I hope this has not been covered already, My search. did not turn anything much up.
Just purchased a Pulse Oximeter as part of my tools in respect of Covid-19. It is a Braun so should be reasonably accurate(?). Using it took some time with readings all over the place. I finally figured out how to get more reliable readings. However I am getting more readings below the 95% than above it. I know that CLL can detrimentally affect Red Blood Cell counts (RBC) However my RBC is in the normal range. I am on wait and watch (10 years) an my last Lymphocyte count was 83 (doubling time around 2 years+ at the moment.
My question is whether CLL can impact on Oximeter readings and potentially lower the reported SPO2 values. I feel perfectly normal with no breathing issues. I don't want to be hiking off to A&E on false readings.
Finally I would love to hear about other folks experiences with SPO2 readings
Thanks in advance and best wishes to everyone for 2022
Jon
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ScruffyDuck
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My readings on my home based oximeter are lower that my readings in the hospital. My assumption is the tolerance of the at home devices are not as good as the ones in the doctors office. Keep taking readings and if you dip below the 95 I’d consider that reason to go to the ER in combination with feeling tightness in your chest. I’m not an expert but that is how I view the different readings I experience. Hopefully, others will weigh in.
Hi ScruffyDuck,This is a great question - one that I've been asking over the past few weeks since I purchased a home oximeter, that is FDA approved for use in clinical settings as well as home. I am also on W&W (6 years); ALC around 35000 and hemoglobin levels seem fine for now.
My SPO2 levels fluctuate widely (94-99 percent) depending on which finger I use (thumb was highest), whether I'm sitting or prone; whether my hand is higher than my heart or lower; whether I get up and walk around for a bit before taking the reading or whether I've been sitting for 10 min. or exercising a bit and whether I allow enough time to get a stable reading - usually around 15 sec. (as you can see, I experimented a lot on myself). Motion and "cold" are most problematic and create a large amount of variation in readings - the impact of cold hands on readings is recognized in the research on the reliability of oximeters.
Cold is not a minor issue in Vancouver, where I live, as the temp at the moment is -12 C outside. I'm always cold. When I had an oximeter reading taken at a clinic, I had to wait until my hands warmed up (after being outside) - even then I had 3 readings taken before the clinician decided that my SPO2 levels which were bouncing around were not indicative of hypoxia. The clinician told me that everyone he tested that day had cold hands that were lowering the readings.
My point being that many factors can influence SPO2 levels on an oximeter.... at the same time, they are recognized as a good tool to "rule out" hypoxia (see article above). They are not a great tool in isolation of symptoms or other measures, to diagnose hypoxia.
As for the relationship with CLL - I think that it is the relationship between hypoxia and CLL that is the issue rather than SPO2 readings (which may or may not indicate hypoxia) and CLL.
There are many studies on hypoxia in leukemias. Here is an example of one that describes the relationship between hypoxia and leukemia progression (but there are many, many other studies on this issue in the research as well):
Sorry for this incredibly long response, but I am only giving you my experience (I'm not an expert). My personal feeling is now that I have a baseline under conditions where I am motionless, sitting, and have my arm extended slightly above a warm table, and my oximeter is warm along with my hands), I will know if a decrease in SPO2 readings on my oximeter, combined with other Covid-19 symptoms may be something to worry about. But this is only one person's view....
Hi Maureen. Thank you for all the information and taking the time to reply. Your experience is close to mine with readings all over the place. I will ask my medical team about it next time I get the chance.
