First, I would like to thank everybody on this site for all the information, which I have found fantastic over the last couple of weeks of devouring this site in search of some relief.
I am currently in the middle of my second cycle, the first happened 6 years ago (I had thought I was one of the lucky ones who would only ever have one cycle). Currently I live in Europe and have found getting oxygen for relief near impossible in my location. However, during my previous crisis, I used Oxygen and it was like a wonder drug. Clearly in most of the developed world (US/Europe/Canada/Australia) getting Oxygen via the medical route is:
· Difficult requiring various visits to different specialists, and some don’t want to prescribe O2.
· Hard to source without tons of paperwork.
· Some health insurance companies won’t cover it.
· NRB masks are not the best option for delivering the O2 (I will explain later).
Fortunately for me I am a scuba diver, an instructor trainer for mixed gas diving using open-circuit and closed-circuit rebreathers as well as a cave diver. The last time I had a cycle I actually owned a dive shop (in the Red Sea, Egypt). Two weeks into my first cycle I found out the information about O2 in the late afternoon, I drove down to the shop, filled an O2 cylinder 80cf/12lt, put a scuba regulator on it and took it home.
That night I managed to prevent every singe attack by breathing O2 for 15-20 min from the moment I felt the attack coming on. I subsequently managed to stop every attack for the following 7 weeks using O2 since I kept it with me all the time. The reason I am writing this is that, having my second attack in Europe with loads of rules and regulations it is clear that, for a cluster head to get quick and relatively easy access to O2, the scuba route may be the easiest and most efficient way forward.
The Equipment Needed:
Any scuba regulator can be configured for O2 use, it just needs to be “oxygen clean”. This is achieved as follows:
· The first stage (the metal part that attaches to the cylinder valves) is broken down and cleaned with a solution that removes all hydrocarbons.
· The O-rings (a first stage is basically a bunch of metal including springs and O-rings) that are made of rubber are replaced by non O2 reactive (EPDM) O-rings.
· Instead of a standard silicone lubricant the first stage and O-rings are lubricated with an “oxygen grease”. The most common brand name is something like “Christo lube.”
The above process is repeated for the second stage of the regulator (the part that goes in the diver’s mouth). Once it is complete the regulator and hoses are reassembled, and the regulator is safe to use in a 100% Oxygen environment.
While you can have a regulator O2 cleaned, you can find plenty that are already O2 clean from the manufacturer.
Why a regulator is more efficient?
· A scuba regulator is basically a demand valve. When attached to the cylinder and turned on, nothing happens until you start to breath. As you inhale the reduction in pressure opens a valve in the second stage, allowing you to breath in as much O2 as you need.
· When you start to exhale, the O2 is shut off, and the exhaled breath escapes through a one-way valve and out of the exhaust ports. You then inhale again, and the above process is repeated giving you 100% pure O2.
A regulator is much better than an NRB (in my very humble opinion for a couple of reasons):
· Much more efficient- no O2 is wasted through a continuous flow system.
· A NRB mask covers your mouth and nose. Compressed gases (whether O2/Air/ or Helium) are filtered for moisture and are incredibly dry, which can lead to serious irritation in the nose. A scuba regulator has a mouthpiece and you only inhale and exhale through your mouth. This leads to no irritation.
· Scuba regulators have a much higher flow rate so offer a minimal breathing resistance and lower the work of breathing.
Scuba cylinders consist of two parts. The actual cylinder which can be made of steel, Aluminium or carbon fibre. The second part is the steel tank valve. To be in O2 service the cylinder and valve need to be cleaned the same way as the regulator and have the appropriate O-rings and parts changed to oxygen compatible materials. Once done it is ready for use with 100% O2.
Who, Where, and How Much?
Almost any technical diving centre or facility will be able to service regulators and cylinders to make them oxygen clean. Getting stuff ready should not be too difficult depending on where you live. In terms of cost this is highly variable but in my travels across the globe it was never more than about $100 to $150 to have a cylinder and regulator O2 cleaned including parts and labour.
Using a Scuba Cylinder for O2:
This is based on my personal experience, so we will all be slightly different. During my cycle the bulk of my attacks were at night when sleeping. I also had some during the day but rarely and only when triggered by something.
I kept a 80cf/12lt cylinder next to my bedside table. When I woke up feeling the start of an attack, I would sit on the edge of the bed and start breathing from the regulator. Within a few breaths I would feel the symptoms backing off, and within a few minutes they would be completely gone. On average it took me 10 to 20 minutes of breathing O2. Although most of the time it was at the shorter end.
An important note about breathing:
The key to using a scuba regulator is proper breathing technique. Rapid fast breathing is pretty bad since you are not letting your blood (by extension your brain) get saturated with O2 quickly. You need to inhale slowly and exhale slowly. Personally, I inhale for 8 seconds and exhale for 9 seconds. So, in effect I am only having 3-4 breaths per minute, but they are top quality breaths full of O2.
This is the way scuba divers breathe, since it is the most efficient way to use gas (reduces gas use), and when breathing oxygen-rich mixtures for decompression it is the best way to oxygenate your body and off-gas the gases.
How long will a 12lt/80cf tank last?
This will vary from person to person, and how you breathe. From personal experience I normally used to have 5-7 attacks per day. And a cylinder 12lt/80cf cylinder charged to 3000psi/200bar would last about one week before I needed to refill it. You have to remember with a demand valve there is minimal waste. In terms of cost this will ultimately depend on where you live, but ultimately a 80cf/12lt cylinder pressurised to 200 bar, should not set you back more than $30/$40 a fill.
I hope this clears up some of the points about getting O2 via scuba gear. I will write a follow up to this post on what certifications will allow to get O2 fills, what you need to get them, the quickest way, as well as a few other ways and methods which should give you access to O2 from a diving centre. I also hope to cover moving around with your O2.