As we approach Valentine’s day and being in the month of love it would be ideal to talk about all the things we admire, love and reach out to. For most oxygen is the dearest thing that is the lifeline to be able to carry on and be able to travel with oxygen, move around with oxygen, stay at home and be with loved ones around you. It is the most important and critical medical need for many.
During this time our dearest friends and family are our support network and loving them is so close to our hearts and keeps our spirits up. If you love you health then keeping up with exercises, breathing techniques and being healthy will help to assist continuing being able to do the things we love such as visitig amazing cultures and countries across the globe.
Rutger Berntsen, founder of international company, OxygenWorldwide has designed and named the M.O.V described as a body warmer vest that was based upon the principles of a portable oxygen concentrator (POC). This medical oxygen vest contains the necessary equipment to provide medical oxygen to the wearer. The vest would be ideal for oxygen users who require a constant supply of medical oxygen and the life line of being able to be mobile and freely move around without the constraints of a more conventional oxygen device. The M.O.V is designed for e.g. young children or active sport users to give the ability to move around more freely such as going to play a game of golf or running around in the playground.
A portable oxygen concentrator (POC) is normally carried around by means of a shoulder strap. This is not convenient when one has to make movements beyond normal walking. The main advantage of the M.O.V. is that the weight of the equipment in the vest is equally divided over two sides located under the arm pits. The fact that the equipment is ‘concealed’ inside the vest could take away the burden of having to carry around a medical device, which to many medical oxygen users indicates the appearance that you are in fact a ‘patient’. Flexible solar panels are placed on the chest and back of the vest to provide (at this stage) power to the display panel. To make the system fully operational the batteries should (at this stage) be charged by plugging into a AC outlet.
For more information and/or a 3D animation contact: email@example.com
Pulmonary hypertension (PH) is a condition where the blood pressure in the pulmonary arteries (the blood vessels carrying blood to your lungs) is high. This increased pressure causes progressive damage to the heart and lungs.
When you exercise the heart beats more quickly to get more oxygen to the muscles. At the same time the pulmonary arteries expand to allow more blood through so that more oxygen can be carried to the muscles. They expand by stretching outwards slightly to create a larger inner area. In a person with PH, the walls of the pulmonary arteries are thicker, so are less able to stretch. Because of this the heart has to work harder to pump blood to the lungs, especially during exercise. If the heart has to work harder than usual over a long period of time then it begins to work less effectively and damage occurs.
PH affects many different types of people. In most people with PH, it is associated with another medical condition:
• portal hypertension
• connective tissue disease, eg systemic sclerosis
• HIV infection
• congenital heart disease
• sickle cell anaemia.
Some people develop PH with no known cause which is referred to as idiopathic PH and in some rare cases it can be inherited.
Your stage of PH is classified as shown in the table below, depending upon when your symptoms occur.
WHO classification of PH:
1 No symptoms of any kind. Physical activity does not cause any symptoms
2 Comfortable at rest, but symptoms occur with ordinary physical activity
3 Comfortable at rest, but symptoms occur with less-than-ordinary effort (eg lifting the arms)
4 Symptoms while resting
Treatment for PH can be split into three categories:
• Conventional therapy (often called background therapy), which can include the following:
• Targeted therapy
• Calcium channel blockers
• Endothelin receptor antagonists
• Phosphodiesterase 5 inhibitors
• Pulmonary endarterectomy
• Atrial septostomy
• Transplant surgery
Most patients will have a regime involving a combination of background and targeted treatment which varies from person to person depending upon the cause of the PH and what stage they are at.
Many patients will need oxygen therapy, although some only need it at night. Oxygen therapy increases the amount of oxygen in the blood and it can also help to relax the arteries in the lungs which leads to reducing the pressure in the pulmonary arteries. Oxygen therapy can reduce tiredness and breathlessness in some people with PH and it can improve concentration and the ability to do everyday tasks.
Having PH can make you tired and lethargic. This may make it more difficult to do ‘normal’, everyday things. Here are some tips from the PHA website from patients to help make life a little easier.
• Where possible, avoid bending, lifting or over-stretching when doing housework.
• Use a lighter vacuum cleaner and iron.
• Do jobs sitting down where possible – a kitchen stool can really help.
