What is the best way to give a cancer patient oxygen. Oxygen pads for lung cancer

Cough is the main symptom at any stage of a cancerous tumor, it clears the respiratory organs of foreign substances. The main causes of cough:

• unsatisfactory activity of the bronchi;
• Spread malignant neoplasm on the pleura;
• the onslaught of lymph nodes on the bronchial system;
• inflammatory process in the bronchial mucosa;
• stagnation of the secret in the serous cavity.

With lung cancer, it happens:

1. Short cough with a special timbre. During periods of attacks, the muscles of the peritoneum contract and the trachea decreases. In case of frequent short coughs, you should consult a doctor.
2. Constant strong attacks of coughing disturb at night in the form of spasms. Attacks continue regularly because there is not enough air. Coughing is repeated regularly until disgust, vomiting, fainting, heart rhythm disturbances.
3. Coughing fits can be dry with anguish without sputum, hoarse, muffled or silent. This is a symptom of irritation and the transformation of healthy cells into pathological ones.
4. Expectoration, especially in the morning, produces much mucus.
5. If there are streaks of blood in the sputum, this is a sign of the appearance of a malignant neoplasm. During oxygen deficiency, severe shortness of breath is observed.

To alleviate the suffering of lung cancer, the following should be applied:

1. Complete ban on smoking.
2. Undergo a course of treatment for inflammation of the respiratory system.
3. Drink fluids 1.5-2 liters per day.
4. Drink tea infused with medicinal herbs.
5. The air in the room should be clean and cool, it should be refreshed with a special device.
6. Apply relaxation techniques that will teach you how to control your breathing.
7. If stagnation of mucus has formed in respiratory organs, it must be removed.
8. Medications help during coughing fits by depressing the respiratory centers in the brain.
9. Support immunity by eating medications or phytocollections.
10. During outbreaks of coughing, the patient should sit.

What influences the development of lung cancer?

In order to determine how the patient can be helped and what can harm him, it is necessary, first of all, to understand why this disease arose. So, the main causes of lung cancer are:

Thus, the causes of lung cancer can be very diverse. In most cases, pulmonologists divide the causes of lung cancer into viral and genetic. As for viruses, doctors still have not been able to identify the main types of viruses that cause lung cancer.

The causes of the development of the disease, which are associated with genetics, are divided into those that are inherited (congenital) and those that are acquired during life. In the second case, there is a change in the structure of DNA, damage to certain chromosomes.

The classification of lung cancer is one of the factors that the attending physician takes into account to determine the treatment and prevention of the disease. Cancer care also provides for such a classification.

This is due to the fact that the spread of cancer cells can affect the specifics of breathing, the rate of development of the disease, the position of the patient during sleep, eating, procedures, etc. Thus, 3 types of lung cancer are distinguished by location on the organs respiratory tract:

What symptoms accompany the disease?

Patient care should be based on the stage of the disease, as well as the symptoms that appear in a particular period of oncology development. Lung cancer most often presents with the following symptoms:

In the later stages of the disease, metastases spread to The lymph nodes, other organs ( chest, brain, organs gastrointestinal tract etc.).

Cancer treatment and care

There are several methods of cancer treatment. Methods of treatment are chosen based on the stage of development of the disease and the localization of large tumors. So, in the treatment of cancer, the following methods are used:

Coagulants are substances that help blood clot faster and form a clot at the site of a vessel rupture. Most often, such drugs are prescribed in case of internal bleeding. Cardiotonic medicinal substances, in turn, accelerate the heartbeat, thereby accelerating the process of contraction of the vessel at the site of rupture.

In the later stages of the disease, bleeding is quite common. That is why, people who care for patients with cancer should know how to slow down parenchymal bleeding correctly, in a timely manner, and with the help of improvised means.

Lung cancer care includes:

Caring for a cancer patient is a difficult mission that requires training not only for medical staff, but also for relatives.

Action and results of oxygen therapy

With an increase in the amount of oxygen in the tissues, healing effect, especially in affected malignant tumors plots. Cancer and oxygen are incompatible concepts, since for cancer cells, a high concentration of gas is detrimental, because they develop in oxygen-free conditions.

Due to oxygen oxidation:

• cancerous tumors are destroyed,
• immunity is stimulated
• detoxification is enhanced
• improves the state of the brain and the body as a whole,
• mood rises,
• stress is reduced
• shortness of breath decreases.

