Travelling with oxygen by car or other forms of transportation may seem intimidating. With a little planning, it can be easy, and safely, done. Travelling with portable oxygen by Aeroplane, by Cruise ship, by Car, by Train can be done without any stress when you know how. Here are a list of popular destinations that people travel to for holidays.
What to Do…
DO allow time to make arrangements for your oxygen needs when travelling long distance, especially if it will be by plane. Each airline has their own policies and procedures for travelling with oxygen. If travelling by car or train, you might need to arrange both portable and a more long-lasting oxygen supply.
DO carry your portable tank only in the case supplied with it.
DO keep your oxygen delivery system out of the bright sunlight or other heat sources.
DO bring extra batteries to power your concentrator in case of emergency.
DO be aware that high altitudes, whether flying or just driving in the mountains, can increase your need for supplemental oxygen.
What not to Do…
DON’T overlook the fact that portable oxygen tanks can only carry a finite amount of oxygen.
DON’T put a portable tank inside a backpack or other carry bag.
DON’T place your tank, cylinder or portable concentrator in a car trunk or other tightly enclosed space.
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: firstname.lastname@example.org
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
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
Portable oxygen concentrators have started a revolution in the medical oxygen industry, with their use having sky-rocketed over the last five-10 years. Industry experts are optimistic about the future of portable oxygen and that patients will be able to get hold of even better equipment in the future to make their lives as close to normal as technology can allow.
Portable oxygen technology is ever-evolving and improving, with POCs at the heart of it. This is driven by the increasing demand for these devices which in turn has been driven by an increase in diagnosed sufferers requiring oxygen therapy, improved availability and increased affordability. These factors are constantly driving down costs for the industry, allowing them to reinvest to improve devices whose demand then continues to help grow the industry and improve it. However it seems these advancements will come with a little give and take.
Patients and doctors want smaller, lighter, quieter devices that also have a higher oxygen output and a longer battery life. The providers also want in addition more durability, reliability and all at a lower cost.
As with other technologies if you move in one direction to improve a singular feature it often has an negative impact on another and getting the balance is difficult.
The patient is the final target audience and their requirement for freedom will be the ultimate guidance for the future of oxygen technology. They require the freedom to easily fly, drive or boat and do daily activities without worrying about running out of oxygen. Freedom also comes from not waiting on deliveries from the oxygen supplier and all this provides patients with the chance to feel normal again.
A main inhibiting factor on their advancement is the highly competitive nature that the industry has evolved into. This has led to providers dramatically lowering prices in order to maintain market share, which is highly beneficial to the patient however it leaves less money available for re-investment into research to drive improvements. With the steep increasing trend of COPD diagnosis around the world it seems there will be an ever-increasing amount of patients and therefore providers seeking to purchase POC’s which will then still allow for re-investment.
It is hoped that the units will become smaller and lighter with increased battery life which is very important as the current units are not as portal as they could be for end-stage COPD patients.
It is agreed that ‘POCs are still in their genesis’ but the ultimate goal is so that the POC is also the primary oxygen concentrator, so you would only need the one unit.
Making something increasingly portable also brings along other problems and the unit then needs to be made increasingly durable and resistant to banging and dropping and other associated hazards. Replacing a bolt or armrest on a wheelchair is a lot easier and less of an inconvenience to the user than replacing a part in a POC.
Future oxygen technologies will continue to be focused on medically accurate and improved oxygen therapy and delivery/recycling methods but also incorporate much more software and intelligence in the design and lighter weight models. In order for companies to drive down costs more of a focus may also be put on patient maintenance and repair so that parts can be cleaned or replaced easily by the patient and not having to send the unit back and forth to the manufacturer.
A study in mice has suggested that by doing something as simple as breathing in extra oxygen may provide our immune cells with an extra boost to fight cancer.
The immune system often can spot and destroy abnormal cells before they grow into cancer. Normally cancer tumour cells put up defences in order to block our immune system from attacking them. One way they do this is because tumours can grow so rapidly that they outpace their blood supply, creating a low-oxygen environment. By maintaining low oxygen levels inside the tumour, this can increase the production of a molecule that blocks the tumour fighters that our immune system produces, called T cells. Lots of research is under way to develop drugs that could block the production of this molecule adenosine, but researchers at North Eastern University wondered whether adding oxygen to tumours could strip away that defence. So they put mice with lung tumours into chambers that let them breathe oxygen doses mimicking supplemental oxygen therapy doses.
