One way of highlighting the importance of oxygen would be to quickly outline what our bodies need to stay alive and more interestingly how long we can survive in their absence This list would have the following:

1. Food - You can last a few weeks without any food before dying.
2. Water - A few days
3. Oxygen - A few minutes.

In each of these cases severe bodily damage occurs before death creeps in and this means that in the case of oxygen there is precious little time available before irreparable damage is caused. Oxygen occurs in a natural state in our environment mixed in the air we breathe. At sea level and in the absence of pollution, oxygen represents approximately 21% of the air around us.When our respiratory system is working properly this amount of oxygen is perfect for our health and oxygen requirements. There are however many cases where chronic lung damage is present and a shortage of oxygen intake happens, causing insufficient oxygen saturation. There are various potential causes for this, the most common one is Chronic Obstructive Pulmonary Disease, which in turn is caused mainly by smoking. In these cases long term oxygen is prescribed. (Note: The Federal Drug Administration classifies oxygen as a drug and it must therefore be prescribed).

It is a long term therapy because supplemental oxygen will have to be supplied from that time onwards - it is a “forever” scenario.

The oxygen is delivered directly to the patient through a nose cannula or oxygen mask at a prescribed flow rate and in a much purer form. When COPD is present the lungs have been damaged so the inhalation process brings insufficient oxygen - and the exhalation process does not clear out all the air. Imagine a glass that holds a pint of water, but you can never pour in a full pint as it already has half a pint. You can only drink half of what is there - and yet you need a full pint to quench your thirst. Something similar to this happens with the air and the lungs, and the result is insufficient oxygen saturating the blood.

The way to increase oxygen blood saturation is by supplying an increased amount of oxygen - so instead of 21% pure oxygen in the air that is breathed in, concentrated oxygen at 90% plus is given. Some patients are prescribed with oxygen on a 24 hour basis and others for shorter periods depending on the diagnosis.

There seems to be an increase in the number of people who have to receive extra oxygen. This may be a few hours a day or when exercising or even full time. The projections are that the numbers will grow as the general population gets older. Baby boomers are aging and many have smoked (something?) in the past. In fact many of us have smoked - some more, some less. Some with high levels of health and lung related damage, others with less.

The fact of the matter is that an extremely high percentage of people who need supplemental oxygen do so for a smoking related reason. In many cases they are or have been smokers, and in other cases (and this from every point of view including social responsibility) it is worse as they have been second hand smokers. Not all smokers will need supplemental oxygen but a vast majority (the percentage is somewhere in the nineties) of those who need additional oxygen have been smokers.

As research for this article (not scientific research but simple observation) I was walking the streets of San Francisco and was surprised at the number of people of limited income who were receiving oxygen from small delivery systems. Portable oxygen machines of one sort or another were being used by many more people than I had imagined. One or two were actually stealing a puff or two from a cigarette. Anyway, these units were in general terms unobtrusive and for the most part passed unobserved. Note: Higher income people were not walking the streets at that time.

Aside from the obvious smoking related criticism, the interesting thing that I observed was the quality of the oxygen delivery systems. They were small, easy to carry. Some in small hip bags, others in trolleys and even others in supermarket trolleys with the rest of the owners earthly possessions. They were obviously providing a solution to their owners supplemental oxygen needs.

This, the bringing of a solution to a patients oxygen supply needs, is paramount for all current and future patients on long term oxygen therapy. From the point of view of an individuals health and what can sometimes be seen as even more important, quality of life, being able to breathe with the assistance of a mobile delivery system makes all the difference.

Obviously prevention should be a major factor in any health issue, but it doesn’t eliminate the need to find solutions to actual needs - whatever the origins.

The solutions for those on supplemental oxygen are there - compressed oxygen cylinders, liquid oxygen tanks or oxygen concentrators - and are bound to get even better.

In the long term, and seeing that so much of the need for extra oxygen is smoking related, it must be solved by education. In many parts of the world smoking is now not only frowned upon but actually legislated against. Many smokers are dropping the habit and socially it is no longer acceptable.

However new smokers are appearing constantly on the scene and in large numbers.

And these smokers are not 25 year olds or 40 year olds or 60 year olds. They are our youngsters - teenagers. Those who can’t vote or drink alcohol or have a drivers license. They do know that smoking “can” affect their health, but the “can” disappears under a self justifying “may”, which in their language means “not to me it won’t”.

Education is the only real way to reduce the number of future victims of insufficient oxygen. This doesn’t mean no laws, but that the focus should be on the positive and not on the limiting.

