Help-Oxygen Question

[Debi]

Wasn't sure where to post this, feel free to move if necessary...

I went to the Pulmonary Specialist here in town for occasional SOB I've been having. Well, he ran tests, and one of them was an overnight thing where I had a monitor and had to wear one of those things on my finger that measures oxygen in your blood.

Well, the night I wore it, I kept waking up, and every time the O2 level was between 94 and 97. Any time my 02 has been measured since my surgery, it has been in the high 90s, including during a 6 minute walking test last week when it stayed at 98% for most of the time. Today the doctor told me that my pulmonary function results are great, but almost as an afterthought he said that I could benefit from having oxygen at night.

He said during the overnight test, my O2 was in the 90s but registered 88%, 1% of the time. By the way, when I originally had to schedule the test, I had to pick from one of 3 local oxygen companies - I didn't have a preference so the doctor's office just called one of them. When they called me to bring the stuff by, I had asked if my insurance covered it and the provider said it was complimentary, because if I needed oxygen, they would be the one who 'acquired' me.

Okay, so I'm paranoid and hate the limited possibilities of medical care in this town. I just keep thinking this is some sort of scam to get insurance money and kickbacks. (Incidently, while I was in the waiting room today, one of the providers stopped by with a bag of fresh vegetables for the nurses and asked if they had any 'new business' for them.)

All that said, is this normal practice of oxygen providers-providing free equipment for overnight screening in return for your business if you need oxygen? And do you normally need oxygen if you reach 88% oxygen level for 1% of 8 hours, which would be about 8 minutes if I'm figuring correctly. And can somoeone get used to oxygen and need it more?? Do I really need oxygen do you think?? And yes, you can tell me, I value all your opinions much more than I value this doctor's opinion.

Within 15 minutes of leaving the doctor today, the Oxygen provider place was calling my cell phone. I told them I would get back to them.

[Connie B]

"Debi"]

All that said, is this normal practice of oxygen providers-providing free equipment for overnight screening in return for your business if you need oxygen? And do you normally need oxygen if you reach 88% oxygen level for 1% of 8 hours, which would be about 8 minutes if I'm figuring correctly. And can somoeone get used to oxygen and need it more?? Do I really need oxygen do you think?? And yes, you can tell me, I value all your opinions much more than I value this doctor's opinion.

quote]

I just completed Respitory Physical Therapy. WOW, what a SCAM!! WOW! WOW! WOW! Your oxygen level always goes down when resting or sleeping. Mine even went down during excertion, which also is common. I am very very sceptical of what they are doing with you. I would talk to your Pulm Doc. My levels during the treadmill tests were 89 to 95 range. They said it was normal. They also told me or taught me that drinking water will help bring those levels and your blood pressure levels up. That was true because we did it.

I don't know Deb, but it all sounds fishy to me. I can and will ask my RT's or I will share this post with them.

[cindi o'h]

Deb,

Did your doc ask about a sleep study? If you are apnetic?

The suppliers are competitive, for sure.

What does SOB during the day have to do with nighttime depravation? When are you SOB or Air hungry?

Cindi o'h

[Donna G]

If it is only at night when sleeping , I would think of Sleep Apnea . Perhaps you need a C-pap machine not oxygen. Your need for Oxygen increases with exertion and activity not with rest and sleep. I bet it is more a relaxation of your airway that a C-pap would help.

Donna G

[Snowflake]

Debi,

If it's apnea, you do NOT need oxygen. You would get an A-PAP or C-PAP machine that has a mask that goes over the nose. It forces you to breathe, but it does not supply oxygen, just air from the room.

Not sure what I would make of it, my O2 levels are high 90's but I don't know what they are when I sleep (and if I did know, I wouldn't be sleeping, ya know?).

When the vultures start circling around the money, it's time for another opinion....

[cindi o'h]

I forgot to add, Deb, that in the State of Minnesota, there are regulations preventing referrals from a doctor directly to a supplier. The orders must come from a physician, but it is the patient who must choose a provider of the service to prevent just what you are questioning.

Cindi o'h

[Frank Lamb]

Debi,I was on O2 24/7 for a long time after surgery.I was finally able to get to where I don't need it in the day time.However when sleeping I drop below 80% 7 or 8 times a nite.I now use a machine that takes the room air and converts it to medical grade O2.They say it doesn't stop sleep apnea but it makes it easier to recover from it.

When using that fingertip machine anything below 88% is usually cause for O2.However the only true way to get your oxygen saturation in the blood is to have a test where they stick a needle way down deep in your wrist.I think it's called a gas or gash or slash test.(I don't always hear well).I believe it has to be above 75%.

