Me and my gizmo

[Oxygeniser]

I did a post yesterday about my open heart surgery and today this popped up - me with my gizmo - it is a spirometer which is linked by Bluetooth to my mobile telephone. I use it every other week t send test results to Nottingham City Hospital so that they can monitor my pulmonary fibrosis remotely. I go the the hospital once a year and have a telephone chat with my thoracic consultant six months in between.

I can see and have a record of my test results after I have done them, including graphs and it tells me if I do a test incorrectly, such are the wonders of modern technology.

By coincidence there is a report in The Guardian today about how bad the UK is at diagnosing and treating lung conditions. It says, among other things:

‘Across Europe, only Turkey has a higher respiratory death rate than the UK, analysis of data up to 2018 shows, the latest comparable data available from across the continent. The death rate is 162.7 per 100,000 people in Turkey and 134.5 in the UK.

In Germany, the rate is 76.8 while in France it is 59.1 – half the UK rate. People in the UK are three times more likely to die from lung conditions than people in Finland, which has the lowest respiratory death rate (38.4) in Europe, Asthma and Lung UK said.

It described the UK figures as “shameful”, and said that lung conditions had for too long been treated like the “poor relation compared with other major illnesses like cancer and heart disease”.

Despite them being the third biggest cause of death in the UK, only 2% of publicly funded research is spent on lung conditions, it added. The charity is calling for more funding to research diagnostic tools and treatments, and urged ministers to bring in tougher clean air targets. It also called for improvements in the care of patients outside hospital’.

I am clearly one of the lucky ones. Early diagnosis has to be the No.1 priority with easily reached ‘Asthma and Lung Centres’ - not ‘regional hubs’ involving expensive journeys for patients and those who support them.

I am also of the view that trained and supported ‘Lung Technicians/Nurses’, backed up by physios as well as doctors, working locally offe a cost effective way forward to the advantage of all.

Finally, we can afford to do these things. People are the greatest resource the nations which make up the United Kingdom have. We are worth the investment.

[MMaud]

I also have a bluetooth home spirometer, exactly like yours, but no nose clip.

Was the nose clip suggested by your clinic?

[Oxygeniser in reply to MMaud]

Hi MMaud. Yes, I have two nose clips and, yes, I was instructed to use it. I have no idea as to the clip’s significance. Regards Robert.

[Caspiana in reply to Oxygeniser]

The clips are to stop you breathing through your nose during testing. Very significant. 😀

[Oxygeniser in reply to Caspiana]

Thanks Caspiana. Obvious of course. I’ve been doing it a long time and, now you say, I have a vague memory of being told this. Regards Robert.

[Caspiana in reply to Oxygeniser]

😊👋

[MMaud in reply to Caspiana]

Oh, I understand what they do, but just a bit surprised nobody mentioned it. The YouTube video I watched didn't feature a clip either.

A nice little boost to the numbers with it.

[Hidden in reply to MMaud]

Spirometry is usually done with a nose clip as you can lose (a small volume of) air from the nose during testing. Generally speaking, though, for most people the volume involved is so small it doesn’t make too much difference to the figures, particularly as spirometry isn’t exact. As a result, my understanding is that the main purpose to spirometry day to day is to track trends rather than determining exact lung function, so the main thing is consistency; as long as you do the same every time, it will accurately reflect the trend of your figures and enable medics to make decisions about your care as a result. That said, the next time you’re at clinic, ask them for a nose clip, or just keep the one they give you if you do spirometry there - will only go in the bin, otherwise, and they can be reused by the same person without issue.

[Oxygeniser in reply to Hidden]

Thanks Charlie. I’m glad I shared the pic of me and my gizmo. I do four tests (three were asked for, but I add one for luck, as each one seems to be better than the previous test), the best one of which the gizmo sends to the hospital. All clever stuff, Regards Robert.

[Hidden in reply to Oxygeniser]

The child was given a nuvoair home spirometer, which is a similar looking but slightly more sophisticated one to the one you’re using. However, as a direct result of her, it’s been discovered that for a tiny subset of patients with structural anomaly and/or underlying tracheomalacia/tracheobronchomalacia (floppy airways), turbine driven home spirometers like these are useless. We’ve now tried all of the available ones on the market and confirmed that the software massively and arbitrarily overestimates fev1 as a result of the fluctuation in volumes and pressures that happen when forcefully exhaling with underlying airway collapse. In Bod’s case, she was getting figures that were routinely more than 20% higher than the reality for both fev1 and fvc. They’re great gizmos, but it turns out not suitable for everyone, unfortunately. End result being we still have to travel to clinic to monitor lung function.

[Oxygeniser in reply to Hidden]

Thanks for this info. I will check the FEV1 reading and share this post. Regards Robert

[Hidden in reply to Oxygeniser]

You’d soon know if it was out - child’s fev1 is high 60s, 70 max when well, and it was telling her she had an fev1 of 80%+. We did paired data in hospital to study what was happening and the ward spirometer said her fev1 was 67, the nuvo said 88% 😂 Took us ages to convince the manufacturer, though.

[MMaud in reply to Hidden]

I've only ever does one spirometry test, which took place in my car, at a drive through.

Oh, the joys of diagnosis and care in apandemic!