She just started Oxygen today, and I'm noticing lots of nasal effluent. I positioned her on her side so it would run out. Is there anything I could do for added comfort? Should I vaseline the inside of her nose? how often should i change the water in the humidifier part of the machine? If she is breathing mainly through her mouth is the nasal oxygen tube doing her any good? Should I hold it near her mouth at times?
Perhaps this will be helpful 'til someone answers your specific questions. If your loved one/patient has a visiting nurse, call and request a callback. The answers to your questions are very important.
As to comfort, it's not unusual for the skin on the ears and adjacent upper neck to become irritated. Your oxygen supplier can provide you with little grey foam strips that fit over the tubing to protect if from chafing. Sometimes nurses will fold up Kleenex and put it over the tubing, but it doesn't stay in place as well as the foam tubing.
Absolutely NEVER use Vaseline or any substance containing petroleum when oxygen is in use. That includes most chapsticks. This is a major safety issue. See: http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000049.htm
You should have been given a sign that reads:
"OXYGEN IN USE! ABSOLUTELY NO SMOKING!" to put on your door. If you didn't, you can make one up. Be sure that no one does smoke inside the house.
The humidifier bottle should be filled between the minimum and maximum lines with distilled water - fill it whenever the water drops to the lower line.
You can distill the water yourself, which I did years ago simply by boiling it. However, online instructions now are a bit more complicated, so it's easier to just buy it.
I found it for $1.19 a gallon at a local grocery store chain. Walgreen's also carries it in our area.
Years ago instructions were to change the bottle weekly; my father maintains his own concentrator and supplies, so I don't know if it's the same now.
You should have been given a manual which addresses all these issues, including other troubleshooting issues if the concentrator isn't working properly (such as when the tubes get twisted and oxygen isn't coming through the cannula.)
The air should be coming into her nose even if she's breathing through her mouth, but you might want to try to get her to breath through her nose. Does she breathe through her mouth normally? Did you check the cannula to ensure that oxygen is coming through?
The easiest way to check for unobstructed flow is to hold the nasal "prongs" close to your hand - if it's flowing properly, you'll feel a little soft stream of air, from each of the "prongs". If not, it's time to troubleshoot. This is when you either read the manual or call the oxygen supplier, night or day.
You shouldn't have to hold it close to her mouth, and in fact I think that would defeat the purpose of the cannula. I'm wondering though why she isn't getting air into her nose, or if that's how she's always breathed.
If the mouth breathing continues, I would contact her pulmonary doctor or the doctor who prescribed the oxygen. I'm not sure whether or not she'd be getting the help she needs otherwise.
You should also know that Medicare instituted competitive bidding by oxygen suppliers (which fall into the category of DME [Durable Medical Equipment] suppliers). It's my understanding from our former supplier that several thousand smaller DMEs, which are better than the conglomerates in my opinion, went out of business.
I've also been clued into the fact that the kind of service that existed before competitive bidding is gone. I've seen that already. I don't know how your hospice company will perform as they're not strictly a DME although they may have a DME sideline or may contract with one to supply their clients.
Don't change this without consulting a doctor.