Regular exercise and help survival of COPD and asthma patients

COPD includes emphysema, chronic bronchitis and asthma and is often related to smoking. Common symptoms include difficulty breathing, chronic coughing, wheezing and phlegm production and over time can prove fatal.
Regular exercise could help boost the survival of people who’ve left the hospital after being admitted following an exacerbation. The risk of hospital readmission and death is especially high after a person has been hospitalized for COPD.
“We know that physical activity can have a positive benefit for people with COPD and these findings confirm that it may reduce the risk of dying following hospitalization,” says Dr. Marilyn Moy from Harvard Medical School.
Having a difficulty to breathe often leads to a more sedentary and immobile lifestyle for patients and results in de-conditioning of multiple organ systems including the heart and muscles. It also results in a greater reliance on supplemental oxygen and medications and a general decrease in health. Improving muscle function with exercise has been demonstrated to decrease the chance of readmission to hospital. Exercise can avoid microscopic lung collapse and sedentary patients have a greater risk of developing blood clots.
Researchers in a Californian study found that those who did any amount of moderate to vigorous physical activity were nearly half less likely to die in the 12 months after hospitalisation than inactive patients. Even low levels of exercise reduced the risk by over 25%. The researchers believe that tracking physical activity levels might be a good way for doctors to pinpoint those COPD patients at high risk for death after hospitalization.
According to Dr Mensch, “COPD has now joined other chronic diseases, including type 2 diabetes and cardiovascular conditions, where exercise has been shown to decrease mortality and prolong life.” This is particularly important for COPD as GPs have little to offer patients to help lower disease-linked death risk.
Another study in Australia has also shown that physical activity undertaken in small intervals spaced throughout the day can safely and markedly improve the health of people with COPD. The study established that 150 minutes of exercise per week is
most effective in reducing cardiovascular and metabolic disease, the development of cancer, and overall mortality.
Evidence shows that exercise can greatly improve the physical state and quality of life of COPD patients, reducing their breathlessness, and improving energy levels. Setting feasible exercise goals that incorporate physical activity into everyday tasks is a recommended option for COPD patients. The use of portable oxygen concentrators can help patients achieve these goals as these oxygen units allow the patients to move around with their oxygen supply whether indoors or outdoors and not be tethered to their oxygen tanks so they can move around, go for walks or exercise.
Researchers suggested that, in addition to trying to perform light exercises everyday, patients should focus on the reduction of sedentary behaviour, such as trying to spend less time sitting and taking short walks. Minor walks taken after sitting for a considerable time without breaks is highly recommended as for people with severe disease simple goals like this may be a more realistic place to start that trying to go for a 30 minute walk each day.
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Lupus and PH

