Will ProfG hate the essential bit of your COVID kit and is he working too hard?

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If you want to monitor yourself at home for COVID-19 infection it is good to have a thermometer, but a pulse oximeter (to measure blood oxygen) is a good device to see when it is time to go to hospital.

There was a sad case of a doctor who was suffering from COVID-19. Their oxygen levels dropped and I am sorry they became incapacitated and died before they could get help. The oximeter could have saved them because although they may have felt OK to start with, the low oxygen level would have sounded warning bells and off you go to A & E (ER for our American Readers).

I bought one off Rbay (rubbish from Ebay) or was it Amazulu…. from a so called UK seller, which arrived from China. It was so rubbish they refunded without question, even before I complained. I guess it may have been the same vendor of the dodgey COVID-19 tests that the UK Government spent 20 million on:-). However this week I splashed out abit more cash and got one that works.

However, I think it is one of the most annoying bits of kit in hospital. They are linked to alarms and you get them in stereo, if the device falls from your finger. The oxygen saturation levels drop and an alarm goes off by your bed and an alarm goes off in but the nurse station too, They fall off your finger so often you habituate to the noise. I remember getting out of bed so see if the guy next door had carked-it . I used to stick it on my toe as it was a pain in the A to have it on your finger. Sleeping in hospital from my experience was two hopes one is Bob Hope the other is No Hope.

We hope ProfG has been getting some rest. I spoke to him yesterday and he is still in pain and in need of pain medication.

I said he was taking his teaching responsibilities abit too seriously and did not need to give the students a new case study. “Runner gets muscle aches takes paracetamol, then hip pain takes some non steroidal anti-inflammatories but gets run over by a motor bike smashed pelvis and there is acute and mega pain and pain generated from within the nerves running down the arm. What drugs are going to be taken and what is the prognosis?”

As part of medical school at Barts and the London the students do Problem Based Learning. Here they learn about neurological and other problems through examining case scenarios. So ProfG has made his own. One of the objectives is to learn about acute and neuropathic pain and the treatment of pain. Here you use the Anagesic Ladder.

You often start off with a anti pyrectic analgesic like paracetamol. Then escalate to non-steroidal anti-inflammatory if it doesn’t work y

to something like Ibruprofen and stronger NSAIDS diclofenac and if that fails the pain killers become stronger and may end with opioids.

Practical Guide to Opioids and Their Complications in Managing Cancer Pain  | Cancer Network

It is a bit of trial and error finding treatments that work. I am sure some of you reading the blog will have experience in this. In MS, the pain is often generated within the nerve due to damage and it often does not repond well to opioids.

In the PBL case scenarios after a few failures the pain-docs often get it right..let’s hope that in ProfGs scenario the acute pain goes with bone healing and that the neuropathic pain goes with removal of bone fragments and analgics are not needed for the rest of his life……. Surely if he is writing the PBL he can have a happy ending.

This weekend is Children in Need Appeal.. Please consider the supprt for the ProfG in Need appeal

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MouseDoctor

15 comments

  • You can keep a sats probe on your finger or foot by putting a sock on over the top. A sock on your hand looks a bit silly, but it works.

    • My Garmin watch measures SpO2 on the wrist (not sure I completely believe the numbers though) so I have on occasion wondered if wrist band might be easier to use.

      OTOH, the falling off has the advantage of there being one less wire that might strangle you (thus sounding the alarm 😛 ). The EKG wiring during my ocrelizumab infusion sure would carry that risk while asleep…

      I also have a cheap Chinese finger reader. Not sure the results are totally accurate but at the very least do not look bogus. So as an indication that it is time to call an ambulance that should do.

      • Let’s face it even the ones that work are Chinese….in my case they did not want it returned so they knew it was a piece of rubbish.

        We had a student their saturation levels were 88 percent and they called NHS direct on 111 they sent over a paramedic with some oxygen.

        MD2 has beaten that and lived to tell the tale but that’s another story.

        • When we got bored waiting for everybody to come to theatre when I was a surgical trainee, on night shifts, Sats monitors were beginning to become smaller than VHS recorders. We used to compete to see who could hold their breath for longest and drop their sats most. My record was 57%, but the urge to take a deep breath kicked in around 94% with uncontrollable diaphragmatic movement. The thought of people not feeling too unwell with resting sats of 88% is incredible. Carbon Dioxide respiratory drive in action. It was really interesting to see the way oxygen sats fall more rapidly as you move down the oxygen disassociation curve.

  • ☹☹☹
    What a shame. I hope Prof G’s pain management is sorted soon.

    I didn’t think paracetamol was considered a NSAI at all.

    • Approve yep I thought that too when I read this morning changed. Aspirin has anti inflammatory properties paracetamol does not.

  • Dear Mousedoc, thank you for updates about ProfG’s health. Looking forward too see him recovering, giving talks and writing posts again soon.

    • In the words of Arni he,ll be back but at the moment it is very painful to do much with his arm. Let’s hope it heals. He is getting good care and Ian sure he is being Dr House and diagnosing himself. My mum fell off her bike and broke her neck when she was in her mid 70s sadly she didn’t get decent care, the bones have healed wrong and the drugs required for the rest of her life will cost alot more than the few pounds for a X ray that would have spotted the problem. That marked the end of her head banging career:-)

  • I guess you can’t really give any name of make or website but please could you give an indication of what I should realistically pay for a reliable pulse oximeter? There are so many online and I can’t afford to waste any money on something too expensive or useless. Thank you so much for this helpful blog.

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