A well-known way to solve breathing problems in lung cancer is oxygen therapy.

Saturation of the upper respiratory tract is carried out using a special concentrator. In lung cancer, an oxygen concentrator is a necessary device. It can be both home portable and stationary medical.

The doctor prescribes short sessions of 20-50 minutes. Although there are no absolute prohibitions on the use of the concentrator, it is still worthwhile to carefully follow all the doctor's prescriptions: duration and dosage, in order to avoid negative consequences.

oxygen cocktails

Oxygen cocktails are another way to enrich the body with O2; they were invented back in the 60s by Soviet scientists. In the course of one of the studies, when oxygen was introduced into the stomach in the form of foam with a probe, it was found that this procedure has a beneficial effect on the patient's health. Since then, it has become known as enteral oxygen therapy.

In the modern world, various flavors are added to the foam, such as juices and syrups. Such cocktails have become an integral part of the diet in health resorts and children's camps.

Inhalation of O2 compensates for hypoxia. As a result, shortness of breath decreases in patients, the activity of the heart, kidneys, and liver normalizes, and intoxication with metabolic products decreases. Treatment of cancer with oxygen is safe for humans, as long as the dose is not exceeded, and is perfectly combined with other types of therapy, without negative consequences.

Innovative methods of treatment, new generation drugs, ethnoscience or all together - it's up to you which concept to choose, the main thing is that it becomes effective for you.

Health to you!

Complete or partial removal of the lung reduces the functionality of the respiratory system. Stable compensation of functional disorders due to the inclusion of adaptive mechanisms of the remaining lung, cardiovascular system and other organs occurs within 3-6 months after partial resections and 4-8 months after pulmonectomy.

In order to activate compensatory mechanisms in pre- and postoperative period dosed physiotherapy exercises, breathing exercises, inhalation therapy (mucolytic, antibacterial, bronchodilator drugs), oxygen therapy are carried out, expectorant mixtures, broncho- and coronary dilators are prescribed.

By the time of discharge from the hospital, the patient must learn the basic exercises physiotherapy exercises and receive instructions on the scope and nature of its implementation at home. Important role in the rehabilitation of patients with lung cancer, the treatment of concomitant pulmonary pathology (chronic bronchitis, emphysema, etc.) is assigned.

Chronic pleural empyema - develops due to infection of the pleural cavity. According to the pathogenesis, chronic empyema can be open (maintained by broncho-, esophago-pleural or pleuro-cutaneous fistula) and closed (supported by chondritis, osteomyelitis of the ribs, foreign body and insensitive to applied antibacterial agents microflora).

Treatment of chronic pleural empyema is predominantly surgical. A positive effect on the healing of bronchial fistulas is provided by local laser therapy, carried out simultaneously with the sanitation of the bronchial tree.

Radiation damage to the lungs. They are acute, subacute and chronic. The acute course is characterized by cough with a small amount of sputum difficult to separate, chest pain, shortness of breath, mainly expiratory in nature, and a rise in body temperature.

Main therapeutic measures are targeted antibiotic therapy, the appointment of anticoagulants, inhalations with bronchodilator mixtures and expectorants, breathing exercises.

To prevent pneumosclerosis, corticosteroids are prescribed. The best effect can be obtained when inhalations of 5-25% DMSO solution, low-frequency magnetic therapy are included in the complex treatment system.

When the tumor process has been cured for 5 years or more, the therapeutic effect of inhalations can be enhanced by electrophoresis of a 10% DMSO solution on the projection of the greatest changes in the lungs. The duration of treatment for radiation pulmonitis is 4-6 weeks, late radiation fibrosis requires 2-3 courses with an interval of 3-4 months.

Long-term oxygen therapy is also used in patients with Pa02 above 7.3 kPa but with signs of nocturnal hypoventilation. This group of patients includes those with chest wall disease associated with obesity, chest disease, or neuromuscular disease.

Long-term oxygen therapy is also used in combination with CPAP in OSA, although it is not the first line of treatment in this case. In this situation, the appointment of long-term oxygen therapy requires a referral to a specialist in these diseases, since a special examination is necessary.

Although long-term oxygen therapy is usually given for life in patients with COPD, in the case of chest wall disease and sleep apnea it is temporary, possibly until respiratory failure improves on respiratory support or weight loss in the case of patients with sleep apnea.

