Options for Supplemental Oxygen at Home

[gerald]

I ran across this this morning and found it to be a clear coverage of options for Oxygen and provides a good starting point for investigation.    The part about doubling up on lines with a Y connect was interesting.

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Options for Supplemental Oxygen at Home
March 28, 2017 Kim Fredricksonby

Over the last two-plus years I have become an unwilling expert on the ins and outs of supplemental oxygen.

When I started using supplemental oxygen I knew next to nothing and found it very hard to get the help and information I needed. I’ve learned a lot and would like to pass on what I’ve learned to you. I am sharing based on my own experience and realize what I share may be incomplete. I’d love to get your input on this topic!

The use of supplemental oxygen must be ordered by a physician, approved by insurance and offered by the oxygen provider. Today I’ll be covering different types of oxygen I’ve used at home, and next week I’ll share options for using supplemental oxygen away from home.

Options for supplemental oxygen to use at home:

Gas cylinders: Oxygen can be delivered to your home as compressed oxygen gas. This compressed gas is stored in steel and aluminum tanks or cylinders. Larger tanks are stationary and used at home. The top of the cylinder has a place for a “regulator.” This is a device that regulates, or controls, the air flow coming from an O2, or oxygen, cylinder, usually between 1 and 15 liters per minute. Your oxygen provider will deliver the amount of tanks or cylinders you need on a weekly or biweekly basis.

Oxygen concentrators: Oxygen concentrators are also available for home use. There are “low flow” concentrators, delivering 1 to 5 liters per minute of oxygen, and “high flow” concentrators that go up to 10 liters per minute. An oxygen concentrator is an electrical device about the size of an end table. It concentrates oxygen in the air by removing nitrogen, and then concentrates that oxygen, and sends it back to you to breathe through a nasal canula. This method is less expensive and easier to maintain, as it requires no refilling of tanks.

However, oxygen concentrators may give off heat and are noisy, and they may significantly increase your electricity bill. You will still need a back-up source of oxygen in case of a power failure, so make sure you have gas tanks on hand to use just in case. A humidifier bottle can be attached to the concentrator to add moisture to the dry air delivered by the concentrator.

When you need more than 10 liters per minute, you can hook two concentrators together with a Y connector to deliver more liters per minute. Check out my video below to see how this works.



Liquid oxygen: This is made by cooling oxygen gas and converting it to a liquid. Once approved, the provider delivers large tanks of liquid oxygen to the patient’s home, which must be filled weekly or biweekly by the oxygen provider. The biggest problem I have experienced using liquid oxygen is that some oxygen suppliers are reluctant to carry it or do not offer it at all because it is very expensive for them to provide. I had to fight for three months for my oxygen provider to be willing to deliver it to me, and another two months to bring me portable oxygen containers to use away from home.

Liquid oxygen tanks deliver only six liters per minute, but they can be hooked together with a Y connector to deliver 12 liters per minute with two tanks, or 18 liters per minute with three tanks. Check out my video to see how this works.

I prefer liquid oxygen over gas cylinders or a concentrator

Liquid oxygen is slightly cool and soothing, and is much easier on my nose, which dries out terribly with a concentrator. This is especially important as the patient requires higher levels of oxygen.

Portable oxygen containers (called strollers) hold more and weigh less than gas cylinders, and are easier for me to use when out and about. I’ll talk more about these next week.

Insurance coverage

Supplemental oxygen is very expensive. Most insurance plans cover this cost, but some do not. I’ve had both experiences. My first provider did not cover supplemental oxygen in their individual plans (which I had). They did cover it in their group plans. I took my insurance company to the state insurance board, but lost. I had to buy my own equipment. My current insurance company covers the cost, and I’ve had no problems with them. Please check directly with your insurance company about what your policy covers.

pulmonaryfibrosisnews.com/2017/03/28/options-for-supplemental-oxygen-at-home/

[barb7330]

Very interesting read Gerald....I have been having to use oxygen much more since I was sick a couple of weeks ago....When I went out had a small portable that would only go to 3 litres...Wasn't doing a thing for me so I called my supplier and they came out with an inogen that put out 5 litres and I seem to need that much when active.

[ozboy]

Remember that Mark 6 on a POC is certainly not 6 L a minute. ......Many people make mistakes when comparing POCS with what Oxygen Devices they currently use...

www.portableoxygensolutions.com/portable-oxygen-concentrator-comparison-guide/


This is what happened to my friend recently..QUOTE

''Doing it tough today. Run out of bottled 02 and the portable oxygen concentrator just not cutting it when l move or drive. Drove to Ballarat and back with sats barely in the 80s just to keep an ortho apt. Mark 6 on a POC is certainly not 6 L a minute. At the hospital l used their bottled 02 to preserve mine which ran out just as l got home. Never so pleased to see my home machine!''

[John]

thankyou  ozboy good find . 

[barb7330]

I'm using the 5 litre when active and I still find myself SOB at times especially if I'm hurrying.

