• Donations
  • PERF board member Jeanne Rife made a very generous donation towards payment of our new printer in memory of her daughter, Gale Marie, and her mother, Bertha Sanford, both of whom died very recently. Our sympathies are with you, Jeanne.

    Another PERF Board member, Barbara Borak, also receives our deepest sympathies for the loss of her father, Elmer Lewis. His many friends made generous memorial gifts to PERF in his name.

    The family of Jerry Donatoni called to tell us that the Second Wind helped Jerry as much as any medicine. That meant a great deal to us and we thank you for taking the time to make that call during this sad occasion. Memorials in honor of Jerry Donatoni were made by Mr. & Mrs Joseph Donatoni, Rena Legge, Pat Peller, Madeline Fish, Joan Berlin, Mary & Aldo Dellape, Mr. & Mrs. John Casey, Arthur & Florence Cohen, Wallace & Clara Ford and Arthur & Doris Golden. A memorial donation was also made by Virginia Elson in memory of David Elson. Those of us in PERF join with all of you in offering condolences to the loved ones of these departed friends and family members.

    We also send thanks for donations to Barbara Knowles, Kris Brust, RN, John Skolfield, Jr., with very special thanks to Dave Nelson and Linda Burns!
  • We Got Mail
  • Increasing Oxygen Levels Without Oxygen:
  • Several people have written something like, "I have a friend with emphysema whose oxygen levels are dropping. He was told that there are new techniques using hydrogen peroxide to drink or to use IV (intravenously) to cleanse the blood. Can he raise the oxygen level of his blood this way?"
  • Sorry but the answer is no, if you are referring to various scams out there that say you can increase blood oxygen levels with a pill or drink of some sort. Do NOT let your friend use herbal therapy or IV therapy to try to improve the oxygen level of the blood! Beware of people claiming to offer "quick improvement" or "cure"! These scams have been around for a long time. They offer no help, cost a lot of money, and can sometimes be dangerous.
  • Pulmonary rehab can help to improve breathing techniques, teaches pursed lip breathing, and helps to get muscles more efficient with an exercise program. An exercise program also may help to get rid of excess mucus in the lungs. These things, plus proper inhalers, help to fine-tune and slightly improve oxygenation in many people.
  • However, the only way to substantially increase the oxygen level of the blood is to breathe it in with oxygen as prescribed by a physician. Oxygen is a medication. It can be obtained only with a prescription that specifies the liter flow necessary to bring the oxygen level of the blood back to a normal level. Your friend needs to talk to his physician about his concerns as soon as possible. He is fortunate to have such a caring friend as you.
  • We also get letters from people who are not happy using their oxygen and hope that pursed lip breathing can be used instead.
  • Dan wrote "My COPD doctor gave me a prescription for oxygen when I am sleeping or walking around. My daily routine is going to the mall and walking for 30 to 40 minutes per day. I'm a little embarrassed to go out in public with oxygen on my body so I don't use it. I do PLB to get my oxygen up but it only lasts about 7 minutes before it goes way down again. Then I come home and gag the rest of the day. I guess I'll just wait until I can breathe better, before I use my oxygen."
  • Dear Dan: I was so sad when I finished reading your email; sad because of how you are suffering, and sad because your rehab program didn't succeed in helping you to better understand, appreciate and take advantage of your oxygen. Of course, I don't have access to your records and only your doctor can properly advise you. He knows what your blood gases and oxygen saturations are, and how much oxygen you need . You do need to call your physician and let him know about the problems you are having. They may be due to exercising so hard without the oxygen or they may be due to another problem. Your doctor will be able to decide that when he sees you. At that time, you also need to tell him how you feel about using oxygen so that he can help you with this. While you are waiting to hear from him, I am going to review some general information that I hope will help you a little. I also urge you go through our past newsletters. We have written many-many articles on oxygen, why it is used, what happens when you don't, and its value in exercise. The time spent by us will be more than worthwhile if we help to convince you about the need of using your oxygen as prescribed.
  • I am so impressed that you make the effort to walk 30 or 40 minutes a day when you feel so miserable the rest of the day. You are one tough guy with tremendous motivation and drive. Now all we have to do is change a few attitudes and you have great potential for improving!
  • Lets talk about pursed lip breathing (PLB). I'm a great proponent of this and Dr. Tiep and I, with the help of enthusiastic patients, did some of the early research proving how effective it is in helping some people increase their oxygen levels. It is great for emergency use, to avoid panic, and to help bolster your oxygen levels. BUT, it is NOT a substitute for oxygen!
