O2 Desaturation

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Tue Mar 22, 2005 9:24 am

The MD who reviewed my sleep study made a comment:

"I would recommend an overnight oximetry study following initiation of CPAP. Note: The patient's average oxygen saturation was low during the CPAP titration portion of the study. It would be important to determine if this has been corrected once the patient is on continuous CPAP."

My regular MD didn't think this was necessary. Just want to see what you guys think, I know your not MDs. I'm still not feeling 100%, I started on January 25th. I'm on Remstar Auto with C-Flex running between 6-14. Average 1.5-12.5, depending on the night.

Thanks,

Heidi

wading thru the muck! · Post by **wading thru the muck!** » Tue Mar 22, 2005 9:30 am

Heidi,

They can give you a recording pulse oximeter that you ca take home with you and monitor your O2 desaturation while using your machine in you usual sleep circumstances. No need to go for an overnight study for this. If you do this, make sure the unit you get is designed for monitoring apnea related desaturations. This means it needs to have very frequent measurements.

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Tue Mar 22, 2005 9:34 am

This I guess is another situation where I must be my own advocate and press for what is best for me.

Boy this happens a lot in the medical field. I wonder if I were the doctors family member if things would be different?

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Tue Mar 22, 2005 6:59 pm

I called my MD and they said "no". I said what do you mean "no". The nurse told me that "we don't do that as a routine" I said, "I don't care what you do as a routine, it was recommended by the MD who translated my sleep study" The nurse just said she said "no". I asked if the MD had actually read the study and the nurse said she looked over your chart and so I assume she read the sleep study.

What a crazy world we live in....

Guest · Post by **Guest** » Tue Mar 22, 2005 7:44 pm

You might want to consider a new doctor. Sure it's a pain to do so, but your doctor should be cooperating with the specialists.

Tom

wading thru the muck! · Post by **wading thru the muck!** » Tue Mar 22, 2005 7:56 pm

I think she needs to give you a better answer than that. If you should, God forbid, have some type of Terry Shiavo brain damage due to O2 desaturation, your husband will have no problem sueing the pants off your Doc. I think she needs to go over with you what your desats were and why she thinks overnight oximetry is not necessary.

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Tue Mar 22, 2005 10:22 pm

I called the MD who evaluated my sleep study, his nurse is going to reorder all of the documents he used to evaluate my sleep study.

I explained about the O2 desaturations and that the MD didn't feel it necessary to follow up and she agreed that something was wrong with this picture.

I should hear from specialist Thursday. I am looking for a new clinic.

My 9 year old had a Album/Creat urine test (non-fasting). I received results it was 100.7. Diabetic Endo MD wanted follow up. His regular MD at this "great clinic" said it isn't necessary, just wants me to keep a closer rein on his blood sugars. Mind you his A1C is 7.0.

Went to Diabetic Endo today and he wrote this MD a note, he wants it done!!!

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Tue Mar 22, 2005 11:29 pm

Here is an article about oxygen desaturations. I don't fit into the catagories but apparently the MD who analyzed my study thought it was significant enough to look into.

http://meeting.chestjournal.org/cgi/con ... 6/4/783S-a

Not feeling up to speed just yet! I wonder why?

Heidi

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Wed Mar 23, 2005 9:08 am

Does anyone else know about this desating even while on CPAP????

I'm curious what would they do, clinic said they can't send me home with oximeter...

wading thru the muck! · Post by **wading thru the muck!** » Wed Mar 23, 2005 9:24 am

Heidi,

If you O2 levels do not improve enough with just the cpap, they can add supplemental oxygen to your hose. I know there are a number of people on the forum that use this.

2listless · Post by **2listless** » Wed Mar 23, 2005 10:28 am

I use supplemental oxygen with my CPAP. Been on CPAP for a very long unsatisfying year. The O2 supplementation started in November. I also suffer from asthma. I have low inspiration and expiration levels. The O2 oximetry can be done overnight at home through your DME supplier. They drop it off, take you on a little walk to get a movement reading, then show you how to wear it. It is painless, just annoying - another thing attached to your body. It will show if the CPAP is doing what it is supposed to do. My personal physician ordered supplemental oxygen after 3 nights of studies showed desat levels of 76% even while on CPAP. The Sleep Doctor, and I quote, "I do not think you need the supplemental oxygen but it is not my decision to make" Duh, why do I need him then? My doctor ordered 1 liter of oxygen added through the tubing at night. My last oximetry showed no levels below 90%. Visited my pulmonologist, he raised the O2 to 2 liters and will be doing several more overnight oximetries. He considers anything under 92% "problematic". So as you can see, everyone in the medical field is in agreement. Can you tell any difference in how you feel? No! When you turn off the O2 it has a half life of about 2 minutes. So while walking around, I desat to 76% for no known reason, then it pops back up again. No wonder people throw in the towel and self diagnose and self-medicate!
I also know that CPAP may not be effective with asthma. So, next week when I see the Pulmonologist again - I will address that issue. Good luck! PS I find out that the DME supplier should be sending out a Respiratory Therapist, certified. I have Travis the delivery boy!!!!!!!!! LOL

Mikesus · Post by **Mikesus** » Wed Mar 23, 2005 12:05 pm

You might be desating from Vocal Cord disfunction (it is often confused with Asthma) It can cause the rapid desat like you said, and once your vocal cords stop constricting your sat level bounces back. (I have vocal cord disfunction as a result of GERD and had the desat problem, however mine did not drop as low. However, I would suddenly get dizzy and faint while walking) Look up Vocal Cord Disfunction (VCD) at http://www.njc.org as of last fall, they were the only place that diagnosed VCD and offered treatment for it.

National Jewish Center in Denver is the #1 respiratory Hospital. Check it out...