Reason to be wary for those asymptomatic?

[audreyh1]

Thanks...
I got one of those Oximeter devices a couple of weeks ago, and it is consistently giving me 95/96 type readings for myself and some others.
One always wonders if the thing is accurate, but it seems accurate enough.
if my readings go to 90 I'll know something is wrong.

I'm so glad I don't need to be sticking a "big needle" into my arm everytime I want to know my O2 level

Try this experiment: do your normal measurement, then leave the pulse oximeter on, and take some deep breaths and wait a bit. We’ve seen our blood oxygen level go up 2 or 3% doing that. Seems to indicate it’s working, but what do I know...

 

[audreyh1]

I read about one pro athlete who determined something was wrong because his respiratory rate had increased to above normal according to some personal monitoring device* he was wearing due to his training. He got tested and found he was positive for COVID-19.

Clearly we have a situation where people are having some degree of respiratory failure and not realizing it at all. I had read about people breathing more rapidly and shallowly.

* i don’t know what device, but it would not have been an Apple Watch without some additional sensors.

 

[EastWest Gal]

Try this experiment: do your normal measurement, then leave the pulse oximeter on, and take some deep breaths and wait a bit. We’ve seen our blood oxygen level go up 2 or 3% doing that. Seems to indicate it’s working, but what do I know...

I’ve seen that routinely. Probably working fine. I wonder if the clotting that COVID causes leads to inaccuracies in the sat monitor. Poor perfusion (shock, for example), gives falsely low readings.

 

[Rianne]

This is the account I read, from a hospitalist in AZ:
http://www.tucsonsentinel.com/opini...-reopening-without-mask-mandate-catastrophic/

I think this quote says it all. I appreciate the honesty of the author.

"We have no idea what we are doing. We are sharing evidence from small studies that could help and utilizing treatments that we think and hope are helpful. Of course, we also thought hydroxychloroquine was helpful a couple of months ago. So, we're hopefully helping people, maybe hurting them, and trying our best"


Scientific information is changing daily. Every person is different, some healthy individuals end up on a ventilator, others with pre-existing conditions survive, others have symptoms that last weeks/months, while others recover completely (at least for the time being).

I will continue to behave as everyone has the virus, except my DH. Although, I still believe he was infected in April but i posted all that awhile ago.

 

[Midpack]

I think this quote says it all. I appreciate the honesty of the author.

"We have no idea what we are doing. We are sharing evidence from small studies that could help and utilizing treatments that we think and hope are helpful. Of course, we also thought hydroxychloroquine was helpful a couple of months ago. So, we're hopefully helping people, maybe hurting them, and trying our best"


Scientific information is changing daily. Every person is different, some healthy individuals end up on a ventilator, others with pre-existing conditions survive, others have symptoms that last weeks/months, while others recover completely (at least for the time being).

I will continue to behave as everyone has the virus, except my DH. Although, I still believe he was infected in April but i posted all that awhile ago.

+1. There are way too many people jumping to conclusions. Wear a mask, practice physical distancing (avoid crowds) and increase your cleanliness as much as possible. That's about all we know for sure, yet some people even want to argue about that still. The rest of it is good to keep in mind, but you might as well stay-at-home entirely if you believe everything Covid-19 that's published anywhere.

 

[harllee]

DH and I are high risk (almost age 70 and DH has an autoimmune disease) and we have been checking our oxygen level with an Oximeter every day or so, both running about 96. So we left our home in the middle of NC (elevation about 500 feet ) and went to our home in the NC mountains (elevation 5000 feet). We don't really notice the change in elevation much when exercising, etc. After a couple of days we unpacked and the Oximeter and one of us was at 91 and the other at 93. We freaked out thinking we had Covid-19 (but we had no symptoms other than low oxygen level but I had been to the dentist). Finally it dawned on me that we had gone up 4500 feet in elevation and I researched it the internet said that an increase in elevation would case low oxygen levels. It has been about 10 days now, we have both been doing breathing exercises and today our oxygen levels are back to 96. Whew.

 

[ivinsfan]

DH and I are high risk (almost age 70 and DH has an autoimmune disease) and we have been checking our oxygen level with an Oximeter every day or so, both running about 96. So we left our home in the middle of NC (elevation about 500 feet ) and went to our home in the NC mountains (elevation 5000 feet). We don't really notice the change in elevation much when exercising, etc. After a couple of days we unpacked and the Oximeter and one of us was at 91 and the other at 93. We freaked out thinking we had Covid-19 (but we had no symptoms other than low oxygen level but I had been to the dentist). Finally it dawned on me that we had gone up 4500 feet in elevation and I researched it the internet said that an increase in elevation would case low oxygen levels. It has been about 10 days now, we have both been doing breathing exercises and today our oxygen levels are back to 96. Whew.

I often think about this when people are talking about where to locate after retirement. Certain health conditions can make it more difficult to be comfortable at higher elevations. My HS town is Utah is at around 6200 ft and when we travel there from my "flatlands" I absolute notice the change for at least several days. Went from "flatlands" to Brian head UT and thought "WTH" is wrong with me..it was 9800 ft. the highest town in UT. I felt like I was wearing cement shoes.

