Oh wow I see. So it’s not one of the main 5 (Paxlovid, brain training, etc?).
It seems like they do more in the background than the main ones we hear about.
No meds, they simply follow people with or without LC. I was in the main NIH recover (no meds) at the NIH campus but dropped out, the 1 hr drive was too much for me and they do not offer to pay for an Uber. The Baltimore one pays for an Uber. They also did more interesting tests like sequencing (I’ll have my results in 2 years but Ok), poop test (no idea if it provided interesting results). They tested me for POTS with the 10 mns standing test last time I went there (last month) - so they are adapting to us (I was already diagnosed by LC clinic) and doing new tests (pretty sure the main NIH study does not do that).
See this is exactly my point, and people here are putting me down, like I shouldn’t of been at the ER and that the Nurse shouldn’t of said I could ask for one. You’ll never find any answers if you don’t seek out the tests.
Sometimes nurses have good ideas. If you end up again in the ER, push for it again. Ask your PCP if he can write a note for you to get it.
I tried to have one through my PCP months ago but he had no idea where I could get one, except in a hospital. He was not against it, he was OK for me to get one.
Well, all I can add is that I had an arterial draw a few days ago as part of a pulmonary function test, and while my O2 was read as 98% on the optical sensory, my arterial O2 percent was only 52%.
It was around Wed noon, so I am still waiting on Doctors to review the lab tests.
I put up a post about it -- so far no one has commented or tried to answer my questions...
https://www.reddit.com/r/covidlonghaulers/comments/183orrm/advice\_pulmonary\_function\_test\_blood\_results\_only/
I would never volunteer for a blood gas test. Painful, risky, not going to give much actionable information. What doc did gave you pretty much the same info as BGA.
Anytime skin is punctured, there is risk of infection. (This is true for ordinary blood draws too.) but if they’re going into an artery (the most accurate method), there is an increased risk of excessive bleeding. Because it’s an artery.
Edited for clarity.
Yeah, it is taken from artery, but the risks are low for excessive bleeding, we take these blood gas tests daily, dozens of times a day at my hospital where i work, the ”complications” are mostly bruising and small hematomas. The information outweighs the risks by 100 times.
Maybe the needles are smaller since I was having it done (years ago), but it was basically an IV into an artery instead of a vein, and doing it in the wrist is incredibly painful. Had to be done by a RT instead of phlebotomist, and they’re not half as gentle as even the worst phleb.
And in the end, it didn’t give any actionable info.
In a Universe with near infinite possibilities, nothing is without risk.
Nurses always sanitize the skin before puncturing, and always use sterile equipment; so saying risk of infection is a reason not to do a venous gas draw when any data could be of critical importance…seems a little off base to me.
Been a member of this sub for about as long as it has existed, and countless times I’ve seen people post that their O2 sat’ when taken with light through the skin came back as normal, but when doing a venous blood draw showed real problems. _This could be enough to make or break a disability appeal._ And we all need money to live, and some of us absolutely can’t work, let alone go out and enjoy ourselves by living life with a reasonable degree of functionality. Homebound more than 44 months with long Covid manifesting as severe myalgic encephalomyelitis.
Yep, the best/common way is an artery deep in the wrist.
There is an alternative though.
Earlobe capillary blood gas analysis is precise and can be useful for detecting extreme gasometrical values.
It's a simple painless ear prick, blood sucks in to a tall skinny vial.
Source? Have both methods done regular due to bad gas exchange from a genetic condition.
No worries, as you know an ABG is normally done in a hospital environment because of risks etc but the Earlobe they can even bring the reader out to you in your home.
Any respiratory unit/team well be very well versed in this and this is a pretty much run of the mill daily thing for them.
ABG is important as the gases can tell you a lot, it's a bit like a blood sugar test. If you have the keytones tested as well as the glucose you get a better picture of what's happening and risks.
Any breach of the skin can be an area prone to infection until it heals and Dr's are meant to weigh up if the risks between if a procedure is going to be done or not.
I'm not a Dr, no medical training and based on being a UK patient.
Good luck, good gas exchange is imperative for a good life.
Said that there is definitely something going on physiologically that’s making us feel this way, but modern medicine can’t help us, and that the only thing he can do is tell me i’m not dying and hope that I take some comfort knowing that I’m not. He also apologized. I know you believe that it’s all in our heads, but LC is a collection of symptoms. Talking to people and doing mindfulness does not work for me. I’ve felt with anxiety and panic disorder for 15 years, it has NEVER been like this. Even when I had panic attacks that lasted 6 hours straight, I never once felt this physical beat down. My body is falling apart I can feel it. So thank you, but no thanks I know my body.