PH or Pulmonary Hypertension is a disease that causes high blood pressure in the lungs due to narrowing in the pulmonary arteries by thickening of the vessel walls. It results in the heart having to work harder to pump the blood and the organ can become enlarged and weakened leading to heart failure. It can be caused by an underlying disease such as Lupus.
Lupus is a less common disease that many people haven’t heard of. It is an autoimmune disease that occurs when the immune system attacks healthy tissues resulting in inflammation, swelling, pain and cell tissue damage. There are different types of Lupus but the most severe is systemic lupus erythematosus (SLE). Symptoms range from mild to severe, and many people will have long periods with few or no symptoms before experiencing a sudden flare-up, where their symptoms are particularly severe. Even mild cases can be distressing and have a considerable impact on a person’s quality of life. Lupus is a complicated condition and common symptoms are fatigue, joint pain and swelling and rashes, however the disease can cause systemic damage and can effect organs like the kidney, heart and lungs.
They are both very separate diseases and PH does not cause Lupus however Lupus can cause PH. Patients suffer from shortness of breath, fatigue and fluid retention; symptoms also seen in patients with PH. The development of lupus-associated PH is not completely understood and “it is not yet known, for example, whether lupus itself can directly cause PH, or whether lupus is simply a trigger for the development of [PH] in susceptible individuals,” the report explains.
It is more common in female patients to develop lupus and PH at a younger age (15-50 years) than those that traditionally develop PH alone. PH can worsen the symptoms of Lupus and it is important to diagnose it early. Individuals should be aware of swelling in the feet, ankles, legs and abdomen, difficulty in breathing, chest pain, light-headedness and fainting.
There is currently no cure for either PH or Lupus but there are treatments that can help to ease the symptoms. Medications to help with inflammation, swelling and to ease blood pressure as well as measures to deal with fluid balance and supplemental oxygen to help with breathlessness and oxygen levels in the blood. Oxygen therapy helps with both diseases simultaneously; by helping to reduce inflammation and increasing blood oxygen levels which helps in tissue repair to reducing breathlessness, easing the hypertension and decreasing blood pressure among many other benefits. If Lupus is in association with the PH then immuno-suppressive medications can sometimes be administered which help with the inflammation and irritation in the body however they can also cause damage in the blood vessels in the lungs which can be counterproductive. Lupus is still very much an unknown disease and with time and understanding of its processes there will hopefully be more effective treatments in the future that could ease Lupus symptoms as well as PH symptoms if the patient suffers with both conditions.
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Could lung coils be the new treatment for COPD?

A recent trial has shown that the use of lung coils has produced significant lung function improvements for emphysema patients.
In advanced emphysema parts of the lung become hyperinflated when patients breathe in and these can press down on and impair the healthy lung tissue as well as pushing down on the diaphragm making breathing extremely difficult. Patients would normally undergo surgery and have a lung-reduction procedure, however this is risky and very invasive. The new lung coil may offer a less invasive and effective alternative treatment to reduce lung volume.
The coils are shaped in a simple loop around 10-15cm in length when stretched out. They are made from Nitinol which is a metallic ‘memory’ material that returns to its intended shape even after long-term repeated stretches and compressions.
They are inserted into the lungs using a bronchoscope and placed in areas with diseased lung tissue where they immediately resume their looped form. The coils grab lung tissue and pull it inwards to reduce the lung volume in these sections to allow other sections with healthy lung tissue to inflate more normally. It has been shown that a minimum of 10 coils are needed in order for there to be significant clinical benefits but 12 per lung is the current practice.
Coil treatment has shown to provide significant improvements in the 6 min walking distance test and forced expiratory volume and also less dependence on supplemental oxygen. These results are from 3 months post coil insertion and the trial is still continuing for another 9 months to see if the good results continue long-term. If the results continue to show an improvement in lung function and breathing ability long-term then the coil treatment will be an effective new treatment for COPD patients and other patients with diseases where damaged lung sections cause difficulty in breathing. It is far less drastic and invasive than lung reduction surgery and results show that it is more effective.


