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SURVIVING THE PANDEMIC: Do You Use A Pulse Oximeter? (And If You Do, Why Didn’t You Tell Me?)
By
Published: Apr 25, 2020
Category:
Pandemic: Dispatches and Essentials
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A MINUTE OF INSPIRATION: WATCH JAVON KINLAW’S SHORT VIDEO
In the NFL Draft, he was the 14th pick. Very rare for a defensive tackle to be picked this early.
DO YOU USE A PULSE OXIMETER? (AND IF YOU DO, WHY DIDN’T YOU TELL ME?)
Andy Tobias and I were college classmates who became lifelong friends. He writes brilliant, reader-friendly books on personal finance, gives fortunes away, was treasurer of the Democratic National Committee from 1999 until 2017 — and publishes an essential website. (You want his posts by email; the sign-up will take you 4 seconds.) When he wrote that he was getting a pulse oximeter, I snapped to attention.
A finger pulse oximeter is designed for people who want to know their SpO2 (Blood Oxygen Saturation Levels). You also learn your pulse rate, but right now that’s a bonus.
How it works: The device is placed on a fingertip. It passes two wavelengths of light through the finger to a photodetector that “measures the changing absorbance at each of the wavelengths.”
It’s used in emergency rooms to measure the oxygen levels of COVID-19 patients. Low oxygen levels may indicate that coronavirus patients have pneumonia -— and require immediate medical attention —- even before they feel a shortness of breath.
The reason to get one:
– Normal oxygen levels could signal that you don’t need to visit a hospital.
– COVID-19 patients can have pneumonia for days before they develop a shortness of breath. Low oxygen levels are a way to detect these cases earlier — without a coronavirus test or doctor’s visit.
– If you go to a hospital and are put on a ventilator, the likelihood you will die is around 80%.
Here’s the science…
From the Times:
We are just beginning to recognize that COVID pneumonia initially causes a form of oxygen deprivation we call ‘silent hypoxia’ — ‘silent’ because of its insidious, hard-to-detect nature.
The coronavirus attacks lung cells that make surfactant. This substance helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from Covid pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath.
Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. Twenty percent of Covid pneumonia patients then go on to a second and deadlier phase of lung injury. Fluid builds up and the lungs become stiff, carbon dioxide rises, and patients develop acute respiratory failure.
By the time patients have noticeable trouble breathing and present to the hospital with dangerously low oxygen levels, many will ultimately require a ventilator.
Silent hypoxia progressing rapidly to respiratory failure explains cases of Covid-19 patients dying suddenly after not feeling short of breath. (It appears that most Covid-19 patients experience relatively mild symptoms and get over the illness in a week or two without treatment.)
A major reason this pandemic is straining our health system is the alarming severity of lung injury patients have when they arrive in emergency rooms. Covid-19 overwhelmingly kills through the lungs. And because so many patients are not going to the hospital until their pneumonia is already well advanced, many wind up on ventilators, causing shortages of the machines. And once on ventilators, many die.
Widespread pulse oximetry screening for Covid pneumonia —- whether people check themselves on home devices or go to clinics or doctors’ offices -— could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia.
I am ancient, but thriving because I get a monthly infusion of a $75,000-a-year drug (paid almost entirely by Medicare and AARP Supplemental Insurance) for a lung condition that would at some point, kill me, but now has almost no chance —naturally, I rushed to Amazon to buy a pulse oximeter. Good luck with that. It’s one SOLD OUT message after another.
I was able to buy the well-reviewed MIBEST Black Dual Color Finger Pulse Oximeter. (To buy it from Amazon, click here.) It will arrive May 12… light years away. So I went to eBay and bought a second one, arriving in a few days.
READER COMMENT: I know about pulse oximeters because my daughter has epilepsy. We use them during her seizures. I want to relay a piece of info that my sister, the nurse, shared: She says that many patients are getting not-alarmingly-low readings on the pulse ox when they are admitted to the hospital. Further investigation sometimes shows that their actual blood oxygenation is much lower than the pulse ox reads. The med staff has a few theories about why this is, but no certain conclusions. I just mention it in case you (or someone you love) is still getting a good reading, but otherwise has severe symptoms. In that case, you will obviously want to go to the hospital anyway. Don’t let the pulse ox give you a false sense of security if other indications are bad.
Not the first time I’ve thanked Andy Tobias. Now a bit more likely it won’t be the last.
