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Portable Oxygen Concentators
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I give up…
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Hi John
I hope you’ll keep updating us on this.
I calculated it a different way. The bolus volume of a well known POC that will supply 3L/min is 96mL at the highest pulse setting of 6. Let us say that you inhale 10 times in a minute. I choose 10 times because pursed lips breathing is widely recommended at 2 seconds inhalation and 4 seconds exhalation i.e. 10 per minute.
10 inhalations is 10 times 96mL at the highest setting. This as near as dammit is to swearing to 1L/min. If you breathe more quickly than this I doubt you are getting the full amount of O2 or exhausting the CO2. I know for sure that my lungs are hyperextended so breathing faster is no use to me as I never completely exhaust my lungs.
There is another POC that has a max bolus of double this so it would add up to 2L/min max.
Speaking from long experience I always do better with continuous flow if I’m doing anything strenuous e.g. walking quickly or uphill.
Pure O2 dispensed in either gas or liquid can have a controller that has C and D settings. D is for “Demand” and allegedly supplies a bolus equivalent to the nominal setting in L/min. However I still find continuous works better for strenuous activity.
Incidentally with 2 perfect batteries at 3L/min C will exhaust them in 1.5 hours. So if you want to fly 10 hours, you need 20 batteries (E.g. LAS to LHR) if you use 3L/min C. That is not feasible.
You can find all these numbers in User Manuals, free on the net.
Thanks again John and, BTW pursed lips breathing does help. (technique also on the net)
Best Wishes to all
Bill
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@johno
Hi John!
We got your full post about the POC comparison with the exception of the table it looks like. Adding anything other than text into the forums (ie. pictures, excel documents, etc) can be quite finicky to prevent spam but there is a way to do it. Do you want to email me the table comparison you made and I can embed it into your post for you? Let me know, and I’d be happy to do that 🙂 My email is: [email protected] . Otherwise the rest of your post looks great and I look forward to reading it. I also replied to your direct message.
Have a great day!
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Liquid Oxygen (LOX) home and portable systems can deliver significantly higher flow rates than concentrators and have light weight portable sizes that can deliver high flow rates for significantly longer periods than portable concentrators or gaseous oxygen tanks. However, they are expensive, not widely available and not reimbursable by most medical insurance plans or Medicare. The high density of cryogenic liquid O2 and the need to continuously vent gaseous O2 to cool the cryogenic liquid poses significantly higher storage, transportation and point of use ventilation requirements/regulations and fire/safety risks than gaseous O2 systems. As with gaseous O2 systems, they cannot be taken on board aircraft.
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Medicare does cover LOX (liquid Oxygen) in just the same way as it covers gaseous O2. Lots of suppliers don’t like doing it and quote the problems John mentions. In fact I have never had any problem with it. I get one delivery /month, I used to get 1/week when I was on gas. My delivery guy takes an empty reservoir to the LOX manufacturer, fills it and delivers it on a wheeled dolly. He picks up my empty and the cycle continues. He doesn’t see it as a problem for him, but he’s a strapping kid and you can believe I keep him sweet.
They supply a portable which you fill daily. Full, it weighs 5.7 lb, exactly what a small gas cylinder weighs. I carry it in a purpose made backpack which I bought on Ebay. The models I use are the Helios Marathon 850 and a smaller one Helios 300. Both of these models are common on Ebay. I bought a Marathon as a spare for $120 and a 300 for $76 including a carry pack. The numbers refer to the volume in mL that each carries.
The 300 is only good for 1L/min continuous or 4L/min Demand (Note: Demand NOT pulse). The carry pack can be worn over the shoulder or on a belt (supplied) around your waist. It is excellent for visits to the doctors or scans where I don’t need much supplemental O2.
The 850 delivers a max of 6L/min Continuous and 4L/min Demand.
The new price for these is outrageous but you don’t need a spare unless you are a compulsive like me.
