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Oxygen in the home

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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:

1. 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.

2. The oxygen gas is compressed and stored in heavy steel pressurized tanks.

3. 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 refill the portable tank myself?
There are two types of portable tanks: liquid systems and high pressure cylinders. The liquid systems are designed to be refilled by the patient. They are simple to operate and very safe. Refilling small high pressure cylinders, however, can be hazardous and should be done only by an authorized dealer.

Can I drive a car while using oxygen? Or travel?
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.