Hi, I am the same. Fed of getting 95 and occasionally 94, I marched down to the chemist from where it was bought. There it was 98 and wouldn’t change. Got home is was 95 - all with the same machine!!! So I figure 95 is OK for me
Warm water - then dry the hands using warm towel, wear gloves for 20mins
Thing is - poor circulation / white fingers / blue fingers - if its new on set - may in itself be an important sign of sepsis. So its useful to know what your normal levels are - when well. BUT if you are getting low sats - or "no" sats or indeed fingers hard to warm up - more so if also a fever and feel unwell - thats time to call for a formal medical assessment ASAP
All of us with CLL should know about assessing ourselves for infection and especially sepsis - not just Covid, other viruses and bacteria also available... I make this general point for other readers of course. Jig
My wife and I find that my oximeter readings (with CLL) are quick and easy. Hers are difficult and often take a long time to appear and she is fit and well. That said, she tends to have temperature variations and that includes cold hands. Knowing your average using the oximeter gives you a baseline and any changes to that are what you will worry about. It's rather the same with BP readings.
Thank you. I am keeping a diary for a bit so I can get a baseline. I had thought using an Oximeter would be easy enough but it seems not - at least in some cases.
I found the same thing, wild variability. I hop on the elliptical and my middle finger is 99, whereas I check my index finger over morning coffee and it is 94. When I started in Sep. I was even getting some readings in the low 90s, but realized I could improve those by picking a different finger and taking some deep breaths (that is, following the instructions!). I don’t use it as much now, just the odd check and if I am in the ballpark I am good to go. I am not a doctor, but so would think if is in the danger zone you would have other symptoms?
Update and thanks to y'all. I placed my hand andthe oximeter in a warm place (and before you speculate to much I placed them in my armpit). I left them there for several minutes and then took a few deep breaths. Put the Oximeter on my favored finger and got a stable reading of 98. Left it for a bit and repeated - another 98. Did one final reading - also 98 🙂
First thing I do with any new health gadget is to take along on my weekly appointment to compare readings. The warm finger advice is great. I have found that my thermometer readings are high if I was vigorously chewing gum or something just before. Good that you asked for feedback here avoiding an unwarranted potential Covid exposure at A&E.
"Normal pulse oximeter readings usually range from 95 to 100 percent. Values under 90 percent are considered low."
Fingernail polish and darkness of skin affect accuracy of readings. These things were apparently never tested in all possible populations. This is a long standing problem with the method used. From 2007:
Dark skin decreases the accuracy of pulse oximeters at low oxygen saturation: the effects of oximeter probe type and gender
I believe that the chips and algorithms used in the devices are also less accurate below 90%. Better technology is needed all around.
I measure 94 to 96 on 2 different pulse oximeters. My RBC is quite normal. My pulse ox values do bounce around 1-2 digits. I don't think any of them claim to be accurate better than +/-2%. An FDA notice says it may be even wider than that:
"Consider accuracy limitations when using the pulse oximeter to assist in diagnosis and treatment decisions.
Use pulse oximeter readings as an estimate of blood oxygen saturation. For example, a pulse oximeter saturation of 90% may represent an arterial blood saturation of 86-94%.
When possible, make diagnosis and treatment decisions based on trends in pulse oximeter readings over time, rather than absolute thresholds."
A MedPage Today article looked at accuracy studies:
— The Skeptical Cardiologist examines pulse oximeters labeled not for medical use
by Anthony Pearson, MD September 17, 2020
Based on papers mentioned there, I've bought several Zacurate brand devices. They look different. I think one cannot trust the model numbers on these things at all. Like masks and respirators, try to buy from the maker's web site, and avoid big markets like Amazon, eBay, Etsy, and even pharmacies and departments stores.
I also have a FitBit. It's laser is green, while every clip-on I've seen uses red. My model FitBit doesn't give direct SpO2 readings, but other models may. I'll try to look for papers comparing smart watch accuracy with clip-on devices.
I have monitored my oxygen saturation levels for several years since being diagnosed with CLL. Low RBC resulted in low oxygen and triggered my CLL treatment. My normal oximeter reading is 92-96 at rest. I will be going in today for my trimonthly blood tests and normally the cancer centers will give me a little higher reading of 96-97. I have been down to 87, but I am not to concerned until getting into the 80s.
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