Supplemental Oxygen: Taking the First Steps

March 19th, 2014 | Author: COPD Coach

Dear COPD Coach

I was diagnosed with COPD about 5 years ago.My doctor has just prescribed the use of supplemental oxygen.What do I need?

Looking to Breathe

Dear Looking,

The first thing you need to do is to discuss with your doctor what type of delivery system is best for you.This discussion should include addressing your needs not only at home, but also what you will need when you’re out and about.Make sure you document your discussion.



Your doctor will provide a certificate of medical necessity, saying that you require supplemental oxygen, and what equipment you will need.Make sure this certificate of medical necessity contains all of the items you discussed.

Your second step is to identify an oxygen supplier that is able to address the needs set forth in the certificate of medical necessity.Know that your oxygen supplier is not your doctor and cannot make decisions about the type of equipment you require.Only you and your doctor may do this!

Once you are provided equipment, you generally cannot change the type of equipment or type of delivery system for a term of five (5) years. Therefore, it is important that you choose the type of equipment and delivery system that will work best for your lifestyle!Note: If your oxygen requirements change, or your doctor feels you require different equipment or delivery system, your certificate of medical necessity should be changed.With a new certificate of medical necessity your oxygen supplier is obligated to provide equipment that fits that need.

There are two main types of supplemental oxygen, also called “modalities”: gaseous and liquid. There are pros and cons with each system as well as different variations.

In the past, many oxygen users were given both a home concentrator (for use while at home) and an “E” cylinder (for going out). The problems with this arrangement were that it required users to pull the cylinder behind them when venturing outside their home. A user’s mobility was limited to the length of their oxygen hose inside the home, making some areas inaccessible.

A recent advancement is the development of “transfill” units. In this system, gaseous oxygen can be produced in the home by a concentrator and stored in a refillable cylinder.These cylinders (“M” tanks) are small, light, and can easily be carried in a shoulder case. The length of time these smaller tanks last varies on your liter flow and the amount of pressure the cylinders are filled with.Note: some transfill units will fill at 2000 psi (pounds per square inch) while others f

ill at 3000 psi. The higher pressure provides greater capacity. This system provides you with greater mobility outside as well as inside your home and eliminates your need for frequent replacement tanks. The entire system is transportable if you need to leave your home for extended periods.

The other modality is liquid oxygen, a popular option with higher liter flow users. In this system, the oxygen is stored in liquid form in a home reservoir which must be filled on a

regular basis.You are able to use the reservoir much like the concentrator, using it to fill smaller reservoirs for greater mobility inside or outside the home. These smaller reservoirs offer longer use times even at higher liter flows. The other advantage of this system is that it is not dependent on electricity like a home concentrator. This means that oxygen use will not add to your utility bills and you will continue to have oxygen during power outages.

The main disadvantage of liquid oxygen is that the reservoir cannot be transported with travel (unless your oxygen provider allows you the use of a travel reservoir), so you must make arrangements to have a reservoir in place at your destination.  Note: In many areas it is very difficult to obtain liquid oxygen. Check with suppliers in your area before deciding on liquid oxygen to make sure it is available.

Be sure to discuss all of these options with your doctor!

-The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice.

If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.


What is COPD? Share Your COPD Knowledge

March 17th, 2014 | Author: Katelyn Turner

You know the stats:

  • COPD is the third leading cause of death in the U.S.
  • 24 million Americans have COPD
  • 12 million Americans remain undiagnosed
  • COPD takes 1 life every 4 minutes

We’ve taken the stats you know about COPD, and put them into an easy-to-understand video, intended to encourage individuals to get their lung health tested through our 5-question Risk Screener.

We ask that you share this video with your colleagues, friends, caregivers, spouses, family members, neighbors–anyone you think it would help. Education is key to the management and treatment of COPD.

To learn more, please visit the COPD Foundation website, or call the C.O.P.D. Information Line at (866) 316-COPD (2673).

Shaming and Blaming

March 7th, 2014 | Author: Fabiana Talbot

The dreaded question for individuals living with COPD is “Did you smoke?” So much is insinuated in three simple words, and so many in our community have to withstand the stigma associated with the disease.  All too often, people with COPD are afraid to reach out for help, let alone raise awareness for the disease, because they believe in the end they will be shamed and blamed for smoking.

Smoking does cause 75% of COPD – but did you know that 25% of COPD patients have never smoked? Environmental,

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occupational, and genetic factors also cause respiratory diseases.  If you did or do smoke however, know that you are not alone. If you feel stigmatized for your condition, just reach out to our COPD community on Facebook or call the C.O.P.D. Information Line at 1 866 316 2673. What is important now is not to look at the past with regret and shame, but to the future with strength and hope. No one has the right to take that away from you.

This leads me to a piece of news that broke this week. Online news site, Mail Online, reported that late actress Shirley Temple Black was, “…a secret smoker who died from lung disease.” When she passed last month, her family did not disclose COPD as the cause of death, perhaps out of fear that she might be stigmatized for smoking.

This is just one example of an individual who had to live in silence about a disease that is the third leading cause of death in the United States. We hope those living with COPD today will come out of the shadows and help educate others about the nature of the disease. We believe the “shame and blame” culture will decline over time with greater awareness and education about the disease.

