After a mesothelioma diagnosis, patients may be prescribed a variety of treatments. In addition, patients – or family members – may wish to take advantage of life-enhancing or life- sustaining medical equipment that is available. There is an array of available equipment serving a variety of functions, from helping someone breathe better to helping a patient move around their home or neighborhood to helping a patient get more rest. The goal is to provide a better quality of life.
Some of these pieces of equipment, like oxygen tanks and hospital beds for the home, are well-known. Others, like spirometer or a shunt, are less well-known. Patients are advised that some pieces of equipment are so common and re-usable that they can be rented from a medical supply store or even from some rehabilitation or hospital facilities. Other pieces must be purchased. Insurance may cover some or all of the cost of these pieces.
The symptoms of mesothelioma include shortness of breath, chest pain, pleural effusions (build up of fluid in the lungs), weakness and fatigue. These symptoms are often uncomfortable, may interfere with the patient’s daily activities and can be life-threatening. Whether used in the hospital or for therapeutic care at home, medical equipment can help patients and care givers manage mesothelioma symptoms. Medicare and other insurance plans may also cover some of the equipment costs.
Some at-home medical equipment can be expensive, especially items such as hospital beds. Luckily, if a patient has Medicare, it may cover many types of needed equipment. Durable medical equipment that is reusable like home oxygen equipment, hospital beds, wheelchairs and walkers are generally covered by Medicare Part B and Original Medicare may pay for this equipment if prescribed by a doctor or other practitioner if deemed medically necessary.
Typically, a Medicare beneficiary is responsible for 20 percent of the cost of equipment. Make sure to contact Medicare directly if you have questions regarding coverage and cost of specific equipment.
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Pleural mesothelioma accounts for the majority of all mesothelioma cases. Pleural mesothelioma patients usually suffer from a buildup of fluid in the lungs that can cause difficulty breathing. If you have been diagnosed with this type of mesothelioma, your doctor may prescribe oxygen or machines that can help you breathe. For oxygen and oxygen equipment, Medicare will usually cover "80 percent of either the actual charge for the item or the fee schedule amount calculated for the item, less any unmet deductible." Contact Medicare directly if you have questions about the amount covered as Medicare payments scales may change.
For mesothelioma patients in more advanced stages of the disease, breathing may be difficult or painful. To ease discomfort and make it easier to breathe, the patient’s doctor may prescribe the use of a mechanical ventilator - also called a respirator, or breathing machine.
The patient is connected to the ventilator through a tube that is placed into the mouth or nose and connects with the windpipe. The ventilator blows a mixture of air and oxygen into a patient’s lungs. Sometimes, use of a ventilator can cause pneumonia and lung damage if not used properly.
It is important for patients with mesothelioma to monitor their lung function. A spirometer typically consists of a mouthpiece, tubing and a recording device. After taking a deep breath, the patient exhales vigorously and quickly into the tubing. The volume of air inhaled or exhaled and the length of time each breath takes is measured.
These measurements can tell doctors about the health of a person’s lungs, and most tests are done in a doctor’s office. However, there are new spirometers on the market that make it easier to take measurements on your own.
One is called Spiro PD. It is a small, digital spirometer that allows patients to enter, store and retrieve personal information and test their lung function when it is convenient. The information can even be uploaded into a computer for easy sharing with your doctor.
When patients need to travel or want to enjoy the outdoors, they need a breathing aid that is easy to take with them. Portable oxygen tanks come in a variety of sizes, and some are made specifically for airline travel. These oxygen cylinders are lightweight and a variety of carrying cases and bags are available. A flexible tube with two prongs is inserted into the nose and delivers oxygen.
Because oxygen is flammable, be sure to keep cylinders away from heat and open flames. To prevent infections, the equipment should be washed with a mild detergent and sanitized with a vinegar solution of one part vinegar to three parts distilled water.