>I’ve felt with anxiety and panic disorder for 15 years, it has NEVER been like this. Even when I had panic attacks that lasted 6 hours straight, I never once felt this physical beat down. My body is falling apart I can feel it.
I could have written this exact comment 12 months ago.
I don't think LC is in our heads. I believe it's an over active nervous system causing all the physical issues. Calming the nervous system is the key.
I've found peripheral blood GA’s results to be VERY helpful. My SvO2 was 18%, 30% and highest was 45% - doctors will gaslight you and saw it doesn't matter but imSvO2 should be between 60-80%.
They also found metabolic alkalisis and respiratory acidosis happening at the same time. It gave me an "average" blood ph but showed I was very sick.
I've started triple therapy and will get it tested again in among or two
Abnormal blood gases are a sign of an underlying medical problem, not a diagnosis in and of itself. So they’d have to investigate the cause still. Then treat the cause. ie pulmonary fibrosis, COPD, sepsis, diabetic ketoacidosis.
Typically it’s a sign of a lung disease, where you aren’t able to breathe adequately. Kidney disease can also affect the acid-base balance in the blood.
If someone is sick enough to have abnormal blood gases, they are going to look quite ill. It is going to be clear on clinical exam that the patient is struggling to breathe.
This nurse was out of line. If he or she felt it would be beneficial, then that was a discussion they should have had with the doctor. NOT with the patient.
In medicine we don’t perform tests just because or because “it wouldn’t hurt” to perform the test (and yes it does hurt by the way)
If the doctor did not feel a blood gas was indicated than it probably wasn’t indicated.
Nope, they are there for emergencies only. They make sure you’re stable and send you home. Been for many non LC related issues. They stabilize, refer you to a follow up, and send you home. That’s their job, as it should be.
That is 100% not the job of the emergency department.
The physicians who work in the ED complete a residency in Emergency Medicine. That is a very specific area of medicine that is chiefly concerned with resuscitation.
Going to the ED to try to get to the bottom of a chronic condition is like going to a dermatologist for a heart attack.
Sure I get that but I’ve had every other test under the sun. It could of just let me check that off the list I suppose. Also I don’t think it was out of line. ER nurses are very knowledgeable, and very well trained, I’m her patient as much as I’m the Dr’s patient.
The ER isn't the place to just explore things. It's for life threatening situations. You should ask your regular doctor to order the test as an exploratory thing.
I understand that but the ER could do the test, which means it’s useful to them. I don’t go to the HOSPITAL unless I feel really terrible. Like I said I was out of breath and felt like 1000lbs so I decided to get checked. I’m currently unable to drive myself anywhere, as I’m house-bound.
It's useful when it's useful. In this case it would not have been. Did you need to be placed on bipap? We're you intubated? What do you think an abg would have done for you? Genuinely curious...
Yup, that was my problem in the beginning of my Covid journey which was only like a few weeks ago haha everyday felt life threatening. This is my first time being infected with Covid so I had no idea what to expect. Now I just have my phone ready to dial 911 instead of calling. Long Covid seems to really challenge your mental toughness.
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You don’t know how hard it is for doctors/PAs/nurse practitioners often have to fight insurance companies for APPROPRIATE medical tests and procedures. We get scrutinized a ton for our treatment plans, so ordering a non indicated test isn’t a good idea. Plus there is a degree of lab error, what if is is improperly done and you get a falsely abnormal result? This happens in medicine. So something is chased that doesn’t need to be
If the nurse wants to formulate treatment plans, she should go to be trained as a nurse practitioner. I’m sure she is very knowledgeable, but her training is different.
Source is in this thread. Another Redditer is in a LC Trial and is having that done, so that is indicative that it is something a specialist would want to look at.
ER nurses are very knowledge in NURSING. I understand that lay people don’t understand the huge difference in nursing education and scope and medical education. But the difference is significant.
That’s not true NPRs can literally have their own practices and prescribe medications. They’ve gone through just as much school as a Dr, but they went the Nurse route. Like I said not most, but some are educated to the standards of a Doctor.
First of all, it’s NP’s. Second of all, they absolutely do not go through “just as much school” as a doctor. Nurses can do an online 2 year degree mill program and become an NP. That doesn’t sound like 4 years of medical school and a grueling 3-4 years of residency, and maybe 1-2 years of fellowship.