Long-term oxygen therapy is also indicated for the palliative treatment of severe dyspnea in patients with lung cancer and other causes of disabling dyspnea, common in patients with severe end-stage COPD or neuromuscular disease.

All patients requiring long-term oxygen therapy should have a full evaluation in a specialized center. The purpose of the examination is to confirm the presence of hypoxia and to select an appropriate oxygen flow rate for satisfactory correction of hypoxemia. Evaluation for long-term oxygen therapy depends on arterial blood gas values.

The determination of gases in the blood of the radial or femoral artery or in arterialized capillary blood from the earlobe is used. The latter has the advantage that samples can be taken by different healthcare professionals.

During an exacerbation of the disease, the examination is not carried out. Since recovery after an exacerbation can be long, hypoxemia persists after it, the examination should be carried out no earlier than after 5-6 weeks.

Blood gases should be measured rather than Sa02 with a pulse oximeter, as assessment of hypercapnia and its response to oxygen therapy is required for the safe administration of long-term oxygen therapy. Pulse oximetry also has low specificity in the critical Pa02 range for long-term oxygen therapy, so it alone is not suitable for use in examinations.

However, the value of oximetry in screening patients with chronic respiratory disease and in the selection of patients requiring further blood gas analysis. Patients on long-term oxygen therapy require a formal evaluation after its appointment to ensure that there is a satisfactory correction of hypoxemia and that they are complying with the treatment.

http://tumor.su/reabilitacia/rlreab.html

http://www.oxyhealth.ru/oxygen-poduchki/rak-legkih/

http://dommedika.com/phisiology/oksigenoterapia_pri_gipoventiliacii.html

»» №5 2001 Palliative care

We continue to publish chapters from the book "Palliative Care for the Patients" edited by Irene Salmon (beginning - see SD No. 1, 2000).

Dyspnea- this is an unpleasant feeling of difficulty breathing, which is often accompanied by anxiety. Shortness of breath most often occurs or worsens in the last few weeks before death.

Shortness of breath is usually accompanied by symptoms such as tachypnea (increased breathing) and hyperpnea (increased depth of breathing). The respiratory rate at rest with shortness of breath can reach 30-35 per minute, and physical activity or anxiety can increase this figure to 50-60 per minute.

However, it should be borne in mind that neither tachypnea nor hyperpnea can serve as diagnostic signs of shortness of breath. Shortness of breath is a subjective phenomenon, therefore it (like pain) should be assessed on the basis of the patient's description of his state of health.

Human breathing is controlled by the respiratory centers in the brain stem. The volume of respiration is largely determined by the chemical composition of the blood, and the rate of respiration is determined by mechanical stimuli transmitted through the vagus nerve.

An increase in the rate of respiration leads to a relative increase in dead volume, a decrease in tidal volume, and a decrease in alveolar ventilation.

Some patients with dyspnea physical activity there are panic attacks. During these attacks, patients feel as if they are dying. At the same time, the fear caused by shortness of breath, as well as a lack of awareness of this condition, cause an increase in anxiety, which in turn increases the frequency of breathing and, as a result, increases shortness of breath.

There are a lot of reasons for the occurrence of shortness of breath: it can be provoked directly by the tumor itself, the consequences oncological disease, complications as a result of treatment, concomitant diseases, as well as a combination of the above reasons.

The causes provoked directly by the tumor itself include unilateral or bilateral pleural effusion, obstruction of the main bronchus, infiltration of the lung with cancer, cancerous lymphangitis, compression of the mediastinal organs, pericardial effusion, massive ascites, abdominal distension.

Causes resulting from cancer and / or loss of strength: anemia, atelectasis (partial collapse of the lung), pulmonary embolism, pneumonia, empyema (pus in the pleural cavity), cachexia-anorexia syndrome, weakness.

Shortness of breath can be caused by complications of cancer treatment, such as radiation fibrosis and the effects of chemotherapy, as well as comorbidities: chronic non-specific lung disease, asthma, heart failure, and acidosis.

If shortness of breath occurs, the patient should be explained his condition and encouraged in order to reduce the feeling of fear and anxiety, and also try to change his lifestyle: make a daily routine so that rest always follows after the load, if possible, help the patient around the house, with buying groceries and etc.