Mesothelioma patients often suffer from pleural effusion, the accumulation of fluid in the lungs. This often causes difficulty breathing and chest pain. Patients who suffer from peritoneal mesothelioma will often develop ascites, a build up of fluid in the peritoneal cavity. This causes difficulty breathing, loss of appetite and abdominal pain.
These fluid build ups reoccur often and involve countless trips to the hospital and invasive procedures. In order to manage these conditions and improve quality of life, doctors may insert shunts or catheters in the pleural and peritoneal cavities to drain excess fluid, relieve pressure and minimize hospital stays. Shunting and insertion of catheters can be an alternative to thoracentesis and pleurodesis.
Medicare typically covers these types of surgeries, follow-up surgeries and supplies if deemed medically necessary.
Pleural effusions are often a recurrent problem for patients with mesothelioma. Hospital chest drainage procedures are often costly and painful. One end of the pleuroperitoneal shunt is inserted into the pleural cavity and the other end is inserted into the peritoneal cavity (abdomen). A pump is located on the tube and is pumped manually by the patient. This allows fluid from the lungs to be drained into the peritoneum.
While these shunts are still used, they are no longer widely used because of a high rate of blockage, infection and tumor seeding. Tumor seeding occurs when cancerous cells travel through the shunt from the pleura and cause tumors to grow in the peritoneal cavity.
In peritoneal mesothelioma patients, this type of shunt can be used to drain ascites (excess peritoneal fluid) and re-infuse it into the body through a vein. The Denver shunt is a tube that can be surgically inserted into the peritoneal cavity and routed to a vein. This type of shunt has a pressure- sensitive valve, which opens when fluid pressure is greater than 1 cm of water.
The excess fluid then travels from the peritoneal cavity into the vein. Having a PV shunt placed has its benefits and risks. While it is effective in managing symptoms of ascites, it can also cause tumor seeding and certain patients experience a number of complications. Patients are usually carefully screened before shunt placement.
The indwelling pleural catheter (IPC) is used as an alternative to shunting in patients with pleural effusions. The catheter is a flexible tube that is surgically inserted into the pleural cavity and drains the fluid into a glass vacuum bottle.
This type of pleural effusion management reduces hospital stays, and provides effective management of symptoms associated with pleural effusions. Patients can drain pleural fluid at home with a nurse or outpatient management and remain comfortable without additional surgery.
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The stress of living with mesothelioma can sometimes be eased by being surrounded by family and friends at home as opposed to at the hospital. To be as comfortable as possible and avoid unnecessary strain on the body, patients can benefit from medical equipment that sustains daily lifestyle needs.
Hospital beds, wheelchairs and shower chairs or commodes fall under Medicare's durable medical equipment category. Patients generally pay 20 percent of the Medicare-approved amount after paying the deductible. A Certificate of Medical Necessity, a special form filled out by your doctor and sent to Medicare, is required before patients may purchase or rent this equipment.
While hospital beds are most often used in the hospital setting, they are also available for patients who are receiving care at home. If a patient is using a ventilator or oxygen tank, the size and shape of the bed makes it easy to have these items nearby.
The adjustable frame can also help patients sit up on their own, and the railings can prevent accidental falling. When using hospital beds, the FDA recommends checking the motors for dust and debris, checking for the proper fitting of the bed frame, mattress, rails and any other accessories, and proper use of bed rails. Hospital beds can be expensive, but most insurance companies cover their cost and patients have the option to rent rather than purchase a bed.
Some mesothelioma patients who suffer from difficulty breathing may need mobility aids such as wheelchairs. If using a wheelchair it is important to always read the operating manual and take proper precautions to avoid injury.
Some patients may have difficulty standing in the shower for long periods of time. Shower chairs are made of waterproof material and provide a safe and comfortable alternative to standing in a shower. However, remember that shower chairs are designed to be used in walk-in showers only.
If the chair has wheels, always make sure the wheels are locked before sitting on it. Caregivers should also take care to secure patients in the chair with a safety bar if the chair has one to prevent accidental falling from the chair. Clean the chair after every use with a sanitizer or a solution of one part bleach to 10 parts water.
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