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kika CH.com Veteran Offline I Love CH.com! Posts: 122	Need hard data to take to MD Sep 9^th, 2010 at 12:20pm Hi I am going to my MD tomorrow and plan to ask him to write me an Rx for the high flow oxygen regulator, but I KNOW he is going to resist. Can anyone direct me to any medical/ scientific studies that support the use of high flow O2? TIA
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Potter CH.com Alumnus Offline Team MOOSE DROOL Stinky Stuff on a Hook Prostaff Posts: 3600 Blgs.Mt. Gender:	Re: Need hard data to take to MD Reply #1 - Sep 9^th, 2010 at 12:36pm Click this Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to or Potter
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DennisM1045

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Re: Need hard data to take to MD
Reply #2 - Sep 9^th, 2010 at 12:47pm

The info you are looking for is about 2/3 down the page Potter references.

What flow rate are you perscribed now? If it's 12lpm and you have a 15lpm regulator odds are you Dr won't go higher. Mine wouldn't either. The reason is that the current literature (that I know about anyway) doesn't talk about flow rates higher than 12lpm.

Someone please chime in if this is outdated info.

Even if he/she does, odds are your O2 provider won't have a regulator that goes above 15lpm. Most of us have to go out and buy our own.

Ebay is your friend. There are relatively cheap options out there.

25lpm e-tank (CGA 870) regulators are ~$15-$20.

I bought an m-tank (CGA 540) welding regulator for $47 delivered. This type of regulator measures in PSI instead of LPM. It isn't a click style so you simply ramp up the flow as high as you need to. It is capable of flowing O2 at rates much higher than I can breathe at.

-Dennis-

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Where there is life, there is hope.
Where there is Oxygen, you must use proper caution.
So be safe, don't smoke while using O2. Kill the pain and not yourself.

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Lee_Ann CH.com Junior Offline I love YaBB 1G - SP1! Posts: 34 Texas Gender:	Re: Need hard data to take to MD Reply #3 - Sep 9^th, 2010 at 12:57pm If that doesn't work, we got a high flow regulator from our local welding supply. I also think you can buy one from Ebay. Good Luck!
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Linda_Howell

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Re: Need hard data to take to MD
Reply #4 - Sep 9^th, 2010 at 1:10pm

Here is some hard data by Dr. Rosen to print off. The link to the left in yellow is very good, but I've found Doctors will generally take to heart something coming directly from another Dr.

Quote:

"High Oxygen Flow Rates for Cluster Headache"
by Todd D. Rozen, M.D., Neurologist

As discussed in previous issues of the Headliner, cluster headache patients require effective abortive therapy due to the extreme intensity of their pain. The two most effective cluster abortives are injectable sumatriptan and inhaled oxygen. However, since a large percentage of cluster sufferers are cigarette smokers and at high risk for coronary artery disease, many cannot be treated with the various triptan medications. In these cases, oxygen therapy becomes the preferred option.

Oxygen, the safest of all cluster therapies, is usually prescribed based on a landmark study by Dr. Lee Kudrow. In this study, patients were instructed to use 100% oxygen via a nonrebreather face mask at 7-10 liters/minute. Although usually effective, a certain subset of cluster patients do not achieve relief from this treatment. The author hypothesized that treating patients with higher flow rates of oxygen, up to 15 liters/minute, might provide relief to those sufferers who had not responded to standard oxygen therapy regimens.

Because MHNI has many intractable cluster patients, it was decided that a higher dose of oxygen therapy would be utilized in a few patients. Several important cases recently reported in the medical literature, found this therapy to be quite effective in patients who previously did not respond to lower dose oxygen inhalation.

MHNI's experience indicates patients who do not respond to the standard flow rates should be given the opportunity to use up to 15 liters/minute. However, prior to initiating this therapy, patients must obtain clearance from their primary care physician since serious lung disease and other conditions can make oxygen therapy unsafe or inappropriate. In addition, such oxygen therapy should not be used for more than a maximum of 10-20 minutes at a single setting.

The basis by which oxygen turns off a cluster headache is unknown at this time. Oxygen's constrictive effect on cerebral blood vessels may play a significant role.

After you get the script, Then you can go to E-bay as been suggested and get another regulator that goes higher. Someone here got one for as little as 39.00
The difference in aborting time between a 12 lpm one and a 25 lpm...is astounding and well worth the extra bucks.

Linda

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Hurt people.....hurt people. Think about it.

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kika

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Re: Need hard data to take to MD
Reply #5 - Sep 9^th, 2010 at 2:56pm

DennisM1045 wrote on Sep 9^th, 2010 at 12:47pm:

What flow rate are you perscribed now? If it's 12lpm and you have a 15lpm regulator odds are you Dr won't go higher. Mine wouldn't either. The reason is that the current literature (that I know about anyway) doesn't talk about flow rates higher than 12lpm.

