Nasal Cannulas and Supplemental Oxygen Can Cause Irritations

Charlene Marshall avatar

by Charlene Marshall |

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Learning to use supplemental oxygen as a young adult was arguably the hardest part of my idiopathic pulmonary fibrosis (IPF) diagnosis. My life changed once I required the help of a plastic tube with two prongs up my nose to complete basic tasks that most people take for granted.

While I wasn’t dependent on supplemental oxygen when I was diagnosed, it wasn’t long before I required it at night, and then with activities that required exertion. Now, I need it regularly. Some days, I’m still adjusting and learning how to live a productive life with oxygen.

I describe managing supplemental oxygen at home as a full-time job. There is a lot to learn, especially in the beginning. Thankfully, I can still manage for short periods without oxygen, so a situation like losing power and not having back-up tanks isn’t critical, but it does cause anxiety.

I always try to be proactive by keeping extra tanks handy in case a power outage happens. Unfortunately, learning to be proactive occurred as a result of enduring stressful situations that I’ve learned from.

In addition to being proactive in storing oxygen, I’ve had to find solutions to maneuver around the house safely. I’ve purchased longer cannulas, but they get caught on things, and other patients have told me their pets sometimes chew holes in them. As a result, we must take steps to ensure our oxygen line is kept clean and safe as we walk around the house, especially when using longer cannulas.

I have also learned to quickly spot outlets in public spaces I go to with my portable oxygen concentrator (POC). Some machines like mine have a lengthy battery life, but I usually feel more comfortable knowing where I can plug the POC in when I need to. I also regularly obsess over where the car charger for my POC is, especially during longer road trips.

While these are just some of the things I’ve learned since requiring supplemental oxygen after my IPF diagnosis, I am still learning. Many patients would agree that managing supplemental oxygen is an ongoing learning process. How to do certain things, and ways to increase the portability of oxygen tanks and concentrators, are popular topics of discussion at our PF News Forums.

Another topic is how to make the cannula more comfortable while wearing it 24/7, because often it is irritating. Following are some of the ways it can negatively affect users:

Skin breaks down behind the ears

Anything that rubs against the skin for a prolonged period will cause irritation or a breakdown of the skin. I’m guilty of wearing my cannula tightly to my face, because I get frustrated with having to push it up all the time. And given the ongoing pandemic, the less I touch my face, the better.

But tightly wearing my cannula causes irritation behind my ears. To alleviate this, I put the cannula over my head and tighten the tubing around the crown of my skull, letting the excess tubing fall behind me rather than in front. This gives my ears a break when the skin is irritated from wearing the cannula the normal way.

Tender nose sores

Depending on the type of cannula, small blisters might appear at the base of my nose, which becomes increasingly tender the more I wear that specific tubing. Sometimes changing the cannula to a new one (of the same brand) helps, but other times it doesn’t.

Patients requiring oxygen also must be careful with the type of lotion they use to alleviate sores, because some lotions are flammable. For example, Vaseline should not be used to moisturize your nose when using supplemental oxygen.

Rather than the standard plastic tubing, I find Flexi-Soft cannulas from Salter Labs much more comfortable.

Broken capillaries

I’ve always had rosy red cheeks, especially when I’m not feeling well or if I’m frustrated or have been crying. I thought this was worsening as I got older, but after a recent facial, I learned that the redness might be caused by broken capillaries in my cheeks.

The facialist explained that she could see where my cannula rested across my cheeks, and she provided me some organic skin care products to help heal the broken capillaries.

Nosebleeds

Many patients who use oxygen regularly end up with nosebleeds due to the dryness that oxygen causes. Nasal passages become irritated, which leads to frequent bleeds that often are prolonged and difficult to stop.

What are some of the unexpected irritations oxygen cannulas have caused you since requiring supplemental oxygen?

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Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.

Comments

Judith A Caminiti avatar

Judith A Caminiti

My biggest problem with oxygen 24/7 is kinking hoses. Once it starts to kink its not long before I have to change cords. I keep looking for solutions as the long cord enables me to get around in the house. I don't like having to stay put . Any suggestions would be appreciated

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Charlene Marshall avatar

Charlene Marshall

Hi Judith,

Thanks so much for reading my columns and reaching out via the comments. Sorry to hear about this struggle with your 02 hoses - them kinking is such a pain, isn't it? My friend figured out how to enclose the tubing in a really soft cover basically, I can try to find out what it is if that would be helpful for you? He doesn't use it for the issue of his hose kinking but rather to protect the tubing from his cat who tries to chase the long cord. I think it might also work for what you're looking for. Let me know if you'd like me to find out the information for you and pass it on :)
Char.

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Don Augustine avatar

Don Augustine

When I was in the Hospital recently for carotid artery surgery they gave me a cannula that had very soft rubber tips that fit in your nose. I tried to find them but I had no results, can anyone help ?