• If your duvet is heavy, consider buying a lighter one.
• Use extra pillows to raise your head and make it easier to breathe.
• If you use an oxygen concentrator, consider putting it outside the bedroom to avoid the noise disturbing you.
• After a bath, open windows before the house becomes too humid.
• Have chairs ready for places where you stand (eg, shaving or applying make-up).
• Slightly larger clothes can be less tiring to put on and take off.
• Put on a bathrobe straight after a bath or shower to avoid having to towel yourself dry.
• If bending down to put your shoes on is difficult, use a long-handled shoehorn.
Out and about
• Plan ahead to avoid having to rush.
• Consider asking for a wheelchair.
• If you drive, carry spare medication in the car.
References: http://www.phassociation.uk.com and www.who.int
Home Oxygen Therapy is a medical treatment for patients suffering from chronic lung diseases. It involves the use of an oxygen concentrator to deliver oxygen via a nasal cannula or face mask to the patient and some may require being tethered to the machine on a constant basis. COPD is an umbrella term for these conditions and patients have restricted airflow through the lungs and experience coughing, wheezing and shortness of breath. The effect on quality of life can be significant and some are unable to participate in physical activities and require help to move. Home oxygen therapy aims to improve the patient’s freedom, health and quality of life by allowing treatment at home. Patients are encouraged to try and maintain a certain level of activity as research has shown that if exercise and mobility are retained then lung capacity and respiration improves.
However some patients find this difficult as they are tethered to a pressurized oxygen container via tubing and the weight, which is typically 4kg, can make transporting and lifting awkward especially for the more elderly patients. Some patients use a small hand cart to transport their equipment around or use a portable unit which they can carry over their shoulder. Despite the huge benefits of H.O.T it still imposes restrictions on the user’s movements, mobility, ability to participate in certain activities and quality of life.
A Follower Robot has been devised to help improve these patient’s lives. The robot can carry the equipment thereby reducing the physical burden and increasing freedom of movement. It is capable of following the patient’s movements and can follow behind the patient. It is simple to use, low weight, compact and at a low cost.
They have started testing these robots on H.O.T users to see if they are indeed beneficial and can aid them in their daily activities efficiently. Most users have found the robot easy to use and to manoeuvre with. It is hoped that after more trials are completed it can be manufactured and sold commercially for COPD patients. These robots could drastically improve patient’s lives allowing them to easily move around and enjoy more out of life which could have a positive effect on their health also. More importantly, how amazing would it be to have your own robot?!
References: www.robomechjournal.com and http://link.springer.com
Scientists claim to have found the root cause of asthma which could also aid in the treatment of other respiratory diseases like COPD. This breakthrough could mean that there could be a new treatment within 5 years.
They have found a protein within the airways which they believe triggers an asthma attack. Asthmatics seem to have higher levels of this protein and when they breathe in a trigger such as dust or pollen these protein molecules cause a rapid increase of calcium within lung tissue cells. High levels of calcium within these cells make them contract and cause the airway spasms which trigger an asthma attack.
The presence of this protein makes cells more sensitive to any asthma triggers, which then makes an attack much more likely.
A drug already exists which can deactivate the protein and clinical trials could start within 2 years, raising hope that a treatment could be available within 5 years.
It is hoped that a few courses of treatment would be enough to stop asthma attacks. Not only this but there is hope that it may have a role in tackling COPD and chronic bronchitis for which there is currently no treatment. Hopefully at a minimum it may prevent flare-ups for these patients and make them less susceptible to the triggers such as dust, smoke and pollen, which can stimulate a severe respiratory event. This could help COPD sufferers enjoy fewer flare-ups and less respiratory distress improving their ability to lead more normal lives.
Whatever stage your respiratory disease may be at, preventing flare-ups is highly important to ensure you stay as healthy as possible and to keep your breathing as easy as possible. This means you need to be aware of the triggers and eliminating any exposure to cigarette smoke, fire smoke, dust, chemicals, excessive wind and pollution. Breathing can also be difficult at temperatures around or below freezing, above 90 degrees F, or on days with high humidity, ozone levels or pollen counts.
Many patients have a component of asthma and some prefer warm, dry climates whereas others may prefer more humid environments.