If you are young and healthy you can adjust, but if you older and on certain meds particularly heart meds you might never feel comfortable.

I could see checking your ox level if you are feeling ill, but every day in this case it caused you some extra stress.

 

[intent]

Have you or your wife talked with your doctor about your breathing issues/chest constriction? Do you think your lung damage would show up on x-rays?

We haven't talked to a doctor since first being diagnosed. My wife is generally resistant to seeing the doctor, and as she's feeling much better than she did in April/May, it would be a challenge to get her to go in.

I honestly have no idea if anything would show up on an x-ray. I don't even know for sure if anything I'm experiencing is actually Covid-related (though the toes sure fit the description to a tee, so I'm inclined to agree with the doctor that I had the virus).

We absolutely appreciate the concern, and are hyper vigilant/aware of any changes in our conditions. The main idea I wanted to share was that if there are long-term damages from the virus, and if we're experiencing damages, hopefully most will experience symptoms similarly mild to ours.

 

[harllee]

I often think about this when people are talking about where to locate after retirement. Certain health conditions can make it more difficult to be comfortable at higher elevations. My HS town is Utah is at around 6200 ft and when we travel there from my "flatlands" I absolute notice the change for at least several days. Went from "flatlands" to Brian head UT and thought "WTH" is wrong with me..it was 9800 ft. the highest town in UT. I felt like I was wearing cement shoes.

If you are young and healthy you can adjust, but if you older and on certain meds particularly heart meds you might never feel comfortable.

I could see checking your ox level if you are feeling ill, but every day in this case it caused you some extra stress.

DH's doctor suggested that he check his oxygen level frequently because he has a lowered immune system due to psoriatic arthritis and takes Humira and Methotrexate so he is at very high risk for Covid-19. I check mine when he checks his. I should have realized that altitude would affect the readings--dumb me. In any event we have both acclimated to the altitude and our oxygen levels are back to 96.

 

[Another Reader]

I’ve seen that routinely. Probably working fine. I wonder if the clotting that COVID causes leads to inaccuracies in the sat monitor. Poor perfusion (shock, for example), gives falsely low readings.

Apparently, one problem that comes up with COVID is high endogenous CO levels in blood. The virus interferes with the natural level of CO that is formed by heme oxygenase attacking heme in red blood cells. Old red blood cells produce more CO, young ones less. The virus is believed to attack all red blood cells, causing them to produce more CO as they die. Some symptoms may result from endogenous CO poisoning that would be incorrectly identified without arterial blood gas measurements.

The CO that is formed bonds to hemoglobin preferentially over O2. It is not distinguished from oxygen by the oximeter. The oximeter will give a false high reading as a result.

Something else to worry about...

 

[ivinsfan]

DH's doctor suggested that he check his oxygen level frequently because he has a lowered immune system due to psoriatic arthritis and takes Humira and Methotrexate so he is at very high risk for Covid-19. I check mine when he checks his. I should have realized that altitude would affect the readings--dumb me. In any event we have both acclimated to the altitude and our oxygen levels are back to 96.

That's not dumb but I sorry the lower readings caused you to feel more anxious.

 

[LOL!]

We haven't talked to a doctor since first being diagnosed. My wife is generally resistant to seeing the doctor, and as she's feeling much better than she did in April/May, it would be a challenge to get her to go in.

Are you not the classic case of a very good reason to go get tested to see if you have antibodies against covid-19? Are these tests available and free in your area? If not, why not? One would not have to see a physician to get this test done, but a blood draw would have to be done.

Actually, you both could have progressed to be asymptomatic walking carriers of live coronavirus.

 

[intent]

Are you not the classic case of a very good reason to go get tested to see if you have antibodies against covid-19? Are these tests available and free in your area? If not, why not? One would not have to see a physician to get this test done, but a blood draw would have to be done.

Actually, you both could have progressed to be asymptomatic walking carriers of live coronavirus.

We've mulled it quite a bit. The cons to going and getting a test, as we see it, are:

• As best as I can tell from researching online, there isn't consensus yet on whether the antibody tests are reliable/accurate
• Even if the test is accurate, there isn't consensus as to whether having antibodies confers immunity
• We would have to venture out into the world. Other than Walmart curbside grocery pickups, we have been self-quaranting since mid-March

Perhaps I'm still in the "there isn't too much to be done for you, so just stay home and let me know if it gets worse" mindset that the tele-doctor communicated to us. I would love to know definitively if we had it, and what our current state is (recovered and immune would be great), but so far I just haven't been convinced that it is possible to obtain an answer with any sort of confidence.

 

[EastWest Gal]

Are you not the classic case of a very good reason to go get tested to see if you have antibodies against covid-19? Are these tests available and free in your area? If not, why not? One would not have to see a physician to get this test done, but a blood draw would have to be done.

Actually, you both could have progressed to be asymptomatic walking carriers of live coronavirus.