Treatment will depend on the cause of the shortness of breath. If the causes of the condition are reversible, then the presence of loved ones, soothing conversation, cool dry air, relaxation therapy, massage, as well as treatments such as acupuncture, hypnosis can help.

At respiratory infection prescribe antibiotics, with chronic bronchial obstruction / collapse of the lungs, compression of the mediastinal organs - expectorants, corticosteroids (dexamethasone, prednisolone); with cancerous lymphangitis, radiation therapy is indicated, with pleural effusion - laser therapy, with ascites - corticosteroids, with heart failure - pleurodesis, fluid pumping, diuretics, paracentesis, blood transfusion, angiotensin-converting enzyme inhibitors; with pulmonary embolism - anticoagulants.

Bronchodilators may also help with shortness of breath. Morphine reduces the urge to breathe and can be used to reduce dyspnea (if the patient is already taking morphine then the dose of this drug should be increased by 50%, if the patient is not already on morphine then a good starting dose is 5 mg every 4 hours). Diazepam (Relanium) is used if the patient is experiencing anxiety. The initial dose of the drug is 5-10 mg at night (2-3 mg for very elderly patients). After a few days, if the patient develops excessive sleepiness, the dose can be reduced. Oxygen can also be beneficial if you breathe it in a few minutes before and a few minutes after exercise.

The nurse must constantly monitor how the daily needs of the patient are satisfied (washing, eating, drinking, physiological functions, the need for movement). It is necessary either to prevent shortness of breath so that the patient manages to meet these needs himself, or to provide him with appropriate care if he is not able to care for himself.

The nurse should have a clear understanding of the causes of shortness of breath and apply appropriate treatment. In case of respiratory infection, inform the doctor, provide the patient with a spittoon to collect sputum, do everything to minimize the risk of infection, place the patient in a position conducive to better ventilation, and apply postural drainage.

When caring for a patient with shortness of breath, the nurse should remain calm and self-confident, and the patient should not be left alone. He needs to create the most comfortable environment - open windows or put a fan nearby, as well as provide an opportunity to easily sound an alarm. The patient should be encouraged to do breathing exercises and teach relaxation techniques.

The nurse should also teach the patient in advance how to control breathing during a respiratory panic attack. During an attack, it is necessary to provide the patient with a calming presence. Taking diazepam at night (5-10 mg) may also help.

hiccup- this is an abnormal respiratory reflex, characterized by a spasm of the diaphragm, leading to a sharp breath and the rapid closing of the vocal folds with a characteristic sound.

There are many potential causes of hiccups. In advanced cancer, most cases of hiccups are due to gastric distension (in 95% of cases), irritation of the diaphragm or phrenic nerve, toxic effects in uremia and infection, tumor of the central nervous system.

Possible methods of emergency treatment are stimulation of the larynx, massage of the junction of the hard and soft palate with a cotton stick, the use of muscle relaxants, as well as reducing gastric distension, increasing the partial pressure of CO2 in plasma. Mint water (dropping peppermint oil into water) can reduce gastric distention, which promotes regurgitation of excess gastric gas by relaxing the lower esophageal sphincter; metoclopramide (cerucal), which contracts the lower esophageal sphincter and speeds up gastric emptying, as well as drugs that reduce the amount of gas (for example, dimethicone). At the same time, mint water and cerucal should not be taken at the same time.

It is possible to increase the partial pressure of CO2 in plasma by rebreathing the air exhaled into a paper bag, or by holding the breath.

Muscle relaxants include baclofen (10 mg orally), nifedipine (10 mg orally), and diazepam (2 mg orally).

Central suppression of the hiccup reflex can be achieved with haloperidol (5–10 mg orally) or chlorpromazine (chlorpromazine) (10–25 mg orally).

Most of the "grandmother's remedies" for hiccups are direct or indirect stimulation of the larynx. For example, quickly swallow two teaspoons (with a top) of sugar, quickly drink two small glasses of liquor, swallow a cracker, swallow crushed ice, throw a cold object over the collar of a shirt (blouse).

Noisy breathing (death rattles)- sounds that are formed in the process of oscillatory movements of the secret in the lower part of the pharynx, in the trachea and in the main bronchi due to inhalations and exhalations and are not necessarily a sign of imminent death. Noisy breathing is characteristic of patients who are too weak to cough.

In these cases, it is necessary to lay the patient on his side to improve the drainage of the airways. Even a slight change in position can significantly calm your breathing.