By the way,when we go away now I don't use any O2 when sleeping.I haven't died from it yet.

I think you are fine without going thru the hassle of having to use O2.But I am not a dr.

[kamataca]

Mom started with one O2 company here in OKC. They had all the paperwork, etc. and it was no cost to her. They were great and we had no complaints with her.

When we found out about the Inogen One, and her ability to use it on airplanes (mom is on hers 24/7) we changed to 'another' O2 company that carried Inogen. They filled out all the paper work for us, and everything is still free for Mom. The first compny wasn't too happy, and Mom felt 'guilty' for changing (I'm sure this was their hope), but we told her it was just business.

My point is, we were able to change at any time, and of course the second company did ALL the paperwork, filing with Medicare, etc. for us. If it is all free for you, I guess having the O2 around wouldn't be a problem. I do agree that if the problem is apnea, you should have that addressed. Of course, Mom has that as well (she's a tricky ol' bird) so she has a C-PAP machine.

Good luck with dealing with all this! Scams abound in the medical world, don't they? I always wonder if I'm being prescribed the best meds for me, or just the ones with the best pharm. rep kickbacks!

Kelly

[marym]

Hi,

I don't know much about oxygen - but ask the doctor what are the measurements - like is 90 to 100 no problem and 80 to 90, minor. He should have some type of guidelines that say what is needed when. Ask him what if you decide to postpone this at this time?

I certainly agree that scams make us all pay more for insurance - which is already incredibly high. On the other hand, I do not want to do without something I need.

I also don't want to become dependent on anything that is not absolutely not needed.

Good luck. I would be interested in the guidelines he offers.

Mary

[Linda661]

Debi:

I'm no doctor either, but your O2 sats sound like a dream compared to my mom (she needed O2 24/7) -- she'd go down into the low 80's or 70's without it, no matter what she was doing. Sounds iffy that you'd need it, but couldn't hurt to have available with occassional SOB issues -- one night of testing isn't much of a sample of what you may actually be doing over time. Would they have you use it every nite, need it or not, or just when you feel SOB (recovery aid)?

With those sats it really doesn't sound like an apnea problem either -- people stop breathing numerous times a night with apnea. You'd need to go to a sleep lab for that to really be diagnosed.

Ask the pulmonologist about the O2 dependence question -- I am aware that O2 settings and use needs to be monitored and too much isn't a good thing, but I don't have the details on it -- I just got looks from nurses with mom's settings and they'd warn me all the time that we should not be changing settings on our own (we never did that anyway).

Linda

[Don M]

Debi: you don't need it.

don M

[cindi o'h]

Don M, you are a gift!

Cindi o'h

[dchurchi]

Debi,

Alan is much like Frank. He was on O2 24/7 and now

just uses it at night with a big machine that converts room air.

Alan will go out of town for a few days and does not

use the oxygen and like Frank he is still alive and

kicking. Alan's oxygen is put through our insurance

company, so I can not respond to the "free" oxygen.

Hope everything works out.

[teresag]

I'm with Donna G. Sounds like sleep apnea to me. Many people have it; it is characterized by intermittent cutting off of the airway and decreases in oxygen tension during the night. Symptoms include morning headaches and sleepiness during the day. Risk factors include obesity and drinking alcohol before bed.

An oxygen saturation (the figure measured with the clip-on finger thing) in the 80's is not normal. In people with chronic lung disase, an oxygen saturation in the high 80s may be considered "tolerable," but it is never normal. Healthy people are above 93-95% all the time.

Just in case you are wondering what that nifty red light is measuring, it's recording how much of the red light is absorbed by the fingertip, earlobe, or whatever, and that corresponds to the % of hemoglobin in the blood that is saturated, meaning carrying all the oxygen it can. A person with a normal level can still be short of oxygen, however, if the hemoglobin level is low.

[luvmydog2]

Gosh Debi. I hate to hear all of this. I thought that you were rebounding great from the surgery. I would think another opinion is in order. I have never used oxygen except in hospital (and then I'd pull it off at night). Sounds like Sleep Apnea to me. My O2 level is also in high 90's. I do know that when I did the 6 minute walk, the nurse had to tell me to shut up cause it messes up the level. Yep. She told me to shut up. As far as sleeping level, I am like Becky...I don't know. Anyway, I hope you get over the SOB soon.

[nonni]

Hey Deb

I think this "dude' is talking out of both sides of his face.."Your test was great ...but"

...come onnnn.....I like Don M's answer..."you don't need it'...