Even if he/she does, odds are your O2 provider won't have a regulator that goes above 15lpm. Most of us have to go out and buy our own.

-Dennis-

He agreed to prescribe me 15 LPM, which I have been using with some success. I would like to buy the InGage one that Batch recommends for ~ $200.00 which my insurance will cover BUT I have to have an MDs Rx.

Will go check that link now

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kika

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Re: Need hard data to take to MD
Reply #6 - Sep 11^th, 2010 at 8:04am

Unfortunately I was not able to find any medical literature that supports the use of high flow O2 and the MD refused ( no surprise). He is attending a conference next week and said he will ask about it though.

Interstingly, he said that his reservations about using O2 > 12 LPM is that it can cause a proliferation of blood vessels behind there eye and hence visual problems.

Anyone know anything about this?

Batch?

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Potter

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Re: Need hard data to take to MD
Reply #7 - Sep 11^th, 2010 at 10:48am

kika wrote on Jun 30^th, 2008 at 11:55am:

i am almost afriad to post this ( am a little superstitious), but i THINK the O2 worked miraculously this am!!!!!!!!!!!!!!!!!!!!!
i had it on at the MD's prescribed rate of 7L/min ( which i kow is low flow) and within 6 minutes, the pain was gone. only think is, about 5 mins prior to using it, i took a squirt of zomig nasal, but i did the same thing at work yesterday ( no O2 available) and the symptoms took longer to resolve.
can it really be this effective???????

kika wrote on Jun 29^th, 2008 at 2:01am:

hi

MD decided to change the verap to 180 mg IR twice daily, instead of 240 mg SR daily. also changed the zomig to nasal spray ( 5 mg) from tablet ( 2.5mg) and, he ordered O2. i am pretty freaked out having this stuff in my house for reasons i can't explain. Undecided

took the zomig this am, but didn't work any better than the tablet form, which is weird, seeing as it's 2x the dose.he also wrote an Rx for imtrex injectables if the nasal spray doesn't work.
MD was not in favour of using lithium at this point.
if my pattern remains the same, i'll have a chance to try out the O2 tomrrow am.

cross your fingers........................

Since you already have a script for oxygen just spring for your own regulator.

Potter

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Batch

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Re: Need hard data to take to MD
Reply #8 - Sep 11^th, 2010 at 11:19am

Kika,

Some of the information your doctor will need is at the following link:

Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

or

There shouldn't be any issue with a prescription for oxygen therapy at a flow rate of 15 liters/minute. Even the National Institutes of Health list oxygen therapy at 15 liters/minute as the first acute treatment of choice for cluster headaches.

See the following link:

Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

or

I'll send you a paper early next week that may also help change your doctor's mind about prescribing higher oxygen flow rates.

If push comes to shove, there are several alternative and inexpensive methods of obtaining any flow rate you want.

Take care,

V/R, Batch

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Guiseppi CH.com Moderator CH.com Alumnus Offline San Diego to Florida 05-16-2011 Posts: 12063 SAN DIEGO, CALIFORNIA USA Gender:	Re: Need hard data to take to MD Reply #9 - Sep 13^th, 2010 at 10:48am My wife always peruses E-Bay, sh'e regularly finding higher flow regulators, just grabbed me a 25 LPM for my E-tanks for $20. I'm big on back up's for my back ups! Joe
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Agostino Leyre CH.com Sponsor Offline "Hit like a phillips head into my brain." Posts: 3803 Madison WI USA Gender:	Re: Need hard data to take to MD Reply #10 - Sep 13^th, 2010 at 10:52am Potter wrote on Sep 11^th, 2010 at 10:48am: [quote author=2E2C2E24450 link=1214443000/11#11 date=1214841306] Since you already have a script for oxygen just spring for your own regulator. Potter Yep, a new regulator is probably cheaper than the co-pay on a zomig re-fill.
Back to top	Triptans cause increased number of hits and increased intensity. Learn it, believe it, live it. I use triptans as the absolute LAST RESORT when treating my CH.&& IP Logged

kika

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Re: Need hard data to take to MD
Reply #11 - Sep 14^th, 2010 at 9:09pm

Agostino Leyre wrote on Sep 13^th, 2010 at 10:52am:

Potter wrote on Sep 11^th, 2010 at 10:48am:

[quote author=2E2C2E24450 link=1214443000/11#11 date=1214841306]

Since you already have a script for oxygen just spring for your own regulator.

Potter

Yep, a new regulator is probably cheaper than the co-pay on a zomig re-fill.

I will if I have to, but saving 200 bucks is saving 200 bucks.

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