Parents of teenagers know that the peer pressure, the normal process of finding themselves and their limits, will mean a confrontation of some sort with the parent’s - so those who argue: “its the parent’s responsibility” are being simplistic. Our society with all its good things also has many things that limit self development and entice our young into other non- beneficial actions.

We must search for those things in life that motivate us, our young and future generations, to be the best possible “I’s” and “we’s” that we can.

And never doubt for a moment that we can!

When you place these two phrases together, “oxygen therapy” and “quality of life”, it appears that they contradict each other. But many times the normal reaction is to ask the question:

“How can you think of achieving quality of life if you are dependent on supplemental oxygen on a full time basis?”

But is it really a true assumption or even a fair one?

The majority of people who receive long term oxygen therapy will probably agree that when they were first informed that they had to have additional oxygen, they were shocked and felt depressed. This is a perfectly normal reaction.

We take breathing for granted as it is an automatic process and in fact it is when we hold our breath that we have to make a conscious decision. So when we are told that we are incapable of breathing on our own, thoughts of suffocating and living under an oxygen mask and perhaps being bedridden are bound to cross our minds. This logically produces a feeling of despair and dejection. This is normal but it should not be the norm in the long term (or even in the medium term).

One of the things that makes us what we are, human beings, men and women, is that we can choose how we act, how we react, and what we decide to do about it. It is in our nature to make decisions, which is another way of saying we have the freedom of choice. Whatever the circumstances, whatever the trails and tribulations, we can choose how to act. Even if we make the wrong decision, and we do at times, it is still our decision. Attitude is also a decision we take; it is not forced on us by others and much less by circumstances.

So can anyone, or more importantly, can you, have a life with dignity (that spells “quality of life”) even if you are on supplemental oxygen full time?

The answer is yes.

This does not mean it is easy but by the same account, it does not mean it is difficult either. The question should be based on what “quality of life” means to you. We all go through a phase, some never get out of it, where we search for the meaning of life. If life is measured by quantity and by things, as compared to quality and people, then yes it will be difficult to achieve a quality of life because you are dependent on an extra delivery of oxygen.

If, on the other hand, your life is based on quality and people, if the important things in life go beyond the “material world”, then that same oxygen supply and those material things become tools to help you achieve that which is important.

Day to day there will be times of joy and times of ease but also times of difficulty and exasperation. Only you will make the difference, nobody else will. You decide your attitude.

Others may help, and they should be welcome, but the final choice is yours. You will find there are those who will help either directly or indirectly and you can also have the benefits of the new oxygen systems that are making life easier for so many.

A final point, when your thoughts are turned inwards, when you are in an “I” mode, when everything revolves on and around you, then things can get tough - you are highly tempted to feel sorry for yourself.

But if your attitude, your thoughts and your actions are directed at others, then you will find that the quality of your life is good.

Philip Robinson writes on various subjects and one of his health related websites is about Portable Oxygen Machines. For more information on supplemental oxygen resources visit http://www.portableoxygenmachines.net.

Portable oxygen machines and specially portable oxygen concentrators have changed the way many people, who must have continuous or semi continuous oxygen therapy, are now living.

It used to be that mobility for COPD patients was severely restricted. This meant being house bound or overly dependent on a hospital or clinic.

With the advent of much more practical and better quality portable machines, patients mobility has increased dramatically and you can now find people on supplemental oxygen doing many things they wouldn’t have imagined just a few years ago.

This has happened because of the new portable tanks, because of more advanced conserving devices (that regulate the delivery rates) and, perhaps the most important reason of all - the introduction of portable oxygen concentrators.

An oxygen concentrator is a machine that extracts oxygen from the surrounding air, it concentrates it and then delivers it - directly to the patient (in a home concentrator machine it can also be used to refill an oxygen cylinder). At sea level and if air pollution is not an issue, ambient air is composed of approximately 21% oxygen, 88% nitrogen and a smaller amount of various gases. The oxygen concentrator extracts oxygen, concentrates it and delivers it to the patient.

Things You Need To Know:

• You need a power source to operate, which can be both with rechargeable batteries and a plug in option (including for vehicle).
• There is a continuous rumble from the concentrators motor.
• You can adjust the flow level according to your prescription.
• There are different models with different weights the give allow for your mobility.
• Always check your battery durability and as a safety precaution you should have a spare and charged battery.

Portable oxygen concentrators arrived on the scene around 2002 and since then have had a great impact in the portable oxygen delivery area.

