferably through the nose
Purse lips slightly (as if to whistle)
Breath out slowly through pursed lips
Do not force the air out

Practice this procedure 4-5 times a day initially to get the correct breathing pattern. You should utilize pursed lip breathing when you are experiencing shortness of breath either at rest or with exertion, or if you feel nervous or apprehensive.

IMPORTANT -- You may experience a light-headed feeling while doing pursed lip breathing. This indicates that you are overventilating yourself and you should breathe more slowly.

2. Diaphragm Breathing

The most efficient breathing muscle is the diaphragm. Many people with COPD no longer use this important breathing muscle effectively. This exercise is designed to help you better utilize this muscle in the act of breathing.

IMPORTANT -- You will notice an increased effort will be needed to utilize this muscle correctly. You will notice, at first, that you'll get tired while doing this exercise. Keep at it, for in a short time you'll begin to notice that it will require less effort to breathe, and you'll be rewarded by being able to do it with less effort.

Strengthens the diaphragm
Coordinates diaphragm movement when breathing
Less effort required to breathe
Less energy utilized for breathing


How? Correctly utilizes the most effective muscle for breathing


In the beginning, practice this procedure for 5-10 minutes, 3-4 times a day. You can gradually increase the length of your exercise period and perhaps the effort required by placing a book on the abdomen.

After you feel comfortable with this procedure, practice while sitting in a chair or while standing.

Procedure

Lie on your back in a bed with your kness bent.
Place one of your hands on your abdomen.
Place your other hand on your upper chest.
As you inhale through your nose, make your stomach move out and keep your upper chest as still as possible.
As you exhale through pursed lips, let your stomach fall inward. Your hand on the upper chest must remain as still as possible during the entire procedure.


WINTER ADVICE
For Respiratory Patients


Humidity

In the summer, it is sometimes hard for you to think of needing more humidity. But in the fall and winter months, it's extremely important. In fact, two related subjects are equally important - adding humidity to winter-dried air and keeping your humidifying devices germ-free.

Your Lungs require a great deal of moisture - actually 100% relative humidity - to keep their cleansing systems working and you free from infection. The nose provides a great deal of this moisture to incoming air but in wintertime, it is vastly overworked by very dry air. Briefly, here's why cold air is not capable of holding much moisture. When this cold air is heating in your house, the warmer air is capable of holding more moisture but the moisture is not present in the air so the relative humidity drops exceedingly low...often as low as 6 or 7 percent relative humidity. Dry air can be extremely harmful to everyone. To children - it brings on the continual winter sniffles. To people with chronic lung problems, it can cause serious and lengthy respiratory infections...something to avoid if at all possible.

Here is what you can and should do: Drink plenty of liquids - your nose's humidification system needs a lot. Try to drink 1 1/2 to 2 quarts of liquids each and every day. If this means having to make extra trips to the bathroom, drink lots anyway...the exercise will do you good. Drinking most of the liquid before your evening meal should minimize the interruptions during the night. But drink!!!!, water, juices and more water.

Add humidity to the air you breathe. How much humidity you have to add is not easy to answer - but on the other hand, adding too much is almost an impossibility - remember, the air in your lungs contains 100% humidity. Too much humidity can effect your comfort and furniture - a good rule of thumb is - add humidity until water collects in excess on cold windows (some condensation is natural - just wipe it up occasionally).
Room humidifiers can cost anywhere from $5.00 up to hundreds of dollars. Amazingly, the lower price type of humidifiers may be better for you to use...and easier to keep clean. Humidifiers fall into 3 categories: 1) heated steam vaporizers; 2) cold spray type, or 3) evaporation plate/rotary belt humidifier.

Type number three can be most effective and automatic but it can also breed dangerous bacteria which you will breathe if you don't keep them absolutely clean. Daily cleaning can be difficult so, generally speaking, this system is not best suited for respiratory patients.

The heated steam and the cold spray type humidifiers are usually less expensive, $5-25 and are relatively easy to clean each day. Which is better for you is hard to say. There has been a trend towards the cool spray type - particularly for apartments and rooms that run hotter than normal - steam vaporizers only add more heat.

An unclean humidifier can do much more harm than good. Bacteria grows well in moist, warm environments - such as humidifiers. Most harmful bacteria take longer than 24 hours to develop, therefore, you must clean your unit once a day. The cool spray units are probably easiest to clean. A good idea is to get two units - one for the bedroom and one for the TV or living room. The one in use can be cleaned in minutes and left to air-dry.



Some other good living tips for wintertime:

Avoid drafts
Wear a sweater to keep comfortably warm. Open neck sweaters may be fashionable...but not warm where you need it - try a high collar or turtle neck...particularly for going outdoors.

