I gotta stop writing those “silver lining” posts. Everytime I do, I feel like something bad happens (I talk about the Japanese word “bachi” here). Anyway this time, Emi (who’s just learning to walk) fell back and hit her head on the wooden corner of a Lovevery toy (which I will update with a warning). I’m usually very careful of leaving the toy on a table where she can’t fall on it, but unfortunately it was on the ground and she smacked her head on it. When she wouldn’t stop crying no matter what we tried, we decided to call the Kaiser nurse advice line. And they told us to go to the hospital. I mean normally it would be no big deal but going to the hospital during coronavirus?! My anxiety level had never been higher. Luckily it was a visit to the minor injury clinic where there were minimal patients (no major crowds of sick people thank goodness) and everyone was taking extra precautions. Also we’re very lucky that Emi is fine and the doctor said there should be no lasting damage. Anyway that incident really colored my week and I had been feeling a bit out of sorts.
In other news, I recently purchased a pulse oximeter from Amazon after reading this New York Times article. But if you don’t want to read the whole article, here’s the excerpts I found most useful:
A vast majority of Covid pneumonia patients I met had remarkably low oxygen saturations at triage — seemingly incompatible with life — but they were using their cellphones as we put them on monitors. Although breathing fast, they had relatively minimal apparent distress, despite dangerously low oxygen levels and terrible pneumonia on chest X-rays.
We are only just beginning to understand why this is so. 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.
And he goes on to say:
There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.
Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates.
Pulse oximeters helped save the lives of two emergency physicians I know, alerting them early on to the need for treatment. When they noticed their oxygen levels declining, both went to the hospital and recovered (though one waited longer and required more treatment). Detection of hypoxia, early treatment and close monitoring apparently also worked for Boris Johnson, the British prime minister.
So if it’s going to be a matter of when many people will get Covid-19 (especially if it persists for another year until a vaccine can be made), I wanted to be equipped with this simple and possibly life-saving device. Amazon has quite a few available for now, though this one was the cheapest that looked reliable. Even if I don’t use it myself, I could send it to my mom or whoever might get sick in my circle of friends and family. Or maybe it’s more like a safety blanket that makes me feel I’m better prepared, but for $36 I’ll take it!
