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I knew the odds of coming off a ventilator and living were not good: somewhere between 1 in 10 and 1/3rd. And a high likelihood of lung damage and possibly brain damage from the drugs they use to keep you under.
It's worse than that.
So the measure of your blood oxygenation is called SpO2%. What is considered healthy is 95% or above. When I was on my third of five pneumonias, I was talking to a respiratory therapist and he called BS on that percentage, he said that it could be much lower than that and there was no cause for concern as long as certain other parameters were OK. Sadly I don't know what those parameters were, if he mentioned them. But overall, you probably don't want your SpO2 below 90% sustained.
This article argues that doctors are jumping too quick to put people on ventilators for COVID and that in doing so, we're increasing death rates. They're trained that if SpO2 is too low, the risk of brain and organ damage is too high and the patient MUST be ventilated!
Basic argument of the article is that while people with low SpO2 values definitely need more oxygen, they don't necessarily need ventilators. With low lung function, there's various things to consider. One of the problems of low SpO2 is impaired brain function that can mimic hypoxia, or altitude sickness. Extended hypoxia can cause organ damage or failure. Impaired lung function, which is a problem with later COVID infection, prevents the lung's pockets from completing the oxygen/blood exchange from happening, which not only provides blood with oxygen, but also releases carbon monoxide (CO) from the blood: a two-way exchange!
Basically, many people with low SpO2 are conscious and may be articulate with no brain function impairment, which kind of belies/contradicts the low SpO2 reading! They're not truly hypoxic and may not need treatment with ventilation! This also shows that the CO is being released from the blood.
So what this paper boils down to is that people with low SpO2 can benefit from a CPAP or BiPAP device, or perhaps just increased oxygen pressure from a nasal cannula while continuing treatment and they don't need a ventilator. There's lots more CPAP/BiPAP devices in warehouses than ventilators, and they're a lot less expensive, and don't require a respiratory therapist to monitor, and don't require special meds to keep the patient sedated like they do if they were on a ventilator.
The thing about ventilation, which I didn't realize, is that it might result in permanent lung damage. You've got a machine forcibly pumping air into your lungs and then sucking it out. OK, I knew that. But if it's set a little too high, it can permanently damage your lungs! And I've already got lung damage, and our local hospital has a bit of a reputation for incompetence, so this does not appeal to me! And when the virus is in full-force, it literally covers the interior of your lungs with a slime that impairs the blood/oxygen exchange, hence the low SpO2 saturation. Second, you've got a 10" tube down your throat! Your body probably doesn't like that! I know I have a low gag reflex and I know my body would be fighting like hell to get that out and I'd have to be fully sedated, and that sedation can lead to permanent brain damage! I have few enough brain cells left that I really can't afford to lose any more.
So if you have an Advanced Medical Directive, why not add a codicil saying that if you are hospitalized for COVID, the doctors are to try CPAP, BiPAP, and higher pressure oxygenation before forced ventilation. And if you don't have one, you should prepare one! There's a web site formerly known as Get Your Shit Together that will help you prepare documents such as Advanced Medical Directives, it's now known as Join Cake and it's free. I don't know if the documents are valid outside the USA or if they have them for other countries.
Not a bad idea to have your advanced medical directive in an envelope with your name on it on your refrigerator door, similarly do up a list of any medications like that. If you need medical transport, paramedics and fire fighters know to look at the fridge for stuff like that.
Anyway, very important stuff. I was going to post more COVID news, but I cut the crap out of my thumb preparing dinner, and I don't feel too good right now, but sitting down with my hand slightly elevated seems viable. All my open tabs are on my iMac and I'm on my laptop, so bigger post maybe over the weekend.
https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/
It's worse than that.
So the measure of your blood oxygenation is called SpO2%. What is considered healthy is 95% or above. When I was on my third of five pneumonias, I was talking to a respiratory therapist and he called BS on that percentage, he said that it could be much lower than that and there was no cause for concern as long as certain other parameters were OK. Sadly I don't know what those parameters were, if he mentioned them. But overall, you probably don't want your SpO2 below 90% sustained.
This article argues that doctors are jumping too quick to put people on ventilators for COVID and that in doing so, we're increasing death rates. They're trained that if SpO2 is too low, the risk of brain and organ damage is too high and the patient MUST be ventilated!
Basic argument of the article is that while people with low SpO2 values definitely need more oxygen, they don't necessarily need ventilators. With low lung function, there's various things to consider. One of the problems of low SpO2 is impaired brain function that can mimic hypoxia, or altitude sickness. Extended hypoxia can cause organ damage or failure. Impaired lung function, which is a problem with later COVID infection, prevents the lung's pockets from completing the oxygen/blood exchange from happening, which not only provides blood with oxygen, but also releases carbon monoxide (CO) from the blood: a two-way exchange!
Basically, many people with low SpO2 are conscious and may be articulate with no brain function impairment, which kind of belies/contradicts the low SpO2 reading! They're not truly hypoxic and may not need treatment with ventilation! This also shows that the CO is being released from the blood.
So what this paper boils down to is that people with low SpO2 can benefit from a CPAP or BiPAP device, or perhaps just increased oxygen pressure from a nasal cannula while continuing treatment and they don't need a ventilator. There's lots more CPAP/BiPAP devices in warehouses than ventilators, and they're a lot less expensive, and don't require a respiratory therapist to monitor, and don't require special meds to keep the patient sedated like they do if they were on a ventilator.
The thing about ventilation, which I didn't realize, is that it might result in permanent lung damage. You've got a machine forcibly pumping air into your lungs and then sucking it out. OK, I knew that. But if it's set a little too high, it can permanently damage your lungs! And I've already got lung damage, and our local hospital has a bit of a reputation for incompetence, so this does not appeal to me! And when the virus is in full-force, it literally covers the interior of your lungs with a slime that impairs the blood/oxygen exchange, hence the low SpO2 saturation. Second, you've got a 10" tube down your throat! Your body probably doesn't like that! I know I have a low gag reflex and I know my body would be fighting like hell to get that out and I'd have to be fully sedated, and that sedation can lead to permanent brain damage! I have few enough brain cells left that I really can't afford to lose any more.
So if you have an Advanced Medical Directive, why not add a codicil saying that if you are hospitalized for COVID, the doctors are to try CPAP, BiPAP, and higher pressure oxygenation before forced ventilation. And if you don't have one, you should prepare one! There's a web site formerly known as Get Your Shit Together that will help you prepare documents such as Advanced Medical Directives, it's now known as Join Cake and it's free. I don't know if the documents are valid outside the USA or if they have them for other countries.
Not a bad idea to have your advanced medical directive in an envelope with your name on it on your refrigerator door, similarly do up a list of any medications like that. If you need medical transport, paramedics and fire fighters know to look at the fridge for stuff like that.
Anyway, very important stuff. I was going to post more COVID news, but I cut the crap out of my thumb preparing dinner, and I don't feel too good right now, but sitting down with my hand slightly elevated seems viable. All my open tabs are on my iMac and I'm on my laptop, so bigger post maybe over the weekend.
https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/
