The Gas, The Myth, The Legend... Oxygen FAQs
Updated: Jan 10, 2019
Many times we see lung patients in pulmonary rehab after an extensive hospital admission. They have typically been discharged on oxygen and are (for lack of a better word) scared. They are so worried as to how long they are going to be on “this stuff” and are wondering if they need it in the long run. It takes a while to bring them up to speed but my coworkers and I are up to the task! We want them to be comfortable with what it is, why they are on it, and to debunk any myths they may have heard about it from credible and non-credible sources.
So here I present to you, my version, of Frequently Asked Questions about Oxygen.
What is oxygen and what does it do for my body?
Oxygen is a gas that is in the air we breathe every day. The percentage of oxygen in the air is 21% and the rest of the gases in the air are Nitrogen (78%) and other gases in very small amounts. Oxygen is essential for life. The cells in our body require oxygen to survive. When it comes to our organs, they use it to do all things and so when we don’t have enough of it in our blood, our organs suffer. When we inhale, oxygen is brought in through the lungs and is traded through the capillaries for waste gas (carbon dioxide) that our body is trying to remove. In a healthy body this process acts like a “well oiled machine.” Oxygen in… carbon dioxide out.
Why do I need oxygen?
When you have a lung condition (and/or sometimes a heart condition) you are not always able to get enough oxygen in your blood so that your organs and body can function normally. There are many different reasons why someone would require supplemental oxygen. To name a few…In some cases your tiny air sacs (alveoli) don’t open properly so they can exchange gases with your blood stream, in some cases you have a lot of mucous caught in your tiny air sacs that it blocks the way for the oxygen to get by, and sometimes in certain lung conditions the airways have become stiff and brittle and can’t expand properly to inhale a suitable breath… regardless of the reason, that “well-oiled machine” isn’t performing like it should. When your body isn’t given enough oxygen there is a need to increase the amount of oxygen you are taking in from room air (21%) to a higher percentage in order to get enough oxygen to all the vital areas of the body. You doctor will then order you supplemental oxygen for you to wear as prescribed. The healthcare community takes it very seriously that oxygen is indeed a drug. I recommend if you are interested or think that you might need an order for oxygen, to please contact your pulmonary or primary care physician to talk about whether or not you are a candidate.
So how do you figure out I need it or not?
A doctor, nurse, or respiratory therapist can perform a few diagnostic tests to figure out of you need oxygen. The first thing they can do is get a room air oxygen saturation level using a pulse oximeter. Medicare guidelines in the US state that if on room air, your oxygen saturation (SpO2) is equal to or less than 88% at rest, you automatically qualify for oxygen. Just like that! Easy peasy. If your oxygen saturation is greater than 88% at rest, your doctor can order a 6 minute walk test. During this test you will be asked to walk for 6 minutes and if your oxygen drops below 89% while walking and you demonstrate that using oxygen will improve your low oxygen saturations then Medicare guidelines in the US state that you will then qualify for home oxygen. The therapist or nurse performing that test may also take a minute to titrate the oxygen to make sure you are getting enough liter flow to keep your oxygen levels up. The other test they can do to see if you need home oxygen, is an arterial blood gas (ABG). This is a quick blood test in which blood is drawn from the artery (not the vein) and the oxygen level is then tested by a machine. (For purposes of writing this blog, I only looked into US Medicare guidelines. Feel free if you live outside the US to look into what the guidelines are in your local area.) Lastly, if your physician believes that your oxygen levels may be dropping in your sleep, an overnight oximetry test can be done to see if you need oxygen while you are sleeping.
Will I become addicted to oxygen if I use it?
This is unfortunately a myth that has been around for years and that’s unfortunate because there are a ton of people that have put off using oxygen because of this myth. (No worries, because you have me!) You will definitely not become addicted to using oxygen. There is no scientific or clinical evidence that oxygen is addictive. What people are drawn to is how much better they feel when their oxygen levels have been low for so long that they finally feel a sense of relief. Starting oxygen when it is clinically necessary will help protect your organs from long term effects of hypoxia (low O2) and may also help to stabilize your condition.
Can I tell on my own if my oxygen is getting low?
