Oximetry question

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nebrhahe53

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when I use my finger oximeter I get a range from 80-97. This is without moving, changing my breathing or anything else. My wife reads 96-98 so I know the oximeter isn't broken. If I wear the bipap it still fluctuates- usually from 90-97. These changes are all within about 45 sec. You can see the numbers change every few seconds. Anyone else have these issues?
Yesterday I even got a reading in the 70s then back into the 90s.
 

GregK

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That's quite a range. I don't have a home oximeter but at the office it only changes (increases) if I breath better.
 

bigmark1954

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My home oximeter can fluctuate simply by breathing faster or slower.
Neil, assuming you know how to properly use the oximeter, if you are dropping down to the 70's or even 80's you need to be on oxygen right now.
If you can't maintain at least 90 during the day and when sleeping, your C02 levels wil start creeping up and put nails in your coffin.

I used to play a doctor on TV....Dr. Mark OBGYN:)
 

amysgarden

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I am an ED RN. We see great variations in readings. Typically it is more difficult to get readings in patients with poor circulation. If the green light is not steadily blinking with each heartbeat, then I wouldn't trust the reading. True readings usually do not fluctuate that much in that short of time. Even if a person holds their breath, the reading would not fluctuate that much usually.
 

nebrhahe53

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>I used to play a doctor on TV....Dr. Mark OBGYN

Thanks big mark, about the only dr I dont need now is an OBGYN. I dont think even aLS can make that happen|








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Neil that is a big fluctuation.

Probably the main thing it tells you is that you are doing better when on the bipap (as though we didn't already know that). Don't get too caught up on the numbers.

Use your bipap as you need to, (maybe Dr OBGEN meant bipap when he said oxygen as we don't use oxygen for ALS) use it even if you aren't sure you need it.
 

bigmark1954

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Neil that is a big fluctuation.

Probably the main thing it tells you is that you are doing better when on the bipap (as though we didn't already know that). Don't get too caught up on the numbers.

Use your bipap as you need to, (maybe Dr OBGEN meant bipap when he said oxygen as we don't use oxygen for ALS) use it even if you aren't sure you need it.

Tillie
Yes we do use oxygen.....I am on a 2ML bleed of 02 at night because even with my Bipap, I am dropping to the low 80's. Ask GregK about it if you think I am wrong.
 

GregK

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A low flow of O2, 2L, is not an issue. Especially if used with a BiPap to ensure adequate air exchange.

The problem with oxygen is that it can suppress the urge to breathe deeper which lessens the air exchange and thereby decreases the amount of CO2 expelled.
 

Nikki J

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My sister has it at night with bipap too. Prescribed by her ALS clinic pulmonologist her blood gases were normal but her sat was low on sleep study
 
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bigmark1954

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My sister has it at night with bipap too. Prescribed by her ALS clinic pulmonologist her blood gases were normal but her sat was low on sleep study
Yup.....same as me.
 

4tloml

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Neil, have you tried changing out the batteries? My husband got some readings like yours (all over the place), but with fresh batteries it only goes up or down 1% or 2% during a minute or so reading. You did say the reading was stable when your wife tested, so this may not be a solution, but may be worth a try just to see.
 

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In ALS, some people do better on lower air exchange volumes than "normal" people. Nor do sats correlate with the extent/effect of CO2 retention to the same extent because the physical ability to take in and expel air are two different things. Thus, I'm skeptical about using O2 to treat sats per se without understanding whether long-term you are doing more harm or good.

I suspect from what I've seen here and in literature that some PALS are simply not on BiPAP settings that provide enough pressure support (distance between IPAP and EPAP), since titration is involved and often that doesn't happen in ALS. So their sats are low and someone comes in with an O2 rx.

Beyond that, Amy is right that oximetry readings quite often jump around, esp. with PALS who are less mobile, have compromised circulation, atrophy and fluctuating skin temp.

Go on how you feel. This isn't a "treat to target" disease.
 

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Neil, have you called your RT or pulmo and asked?
 

nebrhahe53

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Yeah Barbie, no answer though. I go again on Aug 27, expect to see bad numbers since I can tell I'm not breathing in as well. I'm having an awful problem with mucus now. Don't know if that can affect readings. As I sit here using my bipap, the reading is 95.
 

bigmark1954

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Yeah Barbie, no answer though. I go again on Aug 27, expect to see bad numbers since I can tell I'm not breathing in as well. I'm having an awful problem with mucus now. Don't know if that can affect readings. As I sit here using my bipap, the reading is 95.
95 is real good....mucous is a big pain in the A$$.
 
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