OXYGEN!!! Less Oxygen!!! More Oxygen!!!

OXYGEN!!!

Monday 12 November, 2007 – 15:35 by Swannie talking about witchdoctors.

I leave watching "House" with strange feelings. A patient is presented with unusual symptoms, a mysterious background, and an obviously unfathomable ailment (why else would the show screen for an hour)? It takes a lot to suspend disbelief, listen to knowledgable gobbledegook, and then accept the final morality message. I’d rather watch "SG-1", but my viewing choices are limited ("The Unit" is fun, but with my backgroud I can better relate to that; if only someone would re-run "The Paper Chase")!

When I was releasd into recovery, after a week of the hospital trying to find me a bed, the ward doctors were astounded that I had such poor muscle control I could not walk. My muscle tests showed that in spite of a severe weight loss and poor stamina I was still capable of lifting a doctor off his feet when the strength of my legs was tested. My sensation and co-ordination were good, too. It was inexplicable that I could not even blow my nose (initially, partly due to damaged lungs) without nearly poking out my eyes. Thank God for spectacles!

The whole siuation, after innumerable and repeated tests, was summed up by the Gibbon: nothing wrong could be found, and someone must be imagining I couldn’t walk. I know I couldn’t walk: the piddles (sic) of waste products I occasionally dropped onto the floor proved this to my satisfaction. Perhaps Gibbon was unwilling to believe the evidence he had garnered, since he had never had to clean up a brown-coloured pyramid after I passed (so to speak).

My initial thoughts were that since I had effectively died from Legionnaires, and no one had ever bothered to do any NMRI of a corpse to see what neural damage had been done before death, perhaps my damage was something no one had ever seen in a recovering patient. Or perhaps it was a side-effect of losing 40kgs of weight? I mean, would anyone (except me) really notice if a few grams of neural matter was also wasted away?

The International Express

It was only after I read that a noted UK food critic had contracted MRSA is hospital and had left there with walking problems, that I took notice of MRSA and did a search. By accident I found a site that was a clearing house for research papers on MRSA. This site claimed that MRSA coud present itself as a meningitis-like illness, with a reported rate of 40% for neural damage!

Since I was inexplicably seeing the Prof in a few weeks time, I decided to broach the subject with him. After all, he was the expert neurologist! And I had no intention of wasting my time re-inventing the wheel. Little did I know he still rode bareback! While waiting to see the Prof, I thought about past experiences in life, and present-day medical procedures, and wondered if a simpler explanation might be that I had suffered oxygen deprivation. After all, I had actually died while being put onto life support, had spent over four weeks with breathing assistance, had spent a shift in intensive care being fed oxygen after my tracheotomy was closed (obviously, after I fell asleep, the signs of breathing distress were clear enough to warrant pure oxygen, to the extent that my eyes had to be protected from the gas).

Since I was inexplicably seeing the Prof in a few weeks time, I decided to broach the subject with him. After all, he was the expert neurologist! And I had no intention of wasting my time re-inventing the wheel. Little did I know he still rode bareback! While waiting to see the Prof, I thought about past experiences in life, and present-day medical procedures, and wondered if a simpler explanation might be that I had suffered oxygen deprivation. After all, I had actually died while being put onto life support, had spent over four weeks with breathing assistance, had spent a shift in intensive care being fed oxygen after my tracheotomy was closed (obviously, after I fell asleep, the signs of breathing distress were clear enough to warrant pure oxygen, to the extent that my eyes had to be protected from the gas).

To top it off, I had a history that indicated that the oxygen concentration as measured in my blood overstated the amount of oxygen my organs were getting. That is, while it appeared I was getting enough oxygen, I could be suffering deprivation (in the tests I had previously had, while I had shown a strong tolerance for fast changes in oxygen levels, a prolonged need for oxygen had some painful side-effects. Muscle and head pain, as well as dizziness and nausea, were often-repeated symptoms, even after long periods of unconsciusness).

I have previously reported that when I approached the Prof about MRSA, he ignored me. When I then aproached him about oxygen levels and hyperbaric treatment, he told me that it didn’t matter what caused the neural damage, it existed and was mine to suffer with until I died. It was at this point that my reaction to his medical malpractice descended into sexual epithets (actually, just one epithet, but that was all the excuse he needed to throw me out unless I begged to be let back under his carelessness).

Right now I am waiting for the first of the side-effects of the Prof’s rancour tomorrow, and I am not too confident. I may have to lean more heavily on a few people in order to survive a bit longer. If you see any more posts, you’ll know.

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Less Oxygen!!!

Wednesday 14 November, 2007 – 13:24 by Swannie asking if this his problem’s cause?