The results showed that tumours shrank more in the high-oxygen group, and even more so when researchers also injected the mice with doses of extra T cells. With the extra oxygen, “you remove the brake pedal” that cancer can put on tumour-fighting immune cells, said Michail Sitkovsky, director of the New England Inflammation and Tissue Protection Institute at North Eastern University, who led the work. The extra oxygen changed the tumour’s environment so that immune cells could get inside and do their jobs.
The study has exciting potential but obviously it must be tested in people first. If it works then this supplemental oxygen approach could be utilised to work in conjunction with other cancer therapies to aid in the battle against cancer.
References: http://www.usnews.com and http://blackburnnews.com
Living with chronic obstructive pulmonary disease (COPD) doesn’t mean you have to stop living your life. Being on the correct medication and oxygen treatment regime is crucial but there are some tips on lifestyle changes that you can make to help you manage the disease. Stop Smoking
Smoking is the number one cause of chronic bronchitis and emphysema. Together these diseases comprise COPD. If you haven’t already quit, it’s very important to take steps to stop smoking. Talk to your doctor about smoking cessation strategies.
If nicotine withdrawal is a concern, your doctor may be able to prescribe nicotine replacement therapy to help you slowly wean yourself off. Products include gum, inhalers, and patches.
People with COPD should avoid all inhaled irritants such as air pollution, dust, or smoke from wood-burning fireplaces. Defend Against Infections
People with COPD are at risk for respiratory infections, which can trigger flare-ups. Infections that affect the airways can often be avoided with good hand-washing hygiene. Cold viruses, for instance, are often passed through touch. Simple soap and running water do a good job of removing potentially infectious germs.
It may also be helpful to avoid contact with people who show signs of cold or flu. Your doctor may also recommend an annual flu vaccine. Focus on Good Nutrition
Eating right is an important way to keep your body and your immune system strong. It may be helpful to eat smaller meals, more often. Try to eat a diet rich in fruits, vegetables, fish, nuts, olive oil, and whole grains. Cut back on red meat, sugar, and processed foods. Following this dietary pattern has been shown to help reduce chronic inflammation, while supplying plenty of fibre, antioxidants, and other nutrients to help keep you healthy.
Your doctor may also recommend nutritional supplements to ensure you’re getting the essential nutrients you need. Tend to Your Emotional Needs
People living with disabling diseases such as COPD occasionally succumb to anxiety, stress, or depression. Be sure to discuss any emotional issues with your doctor as they may be able to prescribe medications to help you cope or also recommend other approaches to help you cope. This might include meditation, special breathing techniques, or joining a support group. Be open with friends and family about your state of mind and your concerns and let them help in any way they can. Stay Active and Physically Fit
Research shows that exercise training can improve exercise tolerance and improve quality of life among people with mild to moderate COPD. It can also help provide relief from shortness of breath and improve your mental well-being.
Asking for portable oxygen devices from your supplier can aid you in being more mobile and to have oxygen with you whilst you exercise or carry out more strenuous activities.
There is a myth that if you are on oxygen therapy then your life is effectively over and that it is too restrictive and complicated to go away on holiday. This is not necessarily the case and for most sufferers the world is your oyster. Always check with your doctor first to ensure you are fit enough to travel and ask your doctor to write a letter stating this just in case you need it.
All you need to do is prepare and plan the holiday well and ensure that you consider some factors when planning your trip:
• Climate: many people with lung conditions prefer warm climates that have salty air. Lower oxygen levels at higher altitudes can make breathing difficulties worse.
• Terrain: whether your destination is flat or on a hill could affect your ability to get around comfortably.
• Wheelchair access.
• Transport availability.
• Special needs such as oxygen treatment.
• Plan in advance: if you leave things to the last minute, you could forget something crucial. Think about how far you can walk, how many stairs you can manage, access to toilets and what transport you can use.
• Be realistic: places you liked in the past may not be suitable now. Pick something you and your carer can cope with physically.
• Shop around: different companies have different policies for people with lung conditions, so find the best deal for you. Many travel agents offer holidays for people with special requirements.
