Oxygen and CPAP Connection Questions

[palerider]

No con here. My pulmonologist prescribed oxygen, after I thrived on oxygen in the hospital for 5 days and have been non-functional at home since then. She is convinced I medically need it. Evidently, she thinks there are means other than the six minute walk test to satisfy Medicare requirements.

We shall see if I get my oxygen paid for by Medicare or die first. I am sure you [palerider] are rooting for the latter.

Shows how little you know me.

Does anyone know of any online forum or support group for home oxygen users? The equipment looks a lot more complicated to me than CPAP,

It's exceedingly simple, oxygen concentrator, hose, nasal canula or CPAP adapter to bleed o2 into the hose.

Much simpler than cpap, my brother owns two concentrators.

[Goofproof]

The pulmonologist's office has faxed an order to the DME for Oxygen 2LPM and a standard nebulizer, for continuous use. She put a diagnosis of Reactive Airways Disease and OSA. Length of need 99 months, which I am told means forever.

I had pulmonary function tests this morning. I got a copy of the raw results without interpretation.

Does anybody know of an online forum such as this for people who use oxygen where I can ask stupid questions such as I ask here? I have NO experience with oxygen and want to know what I am getting myself into, preferably before it is delivered and I have no idea how to set it up or what to ask.

Thanks for your help.

Maryland CPAPer 2

I have lots of experience with oxygen, I've been breathing it for 76 years, welding with it for 30 years, now using it for xpap for 12 years.

I bought a recording pulse ox, to track my O2, trying to determine what was making me not being able to catch my breath after walking or moving. I found out O2 wasn't the answer, I had had a quad by pass and too much damage had happen, adding O2 wasn't the answer, I still use it with my XPAP at 3l, (Upped from script of 2l, because of vent from mask).

If I shopped for myself, I'd take a baseball bat with me, use it to educate the kids riding the handicap carts. Jim

[colomom]

The equipment looks a lot more complicated to me than CPAP, which few master on their own. From what I have read so far, you sign a 5-year contract with a DME for whatever oxygen equipment you end up with, and the DME still owns the equipment at the end of the 5 years. Knowing nothing about oxygen equipment and not being willing to commit to anything about which I know nothing for a 5+ -year period, I don't want to get stuck with the equivalent of a CPAP brick.

Maryland CPAPer 2

The equipment is not that complicated. Some concentrators are quiet noisy, if possible for nighttime use you may want to find a spot for it in a closet or a hallway outside your bedroom. There needs to be a bit of space between it and the wall, and of course you'll need an outlet. Since you'll be using it during the day a humidifier would be a nice addition, I would also ask them to leave you with some extra hose. You'll probably be stuck with whatever the DME gives you; but if you have a choice the Philips Respironics EverFlo is much quieter, lighter, and a bit smaller than other concentrators.

My direct experience with O2 therapy is with my son who is covered by BCBS, but I have had a few relatives on Medicare who I have helped thru the process. You'll want to verify this, but my recollection is that with Medicare you pay to rent the machine for 3 years, then for the next 2 years you essentially rent it for nothing, then after 5 years the need for O2 must be re-certified and you go back to paying rent for 3 years and it being fully covered for 2. Assuming you get approved they'll also have to give you a portable option, but Medicare doesn't specify what that must be so they'll probably give you tanks rather than portable oxygen concentrator because those are expensive. If I were you I would call Medicare to find out what your out of pocket cost will be and to verify that O2 therapy has been approved. If Medicare does not approve you for O2 therapy do not use a DME and buy a concentrator out of pocket. To give you a ballpark of costs you may be looking at, Lincare billed over $500 per month for my son's old, noisy, piece of junk O2 concentrator we rented from them (BCBS knocked down to $150 a month). Once our deductible reset I picked up a much nicer new EverFlo for $600. My mom is on Medicare and uses O2, for her buying a concentrator out of pocket was in the long run much less expensive than renting thru the DME. This is all of course antidotal, you should be sure to contact Medicare to find out what your costs will be and research current prices to figure out what makes most sense for you.