We are proud of all of our community members who speak out about COPD, and have the courage to stand up to those who may judge and marginalize us.

Have you been “shamed and blamed” for developing COPD? How did you deal with it? Please share in the comments section.


Oxygen Use and Huge Electricity Bills

March 3rd, 2014 | Author: COPD Coach

Dear COPD Expert,

I use a home concentrator 24/7. Since going on oxygen I have noticed a huge increase in my electricity bill. So, here are my questions:

  1. Will Medicare pay for the electricity used by my concentrator?
  2. How can I get help paying for the electricity used by my concentrator?
  3. Is there anything I can do to run my equipment cheaper?

Cost Conscious

Dear Cost Conscious,

The answer to your first question is: Medicare has no provisions to pay for the electricity your concentrator uses. The oxygen user is responsible for all utility costs related to their equipment!

The answer to your second is a “maybe” followed by a “probably not.” Some utility companies do have programs that address this, but it varies by location. It would be best to contact your power company and explain your situation and ask if they have a payment assistance policy or program that might help you. They might also know of other agencies that may have utility assistance programs.

Your electricity costs related to running your concentrator may be tax deductible as a medical expense. Whether or not you can use this deduction would depend on your income and other deductions. In order to figure out how much to claim (and also determine the actual costs you are incurring) you can use the following formula:



First, check the label on your concentrator which gives you the volts and amps your unit uses. Let’s say that the label says 115 volts at 6 amps. Next we take 115 volts times 6 amps which equals 690 watts. Now we figure out the kilowatt hours. We take the wattage (690) multiplied by .001 KW/W which equals .69 kilowatts. Next we figure out the number of hours you use the concentrator. So if you use your concentrator 24/7 that would be 365 days times 24 hours a day for a total of 8760 hours. We multiply .69 KWH time 8760 which equals 6044. We then ask the power company the cost of electricity by kilowatt (let’s say .12 cents. We take that figure and multiply by 6044 and our yearly cost of running the concentrator is $752.28.

As to your third question, you can’t do anything that would make the equipment use less electricity. You can however try to lower other costs in your home that might help in absorbing the additional costs as a result of your concentrator:

  1. Change all of your bulbs to LED. These use a fraction of the electricity for the same amount of light
  2. Keep all non-essential electrical appliances unplugged when not in use. This includes chargers, satellite or cable boxes and TVs. These use a lot of electricity, even when they are not in use because they run on “standby.”
  3. Turn out lights as you leave the room.

Granted, these measures will not make a huge difference, but they will help. Another suggestion is that before getting a new concentrator, do your homework and find one that runs the most efficiently. Selecting one that uses less kilowatts could make a substantial difference in your electric bill. Use the formula above to compare what each model would cost.

Hope this helps,

The COPD Expert

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice.

If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.

Maintaining Your Portable Oxygen Concentrator

February 13th, 2014 | Author: COPD Coach

Dear COPD Coach,

I recently purchased a portable oxygen concentrator. As you probably know, it was an expensive purchase. It is very important that it last for a long time because I will be paying for it for a long time. What advice would you give to make it last?

POC Buyer

Dear COPD Buyer,

I was very happy to find your letter as it addresses a very important topic. As you said, the purchase of a portable concentrator can be an expensive proposition for many, and there are some definite things you can do to help keep it in good shape.

Here are some basic tips:

  1. The unit and supplemental battery must be immediately charged after each use. Do not allow the unit or batteries to remain uncharged for any length of time.
  1. The unit must not be exposed to any environment with tobacco smoke, wood smoke, or chemical fumes. APK1TE_home-oxygen_342x198The unit will pick up the odors and it is next to impossible to clean the order out!
  1. The units are fragile. Do not drop or handle roughly! Take particular care in plugging in the AC adapter and your cannula, as these connection points are easy to break!
  1. When you clean the unit, use a slightly damp cloth, and do not use strong cleaning products on it.
  1. Check your manual to see where the filter is located, and if the filter is able to be cleaned or replaced. In either case, follow the manufacturer’s recommendations on cleaning and replacement.
  1. Keep the unit stored in a safe and clean location

The most common things that go wrong with concentrators are:

  1. Batteries. The batteries are only good for a certain number of charges before they start to lose their capacity. If your batteries are not lasting as long as they once did, it is time to consider replacing them. External batteries can be purchased from your original supplier or elsewhere on the internet. Some units have internal batteries, and these must be replaced by the manufacturer. Batteries can be very expensive, so it might be a good idea to start putting aside some money for their eventual replacement. Most portable concentrator companies provide only a one-year warranty on batteries. By keeping the batteries charged when not in use, you will greatly increase their lifespan!
  1. Sieve Beds. The sieve beds are the part of the concentrator that removes nitrogen from the air and allows you to get close to pure oxygen. Over time, the sieve beds can become saturated and might require replacement. This will usually be indicated by an alarm message from the concentrator. If you send your unit in for battery replacement or any other fault, ask them to check the sieve beds, and if necessary recondition them.
  1. Broken connections: As mentioned earlier, the nozzle where your hose plugs in is often easy to break, as is the plug for the AC adapter. Take your time plugging in!

Other than the batteries, most concentrators carry at least a three-year warranty.

I hope this answers your question, and please accept out best wishes for continued activity and better breathing!

The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice.

If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.