There are other portables that deliver more than these and you can find them on the net
See: https://www.caireinc.com/providers/products/liquid-o2/
By design both the reservoir and portables continuously vent some oxygen so that you can’t over pressure the container if your air conditioner gives out in Phoenix and the temperature rises and stays high. I conducted a test a few years ago to see how much leaks from the reservoir. In a warm house it would take about 10-12 weeks for a full reservoir to disappear if you didn’t use it. The reservoir BTW is built like a Thermos with double walls of stainless steel so the temperature doesn’t vary much.
There is a seminar video on one of the PF sites that discusses O2 therapy in detail – I’ll look for it
Speaking personally, LOX changed my life and the only thing I worry about is losing it because Congress restricts payments to suppliers to save money. We (seniors) are not exactly a priority to Congress.
Bill
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Conservation of the oxygen supply: As has been discussed above, the pulse modes of the POCs are designed to help conserve their output O2 and deliver it more timely/effectively to the patient. Another method of conservation is to add an O2 reservoir at/near the cannula to store the O2 from the concentrator during the patient’s exhalation and delivering it to the patient during their inhale. A study on the topic is available at NIH https://pubmed.ncbi.nlm.nih.gov/3931988/
Several products are on the market with names such as Oxymizer and Oxysaver,
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Inogen TAV (Tidal Assist Ventilator): This is a relatively new product and I believe I am one of the first to buy and use it. It functions as both a conserver and to provide ‘tidal assist’. It works with gaseous O2 tanks or Inogen’s special model concentrator that delivers the higher pressure (50psi) needed by the TAV. There is a full description of it here: https://www.inogen.com/blog/what-is-tav/
I do not need/use supplemental O2 for leisurely activities but beyond that, doing physical work, walking fast, climbing hills/stairs, etc. I need much more than portable POCs can provide. So I use a small gaseous O2 tank, an MB08, 228 liter, 3,000psi tank weighing 2.3lbs, 3.2″ diameter, 11.8″ height. I put the tank in a small back pack with chest strap (and belly strap too but I don’t often use it). I find the TAV performs as advertised. I have tried a number of conserving regulators including smart/electronic ones and find the TAV much superior, both better at conserving and the tidal assist reduces the effort required to do rapid, deep inhales. With the TAV in a pocket or worn as a pendant around the neck, I particularly appreciate the ability to quickly and easily adjust the bolus size/duration with a simple press of an increase or decrease button as my exertion level increases/decreases. No need to get the tank into your hands and look at the regulator settings to do this.
That is not to say that it’s a perfect system. It is not. First off, it is expensive. Just under $1,500 if I recall correctly. There are two hoses to the TAV pendant/hand unit, a heavy O2 supply line to the tank/regulator and a normal cannula hose and they complicate the donning of the gear. It uses a special, venturi effect cannula they call a pillow cannula. It’s made of soft silicon rubber designed to seal in/against each nostril. It requires a little practice and fussing to get them in place correctly. I’ve not worn it for more than an hour at a time and I don’t now if the pillow cannula will become bothersome when worn for long periods. It is also noisy. There are venturi jets within the cannula jetting O2 at much higher velocity than normal systems. Those near you are definitely going to hear it, especially at the higher settings.
I’ve already suggested to them that they build the electronic/mechanical part of the TAV unit into the regulator on the tank. Then only one hose is needed, the cannula run from there. A hand held / pendant remote control could then communicate via Blue Tooth (BLE) to control the TAV hardware at the tank.
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https://www.pulmonaryfibrosis.org/life-with-pf/oxygen-therapy A super overview for those who want to know more.
And here is PFF webinar on oxygen delivery methods.
Bill
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I also have an inogen 5 and medicaid wouldn’t cover it, they only covered the portable cylinder tanks. I also wanted to add this time bit as well since we are living in this covid 19 time. These POC do not filter out viruses. So just be aware that when you are in a public place such a grocery store or anywhere else you may go, the concentrator uses the air around it and yes it does have some filtration just doesn’t filter out coronaviruses which is definitely something to think about right now as those of us needing supplemental oxygen are considered in the high risk category. Not trying to be a Debbie downer just trying to bring to light another thought while searching for any POC
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I have a respironics mini portable condensor and medicare covers it and it is not a portable cylinder tank. Perhaps if you go back to your oxygen provider and get someone further up in their “line of command” you will be able to get you a portable condesor rented and paid by medicare. You pulmonologist has to prescribe it for you.
anne
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I think the key is your doctor. If he prescribes a portable, Medicare will pay for it. The link I posted above to “Living with O2” covers all this. You will be better armed to get the best if you read what the experts at the PF Foundation say. You are dealing with a bureaucracy in both Medicare and your supplier. What you do at the start of your 5 year period is easier to change than when you well into the period.