Hyoscine butylbromide (buscopan, spanil) will help reduce secretion in 50-60% of patients.

Also very important proper care behind the oral cavity, especially if the patient breathes through the mouth. Since in this case the patient feels severe dryness in the mouth, periodically wipe the patient's mouth with a damp swab and apply a thin layer of petroleum jelly to the lips. If the patient can swallow, give him a little to drink.

It is very important to pay attention to the patient's relatives, explain to them, if possible, the essence of what is happening, provide psychological support and teach them the rules of patient care.

Noisy and rapid breathing of a dying person- a phenomenon that indicates the last attempt of the body to deal with irreversible terminal respiratory failure. One gets the impression of severe suffering of the patient, which often causes severe stress for relatives and neighbors in the ward. In this case, blockage of the airways may not be.

In such cases, the nurse, first of all, should reduce the patient's respiratory rate to 10-15 per minute using intravenous or intramuscular administration of morphine. This may require a two- or three-fold increase in the dose of morphine compared to the dose required for pain relief. With excessive movements of the shoulders and chest, midazolam (10 mg subcutaneously, and then every hour, as needed) or diazepam (10 mg intramuscularly) can be administered to the patient.

Cough- This is a complex respiratory reflex, the task of which is to remove foreign particles and excess sputum from the trachea and large bronchi. Cough is a kind defense mechanism. However, prolonged bouts of coughing are exhausting and frightening, especially if the cough aggravates shortness of breath or is associated with hemoptysis. Coughing can also lead to nausea and vomiting, musculoskeletal pain, and even rib fractures.

There are three types of cough: moist cough with the patient's ability to effectively cough; loose cough, but the patient is too weak to clear his throat; dry cough (that is, sputum is not produced).

The main causes of cough can be roughly divided into three groups: inhalation of foreign particles, excessive bronchial secretion, and abnormal stimulation of receptors in the airways, such as through the action of antihypertensive drugs such as captopril and enalapril.

In advanced cancer, coughing may be due to cardiopulmonary causes (nasal fluids, smoking, asthma, chronic obstructive pulmonary disease, heart failure, respiratory infection, lung tumor and mediastinum, paralysis vocal cords, cancerous lymphangitis, pleural and pericardial effusion), as well as causes associated with the pathology of the esophagus (gastroesophageal reflux), aspiration in various pathological conditions (neuromuscular diseases, multiple sclerosis, stroke).

Treatment for cough depends on both the cause and the goal of treatment. For example, the goal of treating a cough in the dying is to make them as comfortable as possible. In this case, one should fight only with reversible causes. So, a significant antitussive effect from smoking cessation occurs after 2-4 weeks. But will the patient survive this period?

There is a fairly wide range of activities and medicines that relieve coughing. Among them are steam inhalations with or without balm (menthol, eucalyptus) or without it, bromhexine, irritating mucolytics (stimulate the formation of a less viscous bronchial secretion, but irritate the gastric mucosa and can cause nausea and vomiting) - potassium iodide, antistrumine, iodide 100/200; chemical mucolytics (change chemical composition sputum and thus lower its viscosity), for example, acetylcysteine ​​(ACC), as well as central antitussive drugs - codeine, morphine.

Among non-drug measures, it should be noted giving the patient a comfortable position for coughing, teaching him to cough effectively, advice to avoid types of treatment and factors that provoke coughing.

The nurse should be vigilant for signs of respiratory tract infection and complications, and if such signs appear, inform the doctor immediately. It is necessary to help the patient in the implementation of oral hygiene, and when the first signs of stomatitis appear, to carry out the necessary therapeutic measures.

Patients and their loved ones should be reassured and encouraged. For example, the use of linen and handkerchiefs dyed dark, such as green, will help reduce the fear of a patient suffering from hemoptysis and his loved ones.

