Low SPO2?

[summit]

probably Wankybach

I award you 3 internets

[detrusor]

FTMFW


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[Kevo]

Well, I had some kind of weird cardiac event on Friday. My GF and I were walking through the local grocery store and ran into a good friend in the bread aisle. We were catching up, I started to feel strange and told my GF I needed to leave.

I took two steps and lost consciousness. The friend I was talking to (a very longtime good friend and maggot who hasn't posted in awhile) grabbed me and laid me down on the floor. I was out cold and stopped breathing.

I was in what felt like a super deep and peaceful dream state. I could hear what sounded like waves gently crashing on a shoreline and a deeper whooshing sound coming in pulses. I didn't experience any pain or fear- just super peaceful and relaxed. I'm told I took a huge breath just as my buddy was about to start rescue breathing after about 15 seconds of being unconscious. Hearing came back online and I could hear carts moving on the concrete floor. I knew someone familiar was with me, then vision came back online. My buddy was holding my hand and checking for a pulse with his other hand.

I immediately knew who/what/when/where I was but didn't understand why. GF was on the phone with 911. Paramedics arrived in a few minutes- it was Snapt's shift that night, but he's out on paternity leave. The paramedics were going through their assessment and I was hooked up to a pulse oximeter and blood pressure monitor. I felt pretty ok, but was a bit confused. I was trying to convince everyone that I was fine. I looked at the monitor- "Far left on your monitor is heart rate?" "Yep, that's heart rate." A few seconds later I watched my heart rate go from 80 to 120, then it crashed over maybe 3 seconds down into the 40s.

Head paramedic is talking to me, continuing his assessment. I start to very quickly have trouble comprehending what he's saying. Shit, there goes brain processing. I look at the paramedic- "I'm losing you guys". Fuck, there goes vision. I run through a list of medical conditions that this could possibly be as I'm losing consciousness- aneurysm? Probably not, I don't have a headache. Heart attack? Doubtful- I don't have chest pain. Aortic dissection? Fuck, maybe I am bleeding out internally. Hearing goes and I'm unconscious again.

I came to maybe 10 seconds later and was suddenly very adamant about going to the hospital. Paramedics hooked me up to a 12 lead- I'm not in AFIB (my dad and uncle both have had AFIB). They get an IV going and then it's a 2 minute ride to the hospital.

At the hospital ECG looks fine, blood pressure looks fine, heart rate is fine. SP02 is 93ish like it always is. My GF is there. My buddy is there. My parents came too.

The family doc working the ER at the hospital recommended transporting me to the regional hospital in Idaho Falls for echocardiogram, CT scan, etc. The same paramedic crew transported me. From this point forward, my vitals were just fine and I felt generally fine.

I spent the night and the next day at the regional hospital and had a slew of tests done- CT scan to rule out pulmonary embolism because of elevated DDIMER, echocardiogram to look at heart structure and ejection fraction, blood pressure while laying, sitting, standing multiple times per day. Everything came back normal. Heart structure and function is just fine. I mentioned low SP02 to the 7 different docs I saw, and they all didn't seem to think it was a major factor.

There was no smoking gun, so I was discharged with a heart monitor glued to my chest for the next 14 days. All in all it was pretty miraculous that my 220 lb buddy was there to grab all 200 lbs of me and gently lay me down on the floor of the grocery store. Huge props to my GF for keeping her shit together as well. All medical staff (especially Snapt's crew) were top notch and EIRMC in Idaho Falls was an all in all great healthcare experience.

The head cardiologists in IF said that if they don't find a smoking gun there is almost never a recurrence in this type of situation, but I do have an extensive family history of cardiac electrophysiology issues on my dad's side of the family that need to be ruled out. Both an uncle and my grandpa would randomly have heart function issues and pass out. Both died suddenly from mysterious cardiac issues. My dad and his younger brother have both had AFIB. That uncle (dad's younger brother) was a professional marathon runner and still ended up with cardiac issues.

On the plus side, I now know that I don't have AFIB or structural issues with my heart and I have a baseline going forward should I run into hereditary issues. The not knowing why this happened definitely sucks and I hope it never happens again. Could it somehow be tied to persistent low SP02? Is this similar to the syncope issues that my uncle and grandpa experienced? I'll have a follow up with the cardiologist I saw after the two weeks of wearing the heart monitor. My uncle and my dad are both recommending that I see an electrocardiologist. My dad's is at the Cleveland Clinic.

