Re: Dr notes from my last and new PCP visit

[Guest guest]

Oximetry readings that are problematic are readings that are 'consistently' low. Take it from a retired ICU nurse whose patient load included pulse oximetry always, so many things interfere with readings; position, cold extremities, movement, sweat... you name it. In my years in ICU, I've probably logged a thousand miles walking to a patient's room to adjust the oximeter probe so the alarm would silence.

If you have true saturation problems, trying to 'catch' a reading isn't necessary. The crappy reading is there all day and all night. If you are 'consistently' 89/90/91/92%, you need a pulmonologist. If you happen to 'catch' a briefly low reading, you probably need a new oximeter or a different finger.

Barb

Re: Dr notes from my last and new PCP visit

Very hard to catch the low O2 readings. Sometimes it is only a few seconds sometimes it is about a minute. I have a bi-pap machine more on this later.She decided to not have me use the bike peddles as she put it at this time Based on his dislike of the stationary cycle (bothers his legs) and his cardiovascular response, as well as his timid nature surrounding exercise, > > > > > > > >> > > > > > > > Until I can know if my home BPs are right I can see no point in using> > > > > > them. Did take BP device to VA to have it checked. First they did 2 readings> > > > > > using auto bp device over my shirt. They then had my us e my device I took> > > > > > my shirt off and took BP this reading was higher then there reading. Based> > > > > > on this was told my devise wasn't accurate Was told they would send me a new> > > > > > device. This was almost 3 months ago and am still waiting. > > > > > > > > > > > > > > > > > > .> > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId> > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/nc3=5191951>> > > > > >> > > > >> > > >> > >> >>

[Guest guest]

This sounds like one of my ED visits. Alarm kept going off most of the time it

was due to heart rate going above set point. once it was low O2. I guess the

nurse was tired of resetting alarm. This time she accused me of holding my

breath to make there alarm go off said many did this.

> > > > > > > > >

> > > > > > > > > Until I can know if my home BPs are right I can see no point

in using

> > > > > > > them. Did take BP device to VA to have it checked. First they

did 2 readings

> > > > > > > using auto bp device over my shirt. They then had my us e my

device I took

> > > > > > > my shirt off and took BP this reading was higher then there

reading. Based

> > > > > > > on this was told my devise wasn't accurate Was told they would

send me a new

> > > > > > > device. This was almost 3 months ago and am still waiting.

> > > > > > >

> > > > > > >

> > > > > > > .

> > > > > > >

> > > > > > >

<http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId<htt\

p://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId>

> > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/nc3=5191951>

> > > > > > >

> > > > > >

> > > > >

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[Guest guest]

I certainly agree with your problematic comment after watching mine for 18

months. Pulmonologist explained that when she found I had purchased one. Her

mainpoints were that the PTN would become overly alarmed or start adjusting

their oxygen on their own. I got to where I could almost tell where it would be

based on what I was doing!

I was DXed with COPD when they determined I needed oxygen, based on a PFT. I

ran 4L from concentrator into my bi-pap at night. One morning when I switched

over to a canula I found no oxygen coming thru. (My puppies has disconnected

the line.) I put my meter on and the level sat on 94-95 for 30 minutes!

I declared my COPD was cured! That surprised a PCP and Pulmo. and then Dr. Grim

spoiled the secret. He explained that noticable LVH improvement starts to show

at 12 weeks after getting HTN under control - it was 12 weeks and 2 days when I

noticed it!

- 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with

previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59

BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, AmlodipineBesylate

5mg, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11

to prepare for AVS.

> > > > > > > > >

> > > > > > > > > Until I can know if my home BPs are right I can see no point

in using

> > > > > > > them. Did take BP device to VA to have it checked. First they

did 2 readings

> > > > > > > using auto bp device over my shirt. They then had my us e my

device I took

> > > > > > > my shirt off and took BP this reading was higher then there

reading. Based

> > > > > > > on this was told my devise wasn't accurate Was told they would

send me a new

> > > > > > > device. This was almost 3 months ago and am still waiting.

> > > > > > >

> > > > > > >

> > > > > > > .