I was admitted to hospital in a coma. Even though I was occasionally delerious, and might have appeared conscious, I have no memory. As I have explained before, you can appear aware but still be unconscious (ask any sleepwalker, if you dare). A coma is the result of a number of things, but all lead back to hypoxia, or lack of oxygen. Sometimes it is the body’s defence from things it decides you can’t be aware of; more often, it is simply a mechanical deprivation of oxygen. Sometimes, it is because of anaesthesia, but this is typically short-lasting.

Hypoxia and Coma

I was in a coma for four weeks, all the time with some form of breathing assistance. This included in the later stages a tracheotomy, and after that was removed, a session with oxygen support due to severe respiratory distress.

In a coma, there is always the risk of hypoxia worsening, to the point of causing neural damage. Basically, the patient is not able to show nurses he is short of oxygen (can’t beak through the coma), but may exhibit respiratory distress or show a lowered blood oxygen saturation.

The problem here is that normal blood range of oxygen-carrying cells range from 130 to 180 grams per litre (according to my blood test results). Lower than this level, and you should be treated for anaemia. Higher than this, and you should be competing in an athletics event and will run foul of the anti-doping checks.

Problems

The problem is twofold here. Normally, bloody oxygen content is measured as a saturation percentage, with 100mmHg (100 mm of mercury, partial pressure) considered acceptable, and anything below 50mHg resulting in neural damage. Firstly, the normal oxygen carry capacity of the blood covers a 40% range, regardless of the saturation. It is possible to receive over 50% less oxygen in your resting state than you need, and a 50% reduction in oxygen can result in some neural damage. No one is the wiser, if you are unconscious, until you show signs of distress (dying is a clear sign), because the oxygen sensors used in hospital only show oxygen blood saturation, not the amount of oxygen actually delivered. The second problem is that hosptal beds are routinely fitted with attachments for supplementary oxygen, since even recovering patients often need oxygen support (typically, 10 to 15 mmHG support). All you need is someone to do it!

Hospitals are well-aware that bed-ridden patients often need supplementary oxygen, that is why the beds are fitted with an oxygen outlet. Somehow, no one seems to have twigged to the reason for this expensive routine design, and only bother to use it when a patient’s respiration is obviously distressed.

The oxygen saturation monitor only measures the colour of the blood. Not enough oxygen-carrying red blood cells, and the colour becomes bluish. A reduction in the number of red blood cells does not cause a colour change, just a change in intensity (and that varies according to where the sensor is attached: finger, ear, or family jewels). Basically (again), if you are in a coma, you are not able to complain you are asphyxiating, and it will take a day for your daily blood test results to return. Unfortunately, my experience is that medical staff generally do not know how to work out what is wrong, and the patient suffers.

Medical staff do recommend light exercise for patients, in bed or out of it. It was never explained to me that exercise increased blood flow throughout the body, just that it would make me feel better (in my case it was ignored that my legs were weak, and that sitting in a chair for up to four hours compressed my diaphragm and made breathing shallow and painful).

Whither the Cripple?

Part of my coma was induced. Part of this reason was the fact of hypoxia due to the rooted nature of my lungs from the illnesses. Part of it was from hypoxia due to the rooted nature of the rest of my body from the illnesses (hello kidneys, why did you take five weeks to show signs of life)?

Part of my coma was induced. (Where else but in a hospital would they induce hypoxia in order to keep you quiet?) My carer said that she was told by hospital staff that the pain I was in often broke through the coma, resulting in them having to dose me with morphine. Or restrain me when I tried to escape from the bed or rip out the drips that were stopping me escaping.

For those reading as I write, this post will end with my usual 12 asterisks in a row. Sorry, but it easier to write directly to the blog and save after each paragraph.

I spent about 40,000 minutes in a coma. Why could I have not spent a total of say 10 minutes with a real oxygen level less than 50mmHG? After all, I did die at one stage, and this would have resulted in an even lower blood oxygen level! Given the fact that many patients probably get neural damage while in hospital, but this can be disguised by the body as recuperation progreses, why could it not happen to an older patient who had less chance of recovering from it? Either Legionaires or a brain fever caused by MRSA (it can mimic meningitis, with a 40% chance of neural damage in those cases) could have caused just a little period of hypoxia, enough to cripple me.

You don’t have to be a witchdoctor to accept that hypoxia could have caused my neural damage. As a professional who is familiar with neuropsychology, I have no problems with accepting this hypothesis, rather than ignore it as most (only one so far admits to it) Posterior Waste Orifices manage. I could believe God did it, but then He has no reason to pick on me (in fact, I am not sure He even believes in me, let alone wants me to suffer). They don’t shot horses anymore, why not afford the same dignity to patients?

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Or they do shoot horses these days, so why not do this to patients, who deserve at least the same consideration shown to a victim of equine influenza?

******     ******

About alarchdu

This blog is just a stream of consciousness. I was severely crippled in 2007, and these are the thoughts generated as I think on this.
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