The major difference between an oxygen concentrator and an oxygen cylinder or tank, is that the concentrator is not a storage device but a supplier of oxygen. This means that so long as the power source is uninterrupted, oxygen will continue to be delivered for as long as needed. In a tank there will always be the limitation based on the amount of oxygen that is stored, whether liquid or gas.

The new designs have both a direct plug in option (so you can plug them in cars, for example) as well as being battery operated. They are smaller, lighter and therefore easier to carry and have a direct and positive effect on peoples mobility.

It seems as if each new model is smaller and has longer lasting rechargeable batteries.

An important benefit is that they have increased the possibility of travel for patients on extra oxygen, and in fact one of the more important aspects of this is that as of May, 2009, the FAA authorized the use of some portable oxygen concentrators on board airlines that cross US airspace (this means all arriving and departing flights). This change is of great consequence as air travel was a major problem. It is still, however, a good idea to check with your airline before a flight.

Although living and having to depend on supplemental oxygen is not something anyone would willingly choose to do, POC’s (portable oxygen concentrators) have really changed people’s lives. The much greater range of activities that can now be practiced, together with increased mobility in general, have had a very positive impact on long term oxygen therapy patients.

For the many thousands of people who depend on supplemental oxygen it is not something they like or something they had looked forward to doing before they were prescribed with additional oxygen. It is however an ever present fact of their lives.

At this stage wishful thinking is worse than useless - it is an excuse not to accept their current health related situation.

Having said that, for a large percentage of people who live with supplemental oxygen, things are much better than they used to be, and perhaps more importantly, than they had imagined. And this is because of new developments in oxygen delivery systems. The developments that relate to design and technical advances, are much more user friendly.

Today a large, in fact a very large, proportion of patients with chronic obstructive pulmonary disease (COPD) lead much more active lives than they could have twenty or even ten years ago. Home oxygen units were the first major change. Prior to that patients lived with what could be termed as a clinical oxygen dependency. Now home oxygen units are able to supply their oxygen needs with out major problems.

There are three types of oxygen delivery systems for patients that need additional oxygen, and these are:

1. Compressed oxygen tanks -that store oxygen as a gas.
2. Liquid oxygen tanks - storing liquid oxygen tat is then released as a gas.
3. Oxygen concentrators - These are not storage containers but machines that extract oxygen from the surrounding area; the concentrated oxygen is then delivered to the patient.

The result of these developments is that living with supplemental oxygen is much easier than previously and this in a sort of reverse “Catch 22″, means that patients have much more positive attitudes with their overall health status; this in turn gives them the motivation for a more active lifestyle; which makes living with additional oxygen easier - and so on with the cycle.Perhaps the most important advances in oxygen delivery systems is in the portable oxygen area. These same home delivery systems have their equivalent as portable oxygen machines but with the added advantage of design developments that are reflected in size, weight, oxygen durability, and in the case of portable oxygen concentrators, power durability (with both a plug in option and rechargeable batteries).

The ongoing results - ongoing as new and improved models are still coming out - mean that living with supplemental oxygen, though not something desired by anyone, is today much easier and binging with it much greater mobility. This has meant amongst other things that the range of activities available to patients is so much greater that you can achieve a high quality of life in terms of greater freedom and mobility.

As a child I was fixated with Jacques Cousteau, the french marine explorer - innovator - documentary and film maker. And one of the things that always struck me, apart from his accent when pronouncing “Calypso” his ship, was that he had co-developed the aqua-lung. This is the tank contraption that allows divers to breathe underwater with much greater mobility.

A design revolution in its time as it replaced those heavy, cumbersome oxygen suits that were anchored by weights and resembled some sort of deep sea monster from a Jules Verne novel. I always thought of them as the “missing sea link”. They restricted the divers mobility not just because it was difficult to walk under water and therefore the diver could only go down to an accessible depth for walking, but also because air was delivered though a hose connected to an air compressor.

The diver was therefore always connected through a hose to a compressor somewhere above - if something malfunctioned with the compressor…

I suspect that aqua-lungs, developed for our survival under water where we can’t breathe, were the inspiration for the types of oxygen systems that are in use today.

The first portable oxygen units to be made for people who need additional oxygen were in fact tanks filled with compressed oxygen. This was an important innovation as before this patients were dependent on a clinic delivering and supplying oxygen. For those needing oxygen on a full time basis it meant never being able to leave the clinic. A most highly depressing state of affairs.

The good thing about human ingenuity is that when a problem is identified (just a note on a definition of a problem - if there is a solution then it is a problem; if not, it isn’t a problem but a state of affairs that can’t be changed) a solution will be found or developed.

