Welcome back! On our last blog we discussed when you need to start wearing oxygen. Now let’s talk about oxygen companies, how they are alike and how they are different.
Not all oxygen companies are alike. More importantly not all lung disease are the same. In very simple terms, pulmonary fibrosis is a scaring of the lungs. Oxygen can not cross the scared tissue to the get into the blood cells. For this reason, pulmonary fibrosis suffers often require high doses of oxygen. With this in mind, you need to be smart about the company you get your oxygen from.
Here are some important questions you need to ask before you choose an oxygen supplier.
1- What do you have in the form of Portable Oxygen Concentrators (POC)? In early stages of PF, you may be able to use low dose oxygen; 2-4 liters per minute (LPM). A POC is easier to get around outside your home. Most POC offer pulsating doses of oxygen. This means the oxygen is supplied to you in spurts or shooting doses. These concentrators are about the size of a ladies purse, and weight about 4-5 pounds. Most come with an AC and DC plugs, making them great for travel. They are also FDA approved for air travel. (More about this in another blog).
Cons: A POC sounds like the perfect solution; however, not all PF suffers can use the pulsating dose. So often PF suffers need a continuous flow of oxygen. Before you accept any POC device; request a trail period. Then get moving. Day one start with a brisk 6 minute walk. Wear a pulse oxiometer to be sure your saturation do not drop below 88%. No fair stopping to caught your breath if you see your saturation drop. This simple means you cannot use a pulsating dose. Send it back. You are only hurting yourself if you are not getting the correct oxygen dosing. (remember you have been addicted to oxygen from the first breath).
2- Can you continue to supply me oxygen if I move or travel out of the state? I know you are not planning to move; however, one of the treatments for PF is a lung transplant. You may not have a transplant hospital in your area. Or you make need to move closer to a different transplanting hospital. Let’s do a what if: What if you want to go to a wedding 2000 miles from home. A good oxygen company will place a stationary concentrator at the location you will be moving/traveling too. It will be a loaner at no charge. If you are moving can they still supple you with oxygen tanks for portability? (once you reach this stage of the disease process you will need tanks only).
Cons: If you are on Medicare or disability you may not be able to change oxygen companies during your disease process. This is due to the federal laws regarding how Medicare pays. In short, after you have been on oxygen for 2 years with Medicare or disability you can not change oxygen companies for the next 3 years. This is the standard of Medicare as of 2017. We are all in hopes this gets better in the future, but it has been true for the last 5 years plus.
3-What is the maximum liter flow you can supply in stationary oxygen? Don’t be surprised if they stumble with this question. See most companies are not willing to put two 10 liters per minute concentrators in your home. As your disease progresses you are going to need up to 15 LPM That requires two concentrators connected together. Some companies will not do this, look for one that will.
Cons: If you are not able to find one that will, ask your doctor what is available in your area. At Duke, it took a lot of work on the part of the triage nurses to get this high liter flow. But it can be done.
4-Does this company accept your insurance? Oxygen companies are just like doctor’s offices when it come to being out of network. The same is true with your copay and out of pocket expenses. My advice to you is check your health insurance policy really well. Your lung disease is going to be life long and treatment can be expensive.