So glad you found a good doc who is advocating for you to get the treatment you need, hope Medicare approves your O2 therapy!

[MarylandCPAPer2]

We shall see if I get my oxygen paid for by Medicare or die first. I am sure you [palerider] are rooting for the latter.

Shows how little you know me.

I only know what you post and the tone it conveys. I missed the comment you made earlier about trying to con Medicare into paying for something that isn't medically necessary. You obviously don't know me, as I don't really want the hassle of continuous oxygen and all the equipment and space it will take up in my home. I can't afford it and if it is medically necessary, then I need help paying for it.

Does anyone know of any online forum or support group for home oxygen users? The equipment looks a lot more complicated to me than CPAP,

It's exceedingly simple, oxygen concentrator, hose, nasal canula or CPAP adapter to bleed o2 into the hose.

Much simpler than cpap, my brother owns two concentrators.
[/quote]

The complications I see are that it involves 1) the presence of oxygen tanks (size unknown but I don't like the idea of having to lug any of them around), 2) the need to somehow take oxygen with me everywhere (driving, shopping, etc.), which I hope involves something portable, which home concentrators and tanks appear not to be, and 3) the need to add oxygen to the CPAP machine and use only distilled water. The CPAP part seems the least complicated, as I still have the connector between the mask and the hose that was used to hook oxygen in to my APAP setup in the hospital. Distilled water is sometimes hard to get, so that adds another aggravation I don't want. When I have used distilled water in my A10, I couldn't breathe until I went back to tap water. I use at least 2 A10 humidifier tanks of water every night and don't like constantly having to lug around distilled water and remember to use it to refill the tank in the middle of my exhausted sleep.

I have been reading some of the online oxygen user forums and people talk about traveling with 20 oxygen tanks. I cannot even imagine it. That usually involves airplane travel, which I don't expect to be doing. They talk about liquid oxygen, having "parties" to refill their oxygen tanks when they return from an excursion, and other things that sound totally foreign to me.

The pulmonologist and her staff member who have conducted the tests have not explained anything to me. I only know that the dr. ordered 2L oxygen for continuous use for 99 months and a nebulizer because I asked for a copy of the fax that was allegedly sent to the DME ordering oxygen. I have not yet talked to the DME--same one who hasn't come up with a replacement A10 for the one that has announced on its display that it "exceeded its normal motor life" and for which my dr. has sent a prescription twice. July 1, 2020 is 5 years of use of the current A10 and I am 100% compliant with its use.

So, what does the DME supply when presented a prescription for 2L oxygen for continuous use for 99 months? A big concentrator, big O2 tanks, and hosing? What about something portable? My worst problems occur at grocery stores and their pharmacy lines, which I barely survive at present. What happens if I only want to use the oxygen during exertion, shopping in large stores, and with my A10 at night? That is not continuous use. How does a person live with a cat with oxygen lines running all over the place, which I assume is necessary when at home.

I would love it if I didn't have to deal with all this oxygen equipment at all. I don't want oxygen, but in the hospital, everyone i encountered told me I need it. I don't know where I would even put the equipment in my house, which will require me to move large amounts of stuff in my house, I assume. I don't want a DME in my house, but the equipment looks too heavy for me to pick up at the DME's and carry myself.

Plus, what goes in a nebulizer and how does it work? I had nebulizer treatments in the hospital that were quite helpful, but nothing in this Rx says what goes in the nebulizer and how it is used.

So, these are some of the issues/ complications I foresee, plus signing a contract for equipment without trying it out. And, does this Rx get me anything portable, because my real problems occur when I am out and about, which isn't very often because I can't breathe? My house has lots of stairs, which are killing me, both due to lack of breath and knee/back/etc. pain problems, so what am I going to be dragging around on the outside and inside stairs that I can cause me to fall? I already fall on a regular basis in my house (and in the hospital). I don't need anything else to trip over.