This is what happened for patients who needed oxygen. New solutions were needed and the portable tank, holding compressed oxygen, was made.

Then came a tank carrying liquid oxygen - and this had the advantage of being lighter and holding a much greater amount of oxygen.

Finally during the first decade of this century, oxygen concentrators came into the scene -and the mobility potential they have brought with them represents such a difference in the lives of those who need extra oxygen, that it is hardly comparable.

In the near future there will be more innovations both for tank and cylinder systems and for oxygen concentrators that will be continuously providing more mobility and a higher quality of life. And as always with human nature, the limitations that those before us had to live with will be incomprehensible to us.

But that is good as it means that higher expectations will generate greater results. And perhaps the greatest result these respiratory aids have brought us is a much greater freedom of movement thanks to these portable oxygen machines.

A chronic condition happens and develops over a period of time. For example emphysema - part of the chronic obstructive pulmonary disease set.  An acute condition makes a sudden appearance and then disappears - which means getting better or getting worse. Another example a sudden attack of asthma can be an acute attack.  On the other hand someone with asthma can have a chronic situation that becomes acute when it flares up.

Supplemental oxygen is administered in many emergency situations - and this can be in hospitals, ambulances or during resuscitation procedures.

When oxygen is given as part of the prescription for a chronic illness, this usually means COPD (Chronic Obstructive Pulmonary Disease).  COPD is a term that refers to both emphysema and chronic bronchitis.  This is an illness that affects many thousands of people - many of whom haven’t yet been diagnosed - and the numbers are increasing as populations grow older.

(Baby boomers are in the segment of the population that is most at risk).

Many times  long term oxygen therapy is prescribed (and as “many” does not mean “always” the prescriptions will depend on the extent of the lung damage as well as other factors particular to the patient - which is one reason why no one should self diagnose or self prescribe) as lung damage is irreversible.

So what does Oxygen Therapy mean?
Basically it is the administration of extra oxygen to a patient so that the oxygen saturation levels of the individual are maintained.  The normal oxygen saturation is between 94-98%, while in COPD patients this will vary to approximately 88-92%.

How is Oxygen delivered?
A flow of 100% oxygen is delivered through a “cannula” (a plastic tube that fits gently into the nostrils) at predetermined intervals, and flow rates; or for some cases an oxygen mask is used.

How is the Oxygen kept for delivery?
There are three different types of oxygen delivery and storage systems.  You can find home units and their portable equivalents.

1. Oxygen Cylinders, which hold compressed oxygen in gas form.
2. Liquid Oxygen Tanks, which store liquid oxygen - in a smaller compartment the liquid is allowed to revert to gas and is subsequently delivered to the patient through a cannula.
3. Oxygen Concentrators.  These are machines that are powered by electricity an extract oxygen form the surrounding air.  The oxygen is then delivered in pure form to the patient.  As the surrounding air holds 78% nitrogen, 21% oxygen (and 1% approximately of other gases), the oxygen is separated and therefore concentrated prior to delivery.

As they were specifically designed for oxygen therapy patients who lead active lives, portable oxygen concentrators are benefiting thousands - making it easier to move about, to plug wherever there is an outlet, with the use of rechargeable batteries. As you don’t have to refill anything and as long as you have access to electricity, they just go on and on and on.

What Are Portable Oxygen Concentrators?

They are smaller units that are easier to carry while still providing the same service as larger units. As they are powered by electricity they are designed to receive energy through electric outlets and many also have a battery  set up. Many people have found them much more convenient to use (and carry) and the end result is that they have increased the range of their activities.
As mentioned above, they extract oxygen, “concentrating” it for delivery, from the surrounding air.

The atmosphere is made up of gases, of which 19 to 21% is oxygen, 1-2% other gases and the bulk is made up of nitrogen. Some studies indicate that earth’s atmosphere 200 years ago had an concentration of about 36%. There is a reduction of 0.8% approximately every 15 years according to some measurements, due to pollution and the destruction of forests. In some places oxygen is found at a concentration of 8% - depending on the pollution levels and/or altitude.

Portable concentrators provide pure oxygen which in turn is regulated with the flow rate and at the desired psi level. You can carry them quite easily either on its in handle, in an accessory bag or pull long in a small cart with telescoping handles and wheels.

The Most Important Benefit Of A Portable Oxygen Concentrator Unit

Mobility, mobility, mobility.

Activity, activity, activity.

You can lead a much more active life than with the other oxygen delivery systems.

And this is a major benefit. POC’s have extended the range of things people can do. This includes work activities, social activities, ordinary day to day activities and sports. The list of things people with oxygen therapy are doing is large and getting larger.