The only reason I post here is that I want fellow sufferers to avoid some of the newbie mistakes that I made. This is your life. Surely it’s worth 10 minutes to read and another 15 to watch the webinar.
When I first went on O2 I was in shock. 5years? I didn’t think I’d be here in 5 years time – but I am. I knew nothing of the organizations and forums like this one. There are some wonderful resources available for free and I try to use them.
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Hi, I have a Simply Go Mini and have been quite pleased and have a larger home machine, Everflo IP21 that is continuous O2 and I use at night for sleep and around the house when I am active at any degree(Has a 50ft tube.) I have Tricare for Life (Medicare +Tricare) and they rent equipment and you deal with a O2 provider. I like my mini, a pulse provider. However, it cannot provide continuous O2 that the regular Simply Go can. That means that you have to have a separate machine for sleep. The mini is about six pounds and I carry it in a backpack bought form the company and use it when walking. The regular simply go is a little heavy for most to carry it and a cart is provider. I will probably need to change to that some day. I found out who you get as a provider is important as it is not possible to change after you choose one. I have a local provider and I would recommend a national one if you travel. With my local provider I have to rent a simply go for $100 before I go out of town as the mini is not made to run overnight for long periods of time and cannot be continuous. A national provider can arrange an appropriate continuous machine at your rendezvous.
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Thanks Bill for that very valuable information. I’ve bookmarked both the article and the video.
I have a stationary concentrator which I use during sleep in conjunction with my CPAP. I also get oxygen tanks which I use outdoors with my rollator. Both are paid for by medicare. Am I correct that if I wanted to add a portable oxygen concentrator I would have to pay for that myself w/o any medicare contribution?
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Probably. The article tells the story but I think your doctor must prescribe a POC – not the model – that’s up to the supplier but your doctor can say what dose you must have. It is very difficult to change after, I think, 3 months. However if your condition changes the article says your doctor can change it. One thing I have not mentioned is that you can download a list of all O2 suppliers in your area from Medicare’s web site. Unfortunately we find this kind of thing out after we have committed for 5 years. O2 suppliers are a sub group of DME (durable medical equipment) suppliers to Medicare. If your pulmonologist has a fair sized practice, either he or his technician can probably tell you who the best and worst suppliers are. Usually there are Yelp ratings on the net.
I used smaller O2 tanks when I found the POC couldn’t keep up. I forget what letter, maybe D, but they are wine bottle size and weigh about 5.8 lb. I rigged up a Walmart backpack with foam. The regulator could provide both continuous and demand – that’s important, not all regulators do. I used as much as 2 tanks a day. I needed 1.5 to play table tennis or walk for about an hour at 2or 3L/min. I was using 10 to 12 tanks a week but my supplier never jibbed. They were owned by a huge Japanese health company and I didn’t realize what a good company they were. How can you know? As I mentioned they had a travel manager and they would lend you, free of charge, a POC for travel in the 50 states. BTW I was using the provided standard Phillips stationery OC to sleep.
If there are any other questions, John, go ahead and ask. I must emphasize that regulations change so I’m probably not up to date on everything e.g. I was surprised to hear that patients were being charged or told “Tough Luck” when they asked for help with an approved POC for travel. I would certainly check that with Medicare, who are up to date on rules and companies.
If there is anybody who has more info please let us know.
I may as well tell you that I am very wary about claims made by salesmen for POC distributors. They are very expensive new and if you find they won’t keep up with what you need, you’re stuck. Caveat emptor!
Best wishes
Bill
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I have one stationary concentrator for 24/7 use, 2 small bottles and a refiller to use with the stationary concentrator, one large standing O2 tank for use when the electricity goes out, and a small portable battery operated condensor all paid by medicare.