Any helpful answers to these questions are appreciated. The people on the oxygen forums appear to have different lung conditions than what I have been diagnosed with and they seem to have complicated problems with their oxygen. I have done plenty of reading online and dread the introduction of oxygen into my exhausted life. Death sounds like a better alternative at present.

Maryland CPAPer2

[MarylandCPAPer2]

The equipment is not that complicated. Some concentrators are quiet noisy, if possible for nighttime use you may want to find a spot for it in a closet or a hallway outside your bedroom. There needs to be a bit of space between it and the wall, and of course you'll need an outlet. Since you'll be using it during the day a humidifier would be a nice addition, I would also ask them to leave you with some extra hose. You'll probably be stuck with whatever the DME gives you; but if you have a choice the Philips Respironics EverFlo is much quieter, lighter, and a bit smaller than other concentrators.

My direct experience with O2 therapy is with my son who is covered by BCBS, but I have had a few relatives on Medicare who I have helped thru the process. You'll want to verify this, but my recollection is that with Medicare you pay to rent the machine for 3 years, then for the next 2 years you essentially rent it for nothing, then after 5 years the need for O2 must be re-certified and you go back to paying rent for 3 years and it being fully covered for 2. Assuming you get approved they'll also have to give you a portable option, but Medicare doesn't specify what that must be so they'll probably give you tanks rather than portable oxygen concentrator because those are expensive. If I were you I would call Medicare to find out what your out of pocket cost will be and to verify that O2 therapy has been approved. If Medicare does not approve you for O2 therapy do not use a DME and buy a concentrator out of pocket. To give you a ballpark of costs you may be looking at, Lincare billed over $500 per month for my son's old, noisy, piece of junk O2 concentrator we rented from them (BCBS knocked down to $150 a month). Once our deductible reset I picked up a much nicer new EverFlo for $600. My mom is on Medicare and uses O2, for her buying a concentrator out of pocket was in the long run much less expensive than renting thru the DME. This is all of course antidotal, you should be sure to contact Medicare to find out what your costs will be and research current prices to figure out what makes most sense for you.

So glad you found a good doc who is advocating for you to get the treatment you need, hope Medicare approves your O2 therapy!

Thank you for the information and your concern. It all still sounds complicated to me, especially whatever is needed for portable use outside the home. I am very appreciative of the pulmonologist, who first saw me in the hospital just as I was being evicted from one ward to the telemetry unit because of a possible heart attack in the hospital (for which I was offered a Tylenol). She saw how much effort it was taking just to sit up and talk in the hospital. I am fortunate that she decided to take me under her wing and follow up with me after the hospital visit, as I see that she is not taking new patients. She is the chief of pulmonology for the hospital. I feel like she is the first dr. who has understood my difficult life, due to inability to breathe properly, which has been going on for at least 5 years. I declined to make a 3-month follow up appt with my previous pulmonologist 5 years ago, telling them I did not expect to live that long and wouldn't be around in 3 months. That dr. has since retired.

Maryland CPAPer 2

[colomom]

Thank you for the information and your concern. It all still sounds complicated to me, especially whatever is needed for portable use outside the home. I am very appreciative of the pulmonologist, who first saw me in the hospital just as I was being evicted from one ward to the telemetry unit because of a possible heart attack in the hospital (for which I was offered a Tylenol). She saw how much effort it was taking just to sit up and talk in the hospital. I am fortunate that she decided to take me under her wing and follow up with me after the hospital visit, as I see that she is not taking new patients. She is the chief of pulmonology for the hospital. I feel like she is the first dr. who has understood my difficult life, due to inability to breathe properly, which has been going on for at least 5 years. I declined to make a 3-month follow up appt with my previous pulmonologist 5 years ago, telling them I did not expect to live that long and wouldn't be around in 3 months. That dr. has since retired.

