Alvin Grancell, Vice President
Mary Burns, R.N., B.S., Exec. V. P
Jean Hughes, Treasurer
Thomas L. Petty, M.D.
Jeanne Rife
Alvin Hughes
Craig Murga
Brian L. Tiep, M.D. Advisor
Barbra Borak
We started last month's newsletter by talking about altitude and promised to give you more information about altitude in this issue. You may remember that as you ascend in altitude the available amount of oxygen in the air decreases. That means that your arterial blood oxygen, and your oxygen saturation, also decreases. Pulmonary patients, who already have low blood oxygen at sea level, may have a problem at altitudes as low as 3,000 ft. (Remember that planes are pressurized at 5,000 to 8,000 ft and occasionally even higher.)
So, how can the doctor tell if you need to increase the liter flow of your oxygen, or if you need to be put on supplemental oxygen when you fly across the country or go up to the mountains? Needs vary with the individual and can be hard to estimate.
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Your doctor may refer to a nomogram, which provides an educated guess as to your oxygen needs. He may order a HAST (High Altitude Simulation Test) which provides accurate information and is easily done in a pulmonary function lab. Another option is to perform a 6 minute walk test to see if you desaturate, and how much, with walking. This can help him to estimate your oxygen needs at various altitudes. Many patients who have gone through pulmonary rehab programs, and gotten sophisticated about their oxygen saturations, purchase their own oximeter. In the very recent past this has required obtaining a doctor's prescription and license number before finding a medical supply company from which to purchase the oximeter. On rare occasions, an insurance company would then reimburse the purchase cost. If you are lucky, and have a friendly rehab program staff to help, you may get an oximeter, like the little Nonin Onyx finger probe, for less than $350.00, including tax. But, we know other patients who have been price gouged for as much as $700.00! |
Thanks to our friends in Alaska, we have learned that you can now get an oximeter, without a doctor's prescription, for $395.00, plus tax, at any REI sports supply store. They have been renamed "SportStat" and are marketed for detecting altitude sickness, also caused by low oxygen levels at altitude. If you live in Denver, Anchorage, Seattle or San Francisco you probably can just walk right into REI and get an oximeter off the shelf. If you live in other areas, you may have to special order one. (The computer order number is 643-382-0013.) Now, I have a few concerns about spreading this news. Oximeters are great for patients that have gone through rehab and are very knowledgeable about oxygen, oxygen saturations and oximeters. Their physicians are often comfortable with having them titrate their oxygen according to their saturations. If, however, you havenŐt gone through rehab, or your program hasn't relied on oximetry, there are some concerns about using this technology without a thorough understanding of its limits. You should definitely get your physician's advice on this. Remember: oxygen is a drug, and the dose (the liter flow) should be prescribed by your doctor and changed only with his/her advice and permission. |
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