The use of oxygen bags in oncology

stage 4 lung cancer? late realized, late ... everyone who wants to improve their health, read "100 years of active longevity ... (long title)" by Bubnovsky. there is a rationale for the usefulness of visiting saunas by cancer patients. and for everyone else - a sea of ​​\u200b\u200binformation on health promotion and rejuvenation

Now there is a device called an ozonator. Maybe someone heard. We ozonize water and drink. We ozonize products. Water saturated with oxygen. The principle of operation of the ozonator uses the natural mechanism for producing ozone after a lightning discharge. Ozonated water has a bactericidal, antiviral and antifungal effect. An ozonator can process food (meat, fruits, etc.) and will pull out all nitrates, chemicals, etc. from them. e. We eat a chicken leg, but it is crammed with everything, and when we ozonize it, so much mucus comes out of it that burns. As you guessed, these are chemicals for rapid growth and so on. That's where now a lot of diseases that can not be treated, where the doctors are at a loss, what's wrong with this patient? and endless trips to all clinics, professors begin. you can also ozonize the air, eliminates unpleasant odors, even mold. Ozonated water is recommended to drink for everyone with all diseases. Patients with skin diseases need to wash, bathe. Call anyone who is interested. I live in Kazakhstan 8778 265 04 17 8705 41 48 538

Oxygen in cancer is the cart before the horse. Compensation of hypoxia - oxygen starvation and organs of tissue cells due to respiratory failure, as a result of tumor growth and overlapping of the lumen of the bronchi and pleurisy, which means insufficient opening of the lungs, is not a treatment. This is just an aggravation of the condition of a cancer patient as a whole due to literally a sip of oxygen making the breath relatively full, and therefore supporting gas exchange in the lungs only for minutes. And then oxygen again. But we need a completely different approach, and the sooner the better. in detail when contacting. Oxygen is only an aggravating factor, but in the case of palliative treatment, it seems to prolong the agony of the body of a cancer patient

With advanced lung cancer, the volume of lung tissue and the ability of the lungs to extract oxygen from the air are reduced. Hypoxemia occurs (decrease in the concentration of oxygen in the blood). In the case of hypoxemia, oxygen therapy with an oxygen concentrator is an important way to reduce shortness of breath and improve quality of life.
It has been proven in scientific studies that in advanced lung cancer, in patients with hypoxemia (low oxygen in the blood), oxygen treatment can reduce the painful feeling of shortness of breath. The required oxygen dose (flow) is typically around 5 l/min.
http://www.o2-generator.ru/articles/rak_legkih.html

There used to be oxygen bags in pharmacies, then there were oxygen inhalers with oxygen bottles that had to be refilled and oxygen bottles in pharmacies. Now there are oxygen concentrators that get oxygen from the air at home in the hospital - all you need is electricity. True, they are noisy when working. A tube is attached, the mask the patient breathes if there is not enough oxygen. .
I won’t say how much they cost, you can take the smallest one, probably enough for the patient ... Some organizations offer medical equipment for rent and oxygen concentrators....

12.09.2018

Margarita Tulup, journalist

For the first few minutes, Zhenya could not believe what was happening: he was sitting on the bed, breathing quickly and often, but his lungs were not filling with air. Then the panic began. His wife held his hand, and she called an ambulance. Ten minutes before her arrival seemed like an eternity, the forces became less and less. Zhenya made several unsuccessful attempts: he sat down, pressing his knees to his chest, raised his hands up in the hope of expanding the diaphragm, breathed like a dog, but he could only swallow air like a fish and repeat to himself: “This is the end. May it come sooner." Most of all, Zhenya wanted to say goodbye to his wife, but he could not utter a word.

There was no oxygen equipment in the first ambulance, so we had to wait for the second one. Paramedics from the second brigade put a mask connected to an oxygen cylinder on the almost unconscious Zhenya, put him on a chair in a car and took him to the Institute of Emergency Surgery. It was winter. He had to sit in shorts and a jacket in the ambulance for about an hour. Zhenya has tuberculosis, his left lung is constricted, in his right there is a hole the size of a fist. This means that only a few hospitals can accept it.

In one of them, Zhenya was disconnected from oxygen cylinder"ambulance", laid on a gurney and taken to the ward. There was nothing to breathe again, the agony began. Zhenya began to cry and demand oxygen. The doctors condescended - they brought one blue balloon with a thin, as if from a dropper, tube for one nostril, but its power was not enough. I had to endure. For the next three days, Zhenya was recovering from the operation, breathing with the help of oxygen brought into the ward, which was supplied through tubes coming out of the wall.

Three days later, he was transferred to the surgical department of the regional TB dispensary, where he again had nothing to breathe. Next to him, on iron cots, people were dying from lack of oxygen. Several young girls who fell ill immediately after giving birth, a lonely guy, grandfather. None of the staff visited the patients.

