Any clues to why my oxygen is so low based on sleepyhead?

ajack wrote:

USMCVet wrote:

ajack wrote:I'm only going to repeat my self a bit. I would delete the part of adjust pressure to 9, near fixed pressure for a night. Saying it 4 times is just silly. I'd just say the, go and see doctor part, again. He should titrate you and you may need to be moved from cpap to bpap.

I'll be honest you seem intelligent and you seem to know what your talking about. I'm not trying to be difficult or ungrateful. Could you please explain the mechanics of pressure of 9 helping vs my current of 6 with 90% being 8 and highest it's ever gotten in 13.
The idea of more pressure seems to make sense on the face of it definitely. But when I had to pressure without CPAP my 02 was better. That's what I'm confused about. I'm always willing to admit when I'm wrong and open to all ideas so please don't give up on me lol

min pressure or peep pressure is one of the main ways you increase o2. It was just to see how you went and if you needed to seek further treatment before your next appointment. The VA will take this seriously for you and do a sleep study. Jump up and down if the doctor you see hesitates, in referring you to the pulmonary unit for an assessment and sleep study.

At the end of the day it doesn't matter, as your issues will be resolved through VA.
I was being conservative at 9 but it is about your 95% pressure. for 95% of the night you are under this and 5% you are over this.. If you were going to go fixed cpap pressure it is one of the main numbers used. It was to remove some of the variables you are having and see what basic cpap will do.

Aggressive would be for a medical person to have the min on 10, see the result, if still no good, then try 15. if still no good, it's the end of cpap and move up the machine list, try bpap and if still no good and can't keep the o2 above 90%, supplemental o2. o2 is the last on the list, given your charts and you are 93/94 during the day. so don't buy an o2 concentrator off of C/List. A change to bpap is a high probability

Thank you for this response! Very helpful. My next appointment is Monday. That article I posted confirms what you're saying and it now makes sense to me.

I'm not sure I can take another month of how I'm feeling and not have it severely effect my life . I'm already at point where all my limited energy is needed for work. Today was worst day yet at work and it wasn't that crazy.

I think I'll pitch the Bipap idea or oxygen idea. Honestly I just need a reprieve from feeling like crap. It's story of my life . Give me blood pressure meds and it gets better and then gets worse. Increase dosage and it gets better before getting worse. Swap meds rinse and repeat.

Start CPAP and go from complete exhaustion to really tired then get worse again. At least hypertension is silent killer. This OSA Hypoxemia is no joke!

USMCVet wrote:

Josiah wrote:Understanding what your problem is is I'm sure a top priority goal, but in the mean time have you considered adding supplemental oxygen to your cpap therapy?

Honestly this is what I want to do. Give me some oxygen so I can at least function . My memory is getting really bad so I started writing down my issues so I don't forget them.

Here is my list so far
People around me have said I am 50% dumber then normal
I am very forgetful now
I am having more headaches
Chest pain more often for which they have found no cause
More shortness of breath which hasn't been looked into at all
Trouble concentrating
Getting dizzy
Still coughing even though stopping Lisinopril a few weeks ago
Less patience
Exhaustion getting worse after it initially got a little better with therapy
Zoning out and forgetting what I was doing which is getting worse.
My thought filter is gone so I pretty much say what I think and hold nothing back

So my doctor wants to do nothing lol.

Have you had any bloodwork done recently?

I went in about a month ago because I was tired ALL the time. Way worse than before cpap. My days off, I would sleep or watch tv all day. Work days, I would come home and fall asleep with my dinner in the microwave. Later, I would be awake with major restless leg syndrome. ANd then it would move on to bad asthma attacks. I had a few other symptoms that I had no idea if they were related (out of breath frequently, mouth breathing a LOT more than normal, strange food cravings, cold all the time, sensitive hands, headaches, dizzy/sick feeling, etc). I was mostly focused on my totally crappy sleep (in bed for 10+ hours, yet awake a lot and feeling like crap).