Have you seen a study suggesting that there are long term asympmatic carriers of the coronavirus? If you have, please share your source? I would be interested in reading and learning. Thanks!

 

[P.S.]

Try this experiment: do your normal measurement, then leave the pulse oximeter on, and take some deep breaths and wait a bit. We’ve seen our blood oxygen level go up 2 or 3% doing that. Seems to indicate it’s working, but what do I know...

This physiologic maneuver is called recruitment, and improves your FRC (functional residual capacity). Increasing flow of air -> increases pressure into individual alveoli that are/ may not be maximally opened (atelectatic) -> pops the atelectatic alveoli open -> those can now contribute to gas exchange.

Apparently, one problem that comes up with COVID is high endogenous CO levels in blood. The virus interferes with the natural level of CO that is formed by heme oxygenase attacking heme in red blood cells. Old red blood cells produce more CO, young ones less. The virus is believed to attack all red blood cells, causing them to produce more CO as they die. Some symptoms may result from endogenous CO poisoning that would be incorrectly identified without arterial blood gas measurements.

The CO that is formed bonds to hemoglobin preferentially over O2. It is not distinguished from oxygen by the oximeter. The oximeter will give a false high reading as a.

Thus the goal is to “push” off the CO by significantly increasing the availability of O2. Increasing the percent O2 inhaled can be done via a number of mechanisms. The goal is to increase the FiO2 but limit further lung damage. Hyperbaric O2, which is used for example in methemoglobinemia and CO poisoning, is being trial-ed in COVID.

Have you seen a study suggesting that there are long term asympmatic carriers of the coronavirus? If you have, please share your source?

I know that RT PCR has been +SARS CoV2 in patients 6-8 wk out from dx, but is this viral pieces or infectious material? To determine the latter you need a BSL lab, and access to the lab I think is what is limiting figuring this out. Plus not all pts shed for this long, so one would have to test alot to find the few, and then in the context of the BSL lab.

 

[ivinsfan]

We've mulled it quite a bit. The cons to going and getting a test, as we see it, are:

• As best as I can tell from researching online, there isn't consensus yet on whether the antibody tests are reliable/accurate
• Even if the test is accurate, there isn't consensus as to whether having antibodies confers immunity
• We would have to venture out into the world. Other than Walmart curbside grocery pickups, we have been self-quaranting since mid-March

Perhaps I'm still in the "there isn't too much to be done for you, so just stay home and let me know if it gets worse" mindset that the tele-doctor communicated to us. I would love to know definitively if we had it, and what our current state is (recovered and immune would be great), but so far I just haven't been convinced that it is possible to obtain an answer with any sort of confidence.

Your story is interesting and there has been more a little young people quit going out and try to kill us old people bashing go on in ths forum. And I won't even mention the M word debate. COVID toes are unique enough that I would say you had COVID . By your own accounting you have not been in a public place since well before you became ill.

What are we to do here, I wish I knew because it's starting to seem nothing is set in stone when it comes to COVID.

 

[teejayevans]

I have an oximeter too. Heard they're not accurate.

In fact one AZ doctor said that they take oxygen readings by putting a big needle into wrists of patients.

So I'm mainly hoping mine is consistent, that instead of giving absolute value accurately, I will be able to tell how much the O2 drops from the baseline I'm getting now, when I assume I'm not infected.

Mine seems accurate, I use it often, you do have to remain still.

 

[audreyh1]

DH and I are high risk (almost age 70 and DH has an autoimmune disease) and we have been checking our oxygen level with an Oximeter every day or so, both running about 96. So we left our home in the middle of NC (elevation about 500 feet ) and went to our home in the NC mountains (elevation 5000 feet). We don't really notice the change in elevation much when exercising, etc. After a couple of days we unpacked and the Oximeter and one of us was at 91 and the other at 93. We freaked out thinking we had Covid-19 (but we had no symptoms other than low oxygen level but I had been to the dentist). Finally it dawned on me that we had gone up 4500 feet in elevation and I researched it the internet said that an increase in elevation would case low oxygen levels. It has been about 10 days now, we have both been doing breathing exercises and today our oxygen levels are back to 96. Whew.

Yep!

Cool, huh? You actually watch your body adapt to the higher altitude!

 

[sengsational]

Apparently, one problem that comes up with COVID is high endogenous CO levels in blood. The virus interferes with the natural level of CO that is formed by heme oxygenase attacking heme in red blood cells. Old red blood cells produce more CO, young ones less. The virus is believed to attack all red blood cells, causing them to produce more CO as they die. Some symptoms may result from endogenous CO poisoning that would be incorrectly identified without arterial blood gas measurements.

The CO that is formed bonds to hemoglobin preferentially over O2. It is not distinguished from oxygen by the oximeter. The oximeter will give a false high reading as a result.

Something else to worry about...

Thanks for presenting those concepts.

Mine seems accurate, I use it often, you do have to remain still.

I take an SpO2 reading every morning and record it. Even if the result is "inaccurate" when compared to arterial blood gas measurement, it sounds like the inaccuracy comes during advanced stages of the disease, when there are lots of compromised red blood cells.