Maryland CPAPer 2

I'm sorry for all you've been thru and yes the medical system makes this all far to complicated, I relate to your situation.

The diagnosis your doc gave pretty much means something is causing restriction in the bronchi (like asthma). The nebulizer should help with that. My simplistic way to think of a nebulizer is its a cross between an inhaler and a vaporizer, it will deliver meds that will help open up your bronchi in vaporized form.

Unfortunately, because Medicare reimbursements are low Medicare patients are often faced with substandard treatment, it sounds like you finally stumbled upon a good, caring doc who is willing to advocate for you. Don't get frustrated or loose hope! It is far more complicated than it should be; but you have finally found the path to better health.

Are there any specific questions/ concerns you have about O2 therapy?

[Goofproof]

The equipment looks a lot more complicated to me than CPAP, which few master on their own. From what I have read so far, you sign a 5-year contract with a DME for whatever oxygen equipment you end up with, and the DME still owns the equipment at the end of the 5 years. Knowing nothing about oxygen equipment and not being willing to commit to anything about which I know nothing for a 5+ -year period, I don't want to get stuck with the equivalent of a CPAP brick.

Maryland CPAPer 2

The equipment is not that complicated. Some concentrators are quiet noisy, if possible for nighttime use you may want to find a spot for it in a closet or a hallway outside your bedroom. There needs to be a bit of space between it and the wall, and of course you'll need an outlet. Since you'll be using it during the day a humidifier would be a nice addition, I would also ask them to leave you with some extra hose. You'll probably be stuck with whatever the DME gives you; but if you have a choice the Philips Respironics EverFlo is much quieter, lighter, and a bit smaller than other concentrators.

My direct experience with O2 therapy is with my son who is covered by BCBS, but I have had a few relatives on Medicare who I have helped thru the process. You'll want to verify this, but my recollection is that with Medicare you pay to rent the machine for 3 years, then for the next 2 years you essentially rent it for nothing, then after 5 years the need for O2 must be re-certified and you go back to paying rent for 3 years and it being fully covered for 2. Assuming you get approved they'll also have to give you a portable option, but Medicare doesn't specify what that must be so they'll probably give you tanks rather than portable oxygen concentrator because those are expensive. If I were you I would call Medicare to find out what your out of pocket cost will be and to verify that O2 therapy has been approved. If Medicare does not approve you for O2 therapy do not use a DME and buy a concentrator out of pocket. To give you a ballpark of costs you may be looking at, Lincare billed over $500 per month for my son's old, noisy, piece of junk O2 concentrator we rented from them (BCBS knocked down to $150 a month). Once our deductible reset I picked up a much nicer new EverFlo for $600. My mom is on Medicare and uses O2, for her buying a concentrator out of pocket was in the long run much less expensive than renting thru the DME. This is all of course antidotal, you should be sure to contact Medicare to find out what your costs will be and research current prices to figure out what makes most sense for you.

So glad you found a good doc who is advocating for you to get the treatment you need, hope Medicare approves your O2 therapy!

A small room or closet is a bad idea, O2 pumps get their O2 out of the air in the area they are in, also being machines and also pumps they produce heat. Two very bad things for the pumps and also you. The more room they have to work with the happier they are. Also O2 can be easy, but there are less options when using OPM, Out of pocket you can have a unit for the house, and a battery powered unit to take around and buy all the batteries you can afford, however don't expect the battery powered unit to last as long as the house unit, and it does cost more also. Jim

[chunkyfrog]

. . .
If I shopped for myself, I'd take a baseball bat with me, use it to educate the kids riding the handicap carts. Jim

Can I borrow your bat?
Too many maskless punks trying to take ME out!

[MarylandCPAPer2]

Are there any specific questions/ concerns you have about O2 therapy?