I was wondering if maybe a vitamin was low, or maybe a thyroid problem. My doctor had my blood checked for iron, and she was completely right. I am now taking iron supplements. Almost immediately, all my symptoms improved. Mo more restless leg. No more "asthma" attacks. No more dizziness. Sleeping much better. Not freezing cold. And definitely not exhausted all day like I was.

Looking back at a couple ER visits last April for other issues (food poisoning and 2 weeks of headaches), the bloodwork back then had a few things that were out of the normal range, and they ALL referred to low iron. It took months to get bad enough for me to realize that my various symptoms weren't just getting old, depression, laziness, becoming a wuss, etc.

If something isn't right (and you know yourself well), ask your doctor (or find a different one) to look into things. I had no idea that my "asthma attacks" were actually times where my oxygen was so low that I was breathing hard to get more oxygen in. I couldn't understand why my inhaler wasn't helping. Even now, a month later, if I miss a pill or two, the symptoms start coming back. I screwed up on Thursday (only took the morning pill), and then slept in late on Friday. Even though I took 2 during the day, I had the worst night last night. Unfortunately cpap doesn't help since my problem is my blood's ability to carry oxygen, not my ability to inhale it.

It is totally possible that this oxygen problem is NOT related to sleep apnea. Hopefully, your doctor is willing to look at other possibilities.

take your SD card and printout of sleepyhead and o2 charts in on monday, even if the doc says the home o2 aren't good enough, you can come back with 'well run the tests you do accept'

For low iron have you looked into cooking with cast iron as well? Gives you some extra iron as well.

If tomorrow doesn't go well then I'm definitely going DIY to figure this stuff out.

Don't know if this is related or not but last night my upper back started to hurt for no reason and today it's worse and feels kind of like spasms? When I cough or take deep breaths.
But yeah I know myself well and something is not right.

I can view all my past blood work online and can check to see what's high. I usually have a couple things that are at least a little high and I know calcium is on that is slightly just in the high range.

Here are my most recent test results.

Lab Test: Metabolic Panel
Lab Type: Chemistry/Hematology

Specimen: Serum (substance)
Date/Time Collected: 21 Aug 2017 @ 0922
Test Name: GLUCOSE (V2)
Result: 111
Units: mg/dl
Reference Range: (70-115)
Interpretation: --

----------------------
Test Name: CREATININE (V2)
Result: 1.0
Units: mg/dl
Reference Range: (0.7-1.4)
Interpretation: --
----------------------
Test Name: EGFR (V2)
Result: >60
Units: mL/min
Reference Range: (>60)
Interpretation: The eGFR is a calculated value and results >60 are imprecise.
Results <60
are abnormal. Please refer to the National Kidney Foundation guidelines.
The MDRD equation for calculating eGFR has not been validated in patients
over 70 years, and the eGFR results alone should not be used to make
clinical decisions.
----------------------
Test Name: POTASSIUM (V2)
Result: 4.8
Units: mEq/L
Reference Range: (3.8-5.1)
Interpretation: --
----------------------
Test Name: SODIUM (V2)
Result: 138
Units: mEq/L
Reference Range: (135-145)
Interpretation: --
----------------------
Test Name: UREA NITROGEN (V2)
Result: 12
Units: mg/dl
Reference Range: (9-26)
Interpretation: --
----------------------
Test Name: CHLORIDE (V2)
Result: 99
Units: mEq/L
Reference Range: (97-109)
Interpretation: --
----------------------
Test Name: CO2 (V2)
Result: 26
Units: mEq/L
Reference Range: (22-32)
Interpretation: --
----------------------
Test Name: CALCIUM (V2)
Result: 10.1 High
Units: mg/dL
Reference Range: (8.4-9.
Interpretation: --
-------------------------------------------------------------------------

Comments: For eGFR: eGFR results >60 are imprecise. Many variables affect the
calculated result. Interpretation of eGFR results >60 must be
monitored over time.

