Archive for October, 2008

How reliable/accurate are pulse oximeter results?

Without going into a complicated history which involves my son being diagnosed first with asthma-like problem, then with pneumonia, then with pneumonia+asthma, please tell me if oxigentation measurement done by a pulse oximiter is a reliable indicator of a problem, in the absense of other symptoms. My 4-year old is behaiving fine, eating again, and being playful and energetic. No breathing problems. No wheezing or crackles. Oxigen was shown to be at 93%. This freaked the Dr out and she gave us an inhailer with albuterol. I don't want to use it (my son hates this stuff). I'm puzzled at being confronted with a normally behaving child (who coughs a little) and an oxygen reading which says he needs breathing treatments...

Pulse oximeters are reasonably accurate most of the time. It's important to treat the patient, not the equipment. When in doubt, an arterial blood gas is 100% accurate.

The normal oxygen saturation for a normal healthy person is 95-98%. Even when I was having lots of trouble with asthma when I was first diagnosed, I was always 95% or better.

Sometimes a pulse oximeter doesn't read properly because of movement, light getting to the sensor, plastic nails, anemia, nail polish, poor circulation, aberrant hemoglobins, and there are a few other reasons for a poor reading. If your son was at 93% saturation, that's low but not critical.

Depending on how your doctor diagnoses asthma, she might be very observant and uses all the potential symptoms to see disease. There is a possibility that your doctor thinks a cough and low pulse oximeter reading mean that your son has asthma needing treatment. Depending on the intensity of the cough, I would probably agree. I think the cough is the most important sign of asthma that you have described. If the cough was severe, I think your son would have been prescribed an inhaled steroid for daily use.

If you have an Albuterol inhaler for your son, what does it say to do with it? Use X inhalations, Y or Z times a day as needed? Use X inhalations every four hours? Maybe your doctor was just being prudent and giving you the resources to treat your son if he has an asthma attack.

For some background, I have asthma. I have normal breath sounds, a cough that improves with Albuterol or inhaled steroid (depending on how bad it is), I don't cough anything out, I get short of breath when working hard, I can function just fine in normal activity, my pulse ox runs 95% consistently, my breathing is normal when I am not symptomatic, and you wouldn't be able to tell that I have asthma by looking at me. Sometimes I use a treatment or two a week of Albuterol and sometimes I go on Advair because my cough gets bad. It all depends on the weather, air pollution, stress, and any asthma triggers I am exposed to. I was diagnosed because I had a horrible cough that wouldn't go away.

Pulse Oximeter review - Contec CMS-50E


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Nonin GO2 Achieve Fingertip Pulse Oximeter - Blue


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So anyone out there use a mouth piece for sleep apnea?

I tried the c_ pap machine with different mask styles nose pillows, full face mask ,i just cant use them i tried the sleep shir i would just sit up and sleep on my back, so now sleep dr said out piece and sent me to a dentist to get it , but no dentist will take my insurance and it costs 1,800 i cant afford that ,so en back to sleep dr and he said that i could order one off the internet for about 90 dollars, which i will do , my apnea the dr said is moderate its est/level 3 cpt99213,does anyone else buy there mouth piece and can handle it please let me know and thank you for your information,

Hello

It is really important to have health insurance these days. Go to: this web site to get the cheapest price.
I saved 30% last month.

http://EliteHealthIns.com

I hope that helps

Alan Mendelson & Express CPAP Supply

anyone who knows someone who has one kidney or weak kidney?

Yes, I have an emergency operation last year to remove one kidney because it was bleeding. Now I have only one kidney. I found myself constantly very drowsy even in the morning and my head is hazy, a bit dazed.
My mum who is diabetic for 33 years and also had a triple heart bypass, was also informed by her doctor that her kidney function has weakened. She also is constantly drowsy and sleeps almost 20 hours a day.

Do you think both of us suffers from symptoms from kidney weaknesses, and if so, what should we do to heal the drowsiness? Any food to avoid or any food to take?

Please help because I have asked many doctors but they brushed my complaints aside and these symptoms are hampering my lifestyle.

Thanks in advance for all your advices.

I know two people who have or have had one kidney removed - my grandfather who lived with it for about 20 years, and a friend who donated one to his sister over 6 years ago.

Neither sufferred from drowsiness, nor haziness, so it's not necessarily related to your single kidney.

You have probably already been told, but please make sure you maintain enough water in your diet. My grandfather died from dehydration (which is very bad news with only one kidney), and he appeared to be a bit crazy/disoriented for a couple of months before he died. No one diagnosed the dehydration.

I agree that you should seek other opinions. And someone who is prepared to analyse your diet and your lifestyle too, because they could be impacting your health rather than a physical ailment.

Good luck.

First Aid Tips : How to Treat Insulin Shock


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What is the normal blood pressure and heart rate for a 15 year old girl?

i am 15 i am 5'2" and weigh 100 lbs. i just took my blood pressure and it said 102/82 with a heart rate of 72. is it high or low. i'm concerned because i've been having continuous dizziness spells and headaches and today i was a little bit nauseous. i got a blood test today but im pretty worried. my doctor said i probably have anemia but i'm afraid it could be something worse.