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Charlene Marshall avatar

Charlene Marshall

Hi Don,

Thanks so much for reading my columns and connecting via the comments. I'm wondering if the cannula you're referring to is the Salter Labs one: https://www.salterlabs.com/16soft-cannulas.html ? I find these helpful and a lot softer than other options. I also wonder if it is worth calling the hospital/unit you were on, to ask which ones they use? Hopefully they'd be able to provide the name for you :)
Char.

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Don Augustine avatar

Don Augustine

Thanks for your reply and recommendation, I will contact the Hospital and see if I can find the name and company and will let you know.
Don

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Steve Dragoo avatar

Steve Dragoo

Hi Charlene,

As always I learn a lot from your willingness to share your personal story. I haven't yet experienced any issues but I am new to 24/7 cannula stuck up my nose. Hope to cut back on its' use soon...

Thanks,
Steve

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Charlene Marshall avatar

Charlene Marshall

Thanks so much for your kind words my friend. I know you've been unwell, but it was so great to see you back on the forums again! Take good care and keep me posted (when you can) on your progress. I also hope you can cut back the 02 use soon!

Warmly,
Char.

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Long term o2, long term damage avatar

Long term o2, long term damage

Well I have been on 4 to 5 lpm of oxygen for almost a year. I often get nose bleeds like a lot. All my healthcare providers tell me that it's normal for people on supplemental oxygen. So I've used the nasal lube that my RTs have recommended. Nosebleeds continued for a good 2 to 3 months.. about every other day. And now.. I have a petforated septum! I have scouted the internet trying to find more information or maybe something I missed... And sadly there's not much information about long term o2 use causing a perforated septum! On the bright side of that... Sincey.septum perforated.. . My o2 sats have gone from a regular of 89 to 92.... To a nice 96!! Anyway I really just think people on o2 should be aware that this really can happen.

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Charlene Marshall avatar

Charlene Marshall

Hi There,

Thanks so much for reading my columns and reaching out via the comments. I really appreciate your sharing this information about 02, as I've heard other patients dealing with chronic nosebleeds as well following prolonged oxygen use. It is helpful to hear others experience it too and what has helped them. Glad your 02 sats are improving! Take care and thanks for writing. Charlene.

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Dee Ireland avatar

Dee Ireland

I have come across your column and it's of particular interest to me. I am 32 and newly diagnosed with PF secondary to connective tissue disease but it all showed up around the same time and my autoimmune disease is primarily ILD. My PF advanced quickly in just 10 months I went from one day waking up with a bruised feeling when I breathed to trying to learn how to use supplemental oxygen while managing to care for my 2 special needs children who are aged 5 and 2. I've been prescribed o2 for exertion and sleep. I have lost a significant amount of lung function very quickly. My last PFT showed a FVC of 54% and a DLCO of 36% I find that it's almost like I can feel myself getting worse by the day. Just a month ago I could do most things without being short of breath and now just walking around my house or heaven forbid trying to use the stairs tanks my 02 and leaves me with burning chest pain. I can feel the restriction and I couldn't just 3 months ago. I feel like I have had no time to adjust to this diagnosis. I worry about my husband and our children. I have a job I love doing surgery in Labor and Delivery and if they cannot approve the use of my POC then I will be forced on disability. The POC may not be safe for use in the OR. So I have to show the hospital it is. On top of all of that. I'm tired all the time. I am barely managing my household and keeping up with my childrens therapy schedules and now i have pulmonary rehab of my own. With how fast this has happened so far I cannot help but struggle with hopelessness. Wondering if it's worth it to make future plans like remodeling the kitchen we had planned to do before my diagnosis. It's very rare I find anyone who is my age who has any kind of PF nobody knows what it is. Or that I won't "get better" anyway I know you know the struggle. I mostly was curious what type of POC you use that has a long battery. My concern is the small ones won't hold a long charge for someone on the go. Some days I wake up and am out of the house by 9am have therapy for myself and the kids then have errands and I might not get home until after 5pm. Any o2 advice for someone who is young healthy and wants to stay active is much appreciated. I'm not sure how I'll keep up with the kids. Especially my 2 yr old who has no idea what's happening and is obsessed with the knobs on my concentrator.?