REAGAN LAUGHED. TIP ‘ONEILL LAUGHED. AND NOW IT’S YOUR TURN
MUSIC: TEDDY THOMPSON: “I SHOULD GET UP”
Caution: Teddy is handsome in that English way. And ridiculously talented. (Start here). And contagious: I once described KC, who was very married, as “the future Mrs. ex Teddy Thompson.)
Depression looms
I’m such a miserable fool
I stay in bed
I don’t wanna got to school
But I see the sun
Is beating down
No excuses from the clouds
I should get up
I should get out
I’m sure there’s something
I can’t do without
I should get up
I should get up
I should get up
The world goes on without me
I know it
I know it
No one misses
The quiet kid
And there are things
I may have missed
But living ignorance is bliss
I’m so wrapped up in myself
I got no time for
Everyone else
WOULD YOU LIKE TO BUY A $1,500 SUIT FROM J.PRESS FOR… $334?
It’s a sale. And a metaphor. Click here.
THE PRESIDENT STARTED TWEETING EARLY THIS MORNING. HERE’S WHY: “NERVOUS REPUBLICANS SEE TRUMP SINKING, AND TAKING SENATE WITH HIM”
From the Times:
Republicans were taken aback this past week by the results of a 17-state survey commissioned by the Republican National Committee. It found the president struggling in the Electoral College battlegrounds and likely to lose without signs of an economic rebound this fall, according to a party strategist outside the R.N.C. who is familiar with the poll’s results.
“Taken aback?”
MY TWITTER FEED
– Real Lysol needs to be from the Lysol region of France. Otherwise it’s just sparkling bleach.
– He prefers diet Clorox.
THE SYBIL: WHERE IS SHE NOW?
From “Rubicon: The Last Years of the Roman Republic,” by Tom Holland. (My review and Amazon buy links here.)
In the beginning, before the Republic, Rome was ruled by kings. About one of these, a haughty tyrant by the name of Tarquin, an eerie tale was told. Once, in his palace, an old woman came calling on him. In her arms she carried nine books. When she offered these to Tarquin he laughed in her face, so fabulous was the price she was demanding. The old woman, making no attempt to bargain, turned and left without a word. She burned three of the books and then, reappearing before the king, offered him the remaining volumes, still at the same price as before. A second time, although with less self-assurance now, the king refused, and a second time the old woman turned and left. By now Tarquin had grown nervous of what he might be turning down, and so when the mysterious crone reappeared, this time holding only three books, he hurriedly bought them, even though he had to pay the price originally demanded for all nine. Taking her money, the old woman then vanished, never to be seen again.
Who had she been? The Romans soon realized that only one woman could possibly have been their author — the Sibyl. And thanks to Tarquin’s belated eye for a bargain, they found themselves with a window to the future of the world.
SAVE THE DATE: ALL-STAR SONDHEIM TRIBUTE, SUNDAY, LIVE, 8 PM
“Take Me To The World: A Sondheim 90th Birthday Celebration” will take place online on Sunday (April 26, 2020) – the 50th anniversary of the opening night of Sondheim’s musical Company. Meryl Streep and Patti LuPone will be joined by Bernadette Peters, Mandy Patinkin, Christine Baranski, Donna Murphy, Kristin Chenoweth, Sutton Foster, Brian Stokes Mitchell, Kelli O’Hara, Aaron Tveit, among others, and Raul Esparza, who has appeared in several Sondheim productions, will host.
“The world is in a hard place,” Esparza said in a statement, obtained by Deadline, “and we are all searching for something great. Well, Stephen Sondheim is greatness personified.”
Watch on Broadway.com.
SONNET
Elizabeth London, who was my screenwriting student at NYU/Tisch, is a Core Member of Hook & Eye http://hookandeyetheater.com, and is developing a new play via Zoom. As a teacher, her specialty is Shakespeare.
I think about the patients in the wards:
Thankful to be in hospital, and yet
Bedridden knowing not backwards or towards
Healing and wellness, will they fully get?
My dear friend, in and out of doctor’s care:
Pneumonia, heart attack, stroke symptoms too,
Her progress, friends with bated breath can swear,
Is up and down, two steps then back anew.
Humility and patience are the key,
She says, a mantra for the healing now.
And yet she’s numbered lucky, isn’t she?
Home, breathing, eating, puzzling: blessed and how!
To each their own the virus plots its way;
All victims struggle: progress day by day.
ESSENTIALS AND DISPATCHES
Everything, all in one place.
UPDATE: EO Hand Soap is available again.
UPDATE: I spoke with a NYC lung specialist. He endorses Vitamin D, but warns you not to double/triple dose. In large doses, Vitamin D becomes toxic.
