Sleep Apnea

[Guest]

My father is 78 y.o., retired, fixed
income, has medicare as primary insurance cov. & B/C B/S of Delaware as
secondary coverage. My Dad has multiple
health problems which lately have gotten
worse with more episodes of pneumonia as
well as more often with attacks of re-
current episodes of chronic bronchitis-
wheezing, coughing & trips to E.R. He
takes prednisone almost daily anymore.
He is currently using combivent inhalers
with the chamber for maximun effect of the drug. We last week were using I.M.
solumedrol after he had just gotten out
of the hospital with bacterial pneumonia Daddy was a mechanic & worked on cars when there was not any
public awareness of the hazzards of ex-
posure to asbestos, at a shipyard during the war. He is Dx with asbestosis with copd OSA, angina, he tried to take a pulmonary function test
but ended up in the hospital because he
became unresponsive. He had a sleep
study done years ago at univ. of Penn &
was dx with osa.
My Question is-
How can i get o2 for him at home, we
cannot seem to meet the 88% sat required
by medicare. This last discharge, after
a week of the IV meds, O2 & steriods, he did a whopping 95% but had to sit down cause he could not get his breath.
He has insurance but why are the guidelines so strict & how can i help
him? This man is as active as his breath
will allow him to be. He stpos all day long at times to go into A/C to help.
The nitro helps his chest pain but gives
him a headache.
Thank you A Loving daughter

[Guest]

There are a lot reasons for shortness of breath, not only low oxygen. The fact that his oxygen stays up and is still short of breath strongly suggests that oxygen would not be of help. However, there was one interesting study looking at people with shortness of breath from lung cancer, granted a different problem than your father, who had normal oxygen concentrations. They were given the nasal prongs with only air running through it, not oxygen and their shortness of breath improved. This is probably due to air flow kind of like a fan is my guess. The extra work of breathing from his lung disease can cause shortness of breath. Deconditioning can cause it. Heart problems can cause it all with normal oxygen concentrations. The reason that it is not paid for at that level is the studies that have been done did not show any survival advantage to giving oxygen at levels higher than 88%. Optimizing those other problems might help.
[quote] My father is 78 y. o... [/quote]