When outside
Breathe through your nose - it will help warm the inspired air. On cold days, wrap a scarf around your face - it will help warm the cold, raw air before it reaches your nose. Also, when you first step out, stop and breathe a few short breaths before proceeding - this can save you a few coughing spells.

If others have colds
Avoid them. Keep them away from you, out of your rooms...their germs are airborne. If they have to be near you, let them wear a surgical face mask - available from your drug store at a very low cost. Also be sure not to use their plates or utensils. The same thing applies to crowds. Avoid them when possible since there are always cold germs a-plenty where there are groups of people.

Blow your nose
This may seem like an unnecessary statement to make. But not so; your nose works overtime in the winter - in trapping out dust and germs. An it's always a good idea to use fresh, disposable tissues (Kleenex) so you can throw them away - in paper bags not waste baskets.

Exercise
Many people think that when the weather gets bad, exercise such as walking is not practical. Daily exercise is extremely important all year-round so when the weather is bad, walk around the house and climb stairs. Try to do as much as you would if you went outdoors even though it's boring. Exercycles are inexpensive ($40-60) and can give you ample exercise while you watch your favorite TV programs.

Breathing exercises are also important in strengthening the respiratory muscles. If you do not have information on these exercises, ask your doctor.

Dust-free air
With the dryness of winter comes a great amount of dust. There are several things you can do to minimize this problem area: If you have central, forced air heating, replace the air filters before turning the system on and then they look clean;
Dust frequently but use a dusting agent (such as Endust) which will keep the dust on the cloth. Drapes and curtains should be laundered or dry-cleaned occasionally - take them down carefully to reduce the amount of dust. Vacuum or dust behind radiators. Change vacuum cleaner bags and filters regularly...before they look full or dirty.


Diet and Weight Control
You should try to stay at or a little below your ideal weight. Since eating and digesting food can be exhausting, it is better to eat 5 or 6 small meals than 3 regular meals.

Flu shots
In order to minimize the chance of getting flu, many respiratory patients get an influenza vaccination in the fall...before the flu season begins. Ask your doctor if you should get one. Be sure to get plenty of rest the 2 or 3 days before getting the vaccination.

Stay away from smokers
You've probably given up smoking years ago. But be aware that smoke from someone else's cigarette can be irritating and can be as harmful to you as if you were smoking it yourself. Ask your friends not to smoke or at least smoke away from you...preferably in another room.

When to Call Your Doctor
When there is an unusual increase or decrease in sputum production;
when there is an unusual increase in the thickness or stickiness of sputum;
when sputum is a new color or is tinged with blood;
when you feel an increase in severity of breathlessness;
where there is pain in the chest, fever, swelling at the ankles, extreme fatigue or unusual drowsiness;
when there is a need for more pillows in order to sleep comfortably;
when there is an unaccountable increase or decrease in weight;
when there is increased fatigue and lack of energy;
where there are complaints of frequent morning headaches, dizzy spells, loss of libido and insomnia;
where there is a development of confusion, disorientation, slurring of speech and somnolence.
COUGHING EXERCISES


Hydration
Thick , sticky mucus is difficult to cough up, especially with a weakened cough reflex. It is important that you drink enough fluids to keep your mucus thin and loose. Check with your physician to determine how much fluid you should drink daily to keep your cough effective.
Humidify your home or at least the room you sleep in and the room you spend most of your time in. Keep your humidifier clean as they are a possible source of infection.
Do not smoke as smoking takes moisture out of your mucus and makes the mucus thicker.

Cough
Remember, control your coughing as uncontrolled coughing can make you short of breath. Discuss with your physician which type of coughing exercise is best for you.
You should perform these coughing maneuvers whenever you feel the need to cough or as instructed by your physician. A good controlled cough is especially helpful when you first get up in the morning and about an hour before bedtime. Have a cup of coffee or tea first (or other drink recommended by your physician) and relax.
Sit up straight in a chair when attempting these coughing exercises. Have a tissue handy.

Exercise A

Sit up straight on a hard-backed, stable chair, relax.
Take in 2-3 deep breaths through your nose and exhale slowly through pursed lips.
Fold your arms across your abdomen.
Take in a comfortable deep breath through your nose.
Lean forward, pressing your arms against your abdomen and cough while leaning forward.
Relax, rest 5-10 minutes.
Perform again if needed.
Exercise B

Sit up straight, relax.
Take in 2-3 deep breaths through your nose and exhale slowly through pursed lips.
Take in a moderately deep breath, hold breath, expel air while saying H or K once.
When you feel comfortable with this exercise try and say the H or K 3-4 times while exhaling.



We hope this page has been helpful to you in providing information about oxygen in the home. If you have any further questions, please consult with your physician.

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