Alzheimer’s disease is the most common form of dementia, which is a set of symptoms that include memory loss and problems with thinking, problem-solving and language. It is a physical disease that affects the brain and proteins build up in the brain forming ‘plaques’ and ‘tangles’ around the nerves. Connection is then lost between the nerves cells and leads to the death of the nerve cells and loss of brain tissue. Patients with Alzheimers also have a shortage of important chemicals that help to transmit signals around the brain. The disease is progressive and as more of the nerve cells die and brain tissue is lost, the more severe the symptoms.
Sleep apnoea is a condition where the walls of the throat relax and narrow during sleep and interrupts normal breathing patterns. During an episode the lack of oxygen triggers your brain to pull you out of your deep sleep so that your airway reopens and you can breathe normally. After falling back into a deep sleep again further episodes can occur even as frequently as every few minutes. Most patients snore loudly and have laboured and noisy breathing and is often interrupted by gasping and snorting. This repeated sleep interruption can make patients feel extremely tired during the day and suffer from reduced mental ability. However unless a partner or family member notices your symptoms whilst you sleep you may not know that you suffer from this condition and many people go undiagnosed.
Recent studies have shown that sleep apnoea may quicken memory decline and bring forward the onset of memory impairment conditions like Alzheimers by 10 years. The development and progression of Alzheimers may also be speeded up by sleep apnoea as well. These studies also revealed however that sleep apnoea patients that were being treated with supplemental oxygen overnight delayed the onset of memory impairment problems by as much as 10 years. Patients with sleep apnoea who were being treated declined at the same rate as volunteers who did not have sleep apnoea showing that being treated by oxygen counteracted the harm being done by the condition. It appears that the frequent drops in oxygen levels during episodes of untreated sleep apnoea have a major impact upon memory impairment and can directly lead to the early development of Alzheimer’s and dementia. Also during sleep is when the brain has time to remove harmful waste products, if sleep is disturbed then there is an accumulation of harmful proteins that block nerve cell function. Certain parts of the brain are more sensitive to drops in oxygen levels than others; certain neurons in the hippocampus (where Alzheimer’s is thought to start) is especially sensitive to drops in oxygen and sleep apnoea may ‘stress’ these neurons out.
There are currently no medications that can prevent the progression of mild cognitive impairment to Alzheimer’s disease or dementia so treating at-risk patients with CPAP (oxygen treatment for sleep apnoea) is a prevention method that is worth trialling and testing. Previous research has already shown that CPAP treatment and supplemental oxygen at night slows and improves cognitive impairment in patients with Alzheimer’s disease and increases brain tissue and now this more recent research backs up these findings. Hopefully soon there will be trials to prove whether supplemental oxygen at night could be the next new treatment for Alzheimer’s and dementia patients or even those who are at risk.
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General benefits of oxygen

The benefits of oxygen can be felt by anyone, not just those suffering from a medical condition and requiring supplemental oxygen. We can all find easy ways to increase our oxygen levels naturally through breathing exercises, general exercise, getting more fresh air and eating a balanced diet of foods that help increase oxygenation in our blood.
The general benefits that oxygen brings to our body includes:
•    Create energy
•    Digest food
•    Eliminate toxins from the body
•    Fuel the body muscles
•    Metabolize fat and carbohydrates
•    Increased clarity
•    Transport gases across cell membranes
•    Strengthen our immune system
•    Manufacture hormones and proteins
•    Remove viruses, parasites and harmful bacteria
•    Keeps the heart pumping and healthy
•    Incites the lungs to breathe
•    Allow the nerve system, and all other body tissues to function normally
Increasing your oxygenation levels and being fit and healthy has shown to be important for your health as optimum oxygen levels can improve wound healing, vision, mental clarity and intelligence, boost your immune system, help fight cancer cells, reduce stress levels, improve your heart and respiration and help you to lose weight.
For those people who use supplemental oxygen at home there are also long-term benefits:
•    Prolongs life by reducing heart strain
•    Decreases shortness of breath
•    Makes exercise more tolerable
•    Results in fewer days of hospitalization
•    Improves sleeping
•    Improves quality of life
Additional Benefits of Oxygen:
With increased oxygen levels the red blood cells can become fully saturated to provide their maximum potential of oxygen to our cells. Waste gases and toxins are removed more efficiently and cells can perform optimally. Many viruses and bacteria are anaerobic and cannot survive in oxygenated conditions. Oxygen can help build persistence to infections as it not only boosts the immune system but prevents anaerobic organisms from thriving. Oxygen also helps to neutralise acids such as lactate acid which builds up from high-working muscles. It improves wound healing by generating capillaries to grow into the wound to provide blood flow and oxygen to the injured cells to boost regeneration. It generally boosts all chemical pathways in our body and we can burn more fat. We feel better, our body is healthier and we think more clearly because of increased oxygenation.
Recent research has also discovered other benefits:
•    Removes free radicals
•    Reduces tissue swelling
•    Increases energy metabolism in the brain
•    Can create sustained cognitive improvement
•    Wakes up idling brain cells that are metabolising enough to stay alive but are not actively ‘firing’
•    Deactivates toxins and poisons (e.g. side effects from some chemotherapy, spider bites, air pollution, etc.)
•    Enhances wound healing (stimulates new capillaries into wounds)
•    Acts as an anti-inflammatory
Oxygen is required for nearly every mechanism within our body and by ensuring your body has the optimal levels of oxygen will improve your general medical health and well-being.
Too much oxygen however has a negative impact on our health which is why supplemental oxygen needs to be prescribed and regulated by a doctor to ensure that no oxidative stress occurs on the body which could lead to heart and respiration problems and necrosis.