The DME called today and said that Medicare approved my oxygen and the DME will deliver it tomorrow. They didn't know anything about the nebulizer, although the pulmonologist put it in the original prescription. Evidently a lot of paperwork has to go back and forth before they call the patient (me) and say "We got an order from your doctor today for oxygen and we're delivering it tomorrow." They got the prescription from the dr. on Monday and this is Thursday, but aside from that discrepancy, it appears that some progress has been made re: oxygen.

What should I expect from the initial delivery? The DME said I would get a concentrator that plugs into the wall, portable tanks, and paperwork to sign. I have read that there is a 5-year contract and asked what the paperwork is. I was told it was a receipt for the delivery and an authorization to bill insurance, no contract.

Questions:
1) Does the concentrator need to be attached to an oxygen tank, and how big is the tank that stays in the house? If I have a choice of equipment, are there any that are preferable, so I don't get the oxygen equivalent of a CPAP brick?

2) I have an old house without a lot of electric outlets. Is it okay if the concentrator is plugged in next to an AC/heat duct for a forced hot air heat/AC system? Another option would be across from the return duct for the heat/AC system, which does not sound like a great idea if the concentrator generates a lot of heat. If neither of these is ok, then I need to get an electrician in to add more electric outlets, which I need anyway but have delayed getting. I am NOT considering putting the concentrator in a closet. Does an oxygen tank connect to the concentrator?

3) I am not able to carry anything heavy and don't want to be lugging around an oxygen tank on wheels when I go out, so what should I hope for as far as the setup for portable tanks? My house has steps inside and outside and I have a problem getting up and down stairs, due to knee and back problems. So, I want something lightweight that will last for a couple of hours when I have to go to a medical appointment or grocery shopping (my only two exciting excursions, these days)?

4) The dr. also prescribed a nebulizer. The DME said they don't have any information about that, even though it was on the faxed prescription order I received on Monday. Does a DME supply a nebulizer, or a pharmacy. The DME said they need to know what medicine to put in a nebulizer and they haven't gotten a prescription for medicine.

5) When oxygen is used with my CPAP machine, where does the oxygen line come from that hooks into the CPAP line? The same oxygen line that I wear when awake at home, or a different oxygen line?

6) How many oxygen lines am I likely to have running around my house?

7) If the prescription says oxygen 2 liters for continuous use, do I have to use oxygen 24 hours a day?

8 Do I need humidification for the oxygen? I don't see that on the prescription. When I was using oxygen in the hospital before the pulmonologist added humidification, I got headaches, jaw pain and symptoms of a heart attack. The pulmonologist said that was because there wasn't any humiditification added to the oxygen, except when it was used with my Airsense 10 Autoset CPAP machine.

9) Is oxygen used while driving? If so, what equipment, what does it plug into, and how does it work?

10) How often is oxygen typically delivered, if used continously 24 hours a day?

11) is all of this hassle and extra equipment cluttering up my house worth it?

Aside from the oxygen that came through a tube from a hole in the wall in the hospital and the equipment I have seen in the pulmonologist's office, I am not familiar with oxygen equipment. Nobody has explained options or anything. The delivery man supposedly explains all that. and brings various pieces of equipment to choose from for the portable oxygen. I asked if I could come to the DME's office to see my options on oxygen equipment, and of course, "No, the delivery man brings them."

I also asked about my long-awaited new CPAP machine. They said my dr. hasn't signed all the paperwork for that. This is going through my primary care dr., she has sent in the CPAP order twice, and she is diligent about returning paperwork. It seems the DME likes to blame everything on prescribing doctors rather than read the paperwork they are sent. I left messages today for the doctors about the allegedly missing paperwork for the nebulizer and the CPAP machine.

Before anybody goes on a rant about DMEs, Lincare has been very good so far when I've been dealing with CPAP equipment, up until the current prescription for a new one after my 5-year-old A10 gave the message that it "has exceeded its normal motor life." I am hoping things go smoothly with oxygen from Lincare.