Being mobile - being able to move around freely, to participate in many more activities.  This can be as simple as going to a friend’s house to play cards; traveling to the shopping mall, to another city, another state, another country - the list is endless. In May this year the approval of some portable oxygen concentrators by the FAA for all airlines that use US airspace, came into effect.

The benefit of being able to pursue, safely, many more activities, derives into one much greater. The recovery of freedom.  Freedom to move and the rush that come from feeling and knowing this freedom is yours.

Many people who today use POC’s have found that they are doing things they thought were impossible and as they experiment with this new found freedom, their creativity and positive attitude to life is expanding. The positive attitude strengthens the immune system, which in turn makes for better health.

But things are easier now with portable oxygen delivery systems and especially travel oxygen concentrators.

For those who have been using extra oxygen for some time now, everyday activities are relatively easy to cope with. (Obviously this depends on many factors, not least the extent of lung damage and age).  But travel until a very short while ago was a major, and many times exasperating and frustrating, exercise.

Travel plans for those who need supplemental oxygen require more care and preparation than usual.  The length of the trip, whether it is a short, a medium or a long one you still have to plan.  If you are going by car, by plane, by train or by ship, there are a series of things that you need to take into account and they all have to do with the oxygen supply.

Will it last during travel?
Can you carry your oxygen concentrator?
What are the rules for taking your oxygen system?

And this is where a travel oxygen concentrator comes into its own.

Air Travel:
The FAA has approved the following POC’s (portable oxygen concentrators): Inogen One, Respironics EverGo, Sequal Eclipse, Invacare XPO2 and the Airsep Lifestyle & Freestyle.  All airlines that fly over US airspace must allow them on board.  Having said that it is your responsibility to make sure you comply with the airlines requirements.

Train Travel:
It is recommended you notify Amtrak at least 24 hours prior to traveling, but as with any travel plans it is always best to give yourself more time.
Maximum allowed oxygen on board cannot exceed one double tank set up of 50 pounds. You must be able to separate the tanks and they cannot be on wheels. A six-tank set up is allowed as long as each tank is less than 20 pounds.
Travel oxygen concentrators that require electrical power must include a self-contained (battery) for trips less than 12 hours. Electrical power on the train may be used for trips greater than 12 hours. You should carry additional oxygen in the event of travel delays.  And finally reserve a private compartment if possible.

Ships and Cruise Vacations
Ask your travel agent if there are any special requirements when traveling with oxygen. Most cruise lines specify each passenger must make his or her own oxygen arrangements. Your oxygen supplier should be able to help you with coordinating oxygen for your trip or direct you to an organization that specializes in travel oxygen. Passengers must provide a letter from their doctor prior to travel indicating they are fit to travel, travel plans and oxygen prescription (hours of use and oxygen flow rate).

Car Travel
Travel oxygen concentrators can be used with most vehicle car lighter adapters or internal batteries decreasing the number of compressed oxygen cylinders required or eliminating the need for liquid oxygen reservoirs.

As a general rule you should always carry a copy of your prescription including oxygen litre flow and hours of use, with you at all times as well as a current list of medications you are receiving. Make several copies of the prescription and medication list as you may need to present a copy to flight attendants or oxygen suppliers during your travel.

Most people don’t need additional oxygen except at very high altitudes so it is not easy for them to realize the difficulties patients on oxygen therapy have to go through – especially regarding moving about.

Just a few short years ago, at the beginning of this decade, the only mobile alternatives were oxygen cylinders and tanks and one has to admit these have also benefited from new designs (including the material they are now made from). But oxygen concentrators have expanded mobility potential for many thousands of people.

With the advent of oxygen concentrators and more importantly portable ones the life and styles of many people have changed allowing them to be much more active.

An oxygen concentrator is a devise that extracts oxygen from the surrounding air and delivers it in a pure form to the patient. This means no oxygen storage needs and for portable units this is very good news.

The 3 Most Important Things In A Portable Oxygen Concentrator.

I presented a simple questionnaire to 10 patients on long term oxygen therapy where I asked them for the three most important things they want in a portable oxygen delivery system. (Note: This is definitely not a scientific study).

Their answers were:

1. Duration. – Easily number 1 requirement (they all stressed this and placed it first). It should last for ages without needing a refill or battery recharge.
2. Small. – So they are easily maneuvered and placed while in use.
3. Light. - As they said this is obvious – insufficient oxygen restricts their weight carrying capabilities.

A lot of the design innovations have been made with these three things in mind - and the duration aspect is probably where we will see new and exciting things.