  • Exercise is one of the things that can really better your condition but NOT if it is making you so sick. So, tell me: What do you think you can do to make things better? I'll bet you know the answer and don't need me to say: Use your oxygen as prescribed by your doctor!
  • Let's talk about your feelings of embarrassment. What do you think of the astronauts? I'll bet you don't think that they look silly using oxygen. How did you feel when you saw that "first step for mankind" on the moon? I still get chills seeing that news clip, but it wouldn't have happened if those guys tried to do it without oxygen. You may say that's different. Well, maybe, but did you know that liquid oxygen technology, and much lightweight portable equipment, is a result of our space effort? Those astronauts were the first users of portable liquid oxygen! Remember that, and those hero astronauts, the next time you feel foolish wearing oxygen. Think of yourself as also being someone out to explore new worlds and attitudes and be as proud of using this new technology as they were, and still are.
  • Did you know that portable oxygen has only been around for about 40 years? Also, appreciate how fortunate you are to have portable oxygen with which to walk around. Many countries in the world do not have oxygen at all, or have it only for the last month or so of life. And that end comes a lot sooner to those who need oxygen but don't get it or won't use it! Still other countries only give oxygen to those who have such low blood levels that they need it all the time, even when vegetating in front of a TV set. There is no oxygen available for those who need it to help exercise!
  • You can't go back the 60's when the doctor wouldn't have been able to give you oxygen, and I guess you don't want to move to Eastern Europe or much of Indonesia and Asia where oxygen is not available. So, would you please again consider taking advantage of being an American in the 21st Century? Please! Use your oxygen to exercise!
  • Maybe you have the wrong portable system. Is it small and easy to carry around? If you are dragging around an antique E-cylinder, I can see why you are so resistant to using portable oxygen! E-cylinders are not portable. If your HMO insurance doesn't cover some of the little units, like the Helios or small lightweight compressed oxygen tanks, maybe your doctor or the staff of your rehab program can contact the HMO and help get you through the system.
  • If you have Medicare and a Medicare supplement, you should be able to get anything you need. With your doctor's approval and support, insist on a small, lightweight unit. Go down to the office of your oxygen supplier and see the various kinds they have available. If you don't already have one, ask your doctor about switching you to a more user-friendly portable oxygen system. I know your physician will want to help. Have you heard about trans-tracheal oxygen? That is the ultimate for those who want an "invisible" portable oxygen system. Are you beginning to see how many options you have?
  • I haven't even started on how to use pursed lip breathing as a temporary help, or all the physiological reasons for using your oxygen as prescribed. We can review some of that at another time. But please, don't go for your next walk at the mall without your oxygen. Write back and let me know how you are doing. We care!
  • [We just heard from Dan. With his doctor's help, he has been switched from a large tank too big to carry, to a Helios system. He plans to use oxygen when exercising.]
  • And a question for Dr. Casaburi:
  • When I was in my forties I took up jogging. In time, I found that I increased the length of time many times over. My question is--did my lungs produce additional alveoli to process the increased load by my jogging or did this exercise cause the lungs to merely operate more efficiently?"
  • This is really an excellent question. It is well known that regular exercise increases our ability to tolerate exercise. This is mainly a result of changes in the muscle. By a process whose mechanism is not totally understood, exercise causes profound changes in the structure and composition of the muscle that is exercised. Muscle capillaries grow, mitochondria (the power-houses of the cell) get bigger and more numerous, and the concentration of enzymes that make the muscle work increase. The muscle is able to do a lot more work before it begins to produce lactic acid. Lactic acid is part of what makes the muscles "burn" and it also stimulates breathing. So, after training, a given amount of exercise will feel less stressful both to the muscle and to the lungs.
  • Some other organs adapt to exercise besides the muscles. Since it is working harder too, the heart will also have positive adaptations and, for example, heart rate will be lower at a given level of exercise. But the lung does not seem to adapt. Very clearly, the lungs do not grow alveoli in response to exercise training.
  • While we are waiting for the results of the FORTE study, it is worth stressing that this is not the only game in town. I know of at least one major drug company who has a drug in clinical trials aimed at stimulating alveolar growth. I suspect others will follow. I am still of the opinion that we are still quite away from an effective way to stimulate alveolar growth. However, the more people working on this problem, the sooner we will reach this goal.
  • Dr. Richard Casaburi

  • 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.