Thank you for any help anyone can give me with these questions.

Maryland CPAPer 2

[palerider]

I have been reading some of the online oxygen user forums and people talk about traveling with 20 oxygen tanks. I cannot even imagine it. That usually involves airplane travel, which I don't expect to be doing. They talk about liquid oxygen, having "parties" to refill their oxygen tanks when they return from an excursion, and other things that sound totally foreign to me.

Are you reading *current* posts? because the use of oxygen tanks has pretty much been relegated to emergency use.

Plus, what goes in a nebulizer and how does it work? I had nebulizer treatments in the hospital that were quite helpful, but nothing in this Rx says what goes in the nebulizer and how it is used.

You put medication in it, hook the breathing piece up to a small compressor, and it .... nebulizes... the medication, you just breathe it in, and it goes all through your lungs.

. And, does this Rx get me anything portable,

Well, that will all depend on the prescription.

[klm49]

So, the doctor says she needs oxygen, but Meducare does not.
This happens all the time, money and politics "trump" science.

Of course, doctors are *never* wrong.

Maybe sometimes--but seldom, compared to those with no empathy for the patient.
Or no soul . . .

So sad people can't keep their political views off the pages. I seriously doubt the current President changed the rules to have Medicare pay for oxygen.

https://www.medicarefaq.com/faqs/medica ... n-therapy/

[palerider]

So sad people can't keep their political views off the pages. I seriously doubt the current President changed the rules to have Medicare pay for oxygen.

https://www.medicarefaq.com/faqs/medica ... n-therapy/

So sad that some people can't avoid twisting things into something they're not.

trump
noun: trump; plural noun: trumps

(in bridge, whist, and similar card games) a playing card of the suit chosen to rank above the others, which can win a trick where a card of a different suit has been led.
the suit having the rank above the others in a particular hand.
"the ace of trumps"
(in a tarot pack) any of a special suit of 22 cards depicting symbolic and typical figures and scenes.
a valuable resource that may be used, especially as a surprise, in order to gain an advantage.
noun: trump card; plural noun: trump cards
"in this month General Haig decided to play his trump card: the tank"
informal•dated
a helpful or admirable person.

verb
verb: trump; 3rd person present: trumps; past tense: trumped; past participle: trumped; gerund or present participle: trumping

(in bridge, whist, and similar card games) play a trump on (a card of another suit), having no cards of the suit led.

Of course, in French, 'trump' is slang for FART

[MarylandCPAPer2]

So sad people can't keep their political views off the pages. I seriously doubt the current President changed the rules to have Medicare pay for oxygen.

https://www.medicarefaq.com/faqs/medica ... n-therapy/

So sad that some people can't avoid twisting things into something they're not.

trump
noun: trump; plural noun: trumps

(in bridge, whist, and similar card games) a playing card of the suit chosen to rank above the others, which can win a trick where a card of a different suit has been led.
the suit having the rank above the others in a particular hand.
"the ace of trumps"
(in a tarot pack) any of a special suit of 22 cards depicting symbolic and typical figures and scenes.
a valuable resource that may be used, especially as a surprise, in order to gain an advantage.
noun: trump card; plural noun: trump cards
"in this month General Haig decided to play his trump card: the tank"
informal•dated
a helpful or admirable person.

verb
verb: trump; 3rd person present: trumps; past tense: trumped; past participle: trumped; gerund or present participle: trumping

(in bridge, whist, and similar card games) play a trump on (a card of another suit), having no cards of the suit led.

Of course, in French, 'trump' is slang for FART

So sad that people ignore serious posts containing serious questions and instead play word games to show off how "smart" they are.

[MarylandCPAPer2]

I have been reading some of the online oxygen user forums and people talk about traveling with 20 oxygen tanks. I cannot even imagine it. That usually involves airplane travel, which I don't expect to be doing. They talk about liquid oxygen, having "parties" to refill their oxygen tanks when they return from an excursion, and other things that sound totally foreign to me.