=========================================================================

Lab Test: Microalbumin Urine Rand
Lab Type: Chemistry/Hematology
Specimen: Urine (substance)
Date/Time Collected: 31 Jul 2017 @ 0930
-------------------------------------------------------------------------
Test Name: URINE PROTEIN (SY/CN)
Result: 12
Units: mg/dl
Reference Range:
Interpretation: --
----------------------
Test Name: MICROALBUMIN* (V2)
Result: 1.0
Units: mg/dl
Reference Range: (0.0-1.9)
Interpretation: --
----------------------
Test Name: MICROALB/CREA RATIO* (AL/BU/CN/SY)
Result: 5
Units: mg/g
Reference Range: (0.0-30.0)
Interpretation: MA/Cr Ratio: 30-300 mg/g = Evidence of early nephropathy.
>300 mg/g = Nephropathy

----------------------
Test Name: UR CREATININE (CN/SY)
Result: 182.0
Units: mg/dl
Reference Range:
Interpretation: --

=========================================================================

Lab Test: Urinalysis Chemical w o micro
Lab Type: Chemistry/Hematology
Specimen: Urine (substance)
Date/Time Collected: 31 Jul 2017 @ 0930

-------------------------------------------------------------------------
Test Name: URINE COLOR (V2)
Result: YELLOW
Units: --
Reference Range:
Interpretation: --
----------------------
Test Name: CLARITY (V2)
Result: CLEAR
Units: --
Reference Range:
Interpretation: --
----------------------
Test Name: SPECIFIC GRAVITY (V2)
Result: >=1.030
Units: --
Reference Range: (1.016-1.022)
Interpretation: --
----------------------
Test Name: URINE GLUCOSE (V2)
Result: NEGATIVE
Units: mg/dl
Reference Range: (NEGATIVE)
Interpretation: --
----------------------
Test Name: URINE KETONES (V2)
Result: NEGATIVE
Units: mg/dl
Reference Range: (NEGATIVE)
Interpretation: --
----------------------
Test Name: URINE BLOOD (V2)
Result: NEGATIVE
Units: --
Reference Range: (NEGATIVE)
Interpretation: --
----------------------
Test Name: URINE PROTEIN (V2)
Result: NEGATIVE
Units: mg/dl
Reference Range: (NEGATIVETRACE)
Interpretation: --
----------------------
Test Name: URINE PH (V2)
Result: 5.5
Units: --
Reference Range: (5.0-9.0)
Interpretation: --
----------------------
Test Name: URINE BILIRUBIN (V2)
Result: NEGATIVE
Units: --
Reference Range: (NEGATIVE)
Interpretation: --
----------------------
Test Name: UROBILINOGEN (V2)
Result: 0.2
Units: EU/dl
Reference Range: (0.2-1.0)
Interpretation: --
----------------------
Test Name: URINE NITRITE (V2)
Result: NEGATIVE
Units: --
Reference Range: (NEGATIVE)
Interpretation: --

----------------------
Test Name: URINE LEUKOCYTE ESTERASE (V2)
Result: NEGATIVE
Units: --
Reference Range: (NEGATIVE)
Interpretation: --

Procedure/Test Name: CHEST 2 VIEWS PA&LAT
Date/Time Exam Performed: 21 Aug 2017 @ 0926
Report:
History: Shortness of breath

Findings: 2 view chest without comparison. Normal heart size,
mediastinal, and hilar contours. Clear lungs. No significant
pleural or chest wall abnormality.