My pulmonologist requested 24/7 O2 in house. He also said I needed portable O2 for use going to doctors, shopping, and other activities. The two little bottles would not serve me for a whole day going out and about for lunch, bridge, and shopping or to movies. I would need the concentrator and I have purchased several batteries to use. I also have the car charger and plug paid by medicare.
Please contact your doctor and ask him/her to request the concentrator. The staff will help with the wording if you MD doesn’t know how to word it.
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Anne,
That is really useful information and it shows how important your doctor’s instructions are.
Bill
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Things have changed since by Dec 11 post. A pulse of 5 is no longer sufficient for any kind of sustained activity. The rental company I have would have solved this problem by given me a tank which would keep me from flying. As a result I cringed and spent the money to buy a different portable, but not backpackable machine; the Claire Eclipse 5. It comes with a pull cart. I’ve only had it a little over a month and my only complaint is battery life which is a common problem with all portables. The 5 has plug-in capabilities and a continuous ratings of 1.5 and 2; it is a 24/7 machine. It has pulse ratings of up to 9, 192ml. I extend the battery life to some extent by varying my pulse settings depending on what my level of exertion is.
Originally I was given the large home Respironics continuous flow machine for use at home and the Simply Go Mini as a portable. I was very happy with the mini as I used it in a back pack. A problem with my provider was when I flew anywhere I would have to rent at $100 a week a Simply Go that had continuous flow 24/7 capabilities and was a plug-in. I no longer have to rent a continuous flow machine but I’m sure I won’t live long enough to pay for the 5.
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Was planning a trip to France in Fall of 2022. I noticed that the non-stop flight was 13 hours. If I’m using my POC that has a total of 3 hours per battery (there’s 2) that leaves 7 hours unaccounted for. Do you buy more batteries to make the entire trip or does the airline have an outlet you can plug in to recharge? Does anyone know or have made a long flight such as this?
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I have posted many times that you can usually rent batteries. Google “travel oxygen companies”, One is Oxygen to Go -oxygentogo.com. They are not the cheapest but they know all the regulations. Inquire early about rentals. I have flown SLC to Paris and back. The return trip is the longest. I shaded how much O2 I needed and used pulse. 20 hours of continuous flow – You’ll need a packhorse to carry the batteries. Ask the airline if their outlets will supply the needed current. I have never found one that would.
I’ll answer any questions I can if you want to know more. Don’t forget you need 150% of the battery life. BTW which POC are you using?Bill
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Thank you, Bill. I’ve only started reading about O2 concentrators and didn’t go through each thread before I asked my question. I will certainly look into the oxygen travel rentals for sure before I book my flight as well as call the airline.
My POC is the Inogen G3 (newest) and I was given a Sequel 3 that works well too. Wasn’t sure which one I wanted to haul with me…maybe take both.
My flight will originate from DFW, TX.
Thank you for the info & comments from everyone!
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Cindy,
Typo – I meant to say you need battery life of 150% the length of the trip eg 13 hour flight, you need 19.5 hours of battery life. The East – West leg is almost always longer because of the prevailing winds. -
Cindi:
You should contact the airline for guidance. Some planes have outlets, some do not. I took an American Airlines flight just last week. It was a domestic flight. Each seat had a pair of USB outlets plus 115 vac outlets. It was an AA Airbus flight. Airlines order their planes equipped with various options. Not all Airbus planes will necessarily be equipped with outlets. I would think airlines would be more likely to have outlets on international flights.
Again, you should contact the airline to find out what the aircraft on your Paris flight will have. Be sure to inquire if the AC outlet is a US standard of French standard. You will probably want to have an adapter to convert the plug on the POC to the French style outlets anyway for use during your stay.
Ron
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The problem is not just the socket, it’s whether it can supply enough current at 110V. Delta has 110V sockets in Delta One but they will not a run a POC.
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I have flown Delta and Air France and both I was able to use the outlets to power my inogen g3, one time the stewardess had the out let reset by the captain from the cock pit.
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John
I wish I’d thought of that. Though I needed 2L continuous to sleep which is a high load.Bill
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I would still take the required batteries.
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I flew Ny to Paris.
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