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Charlene Marshall avatar

Charlene Marshall

Hi Dee,

Thank you so much for reading my columns and reaching out via the comments. I'm so sorry to hear of your diagnosis of PF; this is such a cruel disease and certainly isn't fair in who it targets. I hope your progression slows, that does sound fast. Are you able to take either of the anti-fibrotics for IPF - Ofev or Esbriet? Managing this chronic illness is tough, it must be difficult to do with two littles at home too! In terms of the POC, my favourite for longer term use is the Respironics SimplyGo machine. That is what I use and the only complaint I have is that it is heavy - ~10lbs! However, it comes with a trolly you can cart it around with and a little pouch holds either an extra battery or the charger too so I sometimes have to plug it in throughout the day or switch out the battery. However, this is the device that gives me the most out-of-the-house freedom. Let me know that the OR says about the use of POC; I haven't ever had that discussion with a fellow patient. If you're interested, you can join the PF forums for free: http://pulmonaryfibrosisnews.com/forums/ ... I am bias but it is an amazing platform to connect with others who truly "get it" and understand not only the physical difficulties of living with this disease but the mental and emotional things too, such as hopelessness. Feel free to write anytime and take good care. I am 33 now, and completely understand how difficult this must be for you.
Much love,
Char.

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Danielle avatar

Danielle

Hope you don’t mind my post, I don’t have PF. My lungs were irreversibly damaged from a heart defect that went undiagnosed for the first 14 years of my life. I started out only wearing O2 while I slept over the years I would use it more at my leisure. 2 years ago I some how contracted Whoop and ever since it has been a 24/7 thing. I’ve dealt with nosebleeds, due to dryness and found a silicon nasal dialator helps but it has to fit right for it not to dislodge. Amazon has many options. Also, I have uncoiled my cords and taped them to the wall a day or two before connecting them to stretch it helps a bit with them twisting and kinking. Dry mouth and throat have been a big issue during sleep, again Amazon has a lot of overnight dry mouth mint options. I like the ACT ones best. I have always had rosy cheeks, facialists would tell me that it was rosacea, I’d roll my eyes knowing dermatologists said it was not.Then 4 years ago I woke up and one side of my face was peeling for no reason whatsoever, I changed skincare, went dye and scent free detergent, it started becoming a regular occurrence, tracked what I ate,Then bumps appeared right under where my cannula lies on my cheek. Turns out I am allergic to resins in my cannulas! I have tried several brands but none keep it from reoccurring entirely. A dermaplaning tool, extra gentle cleanser, alcohol free toners and insanely expensive serum and facial cream have helped significantly with dryness, the bumps lessen at times, though the itchiness has not abated even with allergy pills or dabbing anti-itch creams. Gotta laugh at the irony. Merry Christmas!

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Asia Zanders avatar

Asia Zanders

Dee, I completely understand where you are coming from. I have 3 children- ages 10, 7, and 6. At 29- right after I graduated with my bachelor's degree- I was diagnosed with Sjogren's first, then hospitalized January 2020 where I found out about the pulmonary fibrosis. Time went on and I was diagnosed with dermatomyositis and V-Fib recently. I lost hope in everything. 2020 wasn't just bad because of COVID but I really could not go anywhere- not even upstairs. I had to homeschool 3 children on top of that (I had only homeschooled my oldest for a school year) and my husband was working 12 hour shifts. It was rough on all of us. I took a load of medication, now dropped down to a few. OFEV has been the best thing for me. It sucks because I am, now, dairy intolerant (I can't even smell cheese without feeling sick! haha) and I have come to be annoyed with eating and taking medication simultaneously, but it really has improved my life. I started working on my Master's last year and plan to finish this Fall, my husband's work schedule has changed to fit our unknown situations, and we are planning on working on our kitchen this year. (We just got our new appliances a few days ago!) There is so much more I could share because I am looking for other young people who are experiencing what I am going through, but I hope this helps you find hope. Also, try physical therapy. My PT does this thing with my ribs where pushes out extra oxygen and I am able to breathe better for weeks. I am not sure if I can share this but if you search for me on FB, IG, or Twitter, I would respond to you more in depth. Stay Strong.

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Marie atlee avatar

Marie atlee

Hello, I’m on oxygen 24/7 and have a recurring scab in my nostril. I was told not yo use Vaseline, so I use neosporin cream every night. Doesn’t take the scabs away , only softens them somewhat. Any other suggestions would be appreciated.

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Cherilyn caporaso avatar

Cherilyn caporaso

Hello
My husband has ipf and is on oxygen 24/7. He is experiencing a burning sensation up his nose and gets very distressed about it. Also his nose scabs up inside and is difficult to clear. Any advice you can give will be greatly appreciated.

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Deanna Robertson avatar

Deanna Robertson

Being new to oxygen about a week when I get a nosebleed how long after the bleeding has stopped can I put the cannula tube back up my nose x

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Deanna Robertson avatar

Deanna Robertson

Can anyone tell me how to get rid of the itching in my nose from using a cannula tube I’m using Aauagel at the moment but doesn’t seem to be helping much, it’s driving me nuts ,thanks .

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Barbara avatar

Barbara

This was very helpful learning about others who struggle with lung disease. I will try to join your group. I’m on oxygen at night and multiple times during the day. But my breathing seems to be getting worse all the time it effects everything I do. I’m not hopeful with this as there is no cure. Thx for all your posts

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