Impression:
No acute disease. Clear lungs

egfr is 60, but your urea and creatinine ratio is good, kidneys are ok,

co2 normal, I'm surprised, I had money on your retaining co2. I thought you lived in high co2 land, test at 9:30...never listen to someone on the internet
I saw on another thread you had a heart issue, you may be better moving to fixed cpap, You thought I was going to say 9, didn't you but I'd bump it to 9.5 or 10, it increases the heart function, you need to google that https://www.google.com.au/search?q=peep ... e&ie=UTF-8 It decreases but increases function by 10 or more % in HF. they don't make a pill that does that, it is the reason cpap clears pulmonary oedema, Ask your cardio.
I'm just suggesting you get off of auto to fixed, based on this.
https://aasm.org/resources/practicepara ... rating.pdf
2. Patients with the following conditions are not currently
candidates for APAP titration or treatment. (Standard) [5.5,
5.8, Table 1]:
· congestive heart failurees

ajack wrote:egfr is 60, but your urea and creatinine ratio is good, kidneys are ok,

co2 normal, I'm surprised, I had money on your retaining co2. I thought you lived in high co2 land, test at 9:30...never listen to someone on the internet
I saw on another thread you had a heart issue, you may be better moving to fixed cpap, You thought I was going to say 9, didn't you but I'd bump it to 9.5 or 10, it increases the heart function, you need to google that https://www.google.com.au/search?q=peep ... e&ie=UTF-8 It decreases but increases function by 30% in HF. they don't make a pill that does that, it is the reason cpap clears pulmonary oedema, Ask your cardio.
I'm just suggesting you get off of auto to fixed, based on this.
https://aasm.org/resources/practicepara ... rating.pdf
2. Patients with the following conditions are not currently
candidates for APAP titration or treatment. (Standard) [5.5,
5.8, Table 1]:
· congestive heart failurees

No heart condition, that was negligence on Dr's part. Told me I had left bundle branch block ..... She was looking at someone else EKG..... Last EKG was a month or so ago and all was normal, cardiologist that did it showed me my name on it lol. He was pissed doctor gave me someone else's results.

Also a year or so ago I did a stress echo with gas and all was normal. Which was interesting because 12 years or so ago I had one and had mitral valve prolapse and saw myself the valve was extra long and like a whacky wild inflatable arm guy.

In hour and a half I have my appointment. Fingers crossed they do something that helps

Just curious since it has no bearing at all on your oxygen levels, but did you fast for the glucose test?

USMCVet wrote:Also a year or so ago I did a stress echo with gas and all was normal. Which was interesting because 12 years or so ago I had one and had mitral valve prolapse and saw myself the valve was extra long and like a whacky wild inflatable arm guy.

In hour and a half I have my appointment. Fingers crossed they do something that helps

best of luck, glad your tickers in good shape, you can buy a new pair of shoes and won't be wasting your money, after all

Arlene1963 wrote:Just curious since it has no bearing at all on your oxygen levels, but did you fast for the glucose test?

Pretty sure I did, I know the result was pre diabetic range . Who knows maybe I'm in diabetes range which is causing more issues now or maybe it's the lack of oxygen that is causing me to be pre diabetic.

Ah, good show so you do know that you are pre diabetic then. I just wondered if anyone had told you that because in the range it shows as being normal, but for sure it is too high for a fasting glucose reading. Good luck today, I hope you can figure out what is going on with your oxygen levels.

Thanks for seeing that and saying something! I look forward to updating here today.

Here is what I want out of today's appointment.
1: for them to say I need more testing to figure out what is going on obviously.
2: honestly I'm hoping for oxygen short term at least so I can feel normal. My C02 levels in last blood work a while ago we're normal so I'm not sure how much ventilation will help.
3: if no oxygen then auto Bipap with with another overnight oximetry text a week later and if results still low then supplemental oxygen.

But who knows, at least I find it hard to believe they will agree with my incompetent Dr I'm stuck with till March that no action is needed at all.

I'm diabetic, Fasting: under 100 is normal, 110 is cut out some sugars and starches, diabetic is 125+

what to expect the first week, besides being hungry for the first 2 days, then it stops
https://www.verywell.com/getting-throug ... ek-2242037

Nothing official yet, lots of walking in and out to consult with other Dr. So far looks like oxygen but they aren't happy the VA oximetry test does not have the actual study but just the numbers I posted