10 Mistakes that People Who Wear Oxygen Often Make
Welcome back to BreatheLiveFit! For those that are new to my blog, I am a respiratory therapist whom has worked with lung patients for the last 17 years. For the past 10 years, I have worked in a pulmonary rehabilitation center in Richmond, VA. I started this blog because I found out that so many people who had chronic lung conditions needed education on how to manage their lung disease and live their best life from the moment they were diagnosed (not just when they were referred to pulmonary rehab). I hope that by writing these articles each week that you can gain some insight that will help you with your lung condition.
It has been a while since we have talked about supplemental oxygen use. Some people who have a chronic lung condition need additional oxygen because their lungs aren’t functioning properly in order to bring in the oxygen that they need to maintain the health of their organs and tissues. For those that need supplemental oxygen and rely on its use on a daily basis, this topic is very important to review. I am seeing patients each week in our pulmonary rehab that are making mistakes or encountering issues when it comes to their oxygen use. I thought it would be helpful to point out some “problem areas” and how you can fix them.
They only wear their oxygen when they “feel they need it.” – This is an age-old problem with my patients. I think we encounter this problem from time to time for several different reasons. The first reason being that the patient may be new to wearing oxygen and just isn’t aware of its benefits and how much better they would feel if they were to wear it on a consistent basis. I have also heard that patients often feel as if the more they wear oxygen, the more they become addicted to it. This just isn’t true. Honestly, the only thing addicting about oxygen is how good you might feel if you wear it as prescribed by your doctor. Lastly, your oxygen saturations might be at a dangerous level by the time your body “feels it” causing your heart to work harder and faster. The longer you put off wearing your oxygen after it has been identified that you need it, the more likely you can develop other chronic conditions involving other major organs in your body.
They don’t own a pulse oximeter. Once you have been prescribed supplemental oxygen, I highly recommend that you purchase a pulse oximeter. A pulse oximeter will allow you to occasionally monitor your oxygen saturations making sure they are at a safe level. Don’t make the mistake of obsessing over these numbers, however, it is important to be able to “quantify” how you feel and not leave it up to a feeling or a hunch that you might need to wear it. (For more information on pulse oximetry see my blog.)
They are seeing saturations below 90% on a daily basis and aren’t notifying their doctor. Any patient that I have worked with in the past knows that I am not a “knee jerk” therapist. When I see an occasional 88% or 89% after exercise, I definitely don’t freak out. HOWEVER, if you are seeing oxygen saturations below 90% on a daily basis, you need to let your doctor know. Your physician may want you to perform a 6-minute walk test and possibly get an updated chest x-ray to identify if there are changes going on with your lung condition. If you are noticing a decline in your oxygen saturations, don’t wait until your next follow-up appointment 3-6 months from now to have this issue addressed.
Their nose is constantly dry and irritated. This is a very popular complaint from my patients that wear oxygen continuously. My suggestion is to do as much as you can to maintain the moisture in your nares before this becomes an issue. There are a couple of things that you can try to maintain or add moisture in your nares. The first recommendation is to install a bubble bottle to your concentrator at home. They make these bottles for certain liter flows. You can get a standard bubble bottle for 1-6 liters and they also make a high flow bubble bottle for 6-15 liters. In the hospital setting, they are prefilled with sterile water, but in the homecare setting you can add distilled water (not tap water) to them and they will function just fine. Bubble bottles will moisten the air somewhat that comes out of the concentrator. It’s won’t be “high humidity” but it may help some.
The other thing that you can use to moisten your nares is Ayr products. I have mentioned these before and have gotten a ton of positive feedback. I love the Ayr gel that you can apply using a cotton swab or you can try the Ayr spray. Both of these products work pretty well to add a little extra moisture to your nose and are compatible with using supplemental oxygen. Remember: NEVER use petroleum products in your nose and especially in conjunction with supplemental oxygen.
They are not wearing oxygen while bathing. I love the “light bulb moment” I see when I tell a patient who is not wearing their oxygen while bathing, that they absolutely can! If you have oxygen at home and are ordered to use it continuously or with exertion, bathing is a perfect time to use it. I will admit that it will take a little time to get comfortable with finagling oxygen tubing as you wash your face, but you will thank me later when you realize how much easier bathing became when you wore it in the bath and/or shower.
They have irritation and break down behind their ears and in their nares. Irritation behind the ears is pretty common due to the pulling and tugging of the oxygen tubing against the skin all day long. Once the irritation starts, it is time to address it. You don’t want a sore to occur making it difficult to treat and apply ointments while continuing to wear the tubing. There are a couple of helpful solutions if you are experiencing this issue. The first thing you can try is using a cushion around the tubing while your irritation subsides. You can have your oxygen supplier purchase these cushions or you can find them online at distributors like Amazon.
The other thing that some of my patients have decided to invest in are “soft cannulas”. Typically, the nasal cannulas supplied to you by your oxygen distributor are a bit more rigid. “Soft cannulas” are made of a much more pliable material and are softer on the backs of your ears and inside your nose. This may help to prevent any sores from occurring in your nares.
They aren’t wearing oxygen while driving a car. I realize that when you are operating a vehicle that you are sitting down; HOWEVER it is highly important if you have oxygen prescribed for continuous use that you wear your oxygen while operating a vehicle. Oxygen will help aid you in your reaction time and can possibly help you to avoid litigation if you are found to be liable for an accident and not wearing your oxygen as prescribed.
They don’t change their nasal cannula frequently. Nasal cannulas and oxygen masks can harbor bacteria and other germs. I am noticing that a few of my patients are waiting until their cannula is discolored or hardened before exchanging it for a new one. Nasal cannulas and oxygen masks should be changed out regularly and definitely after a flare-up, cold, or infection. Never let your nasal cannula dangle on the floor. Use a zip lock bag, old sunglasses case, or toothbrush cover to enclose it and keep it away from germs and dirt when you take it off. Keep a small stock of extra oxygen supplies in your home and one or two in your car so that you can have easy access to new oxygen equipment if your cannula becomes soiled.
They don’t have their concentrator serviced. Unfortunately, with the number of patients that home care companies see, I have found that they don’t have the “manpower” to keep track of when concentrators need to be serviced. Do your research as to when filter exchanges and other maintenance should be performed on your home concentrator. Mark your calendars to call your home oxygen supplier when maintenance is due. Don’t wait until your machine starts to have problems to get it serviced.
Their portable unit does not meet their needs. Unfortunately, with the progression of lung conditions, my patients are met with this issue occasionally. If you find that your portable oxygen unit is not able to keep up for you to maintain good oxygenation, I recommend that you look into options that will provide you with an appropriate level of supplemental oxygen. It is never easy to give up on the ease of using a portable concentrator, however, your health is more important. Consider calling your physician to discuss other options for portable oxygen if you are noticing that your oxygen levels are low when you are out and about.
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