Tips For The Use Of Supplemental Oxygen

Health Tips:
Jogging_Woman_in_GrassImage Reference Female Jogger on Coleman Avunue in Morro Bay, CA 5-2-07 – Photo by Mike Baird Canon 20D 100-400mm IS lens handheld from an outrigger canoe.

Below are some practical tips to aid in improving your health if you need to use supplemental oxygen at home.
1.    Live on the first floor. If you’re moving or if you can alter your home set-up, opt for a bedroom on the first floor as taking the stairs is good exercise.
2.    Buy safe shoes. Whether you’re relaxing at home or getting some exercise, comfortable, supportive, lace-up shoes are a sensible purchase. Wear a shoe that’s going to be good for balance and ensure foot and joint support. Not sandals or flip flops as these are not good for balance or grip.
3.    Pick up clutter. Older people are at a greater risk of tripping over clutter due to a decreased ability to stay balanced but also you should keep walking paths clear so that oxygen cords don’t get tangled up.  Besides clutter, throw rugs are a tripping hazard and should be removed.
4.    Walk slowly and steadily rather than quickly or at various speeds. Pacing yourself can help retain both your energy and your stamina.
5.    Do necessary tasks and harder chores at whatever time of day you feel is your best breathing time, so you may need to adjust and do certain activities at new times.
6.    Rest when you NEED to rest and don’t force yourself to overdo things.
7.    Buy yourself a grabbing device for picking up things from the floor and for reaching items on high shelves. Activities that require you to bend over or to raise your arms above your head will make you more short of breath.
8.    Use water-based lubricants to help soothe your skin. Oxygen may dry out your skin, mouth, or throat so you can use gauze to prevent your ears or cheeks from becoming sore and water-based lubricants on your lips and nostrils to prevent dryness.
9.    Wear oxygen during activities. Many people tend to take off their oxygen when they climb stairs or walk to the post box, but these are the times when your body needs oxygen the most. You can use a portable oxygen pack that you can switch to but return to the concentrator when you have finished your task. If you don’t wear the oxygen then you’ll become exhausted and put yourself at greater risk for injury.
10.    Take your oxygen into the shower. Many people don’t realize that they can wear oxygen while bathing and doing so can help you avoid fatigue while you complete what could be a strenuous task and make it safer, too. You can put a fan in the bathroom as it can be difficult to be closed up in a hot, humid bathroom. Keep the door open if you can, use a fan to blow air out, and crack open any windows to help you breathe easier. You can buy a shower chair, which will allow you to sit down while you bathe, helping you to conserve energy and avoid falls. You can also install a detachable shower head, which is very helpful because you won’t have to hold your arms over your head which is a tiring position that also disturbs your balance in the shower. If it has a long, flexible arm it will make it easier to reach all of your body parts with less exertion.
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Practical tips using oxygen

