Dear COPD Coach,
I am a 68-year-old woman with Stage 4 emphysema. I work full-time in a sedentary job. I use 2-2.5 liters of continuous flow O2, provided by an O2 concentrator, at night and at home when engaging in any household activity. During rehab exercise I am provided O2 by a canister in a carrier on wheels. I have a portable O2 concentrator that is great for overnight travel and airplane travel (which I doubt I will be doing again). However, my pulmonologist suggests that I may want to use O2 for outside-the-home activities like shopping–anything that involves walking more than a few steps. My portable concentrator is heavy and unwieldy to use for short periods of time. My insurance company would probably cover my use of small canisters which could be refilled using my at-home concentrator. But I don’t want a canister. I’d prefer using one of the small, liquid O2, rectangular containers that I see people wearing over their shoulders or like a backpack. I can only find such units online and I’m unwilling to purchase something without seeing it in person and maybe being able to try it out.
Also, I have no idea what they might cost & have been unwilling to communicate with an online provider about cost. I don’t understand the pros and cons of using liquid O2. Where do I start in finding out more about this kind of product?
First of all, I am glad to see that you are still able to work and get around. Your letter actually asks a couple different questions. I will try my best to give you some of the answers you are looking for.
Mobility is increasingly becoming more important for persons with COPD. Many people are being diagnosed at a younger age, and are unwilling to just sit at home.
Before I answer your questions, let’s make sure we understand the difference between continuous and pulse flow with oxygen. “Continuous” is when the oxygen flows non-stop from the device, through the tubing and into your lungs. Whether you’re breathing in or breathing out, or are in between breaths, the oxygen is flowing. “Pulse” flow is when the oxygen comes out of the device and into you only when you take a breath that triggers the device. You can usually hear a pulse device working by the short hissing sound triggered by a breath.
It’s easy to see why a pulse oxygen device would last longer than one that has continuous flow–because less oxygen is being released. Not everyone requiring supplemental oxygen, however, is able to tolerate a pulse flow-it is simply not enough. So for those individuals who are in the process of deciding on which oxygen system is best, they must first know if a pulse flow is enough to maintain adequate oxygen saturation.This is something your doctor determines, based on your oxygen saturation tests.
The problem is that while great strides have been made in oxygen concentrators, there are still not a lot of good options if you require continuous flow. Most of the units offered for continuous flow are large, heavy with a limited battery capacity. Respironics has a new unit out called SimplyGo that offers 2 liters continuous and a pulse setting of 1-6. The unit weighs 10 pounds. The battery capacity is about 4 hours at a setting of 2 pulse and one hour at 2 liters continuous. At 10 pounds the unit would have to be carried on a cart as many will find it too heavy to carry over the shoulder. Still, it is lighter and smaller than most of the other units available and offers you the ability to use it at your destination for use as a stationary concentrator.
Home fill systems are increasingly becoming a viable option for many oxygen users. The bottles filled by the units are generally the “M6” style which are small and can easily be carried on your shoulder. Both Respironics and Invacare produce home fills units. The biggest difference is that the Respironics unit fills the bottle to a higher pressure which gives the bottles a longer duration. The biggest benefit of home fill units is that you don’t need to “budget” your air supply and you don’t have to wait on deliveries. Another feature is that you can still breathe off the concentrators while the unit is filling the cylinders. The bottles generally take between 60 and 75 minutes to fill depending on the pressure the bottles accommodate.
Liquid oxygen systems can be convenient, but they have a few severe limitations. The portable reservoir requires filling from a large tank that is placed in your home. As liquid oxygen has a tendency to evaporate, the home tank must be filled at regular intervals. Taking trips becomes more difficult as you must arrange for tanks to be placed at your destination, and there is no ability to have a spare available unless you also carry an E tank with you. Liquid oxygen reservoirs are prone to freeze up making them at times difficult to fill.However, the biggest problem with liquid oxygen is finding a supplier in your area that can provide it. It is increasingly being phased out due to the high costs of supply and delivery.
With that said, liquid oxygen provides a great deal of mobility for users within its limitations. The portable reservoirs are light, have good capacity, and many people prefer this system over other systems.
Respironics just recently came out with a home fill liquid oxygen system, but I can’t say much about this system as I have yet to test it. I can tell you that the unit has storage capability, and comes with a portable reservoir with pretty significant capacity and only uses electricity to fill the storage tank Still, it is a promising technology as liquid oxygen suppliers become scarcer.
My advice to you is to talk with your doctor to see if you require a portable with continuous flow. There are pulse units out there that are very light with good battery duration. If you want to learn more about any oxygen system, simply talk with the people you meet who are using them. Many oxygen users are very passionate about the oxygen systems they use and are happy to share their experiences. It is important to remember that no one oxygen system fits all potential users. The trick is to find the system that best accommodates your lifestyle and mobility needs!
I hope this has been of some help.
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.
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