Extreme hot or cold conditions can put stress on the entire body. In order to maintain a constant body temperature, you exert additional energy to warm or cool it down. This additional energy requirement also increases the amount of oxygen that your body is using. Breathing hot or cold air can also have a drying or irritating effect on the airway causing bronchospasm (contraction of the smooth muscle that surrounds the airway). This decreases the size of the airway and makes it more difficult to get the air in and out of the lung, increasing shortness of breath.
In general most patients find that they prefer minimal humidity levels of about 40%. This is also true of indoor humidity levels which can be difficult to maintain throughout the year, if it is a hot summer or a cold winter with the heating on. You can purchase a humidifier that works with your heating system or independent units for single rooms. De-humidifiers can also be purchased to help lower the humidity in certain rooms.
High indoor humidity is often also the source of mould growth in the home which is another trigger, as well as an increase in common indoor air pollutants like dust mites, cockroaches, bacteria and viruses. Also as humidity increases, the density of the air increases. This more dense air creates more resistance to airflow in the airway, resulting in an increased work of breathing (i.e. more shortness of breath).
Look out for common signs of high humidity:
• flooding or rainwater leaks from the roof or basement/crawl space
• poorly connected pipes or leaky pipes under sinks or in showers
• carpet that remains damp
• poorly ventilated bathrooms and kitchens
• condensation build-up from humidifiers and dehumidifiers, air conditioners, and drip pans under refrigerators/freezers
Here are some helpful pointers for when it is hot, although many are applicable to other weather conditions as well:
1. Drink plenty of fluids, fairly obvious for Australians, but please take into account if you have a fluid restriction.
2. Wear appropriate clothing and sunscreen.
3. Plan your activities carefully. Try to organise your activities or exercise for the coolest times of the day – early in the morning, or in the evening. When driving, park in shady areas if possible, and choose places to go that are air conditioned. Place sun protectors in your car when it is parked.
4. Keep cool, indoors. Use your air-conditioner if you have one and remember you do not need it to be freezing cold. A second benefit of the air conditioner is that it removes a great deal of humidity from the air as it cools it. If an air conditioner is not available, use fans and open windows to circulate the air during hot days. Special programmes are available in many places.
5. Use the buddy system. This means making sure that someone contacts you at least twice a day to check that you are OK.
6. Avoid rigorous exercise or excess activity.
7. Take your medications as directed.
8. Pay attention to weather reports.
References: www.healthline.com and http://lungfoundation.com and https://rotech.com
A new study conducted by Jonathan Stamler, a professor of medicine at Case Western Reserve University School of Medicine in Cleveland, OH, and colleagues has shown that the respiratory cycle involves three gases and not just two. He says their findings will transform our understanding of the respiratory cycle and could save lives as it will alter our treatments of various associated diseases linked to the respiratory system and also affect blood banks.
The current understanding is that the respiratory cycle uses blood to transport two gases – oxygen and carbon dioxide. Red blood cells pick up freshly inhaled oxygen from the lungs and carry it to cells in the tissues of the body; and then they bring back carbon dioxide as a waste product to be exhaled from the lungs.
However their study has proven that without the presence of Nitric Oxide it doesn’t matter how high the oxygen level is, the cells cannot accept the oxygen without it. The researchers show how nitric oxide controls the blood flow in small blood vessels inside tissue in a process known as “blood flow auto regulation.” It is the Nitric Oxide that controls the release of oxygen from red blood cells into the tissues that need it. Haemaglobin in the Red Blood Cells needs to be also carrying Nitric Oxide to enable blood vessels to open and to supply the oxygen it is carrying to the tissues.
Prof Stamler says “Within the tissues, the tiny vessels and the red blood cells together make up the critical entity controlling blood flow. Red blood cell dysfunction is likely a hidden contributor to diseases of the heart, lung and blood such as heart attack, heart failure, stroke and ischemic injury to kidneys.”
If you suffer from a condition where there is a lack of oxygen uptake to your cells, it may not be the answer just to increase the oxygen supply, but to also look at whether your Red Blood Cells are functioning correctly and if there is an adequate Nitric Oxide supply. Then if necessary treat the Red Blood Cell problem in conjunction with oxygen therapy.
