Tuesday, October 19, 2010

The Pulmonary Press

MedGroup
October 2011

Oxygen Fire Safety

Oxygen does not explode, but it does support combustion. That means anything that would normally smolder or be difficult to ignite will burn easily when extra oxygen is available. Be careful around stoves, and never, ever smoke when using your oxygen.

What to do Before a Fire Occurs . . .

• Have you given thought to how you would get out of a burning apartment or home?  Identify and determine the nearest emergency exit or exits within your home.  It is important to always know the safest and quickest exit from any location you are in and it should always be based on your physical capabilities.

• Install heat or smoke detectors throughout your home.  Key locations for smoke alarms are: the kitchen, basement, storage areas, trash areas, accessible attics, sleeping areas and hallways.  Please note that there are various types of smoke alarms.  Heat and smoke detectors can reduce the chance of dying in a home fire by approximately 60%.  It is important to make sure your smoke alarms are functioning properly.  Make sure all smoke alarms are kept cleaned and vacuumed regularly to remove dust particles.  In addition to this, you should test the batteries monthly and replace batteries at least once a year to ensure that they are working properly. If you are unable to perform these tasks yourself, ask your friends, family members, building managers, or someone from the fire department to help you out.

• Learn how to use a fire extinguisher. For those who use wheelchairs, you might want to consider mounting a small personal extinguisher in an accessible place. This will be beneficial if you cannot “stop, drop, and roll” if your clothing catches on fire.


Asthma Diagnosis Often Overlooked in Older Adults

Asthma is a common and highly treatable condition in older adults, yet a recent study showed 39% received no treatment at all—compromising quality of life and risking hospitalization. It is often mistaken for illnesses like bronchitis and emphysema, exacerbated by medications like aspirin, and overlooked by patients and doctors alike. At least 40% of asthma sufferers are 40 or older at the time of their first asthma attack, despite the common belief that it is a young person’s disease.

“Don’t simply chalk up shortness of breath to aging” says Raymond Slavin, MD, allergist and professor of internal medicine at Saint Louis University School of Medicine. “The good news is that once we identify asthma, it has an extremely effective treatment.”

One reason aging brings an increased risk of asthma is that our lungs, blood vessels, and connective tissue change structurally as we age, causing a drop in our lung function. And because of the misconception that adult-onset asthma is rare, it may be confused with bronchitis, emphysema, or sinusitis.

Medications also play a role. Beta blockers and ACE inhibitors, used to treat common illnesses in seniors, like heart attacks, hypertension, and congestive heart failure, can cause shortness of breath, wheezing, and coughing. Aspirin, which frequently is taken for arthritis, can trigger asthma.
Source: Pediatrics; August 2010 Respiratory Therapy Magazine


Medicare Corner

Medicare pays for oxygen for patients with chronically significant low levels of oxygen in their arterial blood (hypoxemia) associated with a chronic lung condition or disease that might be expected to improve with oxygen therapy.   A sample of blood that is traveling from your lungs to the rest of your body is collected and measured for oxygen saturation levels. These tests will indicate whether there is the need for oxygen therapy.

Categories/Groups are based on the oxygen test results:

55≤ mmHg, or 88%≤ saturation

For these results you must return to your physician 12 months after the initial visit to continue therapy for lifetime or until the need is expected to end. Typically, you will not have to be retested when you return to your physician for the annual follow-up visit.  However, your physician does need to make notes in your chart indicating he/she has seen you within 90 days of the anniversary from when oxygen was first prescribed, and that you need to continue using the oxygen.

56-59 mmHg, or 89% saturation

For these results, you must be retested within 3 months of the first test to continue therapy for lifetime or until the need is expected to end.

≥60 or ≥90% deemed “not medically necessary”.

Oxygen will be paid as a rental for the first 36 months. After that time if you still need the equipment, Medicare will no longer make rental payments to your homecare company for the equipment. Medicare will then pay only for maintenance of your equipment every 6 months and refilling your portable oxygen tanks. Medicare does not separately pay your homecare company for oxygen accessories such as regulators, tubing, masks and cannulas.  After 5 years, the equipment has reached the end of its ‘reasonable lifetime’ and can be replaced, if you wish, by the homecare company. This starts the 36 month – 5 year cycle over again.  If you elect NOT to have it replaced you must pay for any routine or emergency servicing of the equipment.

Best Exercise

When asked, which the best exercise is, James Skinner, PhD, director of the Exercise and Sport Research Institute at Arizona State University, says it’s the one a person enjoys.



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