Asthma, undiagnosis, low oxygen sats, help?

It's been a long time since I was last on this forum!

Just to quickly give some background, I've been diagnosed asthmatic for 7 years now and it was always well controlled until 2 years ago when I started getting breathless on exertion (I was training as an oboist at the time so breathlessness was very unusual!) I was put on various preventers and relievers as well as steroid tablets but nothing helped. I was sent to a respiratory consultant who ran various tests but all he found was that my heart rate was quite fast (120 beats per minute at rest, up to 199 on exertion).

As a result, he took me off my asthma medicines, suspecting that asthma might not be the cause of my breathlessness and the relievers might be increasing my heart rate as a side effect. When I was safely off them all, he checked my heart again and it was beating at the same high rate. So he sent me to a cardiologist. I should mention that at this point my oxygen sats had always been 98-100, even mid asthma attack.

I saw the cardiologist a couple of weeks ago. She checked my oxygen sats and they were 96, then she sent me on a walk and they dropped to 89. She couldn't explain that and wants to get me back in for more tests (I've had heart scans done and they've been fine). The only medication I take now is pulmicort as a reliever twice a day. Is 89 pretty low for oxygen levels? I'm still getting breathless every day and my asthma is triggered when I'm around things like aeorosols or smoke, but as I have no reliever I just have to wait until it gets better. But the doctors are reluctant to put me back on relievers when my heart rate is still high - they think there is another undiagnosed cause for my breathlessness.

I'm feeling so breathless and tired every day and those oxygen sats kind of freaked me out a bit! Is 89 low, or am I worrying over nothing? Any advice greatly appreciated!!

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  • Technically anything below about 94% would usually be considered low. If its reassuring at all, in patients with COPD they aim for oxygen saturaion to remain between 89-92% so whilst 89% is low, it isnt so low that you can't happily live at that level all day. You're presumably only getting these drops on exerction, so you're likely spending most of the time at higher sats than that.

    I'm surprised a heart rate of 120 was even picked up whilst on asthma medication. But clearly it was good that it was. There is a thing where you just get inappropriate sinus tachycardia, I am very tachy (disproportionatly to my medication) and so take ivabridine to control my heart rate. Being ill, being breathless and stuff can all increase heart rate. For me, it is best if I take a medication to control my heart rate somewhat, and then all my usual asthma medications. There is another drug called verapamil which is also used to treat innapropriate sinus tachycrdia. High heart rate definately causes breathlessness, and you can get a horrible tightness in your throat when your heart is beating really hard, as well as fast, because it can put pressure on your windpipe from so much blood in the jugular (or something like htat - my cardiologist tried to explain it when I was quite poorly).

    Do keep going back to GP, even if its just to keep an eye on things, I assume they've checked you're not anaemic, and that your vitamin/mineral levels are ok? It's concerning that you dont have a reliever, although I understand their concerns too, so do make sure you have clear guidelines for what to do if things go wrong! And you might want a letter for A&E as whilst it is high, they're unliely to consider 120 a 'problem' and so will treat as asthma.

    Hope things get sorted soon!

  • Hi Musicgeek93

    I had some similarities with you. Have you had any arterial blood gases (abg) done? If you're not sure the answer's no;-)

    Abg results can give information on the causes of issues. In my case mine showed my low oxygen levels were down to cardiac or pneumonia. I Had clea r lungs, so that helped towards a diagnosis.

    The best thing to do is gather information that is objective eg blood results, physio reports, hospital summaries.

    I was difficult and combined asthma with heart issues which complicated things. I found a great cardiologist and got taken in for a workup and had a small surgery. I don't get such large drops now, things have evened out.

    sudden oxygen drops were horrid. I was told if you dropped more than 4% that needed investigation. Don't get fobbed off with comments that people with copd live with oxygen levels if 89%. The issue is the level of dropping Rather than the actual number.

    Your body is responding as best it can at the moment. I tried to explain to my family that it felt like I was mountaineering where the air was thin.

    I hope you get an answer soon. Do take care of yourself and don't overexcited yourself.

    MoominMama

  • I also had some similarities. I was getting headaches and some back pain and breathlessness. My oxygen levels rapidly went down when i got out of bed in the mornings and started moving around but did slowly recover after sitting down for half an hour or so. I also sufffered sweating during the night. The Gp kept saying its probably a virus but i wasn't convinced. After some research i acquired an oximitre and started to measure my O2 readings and in the mornings at the worst were falling to 85 but slowly recovered to about 90. I was eventually sent to see a chest consultant who started to carry out tests but before these tests were concluded i deteriorated with constantly low O2 readings and had to go to A & E to be put on oxygen and had a x ray. They kept me in hospital for 10 days with what turned out to be Chronic Eosinophilic Pneumonia. This was controlled with steroid treatment and i am still on a maintanence doze today.

    The consultant told me that any O2 reading below 90 can be dangerous and should get checked out asap. As MoominMama says Arterial blood gases should be taken to confirm the low oxygen count. I hope you find the answer to your symptoms and everything works out ok.

    Cheers

    Grumpy

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