Tips For The Use Of Supplemental Oxygen
Practical Tips:
1.  Keep away from any flame or spark such as gas stoves, fireplaces and candles. Even electric razors can cause sparks so do not use your oxygen whilst shaving. Oxygen isn’t flammable but it is combustible and can aid in the starting of a fire.
2.  Do not allow any smoking anywhere near. Some people put signs up in their homes for visitors to let them know.
3.  When cooking try not to wear loose fitting clothes and stay as far away from the heated surface as possible.
4.  Avoid using any aerosol products as they can ignite in the presence of a spark.
5.  Do not allow flammable liquids to get on your clothing or body as unless washed thoroughly, these could become a hazard.
6.  Do not place your oxygen concentrator in an unventilated area, such as a closet. Not only does the concentrator generate a lot of heat but it uses the surrounding air to produce oxygen so the oxygen in the atmosphere will quickly become depleted in small spaces.
7.  Secure all cylinders to prevent them from falling over. A falling oxygen cylinder can cause damage to the valve, releasing the pressure, which may cause it to become a dangerous projectile.
8.  Call your electric company to inform them that you are using oxygen. Firstly some electric companies have a program that allows a reduction of your rates to help lower the cost of running the air concentrator. Secondly, they will generally put you first in line when restoring power after an outage. They may also be able to provide specialist adaptors or devices to aid you with your mobility and medical equipment to make life easier.
9.  Oxygen hoses can be a tripping hazard so try to have your concentrator in a position for maximum mobility but also where the hose will not cause you or others to trip. Use a coloured hose to make it more visible.
10. Keep the hoses clean and replace on a regular basis. Make sure the filters are replaced regularly, wipe it down with a damp cloth to remove dust and clean tubing to prevent mould if you use water to humidify your oxygen.
Ensure you have an emergency plan arranged in case there is a power outage.
•    Inform your power company that you are oxygen-dependent. Many companies offer oxygen-dependent patients priority service and will inform you of upcoming maintenance/outages and ensure your power is restored as a priority.
•    Collaborate with your oxygen supply company. Ask them to help you determine exactly how much oxygen you will need in case of an emergency power outage. They may also provide you with an emergency cylinder.
•    Contact your local police and fire departments to let them know that you are oxygen-dependent.
•    Talk to your doctor about reducing your oxygen flow rate during an emergency. This may help buy you some time and extend the life of your oxygen supply.
•    Consider installing your own emergency generator, especially if you live in a remote location.
•    Organize a support team of family or friends whom you can call in case of an emergency.
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Your Relationship With Your Oxygen Therapy

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.
Functional 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.
Health Management
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 Management
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)
Symptom Management
The realisation that in most cases oxygen therapy helped to alleviate symptoms which resulted in a greater adherence to the treatment.
Management Balancing
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.
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FAQ's on supplemental oxygen


Why did my doctor prescribe oxygen for me?

Every body needs oxygen to survive. Every tissue and cell in the body needs a constant supply of oxygen to work properly.

The lungs breathe in oxygen from the air, then passes the oxygen into the bloodstream through millions of tiny air sacs called alveoli. Haemoglobin in the red blood cells then picks up the oxygen and carries it off to the body’s tissues and cells.

Lung disease can cause inflammation and scarring in the alveoli. This inflammation and scarring makes it difficult for oxygen to move into the bloodstream. Therefore, the amount of oxygen in the blood drops, and the body’s tissues and cells don’t receive enough oxygen to keep functioning properly. Not enough oxygen in the bloodstream is called hypoxaemia.

Many diseases affect lung capacity and breathing and if your disease has progressed to a point where breathing is becoming increasingly difficult and you’re suffering from hypoxaemia then your doctor may decide to start you with a prescription for supplemental oxygen.

How did my doctor determine that I need supplemental oxygen?

This will be determined by measuring the levels of oxygen in your blood. The amount of oxygen in the bloodstream can be easily measured in two ways:

  • Oximetry — A small, clip-on device shines a light through your finger or earlobe and measures the amount of light absorbed by the haemoglobin in the red blood cells. By calculating the amount of light absorption, the device can measure the percent of haemoglobin that is carrying oxygen, this result is known as the oxygen saturation of the blood. Normally this is around 95 to 100 percent.

