Ask the Advocates: Oxygen and Shortness of Breath
We asked our advocates about their challenges in using oxygen and managing shortness of breath. Here are their responses.
Shortness of breath while using oxygen
Barbara
I started using oxygen about six years ago. At first, it was only at night, and then as my COPD progressed I began using it for exercise and eventually, my doctor told me I had to wear it 24/7. Although the lungs are scarred from emphysema and COPD, the real reason why I have to wear it is that my heart is compromised, and I am actually in heart failure.
My life became more manageable in some ways once I started wearing oxygen. I learned that oxygen can be used in any situation including bathing and showering. Because I am a retainer, my carbon dioxide levels are fairly high so it's important that I do not have my oxygen higher than 92. The biggest problem I have is keeping my oxygen flow where it should be, so I attached a flow meter to my cannulas.
Now it is easy for me to turn the oxygen up or down depending on whether I am resting or exerting. I still get short of breath from time to time and when I do I use mindfulness, concentrating on one object or counting and using pursed-lipped breathing. When I get short of breath I find that exhaling through pursed lips helps remove the stale air in my lungs and make room for fresh air.
Jackie
When I was first prescribed oxygen, the first thing that I thought of was that I wouldn’t be out of breath anymore. Well, that proved to be wrong. What the oxygen did do is get the oxygen to my body where it’s needed: my lungs, my heart, my brain, and the rest of my body that my lungs need that extra help doing.
I didn’t realize that it didn’t help breathlessness. I’ve just had to learn to be slower at the things that I do and take many breaks. When I become short of breath, I use breathing techniques that I have learned to help me get through it. Here is a great article that talks about different breathing techniques. You can read it here.
Another thing that helps me is to remember this saying that I found years ago by Daniel Koepke:
Breathe.
You're going to be okay. Breathe and remember that you've been in this place before.
You've been this uncomfortable and anxious and scared, and you've survived.
Breathe and know that you can survive this, too.
These feelings can't break you.
They're painful and debilitating, but you can sit with them, and eventually, they will pass.
Maybe not immediately, but sometime soon, they are going to fade, and when they do, you'll look back at this moment and laugh for having doubted your resilience.
I know it feels unbearable right now, but keep breathing again and again.
This will pass. I promise it will pass.
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As a career professional, I have practiced respiratory therapy for many years. During this period of time, many of the patients for whom I provided care were diagnosed with chronic obstructive pulmonary disease (COPD) and were prescribed the use of supplemental oxygen therapy. As you can imagine, many of them had experienced and even struggled with shortness of breath (SOB), or dyspnea.
When calling for help with their breathing, many were able to draw on their own experiences as well as rely on coaching they may have received from their healthcare provider (HCP), which, very often, was me! Some patients were able to exert better control over their dyspneic breathing episodes by using pursed-lip breathing.
Others resorted to the use of their rescue metered dose inhaler (MDI). Still, others were able to feel relief by using a small-volume nebulizer with a bronchodilator, such as albuterol. In some cases, an adjustment to the oxygen flow rate or oxygen device itself was in order.
For some patients who had a particularly difficult time, relief could be found through the use of either chest physiotherapy (percussion and vibration), a high-frequency chest wall oscillation device (sometimes referred to as the ‘vest'), nasotracheal suctioning, or, a combination of these therapies. In some cases, a positive expiratory pressure (PEP) device, like the Acapella, was the therapeutic answer.
As a therapist in the hospital and home care settings, I was able to be a part of the therapy provided and felt genuine satisfaction at being able to help care for COPD patients and guide them toward feeling better.
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