Without the proper measuring device (like a pulse oximeter) you may not be able to tell if your oxygen is getting too low. Many people with lung conditions walk around every day and don’t recognize they have low oxygen. It is possible to tell that a person has low oxygen if they are becoming more short of breath, their nose and nail beds may appear blue or grey, or their heart may feel like it is racing…. But these aren’t always linked to low oxygenation. I would recommend that if you have a lung condition that you have a 6 minute walk test done annually. You can also check your oxygen saturations periodically to monitor if you start seeing lower oxygen levels which would indicate that you should notify your doctor. For those that have been prescribed oxygen, you should wear your oxygen as ordered by your doctor. If your doctor says you don’t need it at rest… fine, but if you need it for exertion be sure to wear it. If you currently have an order for oxygen, it’s always a good idea to have your own pulse oximeter that you can check your oxygen saturations occasionally. They have a million different kinds on Amazon if you want to check them out. (Just click on the picture below and it will take you to one that looked decent to me, but feel free to shop around.)
Will I ever be able to quit wearing oxygen?
I am just going to say this and give you my honest opinion…. never say never. However, in my professional opinion and through a ton of experience that I have, if you have had to start on oxygen due to your chronic condition worsening, the odds of you not needing it in the future are slim. BUT, if you had to start on oxygen due to an infection or hospitalization and you weren’t on it prior, you may have just needed it in the short run while your lungs are healing and getting rid of inflammation that occurred during your infection. Never discontinue use of your supplemental oxygen without proper testing to make sure you don’t require it anymore. Your doctor should be aware of this change.
What types of things will I be allowed to do on oxygen and what things should I avoid?
To start, you should avoid open flames and sparks while wearing oxygen. Oxygen is EXTREMELY dangerous near flames so you should keep a good distance from an open flame. NEVER EVER smoke while on oxygen. When I was rounding as a clinical student, one of the worst burns I have ever encountered on a person was someone that was smoking in bed while on oxygen. Not only did they ignite but the mattress did as well… It was awful. DO NOT smoke while wearing oxygen EVER.
Finding your “new normal” will be a challenge at times, but I have patients that golf, ride motorcycles, horseback ride, rock climb, and garden all the while wearing oxygen. If there’s a will, there’s a way… and most things in life (within reason) can be accomplished by figuring out a new way of doing them. Attitude is everything. I would encourage you though if you have to start wearing oxygen 24/7 to look into devices that may be more user friendly for an active lifestyle. I really love portable oxygen concentrators. The technology keeps getting better and better with those puppies and they have changed the game when it comes to allowing people who wear oxygen to stay active in their life. They aren’t always appropriate for everyone (some folks who require higher liter flows of oxygen may not get enough output from them) but if technology keeps improving (crossing my fingers) it won’t be long until they develop one to eventually meet everyone’s needs.
Other tidbits of advice
- If you are prescribed oxygen with exertion, you should wear it in the shower. It may take some getting used to, but generally lung patients get very winded while bathing so wearing oxygen will assist with that. (See other Bathing Tips)
- If you are prescribed oxygen with exertion, you should wear it while driving. Not only can proper oxygen help with your reaction time, you could possibly face litigation if you are in an accident and aren’t wearing your oxygen. You don’t want “the other side” to say the accident was your fault or could have been avoided if you had been wearing your O2.
- Replace disposable oxygen equipment regularly and definitely after a flare-up, cold, or infection. Nasal cannulas and oxygen masks can harbor bacteria and germs. Remember that your home concentrator has a filter that should be changed or cleaned. Have your concentrators serviced to make sure they are functioning appropriately.
- Wearing oxygen can be very drying to the nares. Use a water based gel (like Ayr gel or Ayr spray) or aloe to moisten the nares if they seem to dry out. Never use petroleum products to moisten nares while on oxygen. Also, you can try using a water bottle (we call them bubble bottles in the hospital) attached to your home oxygen concentrator to moisten the oxygen coming out of the machine. These water bottles aren’t highly effective but it may give you some relief. You will want to refill them with sterile or distilled water. Please don’t put tap water in these units.
Are you on oxygen? Do you have any tips or tricks that can help our readers? Comment below to give readers all over the world more tips on wearing oxygen.
Thanks for reading! <3 Christina
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