  • Arterial blood gas study — Blood is drawn from an artery, usually in the wrist, using a needle and syringe. The blood is then sent through an analyser to measure the amount of oxygen gas dissolved in the blood. This result is called the arterial oxygen pressure, and is normally 80 to 100 mm Hg.

Cells and tissues cannot save up a store of oxygen, they need a constant steady supply. When the oxygen saturation falls below 89 percent, or the arterial oxygen pressure falls below 60 mmHg, whether during rest, activity or sleep, then supplemental oxygen is needed.

Your doctor can determine your supplemental oxygen needs by testing you while you are at rest and while walking, and can also order an overnight oximetry study to test your oxygen saturation at night.

When and how often do I have to wear my oxygen?

Your doctor will write a prescription for when and how much you should wear your oxygen, based on the results of your tests. The prescription should specify the following:

  • The appropriate oxygen flow rate or setting, expressed as litre flow of oxygen per minute that will keep your saturations at or above 90 percent

  • When you should wear your oxygen (during activity, overnight or continuously)

  • The type of equipment that you can use that will meet your lifestyle needs.

Why would I need to wear oxygen while sleeping?

Oxygen levels in the blood are naturally lower during sleep, due to a slightly reduced breathing rate and a reduced requirement by your body for oxygen. Also, some alveoli drop out of use during sleep. You naturally have a lower rate, however if your levels are already low as a result of your condition then they may faller dangerously lower during sleep.

If your waking oxygen saturation is greater than about 94 percent on room air, it is unlikely that your saturation during sleep will fall below 88 percent. However, your doctor can order an overnight pulse oximetry test if there is a question about your oxygen levels while you are sleeping.

How do I know that I’m using the right amount of supplemental oxygen?

To determine this your oxygen saturation must be measured while you are using your oxygen. Your doctor or a respiratory therapist from the oxygen supplier should test your oxygen saturation on oxygen while you are at rest, while walking and, if indicated, while you are asleep. As long as your oxygen saturation is in the 90s, you are getting the right amount. 

Should I buy my own finger oximeter to test my oxygen saturations?

Some people feel more comfortable testing their own oxygen saturation throughout the day or during various activities, to make sure they are at least 90 percent saturated.

Finger oximeters are available on the Internet, through medical supply companies and even in sporting goods stores. They can be expensive however and have not been adequately tested for accuracy. You can speak with your doctor who can determine if a finger oximeter is necessary.

How will using supplemental oxygen benefit me?

A lack of oxygen to the body can result in damage to your organs, especially the brain, heart and kidneys. Wearing supplemental oxygen keeps these organs healthy. There is evidence that, for people who are hypoxaemic, supplemental oxygen improves quality of life and survival time.

Supplemental oxygen can also help relieve any symptoms from your disease. It can help relieve you from shortness of breath, fatigue, dizziness and depression. You may also be more alert, sleep better and be in a generally better mood. You may be able to do more activities such as travelling and generally feeling more mobile and able to get around and take part in hobbies.

Does my need for oxygen mean that I don’t have long to live?

People live for years using supplemental oxygen but it will depend upon the progression of your disease and other complicating factors.

How long will I need to use supplemental oxygen?

That depends on the reason oxygen was prescribed. If your lung or heart condition improves, and your blood oxygen levels return to normal ranges without supplemental oxygen, then you don’t need it anymore. 

Can I become addicted to oxygen?

There is no such thing as becoming “dependent on” or “addicted to” supplemental oxygen, everybody needs a constant supply of oxygen to live. Your haemoglobin or cells wont adapt or structurally change in response to a constant higher supply of oxygen. They just use whatever oxygen is available to them.

Does supplemental oxygen cause side effects?

It is important to wear your oxygen as your doctor ordered it. If you start to experience headaches, confusion or increased sleepiness after you start using supplemental oxygen, you might be getting too much and need it to be altered.

Oxygen settings of 4 litres per minute or above can cause dryness and bleeding of the lining of the nose. A humidifier attached to your oxygen equipment or certain ointments can help prevent or treat the dryness.