I guess the other positive is that I didn't have any major regrets as I lost consciousness that second time. Other than trying to run through a list conditions that could be causing the issues and taking note as my systems went offline, I had a general positive outlook. I remember thinking that I was really thankful that my buddy and my GF were there, but that it was kinda unfortunate that my last moments may be in a grocery store.

[AdironRider]

Glad you are ok. In my son's situation, no doc could pin the low O2's on any one thing. All said, with nowhere near the conviction I would consider definite, that he was within the realm of expectation for o2 at elevation. Like ok, fine, its at the bottom end of an approved spectrum, but I strive for excellence, at least when it comes to health stuff.

But man, I wouldn't wish the last moments to be in Broulims on anyone.

Hope you get some clarity in the future.

[bennymac]

that's a crazy story Kevo

imagine that happening while driving or in the backcountry

I'm not heart doctor but if cost is not an issue I'd personally want that investigated to the fullest - smrter minds can weigh in here but even a normal assessment from the electrocardiologist would be helpful in the reassurance department.

do Apple watches or other easily worn devices that monitor heart rate and rhythm keep a running record of events like this?

Hopefully it never happens again

[summit]

Very variable HR with new syncope... scary... surprised you didn't earn a Holter monitor from the cardiologist.

[Kevo]

Very variable HR with new syncope... scary... surprised you didn't earn a Holter monitor from the cardiologist.

I'm wearing a ZioAT monitor for the next two weeks. It's like a glue on holter monitor that is the size of an airPod case. It has a wireless unit about the size of a cellphone that I carry in my pocket that transmits data remotely.

[riser4]

Fuck. My wife had a syncope issue back in November. Scary as fuck. And I suck in a crisis.

[summit]

Kevo glad to hear they have you on that.

[billyk]

Ever have a calcium CT scan of your heart done? Not sure if the costs are different in Colorado, but in Texas it’s only about $40, and well worth knowing what your score is. Mine came back 0 (completely clean) which shocked both me and my doctor. Redid it a couple years later, just to check if the test was screwed up somehow, but still clean. So at least I know I don’t have to worry about that.

[riser4]

Oh, and you shoulda let your buddy start the first breath and then complained "hey man why are you kissing me on the floor of the grocery store!?!?
WTF man?!?!?". I'm a terminal joker.

[Meadow Skipper]

Holy shit!!! I’m glad you’re still up and about, but what a mystery about whatever’s causing that.

[goldenboy]

Glad you're ok Kevo!

Personally I think I'd be in SLC or Denver seeing some specialists if I were you, but hopefully the HRM sheds some light on things. Good luck!

[Core Shot]

Fuck. That’s a crazy story well written.

Maybe ease up on the edibles and mushrooms.

Glad you made it. And had a good crew of friends and professionals to help.

[yeahman]

Scary af. Glad you survived and best luck figuring out what caused the episode.

[Kevo]

Glad you are ok. In my son's situation, no doc could pin the low O2's on any one thing. All said, with nowhere near the conviction I would consider definite, that he was within the realm of expectation for o2 at elevation. Like ok, fine, its at the bottom end of an approved spectrum, but I strive for excellence, at least when it comes to health stuff.

But man, I wouldn't wish the last moments to be in Broulims on anyone.

Hope you get some clarity in the future.

Thanks man. Yeah, dying in Brouhlims would be a bummer for sure.

It is interesting to me that cardiologists and all internal medicine docs that I've ever seen haven't been concerned about the SP02 thing. Their take this weekend was that my heart wasn't overworking itself based on EKG and echocardiogram, so it's not an issue.

They did mention that untreated issues (like AFIB) can really overwork the heart and cause structural issues to develop, but that I don't currently have any issues like that.

that's a crazy story Kevo

imagine that happening while driving or in the backcountry

I'm not heart doctor but if cost is not an issue I'd personally want that investigated to the fullest - smrter minds can weigh in here but even a normal assessment from the electrocardiologist would be helpful in the reassurance department.

do Apple watches or other easily worn devices that monitor heart rate and rhythm keep a running record of events like this?