• Ask questions: travel firms are used to dealing with special requirements. They should be able to answer all of your queries and concerns.
You should ensure that you and your carer have full travel insurance before going away to avoid huge medical bills if you are taken ill during your trip. Look into this first as it may be expensive and you may need a specialist provider depending on your health. Check that it covers all aspects of your medical condition and that you declare everything accurately to them otherwise it may not be valid, leaving you with a huge bill.
Keep your documents safe with you while you travel in case you need them suddenly in an emergency.
The European Health Insurance Card (EHIC) entitles you to reduced cost – sometimes free – medical treatment if you fall ill when travelling in Europe.
Accommodation in the UK is divided into four mobility categories:
• Category One – suitable for people able to climb a flight of stairs that have extra fittings to aid balance.
• Category Two – suitable for someone who needs a wheelchair some of the time but can manage a maximum of three steps.
• Category Three – suitable for people who depend on a wheelchair but who can transfer unaided to and from the wheelchair in a seated position.
• Category Four – suitable for a person who depends on the use of a wheelchair and needs help from a carer or a mechanical hoist to transfer to and from the wheelchair.
Each category has its own logo, which is displayed by accommodation providers that have been assessed. Make sure you choose accommodation that best fits of requirements.
Other countries have different systems so just make sure you ask your travel agent about how to choose your accommodation abroad.
Several coach companies are working towards making their vehicles accessible for people with disabilities. Many coaches now feature kneeling suspension, which makes boarding and alighting easier. Most on-board toilet facilities are now level with the coach seating.
Some companies allow you to bring on board your own oxygen supply and will carry some types of collapsible battery-powered wheelchairs.
Different train companies have different policies regarding people with disabilities, so plan your route in advance and find out which companies’ trains you need.
Many ferry companies have lifts, toilets and wheelchair facilities; some can supply wheelchairs at terminals. A few have special cabins for disabled people and/or offer discounts. Check before you book, especially if you need oxygen.
Camping and caravanning
The Camping and Caravanning Club has three stages of accessibility for camping and caravan sites. So you just need to check that the site is appropriate for your needs.
• No accessible facilities;
• Accessible to people who can move around a little, but not wheelchair accessible; and
• Fully accessible including shower blocks and facilities.
Holidaying With Oxygen
Oxygen for travel in the UK is provided by the NHS. You just need to let your usual oxygen provider know the details of your holiday, including the dates you are going and returning and where you will be staying, and they will arrange everything for you.
You should first get permission to store oxygen cylinders and equipment from the owner of the place where you are staying.
Oxygen suppliers in the UK will only provide oxygen for travel and stays within the UK. If you are travelling abroad then there are many overseas oxygen providers that can fulfil your oxygen requirements and if you are travelling by plane then you need to ensure your airline’s oxygen policy and whether you need to complete any additional documentation for them.
Flying with a lung condition
Many people believe their lung condition will prevent them from flying, especially if they need oxygen but this is not necessarily true. First, ask your doctor whether you can travel by plane and whether you will need any additional oxygen on the plane.
Then contact individual airlines to discuss your requirements and to find out what their policy is for carrying and using oxygen on planes.
If you are planning a long-haul flight and use a continuous positive airway pressure (CPAP) machine to treat the sleep disorder obstructive sleep apnoea (OSA), you should consider whether you might need to use your machine during the flight.
Some airlines have restrictions on what machines are permitted for use on board and others may require you to fill in a form before you travel.
When you contact the airline, find out what assistance is available at the airport as well as on the plane and check:
• the airline’s policy on carrying and using oxygen and medical devices such as CPAP machines;
• the exact length of the flight, and whether delays are likely;
• the facilities available at the outgoing and incoming airports. These might include assistance to get you from the airport lounge to the departure gate and on to the plane, the use of wheelchairs, and whether oxygen is available at the airport; and
• how you should confirm your fitness to fly.
If you are on medication then you will need a letter from your doctor confirming that you need the medication, and you should also keep a list of all the medication and doses you take in case you need to get more during your stay. List the proper names, keep all medication in its original packaging and keep it with you in your hand luggage. A doctor’s letter is required for liquid medicines exceeding 100 millilitres that are taken into the aircraft cabin. When given medication abroad, check whether it can be brought back into the UK. If you are in any doubt, declare the medication at customs.