Only once did the doctor respond to a request for help - he looked into the ward and said to the young guy: “Yes, you are suffocating. What can I do? You don't have lungs."

Four days later the patient got up, took a cup of water, sighed, poured it over himself and fell down. His agony ended forever.

Oxygen support from year to year is needed by patients of completely different age and condition. Most often, it is needed by those whose blood oxygen saturation is too low, respiratory muscles are atrophied: patients with tuberculosis, cancer patients with lung metastases, neurological patients, people with amyotrophic lateral sclerosis, spinal muscular atrophy, who have been in an accident, children with a rare disease cystic fibrosis. All of them, in order to fully breathe, and therefore live, need the help of special devices.

Often they become hostages of resuscitation because they are literally tied to oxygen. Getting out of intensive care means for them to stop breathing. Those who can live without a device or have collected money (by themselves or with the help of philanthropists) to buy it go home.

Stepan, a ward of the Lviv mobile children's hospice, at home
Photo: Katerina Ptakha

There is no separate state funding for oxygen support for patients, and therefore if special devices are bought, then more often for intensive care units or pulmonology departments, carving out a piece from the regional budget for health care. But this is also rare.

Most often, hospital staff either do not see the need for oxygen, or are afraid to notice it. Therefore, at best, Soviet oxygen stations operate in some departments - tubes come out of the wall; and in the majority - the staff uses a cylinder or an oxygen pillow - a rubberized mattress, which is filled with oxygen from a cylinder. In this case, the patient needs to lie down, hug her with his hands, take a mouthpiece into his mouth, on which wet gauze is put on (“dry” oxygen can lead to lung burns and death) and breathe until you “exhale” its contents.

According to palliative care physician Zoya Maksimova, the issue of oxygen should not only be about state funding, but also about the education of medical staff.

In medical training, I always find that there is oxygen concentrators doctors just don't know. In therapy, even an oxygen bag is a rare thing. They "dripped" a person, treated him and sent him home. He is not recommended to breathe oxygen because he simply will not find it anywhere. And now the person returns home, suffocates, calls an ambulance (in which there are no cylinders either, or they don’t know about them). So a person either remains at home to die, or ends up in intensive care for a long time and takes a place there.

Second wind

The wife was lucky to survive and learn to breathe with the rest of her lungs. He began to consider buying an oxygen tank for home. To begin with, it was necessary to save up about four thousand hryvnias for it, then bring the 100-kilogram device home, lift it to the apartment, and then monitor its safety (cylinders explode even in hospitals, let alone apartments). Periodically, the device would have to be taken out and taken with it to the edge of the city in order to fill it with a new portion of oxygen.

At the same time, Zhenya learned that in Europe, unsafe cylinders had long been abandoned in favor of stationary oxygen concentrators - small boxes that turn atmospheric air into pure oxygen and supply it through tubes to both nostrils or through a mask. Such devices do not need to be refueled, only filters need to be changed from time to time.

Even later, he learned that these concentrators are also portable - a small bag for overweight, which gives complete freedom. With it, you can stop being a hostage to the walls, go for a walk, go on business. You can live with her.

Zhenya found out that only one foundation in Ukraine deals primarily with oxygen support for patients - Kyiv's Open Palms. The man collected Required documents, and the foundation sent him an oxygen concentrator for free temporary use. Since then Zhenya has been able to breathe normally, be active and go outside.

Meanwhile, as he runs around on business, he suffocates, and at home he breathes calmly under the apparatus, Zhenya manages to live in such a way “that it would be easier for others”. He helps people with tuberculosis like himself: he buys them small things (toilet paper, razors or sweets), advises on the restoration of documents, and simply supports them by phone.

Two years later, Zhenya found out that the dispensary where he was denied oxygen had cylinders and pillows on the balance sheet, and decided to ask the doctor why they were not being given to patients. “Yes, we have a balloon. Suppose we would give it, a person would live not 10 hours, but 24. But he will still die. And we need to write in the medical card, fill out various papers, fill the cylinder with new oxygen, ”the doctor answered.

Then Zhenya told the staff that there were easy-to-use oxygen concentrators, and advised them to take them from a charitable foundation, having agreed on this by phone. “ Good idea”, the doctors replied. But they did not call the fund.

From time to time Zhenya receives calls from patients who find it difficult to breathe. They ask for help, but the man doesn't know what to do. “If those who are suffocating wrote an official statement about the lack of assistance, we would be able to influence the situation. But those who need oxygen are not at all up to it, they would have to take an extra breath, ”says Zhenya.

