PERF, The Pulmonary Education and Research Foundation, is a small but vigorous non-profit foundation.  We are dedicated to providing help, and general information for those with chronic respiratory disease through education, research, and information.  This publication is one of the ways we do that.  The Second Wind is not intended to be used for, or relied upon, as specific advice in any given case.  Prior to initiating or changing any course of treatment based on the information you find here, it is essential that you consult with your physician.  We hope you find this newsletter of interest and of help

Donations

Memorial donations to PERF have been made by Harry & Barbara Borak for Ross Fredrick and Jill Russell. Roy & Jo Pyle sent memorial donations for Byron Riley, while Lester & Dorothy Elbon remembered Byron B. Riley.

Earl and Jean Roberts made a memorial donation in memory of John Boynton, a loyal long time supporter of PERF and the Second Wind. We join Jean in sending condolences to his widow and many friends.

Kathleen Judge and her family sent us a memorial donation for her mother, Jeannie Judge, obtained from the proceeds of a yard sale. (What an innovative idea!) Jeanne was a long time reader of our newsletter and we will miss the notes we got from her. 

Carolyn Dearen donated $20 in memory of an unnamed good friend and classmate in her pulmonary rehab class that Mary taught many years ago. Carolyn added, "PERF is a thundering storm of Hope for we who claim victory over COPD." She added that "Exercise, Faith, Education and Fun (EFEF)" is her prescription for Health. Those who remember Carolyn will be amused to learn that she is moving yet again! She says her motto is, "Change has always been my passport to life." and adds that every time she moves she makes a lot of new friends. You are amazing, Carolyn, and must have many, many friends! I'm glad you haven't forgotten those of us in Torrance.

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Altitude Adventure

Speaking of movers and shakers here is a vignette by our own Dr. Tom Petty

Late last August, at the beginning of fall in Colorado, 13 oxygen patients with COPD and I boarded a bus in Denver and really got high! We actually traveled up the Mt Evans road to Echo Lake at 10,600 feet. Why? We wanted to test the functioning of a new portable oxygen concentrator, the Eclipse, at that high altitude. We wanted to experience a traveling adventure at altitudes similar to, or above those, of the cabin pressures of commercial airliners, which often are 8000 feet and even higher on occasion. We used a continuously recording oximeter to record everyone's pulse and oxygen saturation throughout the five-hour trip. Each patient had a clipboard in order to be able to record any unpleasant feelings as we traveled to the high country. We saw some changing Aspen leaves and a few elk in an alpine meadow as we looked out at the scenery. 

We then went to a restaurant situated at 7500 feet for lunch. We used our concentrators for all these activities. One person needed higher flows, so we used liquid oxygen for him. Everyone enjoyed the trip.

An analysis of the oxygen saturation reading by the oximeters showed that everyone maintained a saturation of 90% or more. In some cases the flow settings needed to be increased when reaching the highest altitude. 

This was not a formal research study, but it did indicate the performance of the new concentrator, now approved for airline travel on all the carriers that allow portable oxygen concentrators (POC) on board. Right now there are five POCs approved for this purpose. 

I continue to believe that all travelers, and any oxygen patient with high activity, should titrate their oxygen saturations during these activities. See "Titrate as You Migrate" 

I also have written an illustrated booklet that explains how an oximeter works and how it can be used to monitor oxygen saturation in many activities of daily living. It is now available from Nonin, the manufacturer of the oximeter we used. It will be widely available to all oxygen patients and their families without cost. I hope you find it helpful.

Are you interested in getting a copy of Dr. Petty's booklet, "Your Personal Oximeter: A Guide for Patients"? Go to Nonin and you will be able to read the PDF file. You can also order your own copy. If you are a health care professional who would like some copies for your office or rehab program, this site will also tell you how to order them in quantity. 

While there is much valuable information in the booklet we would like to reprint two of the questions we often hear. 

Question: What about getting too much oxygen and retaining carbon dioxide?
Answer: This is an old myth based on misconceptions about oxygen. Oxygen itself will not eliminate or even reduce the drive to breathe. This is true even when patients retain some carbon dioxide. 

Question: Can I use a higher flow rate if I am short of breath while exercising? 
Answer: Yes, and it may be helpful in providing extra oxygen for your muscles as you are walking. You should return to your normal flow rate after exercise. Monitor your saturation during both rest and exercise with your oximeter." 

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COPD Connection

We have an additional message from Dr. Petty that we would like you to read, consider, and discuss with your rehab programs and support groups. 

"I would like to make a personal request for you and PERF to join the COPD Connection. This is intended to be a loose association of all the autonomous groups that, today, are making progress in promoting COPD awareness and treatment. This "organization" will have no central office, no bylaws and no expenses. It is just a means of communicating and collectively using our clout where it will do the most good. PERF must certainly be involved in this effort."

Thanks, 
Dr. Tom Petty

PERF will of course follow the request of our President Emeritus and join the COPD Connection. PERF will also do everything that it can to promote this concept of working together. We already are very involved with the California Society for Pulmonary Rehabilitation (CSPR) and many other organizations. Joining an online patient network like that of COPD-Alert is another step in this direction.

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Questions

We get lots of questions from our website. Here is one of general interest, especially this time of year when many of us are traveling. It is the flip side of the other questions about oxygen and altitude in this issue.

Question: Thank you for this website!! I have a question about altitude. I live in Colorado Springs, CO which is higher than Denver and Denver is 5,280 ft above sea level! I am on oxygen 24/7 @ 2 l/m. If I were to go to the California Coast to visit family is it possible that I might not need to wear oxygen? 

ANSWER: Sure it's possible. But only your pulmonologist will be able to tell you for sure. First get the highest altitude at which you will be staying or visiting while in California. That probably is sea level but there are areas several thousand feet above the coast. Your doctor will want that information. He may be able to give you a yes or no answer right away, depending on your condition and blood gases, or he may want to do a HAST study. This is a simple High Altitude Simulation Test to see what your oxygen level is at a certain altitude. Usually it is done for patients going UP to altitude but I see no reason why you couldn't have one for the opposite reason. Medicare and insurance should pay for it, but ask in advance.

If you get the okay for going without oxygen while staying in California be sure you take into consideration the altitudes you will encounter coming and going in transit. If you are flying remember that the plane is usually pressurized to about 8,000 ft. If you are driving you will also encounter some pretty high mountain passes. 

If your doctor decides that you just need oxygen while sleeping, it should be easy for you to arrange to have a concentrator delivered to where you are staying before you get there. If you have a national company such as Lincare, your regular insurance may take care of rental costs but ask because reimbursement policies change too fast to keep up with! You don't want any unpleasant surprises. Have a great trip, good luck and let us know how you make out.

To all of you from all of us, we hope you have a happy Turkey Day and get the big end of the wishbone! May it bring you health, happiness and easy breathing in the upcoming holiday season.

Do you have a question about respiratory disease that has been bothering you? 
If so, feel free to write and ask us, either through our web site or by mail.
We answer all of your letters.

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