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Need help interpreting Pulse Oximetry results
#1
Need help interpreting Pulse Oximetry results
This is part me venting against poor service, but mostly trying to get some answers.

I've been dealing with a fairly well know Telemed sleep doctor.  My AHI is consistently under 1 per night but after over 2 years I still feel symptoms such as fatigue, brain fog, waking up too early every day etc.  I contacted this Dr. to report my symptoms and he ordered an at-home Pulse Oximetry test.  The first one, according to the Doctor, allegedly made poor contact (I tried to get it to fail before and after sleep and was unsuccessful) so I was charged fee for a second test.  I also tried to make this one fail to ensure good contact and it appeared to be working fine.  The doctor later told me that this one also did not make good contact based on what he could see in the chart (but went on to make pressure changes anyways).

All I initially got from the Dr. were some remotely adjusted pressure changes on my CPAP machine.  After waiting over a month, I contacted them and asked when I would receive my results.  Oops...they forgot to attach them in an email.  Doh.  Anyway, I got my results but I have no idea what it means and so I asked them for some kind of explanation.  The person who was responding to my emails (who I doubt is qualified to make medical decisions or analysis) told me my "AHI was fine/CPAP therapy is working" and that's it.  My average AHI has actually gotten worse (although it is still acceptable) since the pressure adjustments, let alone, my original reason for seeking help had nothing to do with my AHI (my numbers were consistently below 1 almost every night).   I raised this issue with the person who is responding to emails, and now I've been ghosted.  No more responses or answers.  

So, first, I need to know what the results of my Pulse Ox test mean. (obviously) Smile
Secondly, I'm a bit concerned.  The doctor ordered pressure changes based a test he assumed was flawed based on my chart.  (paraphrasing:  "the chart was flawed and it looks like your test malfunctioned, but I'm going to take action anyways based on that?"  WTF?)
 But, if it wasn't flawed, then I may have some severe issues (if it looks like the results were flawed, but they weren't).  Either scenario is strange at best, dangerous at worst.  

So any help with this is appreciated.  I'll deal with the Dr. and my poor service later.  I may be back to report on that and if I can safely assume there are no legal ramifications, I may name this company so that others don't have to deal with this poor service (initial service was actually decent).

Thanks in advance.

   
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#2
RE: Need help interpreting Pulse Oximetry results
Could you please post a proper OSCAR graph and we can try to make some sense out it. I don't know that an oximeter readout gives us much of a clue. Curious who this well-known doc is that works by telemed. Your Vauto gives us much more information that is relevant to your complaints, and the only way an oximeter trace really makes sense is when seen with the machine efficacy data. The oximeter data by itself shows your SpO2 is consistently in an acceptable range, but is lower than optimal. You have occasional excursions near the level of concern of 88%, and in general, your bigger oxygen desats near 90% correspond to increases in pulse. This correlation suggests the data is reasonably accurate and probably points to respiratory events at those times. Again, without the complete picture that could come from Oscar data, we can only speculate.

Your issues will make more sense if we merge your threads so the problems you have with leaks is a part of the consideration here. I think that may be the main problem with how you feel.
Sleeprider
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#3
RE: Need help interpreting Pulse Oximetry results
Will do.
Are you saying that an interpretation of the Pulse Ox test cannot be made using only the graph I've provided and/or cannot be made independent of the Oscar graph?  I'm learning here.
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#4
RE: Need help interpreting Pulse Oximetry results
I modified some of my post to add information we can interpret and how the Oscar data helps.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Need help interpreting Pulse Oximetry results
Awesome.  Much thanks.  I will get going on the Oscar data and report back.
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#6
RE: Need help interpreting Pulse Oximetry results
Ok, here we go.  I gave myself a crash course via the instructions on this site.  Let me know if you need anything else.  Your help is greatly appreciated.

   
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#7
RE: Need help interpreting Pulse Oximetry results
A non zoomed in view of the same report is likely a better starting point.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Need help interpreting Pulse Oximetry results
You have limited the graph's time span to about a half second. It would be more helpful to show the complete 7 hours, 19 minutes and 1-second of data.
Crimson Nape
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Need help interpreting Pulse Oximetry results
    Doh.  This is my first time doing this.  I think this one should be better.  Thanks.
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#10
RE: Need help interpreting Pulse Oximetry results
In the organize your Oscar Chart wiki, the Other Options section shows how to get a 3-minute zoomed view. http://www.apneaboard.com/wiki/index.php...ganization The whole night can be used with that to give better information. We want to see the shape of the respiratory flow wave, so we need more than 1/2 second and the 3-minute view works well. Note the Zoom Control Slider and Zoom Window Minutes on the Daily Events tab. This image is basically what we want to see, however you can switch to the Details Tab once the view is selected.

[Image: Oscar-View.png]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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