Hopefully it never happens again

I'm currently figuring out how far I want to pursue answers. I'm going to start with seeing how things go with the 14 day electrocardiogram and go from there. My dad uses an apple watch to track AFIB, but I'm not sure if it can detect other abnormalities.

If I can get other visits approved, I might book a trip to Cleveland to visit my dad's Electrocardiogist at the Cleveland Clinic. I'm guessing I'll be at out of pocket max for the year after this past weekend, so why not?

I'm worried about the driving or backcountry thing as well, but all docs I spoke to before discharge were pretty confident that the odds of recurrence are low. I was a bit surprised that they cleared me to drive and ski right away. They basically told me to pull over if anything gets weird and to just sit down if I'm skiing and feel weird.

Ever have a calcium CT scan of your heart done? Not sure if the costs are different in Colorado, but in Texas it’s only about $40, and well worth knowing what your score is. Mine came back 0 (completely clean) which shocked both me and my doctor. Redid it a couple years later, just to check if the test was screwed up somehow, but still clean. So at least I know I don’t have to worry about that.

The hospital did a lipid panel and everything looked good. That data point along with normal blood pressure meant that I wasn't a candidate for I a calcium CT scan because my risk of plaque build up is super low, allegedly.

[Harry]

Vibes to OP.

I had several episodes similar in the year/years prior to shit going totally sideways for me. This thread is like a flashback on my life.

Glad to hear OP is getting appropriate medical care.

[EWG]

Sorry Kevo. Hope the 14 day tests sheds some correctable light.

[mangle]

That's nuts. Of very much secondary importance, but I'd be curious to see how FAA medicals go in the future. Maybe you go BasicMed now? Dr. Blue might be a good guy to talk to in the near future.

[Kevo]

That's nuts. Of very much secondary importance, but I'd be curious to see how FAA medicals go in the future. Maybe you go BasicMed now? Dr. Blue might be a good guy to talk to in the near future.

It's definitely a major consideration going forward and a bridge that I'll start to cross after my next meeting with a cardiologist. I'm probably more concerned about that than almost anything else at the moment.

[wkd-rdr]

Elevated D-dimer, with clots ruled out, is an inflammatory process. Have you been checked for covid/flu other viruses? Do you have a history of autoimmune disease or chronic inflammatory condition?

[Kevo]

Elevated D-dimer, with clots ruled out, is an inflammatory process. Have you been checked for covid/flu other viruses? Do you have a history of autoimmune disease or chronic inflammatory condition?

Negative on any history of autoimmune diseases or chronic inflammation. I had what I believe to me a very minor knee injury that I was nursing from the week before- maybe a cartilage issue? Elevated D-Dimer + that injury history + a long road trip is what lead to the pulmonary embolism CT scan workup that turned out to be negative.

I had spent 10 of the previous 14 days at a backcountry hut and had felt kinda sorta maybe sick for half a day and then it went away. At least one person at the hut had a dry cough, so maybe I had been exposed to covid? Neither hospital did a covid or flu test on me while I was there.

A family member and a friend are both convinced this must somehow be tied to the Pfizer vaccine that I took almost two years ago. I had a negative reaction to my second Pfizer shot and was stuck in bed for 4-5 days. My left armpit lymph node swelled up so large that I couldn't move that arm.

It seems like there is way too much noise to signal for me to make sense out of whether this could be covid or covid vaccine related, so I haven't gone down that path of research. I guess I'm open to ideas if someone has an actual study published in a medical journal that could point to a correlation instead of some alternative news site like my brother has been sending me...

[bennymac]

someone dies during a covid infection and the kooks shout "it wasn't the covid that killed them - it was other medical reasons! Don't put covid on the death certificate"

someone dies 2 years after the vaccine and its "oh yeah - I bet it was the jab - can't be anything but that"

if the vax causes permanent D-dimer raise then that test would need to just be tossed in the garbage since 80-90% of North Americans have had the vaccine

[summit]

D dimer is kind of a garbage test...

[detrusor]

^^^^

True, kind of an acute phase reactant that isn’t very specific.


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