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Morbius wrote: ↑

Mon Apr 30, 2018 7:35 pm

Rob K wrote: ↑

Mon Apr 30, 2018 4:28 pm

Got some feed back from the doc. Says level is borderline high and not to concerning. He said we will keep an eye on it.

Using the H-H Equation, your pCO2 works out to be 55 mmHg, which IMO is concerning.

Just sayin'.

What pH did you use for the blood? HH is overly simplistic for actual blood calculations because I think there are other factors that affect the pH of blood and via the relationship of the HH equation the carbonate/bicarbonate ration. I'd go with the Dr. opinion that there is nothing to worry about as they have accesses to a great deal more information than is presented here, and are more experienced than an "internet Dr".

Doc said they only test ph for trauma patients and people that have abnormally high CO2. Said he would set a reminder to have me come in and check it again in a month or so. Like said he wasn't too worried about it.

Rob K wrote: Doc said they only test ph for ...people that have abnormally high CO2.

Seems to me 55 mmHg would qualify.

Rob K wrote: Like said he wasn't too worried about it.

Think he'd be worried if it was his lab value?

TASmart wrote:What pH did you use for the blood?

I used the theoretically "ideal" pH. However, if we are considering that this is a compensated respiratory acidosis, and compensation is never complete (otherwise the driving force for compensation would disappear), then in vitro the pH would be a little lower, and pCO2 could be 57 - 59 mmHg. Current technology is such that there is usually good correlation between measured and calculated -HCO3, That said, if that does not seem to be the case here, then explanation is still required. It is just as likely that things are even worse instead of better.

That said2, if this is compensated respiratory acidosis, a month certainly won't make a difference, as the overall situation is probably irreversible for the most part anyway.

Morbius wrote: ↑

Wed May 02, 2018 7:00 am

...if we are considering that this is a compensated respiratory acidosis...

OTOH, your symptoms:

Rob K wrote: ↑

Fri Apr 27, 2018 7:41 pm

I've been tired, fatigued and low on energy most every day.

do not exclude underlying metabolic disorder.

Morbius wrote: ↑

Wed May 02, 2018 7:07 am

Rob K wrote: ↑

Fri Apr 27, 2018 7:41 pm

I've been tired, fatigued and low on energy most every day.

do not exclude underlying metabolic disorder.

So I have a question.

In reviewing all your old posts, your diagnosis of OSA is based on 15.5 minutes of REM sleep over 3 sleep studies?

viewtopic.php?f=1&t=115389&p=1124373#p1124373

TASmart wrote: ↑

Tue May 01, 2018 10:18 am

I'd go with the Dr. opinion ... and are more experienced than an "internet Dr".

Don't bet the house on that.

Do you have any specific evidence of a specific harmful condition that the observed CO2 blood levels may be indicative of? Or are you just scaremongering? Ohh could be something bad, Drs don't know, could be bad OHHHHH.

TASmart wrote: ↑

Wed May 02, 2018 8:25 am

Do you have any specific evidence of a specific harmful condition ...

That would be getting 2 specific.

While elevated pCO2 (compensated respiratory acidosis) would seem to be highly unlikely given the age and physical make up of this person, it is extremely concernng that during his recent surgery, where not a lot of anesthetic would have been used, he

Rob K wrote: ↑

Mon Oct 09, 2017 6:42 pm

Ended up in intensive care after surgery with respiratory failure.

So either somebody really FUed or there is (are) predisposing factors that would have contributed to that.

On a side note it is not even clear if this person has sleep apnea. The diagnosis was made based on a 15.5 minute period of REM where 3 apneas and 2 hypopneas occurred. Oddly, there was not a significant oxygen desaturation. I would question the validity of the study because the patient took 10 mg. of zolpidem (a REM suppressant and disruptor) before the test. While zolpidem does not have the same potential of the older benzodiazepines to worsen sleep apnea, the patient states that

sleeping pills... seem to make my apnea worse.

This would create a false positive sleep study and also seem to explain him going down the tubes post-surgery.

All that said, the likelihood that this is metabolic (or additionally metabolic) is strong. The results of the other electrolytes would be helpful in order to help pinpoint the disturbance.

Morbius wrote: ↑

Thu May 03, 2018 7:40 am

This would create a false positive sleep study ...

And even if it was valid, as the patient notes, any events could have been caused by the tumor compressing the airway.

Rob K wrote: ↑

Tue May 01, 2018 6:20 pm

Doc said they only test ph for trauma patients and people that have abnormally high CO2. Said he would set a reminder to have me come in and check it again in a month or so. Like said he wasn't too worried about it.

Hi Rob, wanted to check in with you if you ever got an answer from the doctor? I have been dealing with high co2 levels for the last 2 years or so, but no answer, my co2 level is always above range and was at your level as well 33.