That is a totally normal, ok, and healthy blood pressure and heart rate! 120/80 is the ideal blood pressure for ADULTS, but most people don't realize that the majority of people do not actually have this blood pressure, and they have their own normal. I'm 21 and my blood pressure is typically in the high 90s/high 60s to low 110s/70s. My heart rate is usually a bit faster (resting is typically around 90-100), but that is MY normal, and how my body operates. So your blood pressure and heart rate are probably normal for you. These are good charts for pediatric BPs

http://www.nhlbi.nih.gov/guidelines/hypertension/child_tbl.pdf

http://www.nhlbi.nih.gov/health/public/heart/hbp/bp_child_pocket/bp_child_pocket.pdf

but everything is subjective. For example, Lance Armstrong's resting heart rate is 32. That could be potentially dangerously low for someone else, but normal for him.

Heart Physiology (Cardiac pressure-time curve: part 2/6)

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hypothetically with knowing how to identify one who is having a acid-base deficit could I diagnosis someone?

I was recently taught in the nursing program about acid and bases in my pathophysiology class and now just finished the course. If for example a patient comes into ER with symptoms of feeling fatigue and having a distinguish fruity smell from their breath. I suspect ketoneacidosis and that he/she may have type 1 diabetes mellitus. With getting the lab values back from the lab I see that his/her blood serum ph is 7.45 , PCO is 30mmHg and the HCO is 28mmHg. With knowing this I see that the patient is experiencing Respiratory Alkaline with a complete metabolic compensate. I this a possible diagnosis or even a proper one? With this knowledge of being able to figure out someone who is with such symptoms and then seeing on their lab values and such and making a diagnosis is possible? I know I can't really make a diagnoses and that only can a physician do so, but I was just wondering out of curiosity? Thanks!
note: HCO is 20mmHg not 28mmHg

A patient with the fruity smell on their breath is going to be a Diabetic Ketoacidosis patient, Acidosis being the key factor there. They breathe fast in order to blow off the carbon dioxide which is causing the acidosis. I think that a PH of 7.45 is very unlikely in this situation. The diagnosis should be Comensated metabolic alkylosis. Normal lab values for HCO is 22-26, so that is elevated and causing the high end of normal on the PH. The PCO normal range is 35-45, it is decreased to compensate for the high bicarb.

Bottom line, the Bicarb value is high. The respiratory factor PCO is low to compensate for the high bicarb. Hope this helps!

Diabetes mellitus Sign & Symptoms for type 1 & 2 diabetes


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My Father CAG(Angiogram) Report?

My Father aged 74 yrs, with history of diabetes for more than 6 yrs. He was regularly getting chest pain from last 2 yrs. Doctor advised to under go CAG(Angiogram), report details:
LMCA: Normal
LAD: Type III vessel, mid segment mild disease, distal total occlusion
DIAGONALS: D1- origin diseased followed by diffuse disease
LCX: Tight lesion with diffuse disease
OM: Diffuse disease
RCA: Dominant, multiple irregularities with mild disease, PDA diffuse disease, PVLB mild disease
LV ANGIO: Not done
HAEMODYNAMICS: Ao: 170/80
CONCLUSION: # CAD: TRIPLE VESSEL DISEASE, FAIR LV FUNCTION #
Can anyone help me to understand what it all means?
If this is serious, can he overcome this problem with By-Pass Surgery?

The best targets for surgical bypass are those arteries with tight(>75%) narrowing where the artery beyond the narrowing is relatively normal(free of diffuse disease). By these criteria the main arteries here(diagonal, Lcx, Om, Pda all have diffuse involvement and are not good surgical targets. The biggest artery, the Lad is totally occluded and cannot be bypassed. Because of the unfavorable anatomy I believe he is a poor surgical candidate. The fair left ventricular(LV) function on the other hand suggests that he is a pretty good candidate for medical treatment with antianginal and lipid lowering drugs. This is especially true if the LV is not only fair but but totally normal.

Diabetes and Electrosensitivity


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AADE 2009 - Lorena Drago Interviewed by Hope Warshaw

Is this child abuse? Should the siblings be removed?

You may have heard this news earlier, but I have a further question about it.....

"An 11-year-old girl died after her parents prayed for healing rather than seek medical help for a treatable form of diabetes, police said Tuesday."

http://www.madison.com/tct/news/stories/278693

"The girl has three siblings, ranging in age from 13 to 16, the police chief said.

"They are still in the home," he said. "There is no reason to remove them. There is no abuse or signs of abuse that we can see."

um....WHAT? do you agree that there are no signs of abuse there? Should these children be removed from the home?

Removing the children from their home is going a bit overboard. The parents may be whack, but that doesn't mean they don't love their kids.

How about state-mandated weekly checks by medical professionals?

Symptoms of Juvenile Diabetes


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Get Rid of Type 2 Diabetes Now: How to Diagnose the Symptoms of Diabetes in Men, Women and Children, Tips for Managing & Controlling Type 2 Diabetes effectively ... Preventing Diabetes before it even starts!


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Juvenile Diabetes Is Not Child's Play


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