> > > > > > >

> > > > > > >

<http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId<htt\

p://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId>

> > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/nc3=5191951>

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

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>

[Guest guest]

I always liked patients like you . Instead of laying there feeling like a victim, you start making sense of the data. Journaling is the sum of the parts. Also, maintaining a medical file on your hard drive is a must. Ask for every scrap of paper they will give you and chase the ones they will not. Ask for copies of your CTs, MRIs, x-rays, consults, H & Ps, labs, surgical notes... blah, blah, blah. Scan all of them and put them in the hard drive medical folder. After that, don't get scared, get mad. Do the research, do the leg work, get involved. And above all, be intellectually aggressive.

When I used to precept the unit orientees and s/he would finish taking report, I would say, "Okay, now what's the next thing you need to do". Their answer was ALWAYS, "Go assess my patients". I would say, "Nope. Wrong. But thanks for playing". Few had a sense of humor but all wanted to know the right answer. I then told them that 75-80% of the report they just received from the nursing coming off shift was complete bullshit and the first thing they needed to do was find the truth (read all H & Ps, orders for the last few days, doctor's notes, current lab values, test results, etc.), and then, after assessing the patient, see what was logical and what fit with what they read v. what they saw. Had just one nurse done that when my husband was in with Salmonella, he would have received the correct treatment and care.

Had you told me what had happened with the puppies at home and your observations post puppy intervention, I would have used that as my starting point, observed the results (varying O2 therapies, correlating Sats, w-w/o exercise, etc., and reported your revelation correlated to objective data to the doc. We would have won the battle. And you would have been the brains of the operation.

Barb

Re: Dr notes from my last and new PCP visit

I certainly agree with your problematic comment after watching mine for 18 months. Pulmonologist explained that when she found I had purchased one. Her mainpoints were that the PTN would become overly alarmed or start adjusting their oxygen on their own. I got to where I could almost tell where it would be based on what I was doing!I was DXed with COPD when they determined I needed oxygen, based on a PFT. I ran 4L from concentrator into my bi-pap at night. One morning when I switched over to a canula I found no oxygen coming thru. (My puppies has disconnected the line.) I put my meter on and the level sat on 94-95 for 30 minutes!I declared my COPD was cured! That surprised a PCP and Pulmo. and then Dr. Grim spoiled the secret. He explained that noticable LVH improvement starts to show at 12 weeks after getting HTN under control - it was 12 weeks and 2 days when I noticed it! - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD.Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, AmlodipineBesylate 5mg, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.> > > > > > > > >> > > > > > > > > Until I can know if my home BPs are right I can see no point in using> > > > > > > them. Did take BP device to VA to have it checked. First they did 2 readings> > > > > > > using auto bp device over my shirt. They then had my us e my device I took> > > > > > > my shirt off and took BP this reading was higher then there reading. Based> > > > > > > on this was told my devise wasn't accurate Was told they would send me a new> > > > > > > device. This was almost 3 months ago and am still waiting. > > > > > > > > > > > > > > > > > > > > > .> > > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId<http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId>> > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/nc3=5191951>> > > > > > >> > > > > >> > > > >> > > >> > >> >>

[Guest guest]

Conditioning may help then.CE Grim MDOn Jan 31, 2012, at 8:19 AM, Francis Bill SUSPECTED PA wrote: Pulmonary function test was normal. Smoked a few years stopped in my early 20s Have had job related asbestos exposure. > > > > > > > > > > > > > > > > Until I can know if my home BPs are right I can see no point in using > > > > > > them. Did take BP device to VA to have it checked. First they did 2 readings > > > > > > using auto bp device over my shirt. They then had my us e my device I took > > > > > > my shirt off and took BP this reading was higher then there reading. Based > > > > > > on this was told my devise wasn't accurate Was told they would send me a new > > > > > > device. This was almost 3 months ago and am still waiting. > > > > > > > > > > > > > > > > > > . > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/nc3=5191951> > > > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

Suspect low o2 is a random variation.CE Grim MDOn Jan 31, 2012, at 5:57 PM, Francis Bill SUSPECTED PA wrote: Very hard to catch the low O2 readings. Sometimes it is only a few seconds sometimes it is about a minute. I have a bi-pap machine more on this later. She decided to not have me use the bike peddles as she put it at this time Based on his dislike of the stationary cycle (bothers his legs) and his cardiovascular response, as well as his timid nature surrounding exercise, > > > > > > > > > > > > > > > > Until I can know if my home BPs are right I can see no point in using > > > > > > them. Did take BP device to VA to have it checked. First they did 2 readings > > > > > > using auto bp device over my shirt. They then had my us e my device I took > > > > > > my shirt off and took BP this reading was higher then there reading. Based > > > > > > on this was told my devise wasn't accurate Was told they would send me a new > > > > > > device. This was almost 3 months ago and am still waiting. > > > > > > > > > > > > > > > > > > . > > > > > > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/nc3=5191951> > > > > > > > > > > > > > > > > > > > > >

[Guest guest]

If it is random then why does it do almost every time I do the exercise?