Are you reading *current* posts? because the use of oxygen tanks has pretty much been relegated to emergency use.

Evidently not. The first page of topics on online oxygen forums can go back as far as 10 years. Not much activity. Plus, they are for people with pulmonary conditions with which I have not been diagnosed. That is why I am still asking questions here.

Yesterday, I got a nebulizer, oxygen concentrator with a humidifier, a backup oxygen tank to be used in case of a power outage, 4 4lb portable tanks, and 2 7 lb portable tanks. I was told I could get up to 10 tanks of oxygen at a time, in whatever sizes I wanted.

Two liters must be a tiny amount of oxygen, because I was very short of breath after having the oxygen cannula on me for an hour and going outside about 10 feet to check the mail. I was planning to go grocery shopping but was so exhausted suddenly that I quickly took my CPAP machine back to bed, hooked the oyxgen line to it, and at least got some air that way, but no sleep. I went right to sleep in the hospital when oxygen (probably at 4 liters) was hooked into my CPAP machine and I felt rested after 4 hours of sleep, both of which never happen when I use CPAP without oxygen.

The delivery man from the DME said spring water was ok to use in the humidifier and that it does not have to be distilled water, just no tap water. Any thoughts?

He placed the oxygen adaptor directly to the Airsense 10 hose connector, then connected the hose. When I was in the hospital, the oxygen adapter was connected between the hose and the hose to my mask. Any thoughts on which is more effective?

I am exhausted and can't even imagine that lugging a tank to the grocery store for the tiny amount of oxygen I get would do anything except make me even more short of breath than I already am, especially with a COVID mask over the nasal cannula. 4 lbs is heavy for me.

I asked for a manual for the oxygen concentrator, but he said they don't provide manuals, except for the nebulizer. I can't use the nebulizer yet because the prescription for whatever goes in the nebulizer needs to come via UPS or FedEx, and is not delivered with the equipment.

At least I managed to locate the noisy oxygen concentrator well away from my bedroom, in the living room at the opposite end of the house.

Serious responses would be appreciated. I am feeling like all the effort to get oxygen wasn't worth it.

Maryland CPAPer 2

[palerider]

The delivery man from the DME said spring water was ok to use in the humidifier and that it does not have to be distilled water, just no tap water. Any thoughts?

Do you remember the general advice about DMEs statements? "if it's midnight and your DME says it's dark outside, GO OUT
My thoughts would be "ignore everything they say, find a manual for the machine, and follow the manufacturers recommendations"

He placed the oxygen adaptor directly to the Airsense 10 hose connector, then connected the hose. When I was in the hospital, the oxygen adapter was connected between the hose and the hose to my mask. Any thoughts on which is more effective?

I don't know what you mean. If you're asking whether it makes any difference which end of the hose the adapter goes to, then the answer is "it doesn't".
Resmed makes a heated hose designed specifically for use with oxygen, the ClimatelineAir™ Oxy, get one of those for your next tube replacement, it's got an O2 connector built in.

I am exhausted and can't even imagine that lugging a tank to the grocery store for the tiny amount of oxygen I get would do anything except make me even more short of breath than I already am, especially with a COVID mask over the nasal cannula. 4 lbs is heavy for me.

You REALLY need to get over this mask fixation you have. Masks don't restrict your breathing, they don't restrict oxygen, they don't cause buildup of CO2, the only effect they have on breathing is *MENTAL*.

If *ANYTHING*, having a mask over the cannula will *INCREASE* the amount of oxygen you get.

I asked for a manual for the oxygen concentrator, but he said they don't provide manuals, except for the nebulizer. I can't use the nebulizer yet because the prescription for whatever goes in the nebulizer needs to come via UPS or FedEx, and is not delivered with the equipment.

User, (and service) manuals are available online, get to lookin.