The last time an unknown number called him was at eleven o'clock in the evening: the young guy was crying and choking. Zhenya and his wife Oksana loaded their concentrator into a car and drove to his dispensary. The guy died a couple of days later.

And if at this time you needed the device? - I ask Zhenya.

Did I have any way out? he shrugs.

One summer, 14-year-old Anya went to a store near her home. She did not have the strength to go back: she could not breathe, she stood in the middle of the street and cried. Since then, Anya can no longer breathe normally: congenital disease manifested itself after the flu and developed into pulmonary fibrosis. Today she is 29, her illness is progressing. Her chance for salvation is a lung transplant in India at the expense of the state. She believes that her turn will come, but waiting for this moment without oxygen support is becoming increasingly difficult.

I don't even remember what it's like to breathe normally. I remember that before, like all children, I could run in the rain, ride a bike, play snowballs. But how it is - to breathe in the air with a full breast and not think about it, I don’t remember. Now I breathe with what is left of my lungs and elementary things are difficult. Sometimes I just can’t get out of bed because I start to choke, - the girl says in a hoarse voice, clearing her throat.

Anya was able to finish school, then medical University. Every day until three in the afternoon she works as a medical examiner. Staying at work is dangerous for her: lack of oxygen will lead to shortness of breath, nausea, dizziness and loss of consciousness. Every day at four, Anya opens the door of her apartment and goes to bed motionless for several hours so as not to faint.

The cost of a portable oxygen concentrator for the fund is 100-120 thousand UAH.
Photo: Alexandra Shantyr

I go to work because this is the last thread for me. It is so important for me to know that I am just like everyone else. It's a crime to lie in bed when you're 29!

Sometimes Anya "goes for 2-3 hours to breathe" in the hospital. Doctors have never denied her medical oxygen, but they cannot give her a device home. You have to wait in line or share it with other hospital patients - there is less oxygen here than those who need it. It often happens that the power of the apparatus for Anya is too low, which means that the effect of inhalation is rather sedative - for a short time you can relax a little.

Most of all, Anya is afraid that the moment will come when she will not be able to breathe: “It always seems to me that I am dying. Then it’s hard to cling to life,” she sighs, “But so far I’ve been lucky.”

All of Anya's savings and salary go to medicines and inhalers, and therefore she simply does not have the money to buy an oxygen machine. You have to live in constant fear. Anya dreams of breathing in oxygen at least once, and regrets that this is impossible: "I feel like a person while I breathe with the help of the apparatus. After that, life returns to normal."

Way to help

To date, the Open Palms Foundation has purchased and issued for temporary free use about 200 stationary oxygen concentrators, some of them have been transferred and put on the balance sheet of hospitals in Ukraine. Each such device for the fund costs 10-20 thousand hryvnias, and a portable one with batteries costs up to 120 thousand, but only a few of them were bought.

It is difficult to say how many devices are needed by patients in Ukraine now, because no one has calculated this need. The Foundation also never knows how many concentrators it will need, and what need it will be able to cover. One thing is for sure: there is never enough oxygen.

According to Marina Lobodina, a volunteer of the foundation, no one takes the responsibility to declare the need for oxygen support: “Hospital doctors, if they admit that they need help, at best they say: “We would like a couple of devices.” Often, none of the medical staff wants to take responsibility for such expensive equipment, which means that the hospital does not want to take concentrators on its balance sheet. In addition, there is no mechanism for issuing hospital equipment free of charge for temporary use to patients at home.”

Both the Ministry of Health and the Kyiv Regional Department of Health, in response to a request from LB. ua admit: no money was allocated for oxygen supply either last year or this year. Volunteers have never asked the state for funding for this need, they know that it is useless to hope for success in this matter in the near future. Because now they are asking for the support of society. They compete in the “Participation Budget”, a project that allows each of us to choose for ourselves, through online voting, what part of the local budget will go to.

The Foundation proposes to purchase and donate 30 oxygen devices of various capacities to Kyiv. This will allow patients to breathe at the National Institute of Pulmonology, Secondary Hospice. clinical hospital Kyiv and the Center for Palliative Care for Children.

Last year, the fund's initiative turned out to be useless.

It's scary to believe that this could happen again.
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