COPD 101: The Who, What, When, Where, Why & How of Supplemental Oxygen Therapy
Having enough oxygen throughout our bodies is a necessity for life. People with healthy respiratory systems take getting enough oxygen for granted most of the time. After all, who actually thinks about breathing in and out most of the time, right? Well... people who have COPD do!
When you have COPD, the simple act of breathing and knowing that you're getting enough oxygen from the air becomes much less automatic and more worrisome. In fact, as COPD progresses, the person often does not get enough oxygen to properly fuel your cells and bodily functions. Your lungs just are not able to absorb enough oxygen from room air.
So, supplemental oxygen therapy is a commonly used treatment for people who have COPD. For some people, it is only used "as needed", while others may use it continuously. In this post, I'll discuss the "5 Ws" of oxygen therapy (along with a bonus "H").
When is oxygen an option?
If you notice you are having consistent problems catching your breath that are difficult to recover from, it's probably a sign that you are not getting enough oxygen into your body. Do you:
- Find yourself needing to sleep with 2 or 3 pillows under your head or sitting up, in order to feel comfortable breathing?
- Start wheezing, coughing or just feel out of breath when trying to complete daily living tasks such as bathing, dressing or making meals?
- Notice that your lips and/or nailbeds are often a light blue or purplish color?
If you are feeling this way, it's time to talk with your doctor about the possibility of supplemental oxygen! The doctor may want to use a pulse oximeter or draw blood for arterial blood gases to find out what percentage of oxygen you have in your blood. If it's less than 88%, then oxygen will probably be prescribed.
What is supplemental oxygen therapy?
When our bodies can't get enough oxygen from room air, we need to supplement what we do get by breathing in pure oxygen. This oxygen is generally delivered via a plastic tube that has small prongs that insert into your nostrils. Oxygen flows through this tube and right into your airways.
There are 3 types of oxygen delivery devices:
- Compressed oxygen cylinders, the old green metal tanks, which come in both large storage sizes and compact portable tanks that can be wheeled on a small cart
- Liquid oxygen tanks, which also come in large storage tanks that can be used to fill smaller portable containers that can be carried over the shoulder or in a waist pack
- Oxygen concentrators, electrical devices that can separate oxygen from room air. This type of device also comes in both room storage size and portable sizes.
There are pros and cons to each type of device. Talk with your doctor about your lifestyle, budget, insurance and any other influencing factors to help decide which is right for you.
When and where is it used?
This depends on each individual's specific medical condition and the doctor's prescription. When people first go on oxygen therapy, they often don't need to use it all the time. The doctor may prescribe it only to be used at night, when leaving the house or with certain activities. Of course, you should always let your doctor know if these recommendations are not sufficient for you.
As your airways become less efficient in the later stages of COPD, you may need to use supplemental oxygen therapy most, or all, of the time. Again, your doctor will help you decide when the time is right for this.
Where can you use oxygen therapy? This question is easy to answer... everywhere! The beauty of today's oxygen delivery systems is that they all come with portable options. Depending on your flow rate for your oxygen prescription, your portable device may offer some limitations on how far you can go from home. Both the compressed air tanks and the liquid oxygen tanks will eventually run out, so knowing how long they may last is important in planning trips away from the large tank you fill them with.
With the portable concentrators, you have many more options and much more freedom to travel for longer periods and further from home. As long as the concentrators have electrical or battery power, they will keep extracting oxygen from the room air forever. This makes them a great option for extended travel, whether via car, plane, train or even boat.
In the past, people sometimes felt a stigma about using oxygen in public, but these days, it is pretty common to see people walking around with portable oxygen tanks.
Understanding this treatment option
Why use supplemental oxygen? The most obvious answer to this question is "so you can breathe better and easier!" But it's important to understand that research has shown that supplemental oxygen can not only greatly improve quality of life for people with moderate to severe COPD. It can also extend their lives.
Supplemental oxygen will help you sleep better and feel happier and less anxious. You'll be able to tolerate activity much more easily and for longer periods. You'll also be more mentally alert. In people who have severe COPD, oxygen can also help prevent heart failure, a common complication.
How is it implemented?
It's easy! Your doctor will prescribe a specific amount of oxygen for you. This is called a flow rate and refers to how much oxygen (in liters) flows through the tubing into your airways per minute. Most people start out at 1 to 2 LPM (liters per minute), but your doctor will decide what the right amount is for you. The flow rate may be increased for certain activities. It may also need to be increased more and more over time, as your airways continue to deteriorate.
Your doctor will also designate whether you use a face mask or nasal cannula to deliver the oxygen into your body. Most people use a nasal cannula for home oxygen therapy.
Once you and your doctor have agreed on what type of oxygen delivery device is right for you, the prescription will be called into a medical company that specializes in oxygen delivery. The company representatives will teach you how to use your device and administer the oxygen. They'll also teach you about safety. Finally, they'll set up a regular delivery schedule with you.
In summary, supplemental oxygen therapy can make a huge difference in quality of life for the person with COPD. There is nothing to be afraid of or ashamed of. Just as your body needs food and water, it needs oxygen. So, don't be afraid to give it what it needs!
Do you have a COPD exacerbation tool kit?