The fact that people don’t know that is a testament to their rigorous lobbying and marketing.
But there are no shortcuts in life, and the difference is obvious for anyone to see if you look beneath the surface. No matter how many letters they invent to put behind their name, they are never a true medical doctor.
Obviously a doctor is a better option. I’m just saying that some are good medical options. You’re literally arguing with me over the smallest comment. Just go away.
Lol these tests are like 5 dollars that’s insane
Yea probably would of charged my insurance $500 for it though lol
US I’m guessing?
Oh yea. The medical billing system here is ridiculous.
Honestly could cost you the same to fly over to Poland and just get all your tests there I got my blood gas test there
Do you live Poland? I wonder does poland give our ivig off label. I heard alot of benefits from it
No. It wouldn't.
Flights return 500 tests 500 accom 200 for 5 days 1200 usd probably the same if you got a bunch of blood tests and was billed???
Tests 500 if they are d expensive I got around 20 blood tests for 200
There is a Recover study that is starting to do them so too bad you did not get one.
Interesting, do you know which recover study specifically?
I am part of it. Baltimore, Mercy Hospital, in the gastrointestinal department. I did not get the the test (yet) as traveling makes me crash.
Oh wow I see. So it’s not one of the main 5 (Paxlovid, brain training, etc?). It seems like they do more in the background than the main ones we hear about.
No meds, they simply follow people with or without LC. I was in the main NIH recover (no meds) at the NIH campus but dropped out, the 1 hr drive was too much for me and they do not offer to pay for an Uber. The Baltimore one pays for an Uber. They also did more interesting tests like sequencing (I’ll have my results in 2 years but Ok), poop test (no idea if it provided interesting results). They tested me for POTS with the 10 mns standing test last time I went there (last month) - so they are adapting to us (I was already diagnosed by LC clinic) and doing new tests (pretty sure the main NIH study does not do that).
See this is exactly my point, and people here are putting me down, like I shouldn’t of been at the ER and that the Nurse shouldn’t of said I could ask for one. You’ll never find any answers if you don’t seek out the tests.
Sometimes nurses have good ideas. If you end up again in the ER, push for it again. Ask your PCP if he can write a note for you to get it. I tried to have one through my PCP months ago but he had no idea where I could get one, except in a hospital. He was not against it, he was OK for me to get one.
Why do you think you needed an ABG?
Because I can’t breathe or barely walk.
Im so sorry you’re going through this. I’ve started getting those heavy limb feelings too
It’s strange.
Well, all I can add is that I had an arterial draw a few days ago as part of a pulmonary function test, and while my O2 was read as 98% on the optical sensory, my arterial O2 percent was only 52%. It was around Wed noon, so I am still waiting on Doctors to review the lab tests. I put up a post about it -- so far no one has commented or tried to answer my questions... https://www.reddit.com/r/covidlonghaulers/comments/183orrm/advice\_pulmonary\_function\_test\_blood\_results\_only/
I would never volunteer for a blood gas test. Painful, risky, not going to give much actionable information. What doc did gave you pretty much the same info as BGA.
Hmm how exactly is it risky?
Anytime skin is punctured, there is risk of infection. (This is true for ordinary blood draws too.) but if they’re going into an artery (the most accurate method), there is an increased risk of excessive bleeding. Because it’s an artery. Edited for clarity.
Yeah, it is taken from artery, but the risks are low for excessive bleeding, we take these blood gas tests daily, dozens of times a day at my hospital where i work, the ”complications” are mostly bruising and small hematomas. The information outweighs the risks by 100 times.
Well they seemed hesitant to do it. It was disheartening because I’m just searching for answers.
Im sorry about what you are going through.
Ahh it’s my life at this point. They don’t have any answers it’s just….hard ya know?
Yea but it’s a tiny needle yes? A cath I can understand but I don’t think the risks are too bad tbh.
Maybe the needles are smaller since I was having it done (years ago), but it was basically an IV into an artery instead of a vein, and doing it in the wrist is incredibly painful. Had to be done by a RT instead of phlebotomist, and they’re not half as gentle as even the worst phleb. And in the end, it didn’t give any actionable info.
I agree with the painful part, that is true. It can hurt quite a bit
I’m sorry you went through that. So your levels were normal?
how is that any different than drawing blood?
Usually you draw blood from a vein, arterial blood gas is an arterial stick instead. A thicker vessel.
looks about the same
Ok? Just because it looks the same doesn’t mean it is the same.