Preparation is the key. Plan your trip in advance, think through everything you need, ask as many questions as you can of as many people as possible, then decide what’s best for you.
References: http://www.blf.org.uk and http://www.cancerresearchuk.org
When oxygen is in a cold state ( -183ºC), it turns to liquid. More oxygen molecules fit into the same space when in liquid form compared to when it is a gas and so liquid gas only takes up 10% of the space that compressed oxygen does. Therefore this liquid allows for a greater amount of oxygen to be placed in a tank and it weighs less than a compressed oxygen tank.
Liquid oxygen is stored in an insulated stainless steel low pressure container that works in a similar way to a Thermos flask. These base units store and hold the liquid oxygen at an extremely low temperature. As with the compressed oxygen, it can be filled into smaller units from the base unit so that it can be used portably.
Liquid oxygen doesn’t require power via electricity like oxygen concentrators do and also they make no noise.
There are some disadvantages in that liquid oxygen is more expensive than compressed oxygen and does not have as long of a shelf life as it will evaporate over time. Also, you will not be able to take liquid oxygen on a plane.
References: http://www.uk.airliquide.com and http://www.inogen.com
An interesting and unique paper has been researched and published, ‘Explaining Adherence to Supplemental Oxygen Therapy:The Patient’s Perspective’ by Mark A Earnest. It looks at a group of COPD sufferers and investigates their use of oxygen therapy and the factors behind their varying adherence to their treatment regime.
For many people the level of adherence changes with time and reflects their struggle to manage their health, symptoms, physical ability and social issues. However adherence to oxygen therapy tended to increase with time as the realisation becomes apparent that a little compromise to lifestyle is required in order to reap the full benefits of oxygen therapy.
The barriers include the physical difficulty of using the oxygen, self-consciousness and a sense of social stigma, lack of perceived benefit, and fear of side effects from treatment.
The benefits far outweigh these barriers as supplemental oxygen therapy reduces mortality, improves sleep quality and general comfort, increases exercise tolerance, reduces pulmonary hypertension, normalizes heart rhythm patterns and improves cognitive brain function such as memory, intelligence, motor skills and perceptual motor ability.
The pattern of oxygen use adopted by any individual reflects their personal experiences and values and their efforts to optimally manage their lives. Four main areas affect adherence: functional management, health management, social management, and symptom management.
This is juggling the difficulty caused by weight and bulk, the perception that it hinders performing certain tasks with the benefit of improved fitness, strength, stamina and increased ability to perform these tasks.
Individuals voiced concerns that they feared nasal dryness, nosebleeds and light-headedness. That they thought they may become addicted to it or that their lungs would become weakened.
These fears diminished as a result of personal experience. A realisation that the health benefits outweighed these fears and experience via an increase in use during episodes or on advice from a doctor.
Social concerns relating to oxygen use, including embarrassment, self-consciousness, fear of burdening or inconveniencing others, concerns about appearing weak or sick, and a sense of shame, both about prior smoking and accepting dependence on a substance such as oxygen.
These elements tended to evolve over time. Some were able to overcome their fears or sense of self-consciousness by simply returning to a normal routine with family and friends. The desire to preserve independence and retain a high physical function and socialising helped them to overcome anysense of isolation and embarrassment. One woman described how,she felt once she followed her oxygen therapy fully:
‘It opened a whole new vista for me. All of a sudden I was getting more active. I was doing the grocery shopping, and the laundry, and driving, and just becoming self-sufficient, which was what I used to do. I started volunteering then (in the rehab program) as a way of thanking them, you know, for saving my life.’ (Female, age 69)
The realisation that in most cases oxygen therapy helped to alleviate symptoms which resulted in a greater adherence to the treatment.
Every participant in the study described some sense of compromise in the decisions they made regarding their use of oxygen. For most, the compromises were viewed as minimal or had been minimized by time and experience. In the four areas most patients realise that any uncertainties, fears or slight inconveniences in their lives were all far-outweighed by the benefits from oxygen therapy and adapted their lifestyles over time and through experiences and research, which generally resulted in an increased adherence to the treatment.
References: http://erj.ersjournals.com and http://www.ncbi.nlm.nih.gov