One of the more common requests pulmonary specialists get from their patients is about the need for oxygen. Since shortness of breath is a common feature of most lung diseases such as COPD, interstitial lung disease and occasionally asthma, most patients seem to equate this symptom with the need for oxygen.
Back when I started in this business there really were very limited ways to check accurately on the oxygen level of patients and decisions were made on a clinical basis, that is to say, what the doctor felt was going on. Enter the ready availability of blood gas testing and then noninvasive pulse oximetry and we now have accurate ways of determining the need for oxygen in any given patient.
Many patients are often surprised that they do not require oxygen even though they are short of breath. The ease of prescribing oxygen has been made significantly more difficult by insurance companies and medical guidelines which can be used by insurance companies to deny payment. Just to be clear, oxygen therapy when used correctly can be very helpful in preventing some complications of certain lung diseases but it is expensive and cumbersome and often does not relieve the patient’s shortness of breath because it is not being caused by a reduced oxygen level even if one is found.
Most shortness of breath in COPD patients is related to poor muscle strength and air trapping. In these cases, modified activity levels and pursed lip breathing are the best solutions.