> > > > > > > > > >

> > > > > > > > > > Until I can know if my home BPs are right I can see

> > no point in using

> > > > > > > > them. Did take BP device to VA to have it checked. First

> > they did 2 readings

> > > > > > > > using auto bp device over my shirt. They then had my us

> > e my device I took

> > > > > > > > my shirt off and took BP this reading was higher then

> > there reading. Based

> > > > > > > > on this was told my devise wasn't accurate Was told they

> > would send me a new

> > > > > > > > device. This was almost 3 months ago and am still waiting.

> > > > > > > >

> > > > > > > >

> > > > > > > > .

> > > > > > > >

> > > > > > > >

<http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId

> > > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/

> > nc3=5191951>

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

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>

[Guest guest]

Probably because you are deconditioned! (I really don't know but I know mine

will drop when I head to the mailbox but rebound to 95 or so quickly.) My

guess, and it is mine alone as I've never researched it, is you have to get more

air into the lungs so it can get processed as oxygen to proceed to the blood.

In the meantime your heart rate increases so the level of oxygen is reduced

until the lungs can catch up. Then the amount it comes back to is dependent on

how good your lungs are which is dependent upon what condition you are in!

Another thing my mother tught me is, " If you can't overwhelm them with

brilliance, Baffle them with Bullshit " ! Consider the above the latter unless a

medicl professional verifies it and if that happens, remember that you heard it

here first!!!

Another test you can do is put your oximeter on and start your bi-pap and watch

what happens, you do use your bi-pap don't you? Mine goes from 94 to 97-98 and

sometimes 99!

> > > > > > > > > > >

> > > > > > > > > > > Until I can know if my home BPs are right I can see

> > > no point in using

> > > > > > > > > them. Did take BP device to VA to have it checked. First

> > > they did 2 readings

> > > > > > > > > using auto bp device over my shirt. They then had my us

> > > e my device I took

> > > > > > > > > my shirt off and took BP this reading was higher then

> > > there reading. Based

> > > > > > > > > on this was told my devise wasn't accurate Was told they

> > > would send me a new

> > > > > > > > > device. This was almost 3 months ago and am still waiting.

> > > > > > > > >

> > > > > > > > >

> > > > > > > > > .

> > > > > > > > >

> > > > > > > > >

<http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId

> > > > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/

> > > nc3=5191951>

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> > >

> >

>

[Guest guest]

In this case, it is not random. While exercising, your body requires more oxygen (an electron donor in the pathway for aerobic glucose metabolism - translated, the production of the body's fuel). Exercise = increased need for fuel ----> increased need for oxygen. A consistent drop in O2 sat while exercising generally reflects some type of heart or lung pathology.

Barb

Re: Dr notes from my last and new PCP visit

If it is random then why does it do almost every time I do the exercise?> > > > > > > > > >> > > > > > > > > > Until I can know if my home BPs are right I can see > > no point in using> > > > > > > > them. Did take BP device to VA to have it checked. First > > they did 2 readings> > > > > > > > using auto bp device over my shirt. They then had my us > > e my device I took> > > > > > > > my shirt off and took BP this reading was higher then > > there reading. Based> > > > > > > > on this was told my devise wasn't accurate Was told they > > would send me a new> > > > > > > > device. This was almost 3 months ago and am still waiting.> > > > > > > >> > > > > > > >> > > > > > > > .> > > > > > > >> > > > > > > > <http://geo./serv?s=97359714/grpId=7299303/grpspId=1705132763/msgId> > > > > > > > =40621/stime=1327872558/nc1=3848640/nc2=5191949/ > > nc3=5191951>> > > > > > > >> > > > > > >> > > > > >> > > > >> > > >> > >> >> >>