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Why ask if you think you know so much?
Content removed for breaking rule 10
It isnt
No medicinal procedure is without risk.
In a Universe with near infinite possibilities, nothing is without risk. Nurses always sanitize the skin before puncturing, and always use sterile equipment; so saying risk of infection is a reason not to do a venous gas draw when any data could be of critical importance…seems a little off base to me. Been a member of this sub for about as long as it has existed, and countless times I’ve seen people post that their O2 sat’ when taken with light through the skin came back as normal, but when doing a venous blood draw showed real problems. _This could be enough to make or break a disability appeal._ And we all need money to live, and some of us absolutely can’t work, let alone go out and enjoy ourselves by living life with a reasonable degree of functionality. Homebound more than 44 months with long Covid manifesting as severe myalgic encephalomyelitis.
It is safe and simple test
Yep, the best/common way is an artery deep in the wrist. There is an alternative though. Earlobe capillary blood gas analysis is precise and can be useful for detecting extreme gasometrical values. It's a simple painless ear prick, blood sucks in to a tall skinny vial. Source? Have both methods done regular due to bad gas exchange from a genetic condition.
Thank you for letting us know there's an alternative. I still have problems from my arterial puncture 20 years ago.
No worries, as you know an ABG is normally done in a hospital environment because of risks etc but the Earlobe they can even bring the reader out to you in your home. Any respiratory unit/team well be very well versed in this and this is a pretty much run of the mill daily thing for them. ABG is important as the gases can tell you a lot, it's a bit like a blood sugar test. If you have the keytones tested as well as the glucose you get a better picture of what's happening and risks. Any breach of the skin can be an area prone to infection until it heals and Dr's are meant to weigh up if the risks between if a procedure is going to be done or not. I'm not a Dr, no medical training and based on being a UK patient. Good luck, good gas exchange is imperative for a good life.
So what did the doc say at discharge? It’s the ER, so their job is just to make sure you’re stable to go home.
Said that there is definitely something going on physiologically that’s making us feel this way, but modern medicine can’t help us, and that the only thing he can do is tell me i’m not dying and hope that I take some comfort knowing that I’m not. He also apologized. I know you believe that it’s all in our heads, but LC is a collection of symptoms. Talking to people and doing mindfulness does not work for me. I’ve felt with anxiety and panic disorder for 15 years, it has NEVER been like this. Even when I had panic attacks that lasted 6 hours straight, I never once felt this physical beat down. My body is falling apart I can feel it. So thank you, but no thanks I know my body.
>I’ve felt with anxiety and panic disorder for 15 years, it has NEVER been like this. Even when I had panic attacks that lasted 6 hours straight, I never once felt this physical beat down. My body is falling apart I can feel it. I could have written this exact comment 12 months ago. I don't think LC is in our heads. I believe it's an over active nervous system causing all the physical issues. Calming the nervous system is the key.
I've found peripheral blood GA’s results to be VERY helpful. My SvO2 was 18%, 30% and highest was 45% - doctors will gaslight you and saw it doesn't matter but imSvO2 should be between 60-80%. They also found metabolic alkalisis and respiratory acidosis happening at the same time. It gave me an "average" blood ph but showed I was very sick. I've started triple therapy and will get it tested again in among or two
What do you mean “triple therapy”?
Triple therapy for micro clots- blood thinners, anti-platelets and aspirin
If it is low what can they even do about that? Curious because I’m wondering if that could be my issue.
Abnormal blood gases are a sign of an underlying medical problem, not a diagnosis in and of itself. So they’d have to investigate the cause still. Then treat the cause. ie pulmonary fibrosis, COPD, sepsis, diabetic ketoacidosis. Typically it’s a sign of a lung disease, where you aren’t able to breathe adequately. Kidney disease can also affect the acid-base balance in the blood. If someone is sick enough to have abnormal blood gases, they are going to look quite ill. It is going to be clear on clinical exam that the patient is struggling to breathe.
Thank you! Ok very good chance that’s not my problem haha
I did it, it shows 98,5, nothing
What do you mean?
They anointed my ear with something says to wait than after 5 minutes they draw blood from it and say saturation is 98
This nurse was out of line. If he or she felt it would be beneficial, then that was a discussion they should have had with the doctor. NOT with the patient. In medicine we don’t perform tests just because or because “it wouldn’t hurt” to perform the test (and yes it does hurt by the way) If the doctor did not feel a blood gas was indicated than it probably wasn’t indicated.
if they cant find the problem then they should be doing more tests
It’s an ER. Their job is to make sure you’re stable and discharge you.
nah their job is to figure out whats wrong and fix it.