The study also has implications for blood transfusions. Recent evidence shows that blood transfusions lacking nitric oxide have been linked to higher risk of heart attacks, disease and death. It’s not enough to just increase oxygen content of the blood via a blood transfusion. If the Nitric Oxide mechanism is failing then the oxygen will not be able to make it to its destination. Blood in blood banks are known to be deficient in Nitric Oxide and transfusing this blood may actually make things worse by plugging up blood vessels in tissues and to solve this the nation’s blood should be replenished with Nitric Oxide.
It may be the case that many sufferers on oxygen therapy in the future could be helped and treated even more by investigating their Nitric Oxide levels, as there could be additional failings in their respiratory system that could be investigated and more successfully treated.
References: www.medicalnewstoday.com and www.sciencedaily.com
Almost every medical treatment has risks and side effects to it, which vary in degree from person to person. The benefit of oxygen therapy is that it is not a foreign drug, we naturally use it everyday and therefore the only side effects will be due to the administration of it or because of the volume of oxygen being inhaled, which as a result dramatically reduces side effects when compared to other medical treatments. There is also the safety aspect of storing and using oxygen as it is highly combustable but as long as you follow the simple common sense safety advice from your provider you will be very safe.
The side effects may include a dry or bloody nose, skin irritation from the nasal cannula or face mask, fatigue, tiredness and morning headaches. Some people only suffer side effects initially upon first use and then they disappear however if these problems persist then all you need to do is to inform your doctor and provider. Depending upon the problems all your doctor may need to do is to alter the oxygen flow rate or length of time you’re using the equipment.
If nose dryness is a problem then you may just require an additional nasal spray or to have a humidifier attached to your equipment to reduce the dryness effect of the oxygen.
If you experience irritation from the mask or cannula then your provider can try other devices that may fit you better and can recommend over-the-counter gels and devices designed to help lessen skin irritation.
If you use transtracheal oxygen therapy then complications can potentially be a bit more serious due to the more invasive way that the oxygen is delivered via a tube inserted into your windpipe a the front of your neck. You may develop mucus balls which can cause coughing and clog the windpipe, infection and injury to the windpipe. However as long as you follow the advice in the proper medical care and correct handling of the tube then this greatly reduces the risk of complications. Such as keeping it clean and to use suction to remove any build-up.
The majority of users find that they experience a little irritation and dryness which can be easily resolved. Their testimonials are clear in saying that the benefits of oxygen therapy such as improved quality of life, improved mobility and social interaction and longevity of life far outweigh the inconvenience of a few side effects.
References: http://www.nhlbi.nih.gov and http://www.livestrong.com
Companies have been producing portable oxygen concentrators since 2000 and can provide oxygen via continuous flow, pulse flow or a combination of the two.
Continuous flow machines supply the patient with a continuous supply of oxygen, preferred by some patients who have very poor respiratory effort and a low oxygen level although some oxygen is wasted while the patient is exhaling and the supply can be used up quickly but do offer the patient mobility and freedom.
On-demand (also called intermittent-flow or pulse-dose) portable oxygen concentrators (POCs) are the smallest, often the size of a briefcase or picnic cooler and weigh about 2kg. They can deliver oxygen only when patients inhale which avoids any waste of oxygen when the patient exhales. Their ability to conserve oxygen and not waste it is key to keeping the units so compact as the oxygen supply will last longer. Their size allows them to be sleek and come with easy to carry bags allowing the flexibility to take these units almost anywhere, even to high altitudes, as long as there’s sufficient battery run time until the next opportunity to recharge it.
Another type of POC combines pulse and continuous-flow to meet a wider range of patient needs. These dual-supply concentrators can provide a larger volume of oxygen than smaller pulse units, however they need bigger, heavier battery supplies (otherwise the battery run time is reduced) and they are heavier, between 5 and 10kg. These dual-system converters often come with built-in wheels or a cart to make them easier to carry and move around without compromising the patient’s mobility.
There are different brands with slightly different characteristics, but the most important thing for the patient to consider when choosing which type of POC to have is their medical needs around the supply of oxygen they need.
