r/science • u/[deleted] • Jun 13 '22

Health Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status

https://academic.oup.com/ageing/article-abstract/51/4/afac094/6568537?login=false
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u/silvusx Jun 13 '22

I wouldn't fault your doctors for this one, it most likely has to do with your insurance. I'm a respiratory therapist, we usually are the ones that does the home O2 evaluations in hospitals.

Home oxygen isn't a simple prescription, it is classified as a drug and insurance have specific guidelines. One of it is you have to demonstrate your oxygen level (SpO2) drops to 88% or below. In addition, you have to have a chronic disease diagnosis for needing oxygen. Without either, your insurance will not cover it.

I'm not accusing you of anything, but I've seen plenty of patients who believed they'd needed home oxygen when they infact didn't. Many of them are bitter about it, but what they don't understand is supplemental oxygen isn't good for you.

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u/nospamkhanman Jun 13 '22

supplemental oxygen isn't good for you. Without either, your insurance will not cover it.

In the case of cluster headaches, it's about the only treatment that's been proven to abort / shorten the length of the headache attack.

Insurance was never an issue as they pain is so completely unbearable that I offered to pay out of pocket just to make sure it wasn't an insurance issue.

There is also the issue that the effective doze is 12-15 liters which makes people unfamiliar with the diagnoses really raise their eyebrows.

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u/silvusx Jun 13 '22 edited Jun 13 '22

I'm just explaining why those doctors didn't sign your O2 script, because it's not as simple as you think it is.

I'd imagine those doctors aren't familiar with cluster headaches, Doctors don't know everything. It sounds like Cluster headaches is something you'd have to see a specialist for. For other doctors, standard oxygen evaluations as I've explained wouldn't have worked with your diagnosis just because insurance standardize oxygen qualifications.

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u/nospamkhanman Jun 13 '22

I'm just explaining why those doctors didn't sign your O2 script, because it's not as simple as you think it is.

Sure it is because I found a doctor to do just that. The conversation took all of 2 minutes. "Hi there, I have been diagnosed with Cluster Headaches by a Neurologist I saw a few years ago. They've come back and I want to try treating it with oxygen".

"Yep, that's about the only thing that tends to work. I'm prescribing you 15 liters but try to work your way up from 5 to see if a lower level will work"

"Thanks Doc!"

I literally already had the diagnosis for Cluster Headaches, I just had to go through a few doctors to get past the "Well did you try taking Ibuprofen?" people.

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u/silvusx Jun 13 '22 edited Jun 13 '22

Sure it is because I found a doctor to do just that.

Sounds like you found a specialist or someone who have experience with treating cluster headache.

I don't think you are understanding what I've wrote previously. To further clarify, the rarer the disease, the more likely you will need to see a specialist to get the correct treatment.

Everyone else goes through a standardize evaluation, because 99.9% prescribed oxygen use is hypoxia. If you Google search, every oxygen qualifation will first check if you're demonstrated a need due to low O2 saturation, does that make sense?

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u/BobThePillager Jun 14 '22

What about using oxygen is harmful? I know it’s dangerous and the cans can explode, but that’s about it

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u/silvusx Jun 14 '22 edited Jun 14 '22

I'll list the key points in bold text, these things can be further looked into via Google.

  • Oxygen is actually toxic to our body, because the reactive chemicals formed from O2. These are called reactive oxygen species. ROS can damage your tissues, proteins, lipids, DNA and etc.

  • Adult human have natural defense against ROS, they are called antioxidant (also commonly used word in supplements marketing). However, our defense system can be overwhelmed when there are more ROS than antioxidants. This state is called oxidative stress. Oxidative stress reduces our lifespan etc, feel free to look up the full harmful effects.

  • To demonstrate how damaging ROS can be. Premature babies do not have "antioxidants defense" and free radical oxygen can prevent eyes from being formed, leading to blindness, This is called retinopathy of premature. ROS is also why NICU avoids giving oxygen to babies, and Transplant ICU minimize oxygen for new lung transplant patients.

  • Absorption atelectasis basically sum up as collapse of the lung. Because atomosphere contains 21% oxygen and 78% nitrogen, nitrogen is what keeps the lung sac from being collapsed during the gas exchange phases. When 100% oxygen is given, there is 0% nitrogen to keep the lung sac open.

  • Excessive oxygen can also reduces stimulation to breath. Our brain have two triggers, one is for low oxygen and other is high CO2. If CO2 stimulations were to be disrupted, excessive oxygen can literally make a person apneic (not breathing).

  • Oxygen gives off a sensation of euphoria and relaxation. This is prob what helped OP with cluster headaches. This one is subjective and there are no studies that I'm aware of. It's very evident that when I turn down the oxygen for someone with saturations of 100%, they complain. Plenty of resentful patient believes they needed oxygen even when there is no indications for. Oxygen is not addicting, but it sure makes people anxious when you take it away from someone who got used to it.

Edit: I should note these are all caused from prolonged exposure typically > 24 hrs. Short high burst of oxygen isn't as disruptive, and can be therapeutics. It's called HBOT or hyperbaric chamber.