You...yourself would know if you needed it...now if it presist's...different story...but it alway's drops at night...Mine did in the hospital after surgery and when the morning of release came...the nurse said...'you may have to have some oxegen for a while'.

The surgeon came in and said..

"no way"....

Anyway bottom line...if you wouldn't talk so much you wouldn't be getting SOB...

...love ya Deb

hugs Pam'

[rvillella]

My surgeon was worried because at night my breating would slow considerably and he felt I needed to have supplemental oxygen. That way my levels wouldn't drop below 88%. That was the magic number for the VA here in Albuquerque. The big difference is that I had a lung removed and they felt that way.

Ralph

[Andrea]

Before I read the responses by others, sleep apnea popped in my head. My mom has it.

Just FYI, at first she was sooooo resistant to the c-pap mask at night, now she can't sleep without it.

[Debi]

Thanks for all your replies, they really mean alot to me and have given me food for thought, keep them coming...

Bruce, don't waste your worry, I am rebounding well, I'm just confused over the oxygen issue. I sort of brought this on myself since there are times I am slightly out of breath and thought that I should have a Pulmonary Function test since I hadn't had one since surgery, I was more curious than anything on what my breathing capabilities were (I seem to remember something about curiousity killing a cat ...)!

Its not like I am waking up gasping for breath or anything, sometimes it just feels 'close', like there is not enough air circulating, and this can be anytime. Of course the fact that its about 105 degrees out and I am carrying around extra weight doesn't factor into my breathlessness...

Very minor stuff, I don't want anyone to think that this is anything major..I just have issues with medical care here and the fact that I really don't feel like I need oxygen...

I just badly needed advice and always know where to come to get it.

[Donna G]

Another question. Do you take meds before going to bed? Sedatives, pain meds , sleeping pills. Perhaps these are affecting your rate and depth of breathing.

Donna G

[Kasey]

Missed this somehow, Debi...sorry. BUT I have no idea anyway about the necessity for O2. I have learned a lot from this thread though, like I always do from all the experts here. I'm guessing you most likely do not need it. But now I am curious about my own levels...........see what you've started???? Make sure you let us know what you decide to do.

Kasey

[chloesmom]

Debi,

I might run that past another one of your doctors if I were you. You certainly don't seem like someone who would get any benefit from oxygen. Maybe this is some kind of come on.

Cindy

[blaze100]

Hi Debi, Do you hear any "snap, crackle and pop" in your lungs at night? It could be fluid build up in lungs causing sob. Could be something to do with heart.

I guess I am extra sensitive to heart issues now since my right coronary artery was completely blocked. I got that reopened and much of my sob went away immediately.

Barb

[Debi]

Donna,

I take no meds, except Lasix (sp?) in the morning to help with slightly elevated BP.

Barb- they also did an ultrasound of my heart to rule out heart problems (although I had a stress test not long ago that was okay). However, the doctor never mentioned the results the other day and when I asked for them, he couldn't find them. They called over to the medical center that did the ultrasound and found that they are still in the Dictation Department- apparently the transcriptionist must have had some days off since Friday was 9 days after the test .

So, I'll be calling back to get those results sometime this week..

[Welthy]

Debi,

We've had too much experience with oxygen for my husband's taste, so here is our take on the subject. Sounds a little hinky to me. Most lung specialists have their own testing equipment. Most insurance companies have defined blood/oxygen percentages that they will cover home oxygen for. On Medicare (I know you're not on that!!) coverage starts when you are below 90 without oxygen. Tony has had a concentrator in the house since diagnosis. (I can always tell where he is by following his 50 foot hose. He calls it his leash!) He also has a portable pulse activated conserver system with a small tank for when we go out. He hasn't always needed oxygen during the day -- just depends on where he is at with the mix of fluid, cancer, chemo, etc.

Nights are a different matter. He took the sleep test you did and the minute he dozed off the machine's alarm went off indicating he had fallen to 86. Apparently the alarm went off all night, but we hit the silence button to get the sleep he needed. We turned in the machine the next morning for evaluation and got a call back that he had totally "flunked" the test. Oxygen ALWAYS at night. Not an apnea issue. We were already set up at home, so there were no referrals.

Being on oxygen won't hurt you though if your insurance covers it. Being WITHOUT oxygen if your counts do drop at night WILL hurt you. We just had a discussion with the lung specialist about that topic. She said that even if you don't feel winded or sluggish, you are harming your organs when you don't use oxygen if your counts are low. I figure patient's bodies can use all the help they can get to fight this disease, so why starve your organs? We take our concentrator with us or rent one wherever we go.

For what it is worth...

Welthy