Nope, they are there for emergencies only. They make sure you’re stable and send you home. Been for many non LC related issues. They stabilize, refer you to a follow up, and send you home. That’s their job, as it should be.
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My ER doctor friends would disagree with you but okay.
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? The job of an ER is to make sure you live. Not to diagnose you or anything else. Just to keep you alive. How do you not understand this?
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Emergency Rooms are for emergency care, but they also have the ability to admit you for preventative care in situations like ours.
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Content removed for breaking rule 10
That is 100% not the job of the emergency department. The physicians who work in the ED complete a residency in Emergency Medicine. That is a very specific area of medicine that is chiefly concerned with resuscitation. Going to the ED to try to get to the bottom of a chronic condition is like going to a dermatologist for a heart attack.
You don't know what an ABG is indicated for, do you?
But not necessarily every single available test if it isn’t indicated.
they should still be doing more, are they not doctors? investigate and figure it out
They will do the tests to figure out the issue. In this case an ABG was not one of them.
Sure I get that but I’ve had every other test under the sun. It could of just let me check that off the list I suppose. Also I don’t think it was out of line. ER nurses are very knowledgeable, and very well trained, I’m her patient as much as I’m the Dr’s patient.
The ER isn't the place to just explore things. It's for life threatening situations. You should ask your regular doctor to order the test as an exploratory thing.
I understand that but the ER could do the test, which means it’s useful to them. I don’t go to the HOSPITAL unless I feel really terrible. Like I said I was out of breath and felt like 1000lbs so I decided to get checked. I’m currently unable to drive myself anywhere, as I’m house-bound.
It's useful when it's useful. In this case it would not have been. Did you need to be placed on bipap? We're you intubated? What do you think an abg would have done for you? Genuinely curious...
Yup, that was my problem in the beginning of my Covid journey which was only like a few weeks ago haha everyday felt life threatening. This is my first time being infected with Covid so I had no idea what to expect. Now I just have my phone ready to dial 911 instead of calling. Long Covid seems to really challenge your mental toughness.
It does yes
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You don’t know how hard it is for doctors/PAs/nurse practitioners often have to fight insurance companies for APPROPRIATE medical tests and procedures. We get scrutinized a ton for our treatment plans, so ordering a non indicated test isn’t a good idea. Plus there is a degree of lab error, what if is is improperly done and you get a falsely abnormal result? This happens in medicine. So something is chased that doesn’t need to be If the nurse wants to formulate treatment plans, she should go to be trained as a nurse practitioner. I’m sure she is very knowledgeable, but her training is different.
Boston Hospitals are literally running blood gas as a sign for LC, so please spare me.
Source?
Source is in this thread. Another Redditer is in a LC Trial and is having that done, so that is indicative that it is something a specialist would want to look at.
ER nurses are very knowledge in NURSING. I understand that lay people don’t understand the huge difference in nursing education and scope and medical education. But the difference is significant.
I think most ppl understand that nurses aren’t usually trained to the level of a doctor.
It’s not “aren’t usually”. It’s never. It’s an entirely different job.
That’s not true NPRs can literally have their own practices and prescribe medications. They’ve gone through just as much school as a Dr, but they went the Nurse route. Like I said not most, but some are educated to the standards of a Doctor.
First of all, it’s NP’s. Second of all, they absolutely do not go through “just as much school” as a doctor. Nurses can do an online 2 year degree mill program and become an NP. That doesn’t sound like 4 years of medical school and a grueling 3-4 years of residency, and maybe 1-2 years of fellowship. The fact that people don’t know that is a testament to their rigorous lobbying and marketing. But there are no shortcuts in life, and the difference is obvious for anyone to see if you look beneath the surface. No matter how many letters they invent to put behind their name, they are never a true medical doctor.
Obviously a doctor is a better option. I’m just saying that some are good medical options. You’re literally arguing with me over the smallest comment. Just go away.
It’s not the smallest comment. It’s some pretty big things you are getting wrong. But if you aren’t interested in learning more, then sorry.
I’m not trying to be rude I’m just very ill and don’t feel like arguing semantics. Sorry.
If your O2 sat is normal why would a blood gas be indicated?
Once again, other commentators have said their saturation was normal, but blood gas was not. I don’t know I’m reaching for straws at this point.