Oxygen is a colorless, tasteless, odorless gas that is necessary for life as we know it. Oxygen is the fuel that powers the human body. The respiratory system is responsible for taking oxygen into the body (inspiration), getting it to the bloodstream (for circulation throughout the body), and removing the leftover carbon dioxide once the oxygen has been used (expiration). The lungs are the major organs of the respiratory system.

The air humans breathe is composed of 21 percent oxygen, 78 percent nitrogen, and 1 percent other harmless gases. People with normally functioning lungs are able to completely use the 21 percent oxygen from room air; therefore, their bodies do not require additional oxygen. People with lung disease often need additional oxygen, either because they cannot take in enough oxygen from the air or because they cannot process enough of the oxygen they do take in. When this occurs, oxygen deficiency occurs and supplemental oxygen is needed. Symptoms of oxygen deficiency may include shortness of breath, restlessness, mental confusion and constant fatigue.

Oxygen is a medication or drug, and its use must be prescribed by a doctor. Depending on their reasons for needing supplemental oxygen, some people use it just for exercising or while asleep. Others, particularly those with chronic and/or progressive diseases, need additional oxygen 24 hours per day. This is referred to as Long-Term Oxygen Therapy. When prescribing oxygen, the doctor will specifically state how long the oxygen needs to be worn per day, the actual liter flow and estimated length of need.

Oxygen is not addictive, although it is easy to understand why some people think it is. The average person using supplemental oxygen did not suddenly develop the need for it. His (or her) chronic oxygen deprivation and related physical changes occurred so slowly that he did not realize how bad he had been feeling — until he realized how much better he felt while using oxygen! When he left the oxygen off for a few hours, the bad feelings returned, leading him to feel “addicted” to the oxygen. In reality, we are all addicted to oxygen! When used as a medication, supplemental oxygen does not make a person “high” — it simply helps return the body to a more normal state.

Strangely enough, too much oxygen can be as bad for a person with COPD (Chronic Obstructive Pulmonary Disease) as too little, due to changes in his respiratory drive. The normal human respiratory drive (urge to breathe) is triggered more by the build-up of carbon dioxide (CO2) than by lack of oxygen (O2). A person with COPD, especially a long-term and/or heavy smoker, develops a tolerance of sorts to the large amounts of CO2 constantly invading his lungs. His respiratory drive is then gradually triggered more by the lack of O2 (hypoxia) rather than the large amount of CO2 in his lungs. If this person gets too much supplemental oxygen, his body can “forget” to breathe — and he can suffer from the very same symptoms as when he was oxygen-deprived! A flow of about two liters per minute is generally what it takes to balance this for most people with COPD. Each person and his/her reason for needing oxygen are different, though. That is why a licensed medical provider must evaluate a person’s need, determine and prescribe the correct liter flow, and provide ongoing monitoring and evaluation of the person’s condition. In a crisis situation, such as respiratory failure or during an illness requiring hospitalization, a greater liter flow may be needed. Respiratory therapists work closely with the physicians in all hospitals to make sure that patients get the exact amount of oxygen each one individually needs.

It is very common for a person to get depressed after finding out he needs supplemental oxygen. Many people say they were embarrassed by having to wear the cannulas and carry the tanks around in public until they start realizing how many others out there are on oxygen therapy, too! The former smoker often carries the burden of guilt with his tank because he feels like he did it to himself. Nearly everyone feels a sense of loss. All of this is normal. Eventually acceptance creeps in, especially as energy levels return. Yes, it is a very big change, but we humans are a resilient lot. If you find yourself in this situation, slow down and take a deep breath! Let go of the guilt — there’s no need to focus on what you cannot change. Stay on schedule with your medications and your medical appointments. Try to eat healthy and remain active. Supplemental oxygen is really a “life sentence,” and life can still be very, very good!

Alene Payne, MSHE, RRT/RCP, is the manager of Cardiopulmonary Services at Vidant Beaufort Hospital.