Ryan Diesem

The Ryan Report

Home Oxygen Guru – The HO2G Pen

The fall season is again upon us. I hope you made it through these hot months healthy and happy. This issue we’ll be covering a new Portable Oxygen Concentrator (POC) that is hitting the market, ideas for reducing tubing kink and coil, and a hopeful development regarding the availability of liquid oxygen and associated liquid oxygen systems.

New POC from CAIRE: The FreeStyle® Comfort

If you haven’t already, you’ll likely soon be seeing advertisements and information on CAIRE’s newest POC, the FreeStyle® Comfort. As with any new POC on the market, oxygen users will probably be image254curious about what this new unit brings to the table.

In short, the FreeStyle Comfort is most like the Inogen® One G3 and Philips Respironics SimplyGo Mini POCs. Like those units, the FreeStyle® Comfort is a pulse only device


FreeStyle Comfort Maximum Oxygen Production (mL/min): 1050 mL/

min (1.05 LPM)

Available Settings:

1 to 5

Pulse Delivery Type:

Minute Vol. Delivery

Maximum Delivered Pulse Volume:

15 BPM: 70 mL

30 BPM: 35 mL

Unit & Battery (approx.): 5 lbs.

Approx. Battery Time at Pulse Setting 2:

4 hours

Maximum Altitude:

10,000 ft.

Ryan Diesem is Research Manager at Valley Inspired Products, Apple Valley, MN. Contact Ryan at [email protected] com with questions or comments.

featuring settings from 1 to 5 and can generate just over one liter of oxygen per minute (LPM). In fact, its published oxygen production and pulse delivery specifications are identical to that of the G3. The unit has removable battery packs, and can utilize either an 8 cell “single” or 16 cell “double” size battery. With a single battery, the unit weighs 5 pounds; with the double battery installed the weight increases to 6 pounds.

One of the advertised features of the FreeStyle® Comfort is its ergonomic design. Unlike the G3 and SimplyGo Mini, the shell of the POC is curved in such a way that it should rest comfortably against the natural curve of the hip when the device is worn over the shoulder. Effort was also made to balance the weight of the device so that it was more comfortable to lift and carry. In addition to a fitted carry bag that most wearable POCs now come with, the FreeStyle® Comfort also has strap clips on the shell of the device, making the choice to use the carry bag or not up to the user.

The FreeStyle® Comfort is already approved for airline travel by the FAA, and like all POCs comes with a DC power cable for use in motor vehicles. Device sensitivity is indicated to be comparable to the other POCs currently on the market and, in the event that the device does not trigger due to shallow or absent breathing, it will auto-pulse at a rate of 20 breaths per minute. As with all pulse only POCs, despite various manufacturer claims that using a POC on pulse delivery at night/during sleep is OK, I cannot recommend using a pulse POC when you are sleeping because of the uncertainty that the device will trigger in a timely fashion (or at all) when breathing is shallow or the cannula has moved away from the nose during movement.

At the time of writing, the product page for the CAIRE FreeStyle Comfort is not published on the CAIRE website. However, the product manual is accessible and can be found at

 How to reduce coil and kink in your oxygen tubing

With the recent and sudden closure of SoftHose, I received a couple emails asking about how to prevent kinking and twisting of oxygen tubing. SoftHose tubing tended to lay flat and was less prone to the usual annoyances of kinking and coiling that accompanies many types of oxygen tubing which helped make SoftHose a popular option among oxygen users. With SoftHose

tubing no longer available, some folks may be looking for reasonable solutions to the kinking/twisting problem.

The use of 25 and 50 foot extension tubes is very common in the home as they allow for a longer range of motion away from the image259oxygen concentrator or tank. However, these lengths of tubing are especially susceptible to kinking and/or twisting which can impede oxygen flow. One solution to can reduce the occurrences of kinking and twisting is using shorter lengths of extension tubing that are each connected with oxygen tubing swivels. 7 and 10 foot lengths of extension tubing, as well as oxygen tubing swivels, are commonly available, and can even be found on amazon.

com. Connecting 3 to 5 foot lengths of this shorter tubing using tubing swivels will give you both the length you want but with less incidence of twisting and/or kinking.

Another way of addressing kinking and twisting issues is to heat up the tubing and stretch it out to full length while the tubing is still warm. This can be done by placing the length of tubing you wish to straighten in a closable mesh or fabric bag and placing it in your dryer. Set the dryer to low heat and let

image261the cycle run for about 10 minutes. Put some towels or other items in the dryer to help soften any noise the tumbling cannula can make. When the drying time is up, remove the tubing from the bag and stretch the tube to its full length. Because the tubing length is quite long, you may need to secure one end of the tubing or find another person to help when stretching it. Centers for Medicare and Medicaid Services (CMS) recognizes impact competitive bid program has on liquid oxygen availability.

In a hopeful development, CMS has recently admitted there have been flaws in the competitive bidding program that home care providers have been tied to when providing home oxygen equipment to oxygen users on Medicare. If this is Greek to you, all you need to understand is that home care equipment providers are getting less money in reimbursement from Medicare for oxygen related equipment and services than they were ten years ago. This reimbursement is a large part of the operating budget of many home care equipment providers. This drop in reimbursement has led to a significant reduction in the availability of appropriate and therapeutic oxygen systems for oxygen users, especially for those with higher flow oxygen needs. As  we have

seen over the last 10+ years, these changes

especially impacted those using liquid oxygen (LOX) equipment. Many oxygen users had their liquid systems taken from them, and replaced with less portable and less effective equipment.

This admission by CMS is significant. Up until now, it has felt like complaints to CMS about the reduced availability of LOX and LOX equipment were falling on deaf ears. The admission prompted a quick response by a united coalition of 20 pulmonary health advocacy groups, including the American Lung Association and the COPD Foundation, that commended CMS for admitting there is an issue while also encouraging CMS to tailor its oxygen reimbursement rules so they ensure portable oxygen equipment is available to patients who need it most.

It is unlikely that anything will happen in the short term, but this development is a step in the right direction in achieving the goal of getting therapeutic, portable oxygens systems to any oxygen users that need this equipment. Activity and exercise are incredibly important in maintaining one’s quality of life while using oxygen, and currently there are way too many oxygen users that have equipment that significantly limits their daily activity. If you are one of the many oxygen users that has had your oxygen equipment and services impacted by the implementation of competitive bidding/ reduction in reimbursement to your home care provider, the American Lung Association has set up a survey to collect information that they can bring to CMS to demonstrate just how much the competitive bid program has affected oxygen users.

The more real-life scenarios they hear about, the more CMS will realize how poor reimbursement to oxygen suppliers negatively impact the estimated one and a half million oxygen users in the United States. Please take the time to complete the survey at this link, and let the people in power know what you need.