What About Those Machines?

with Linda Crabtree

It's easy to get the equipment mixed up when talking about breathing aids. It's also frightening to have someone tell you that you would benefit from a certain machine but you don't know what that machine does and how you are going to have to use it. I've asked Margaret MacDonald, a registered respiratory therapist, to explain the differences.
Oxygen Once in a While
There is an oxygen concentrator that concentrates room air taking the nitrogen out and pumping the concentrated oxygen to you through a face mask or a nasal cannula which is a small, two-pronged plastic device that fits just inside the nostrils. It doesn't hurt and it isn't frightening.
Portable Oxygen
Some people also receive oxygen from a steel cylinder through a mask or nasal cannula and some people who need oxygen but need to be mobile use liquid oxygen which comes with a small refillable canister that can be rolled around in a small, lightweight portable cart. You may have seen someone using a unit like this at the grocery store or out shopping. Some people who have emphysema use these small units when they go out.
CPAP and BiPAP
For people who can breathe on their own but need a little more support perhaps while sleeping or resting, a continuous positive airway pressure (CPAP) machine is needed and this is used by placing a mask over the nose or a nasal seal into the nose. You are constantly breathing against a pressure so you get a little more in and you breathe out against a pressure. This helps people who aren't getting enough oxygen into their blood or just aren't breathing well enough. It is also prescribed for people with sleep apnea.
Again for people who can still breathe on their own there is the BiPAP machine. It is similar to the CPAP except there are two levels of pressure so when you breathe in there is a higher pressure and you breathe out into a lower pressure.
This would be better for people who don't do too well on a CPAP but don't yet require a ventilator as it gives you more support than a CPAP. With the CPAP and the BiPAP you are doing all of the breathing on your own.
Not Breathing Adequately
For people who can not breathe adequately on their own, a ventilator is prescribed. Ventilator is the correct term, respirator was an earlier term for a ventilator. It is for those who left to their own devices don't breathe enough. Most people who need ventilation long-term have a tracheostomy that attaches them to the ventilator. A tracheotomy is the name for the incision -- a tracheostomy is a permanent hole into the windpipe to assist with breathing and clearing of secretions - it is often permanent for people who need to be ventilated but can be left to grow closed if assisted ventilation is no longer needed. People with airway abnormalities such as a narrowing airway or an obstruction might also have a trach but not necessarily.
Ventilator
A tracheostomy is a common long-term way of hooking someone up to a ventilator but a mask is becoming more acceptable especially for people like us with muscle disorders. Some people who need suctioning and don't have a cough reflex need a trach but if you can cough the good news is you can pretty well count on using a mask. However, if your condition gets more serious you might need a trach. For long-term use there is a talking trach tube that allows a person to talk and still have the trach tube kept open and still receive ventilation.
Granted, being on a ventilator isn't any fun at the best of time but, believe it or not, there is an up side. Getting more oxygen and breathing better means you'll have more energy to face the world, you'll be more alert and your concentration will be better. Your quality of life will be improved because you'll feel a lot better and the stress and worry about your breathing problems will have been taken care of; you'll have done everything within your power to let you be the very best you can be.