With continuous-flow, oxygen delivery is measured in LPM (litres per minute). With pulse-flow delivery is measured by the size (in millilitres) of the ‘bolus’ of oxygen per breath, referring to the burst of oxygen released when you inhale. Other important considerations include the maximum oxygen percentage it can achieve, the number and increment of settings for adjusting oxygen flow, battery capacity and power cord options for recharging.
Your oxygen requirements during sleep is another variable. Usually pulse-flow oxygen concentrators are not used by patients while they sleep, as sometimes the machine is not able to detect when the patient is inhaling, as night-time breathing is low and shallow. Sleep apnoea patients are specifically not advised to use Pulse-flow units as they usually require a CPAP (Continuous Positive Airway Pressure) mask. For patients without apnoea, the use of portable concentrators during sleep is increasing as their preferred choice, especially with the addition of alarms and technology that detects a patient’s slower breathing during sleep and the machine will then adjusts the flow or bolus size accordingly. Continuous-flow mode is considered safer for night use when used with a CPAP machine. Some larger portable oxygen concentrators are designed to operate in both continuous-flow mode and pulse-flow mode.
References: http://en.wikipedia.org and http://hme-business.com
There are many stories of patients being misdiagnosed and given treatment for asthma when in fact years later the patient is then diagnosed with COPD.
Pat Crowe was a healthy, active 39 year old but was told he had developed asthma and was given an inhaler. Over the next few years his health deteriorated, he grew dependent upon and overused his inhaler, suffered from side effects and eventually the inhaler wasn’t enough. Being so breathless meant his confidence plummeted, making him almost housebound.
‘I panicked about going outside and crossing busy roads because I was having trouble breathing and couldn’t move quickly.’
During bad spells and prolonged attacks he was also prescribed strong steroid pills, which caused side-effects, including a swollen face and hunger.
‘My wife became my carer, and my family were very scared watching me struggle to breathe,’ he says. ‘I didn’t even want to get out of bed and go down stairs because I was worried about getting back up. My life changed completely.’
It was only then that Pat’s consultant performed a spirometer test which confirmed that he didn’t have asthma after all but suffered from COPD, which explained why he’d found the condition impossible to control.
COPD is incurable and affects 900,000 people in the UK, usually above the age of 35, and an estimated 30,000 people die from it each year. Experts believe there are also more than two million undiagnosed cases.
Specialist advice is crucial when it comes to achieving an accurate diagnosis says Dr Kurukulaaratchy: ‘GPs need better awareness of these conditions. They both rank highly in hospital admissions, but if management is right early on, you can improve quality of life and possibly even life expectancy.’
Nick Hopkinson, honorary chest physician at the Royal Brompton Hospital, London, adds: ‘Asthma patients usually have normal lung function, but when they experience asthma symptoms or an attack their airways go into spasm, becoming narrow and inflamed. Then, after taking medication – usually an inhaler – their lungs return to normal. However, COPD patients have relatively fixed lung disease, so even on a good day they still have symptoms. Most of the damage isn’t reversible and progressively worsens.’
One major consequence of misdiagnosis is that patients could be given the wrong medication.
COPD patients usually start with bronchodilator inhalers to relieve narrowing of the airways and then go through a variety of drugs, starting with shorter-acting medications and moving to longer-acting ones, as the disease worsens, says Dr Kurukulaaratchy.
‘Research has shown steroids can lead to an increased risk of pneumonia (inflammation of lung tissue) in COPD patients, so this is a risk if they are wrongly labelled as having asthma.’
If the condition doesn’t improve, they can end up using a lot of steroids, which have side-effects such as weight gain, mood changes and osteoporosis.
‘If patients are told they have COPD but it’s asthma and they don’t have inhaled steroids, they won’t be able to control the disease – leaving them prone to worsening symptoms and even death from an asthma attack,’ says Dr Hopkinson. ‘We see 1,100 asthma deaths a year in the UK, often because they weren’t on preventer treatments.’
Also oxygen therapy treatment is a major component of COPD treatment which is prescribed by your doctor, so if you are misdiagnosed then you may not be prescribed oxygen as early as you should have been which can affect your health and long-term diagnosis as COPD damage to the lungs is irreversible.
If you have any doubts about your diagnosis then speak to your doctor or get a second opinion, just to be sure as your health is the most important thing.