[ozboy]

Your portable is just not putting out the volume that you need. You can try pursed lip breathing to get the maximum that your machine can provide.....Technology is still advancing in the output of POC's but 6LTM is pushing the ones currently availaible both pulse and continuous flow, which Simplygo is about the best one around.....

Needing 6LTM to work in regards to saturation drop or comfortable activity you need to go back and use the Portable Cylinders unless someone else here has another suggestion......

www.portableoxygensolutions.com/portable-oxygen-concentrators/respironics-simplygo-portable-oxygen-concentrator/

[gerald]

I have the Inogen One  G2 and it has settings 1-6 which should correspond the the lpm in pulse mode.   But at 6 it uses its batteries fairly quickly.

[gnott]

Whenever one starts talking about "PULSE" settings they need to appreciate that any manufacture's published "PULSE LPM Setting" is what is called an "equivalent LPM". It is only CLOSE to accurate** when the number of breaths per minute and the amount of oxygen brought in with each breath - match identically what a patient is getting with their breath rate and inhalation amount on a continuous setting.

1) Therefore it is almost a certainly to NEVER match what a patient needs to in order to perform the same activity they could with CONTINUOUS.

2) If you read the fine print on most manufacture's machines you will see that the actual PULSE SETTINGS are themselves only "approximate equivalents". Vendors provide specifics for one or two settings then basically extrapolate what the other values probably are.

3) While the amount of "continuous oxygen flow" the LPM, that any device delivers is more or less industry/standards guaranteed - Manufacturers have great latitude in 'defining' what THEIR PULSE SETTINGS might be.

4) If a patient's Oxygen needs are relatively modest (by COPD standards) - say 2 to 3 lpm - and they have used 'pulse' successfully then if they seek out a POC machine that can provide a good margin over that need - say 2 to 6 lpm): Then most quality machines will suffice. BUT if they are at the high end of the lpm requirements and haven't use PULSE much before - they need to try before they buy. I don't care what the girl on the phone says - it doesn't matter how good an offer - it may NOT be for YOU.

This is an interesting short summary of this problem:

www.copdfoundation.org/COPD360social/Community/Questions-and-Answers/Pulse-Dose-vs-Continuous-Flow.aspx

[** 'close' as defined by the game of Horse Shoes.]

[jarca]

good points both ozboy & gnott!

another thing that i'd like to mention is that even my big home concentrator tested 95% @ 2LPM because the "best machine" can only convert room air so much. So "medical grade" 02 from a concentrator can be anywhere from 87% up to 95%
while "tank" 02 is 99.6% oxygen purity
liquid oxygen is 99.6% pure also
www.domorewithoxygen.com/home/guest-post-liquid-oxygen-vs-regular-oxygen

I have gotten to the point that I am needing 5-6LPM when active.
I don't have access where i live to Liquid 02 so I use tanks----
however, the small "C" tanks that used to last me 6 hours on 2LPM pulse now only last 2-2.4 hours at the 5 or 6LPM setting.
It is frustrating to have to change my tanks so often when i go out in feild & am "busy", but I have a box on my ATV so i can carry several extra tanks on my ATV---where a POC i would have to stop at some point and charge batteries.
Lots of things to take into consideration when chosing what 02 set up is best for you----& I think they should spend more time teaching those of us who are prescribed 02 what are choices are & how to use it (but that was a different thread )

Barb; I find I have to "pace" myself or even 6LPM i can drop below 90%sp02 ----I have always been a "fast walker" & i often forget to walk at a slower pace & soon find myself "huffing & puffing".
Unfortunately I haven't found any other "solution" other than to slow down & pace myself.
(hardest to do when with others---today in the store i had to ask where something was & the woman took off to show me; i tried to go her pace & soon realized i couldn't keep up with her---so embarrassing to holler at the back of her head, "HEY, could you please go slower i can't walk that fast"
yes, because i didn't know her name & she was ahead of me i had to yell "hey"---so embarrassing !!!)

[gnott]

As for better education you may or may not be surprised at the number of Respiratory Therapists and Oxygen Supplier's personnel who don't know that much about the various devices themselves. (Why should they? They don't use them, they only read about them.)

Jarca's experience points out probably the most important fact when comparing a POV against Tanks, and that is simply one of "lifestyle". POV ain't for everybody. I tried three POV systems - for me wasn't worth the hassle.

PS: Nerf markets a number of convenient pistols which fire a smaller 'elite' dart. With extra darts they costs less than  $15 and have amazing range and accuracy. You will never have to yell "Hey" again. (I use mine on cats and grandkids. Work very well.)

[lavishgail]

I have such a hard time understanding anything y'all talk about, I feel dumb! I just try to do the best I know how so I can breath when I need to.

[sharon]

Wow that was some good info. Being new to oxygen and not knowing much about it, I learned a few things. I find having to carry it with is a pain, and hard for me since I am rather small in stature and only weigh 95 lbs. I thank you all for the info., I did not know any of this. I was thinking of buying a portable but now I dont know. If a person has to up the liters, I guess it would be a pain, with the batteries.
Gnott I like the nerf dart idea!