Low SPO2?

[skaredshtles]

Kevo - sounds suspiciously like a mt biking friend of mine that had similar experiences due to a COVID infection last summer.

PM me if you'd like some contact info - I'd expect he'd be willing to let you know what his experience was like.

[crashidy]

Reading this I'm continually impressed with the American health care system yet again. Having worked Ems and EMT and being an RN working in ER/Picu/critical care transport for close to 20 years in the Canadian health care system.
I've done medical flights to and from the USA in several states. My daughter spent some time in the driggs hospital, my brother in Boston ICU, my dad in Phoenix.

Had this happened to you in Alberta you would have got an an ecg, maybe transferred to a level one centre for an extended work up which would have been an a echocardiogram. Holter would have been out patient and maybe 24 hrs. You likely wouldn't have seen a cardiologist let alone an electro physiologist.
If you were stable with normal everything on arrival you get referred to outpatient.

Given your family history the chance of actually finding a cause is limited. My suggestion would be Follow up with your families electro physiologist.

Also you may want to consider some genetic testing. Whole exome sequencing. (blue print genetics) Not 23 and me but I can look up what we used. It diagnosed my daughters issues. They have a list of about 80 different things that can be treated or discovered including many cardiomyopathies. Things that won't show up on imaging or blood tests.

Glad you're good and we're treated great in my opinion.

[skaredshtles]

Reading this I'm continually impressed with the American health care system yet again.

Just wait until you see what it costs him...

[crashidy]

Just wait until you see what it costs him...

That's the constant dilemma right? Pay and get treatment or don't pay and get forgotten about and not treated. I've seen both sides and well aware of the costs.

[Mazderati]

Right; great healthcare if you can afford it.

Scary shit.

[Timberridge]

Just wait until you see what it costs him...

Right; great healthcare if you can afford it.

Scary shit.

I thought most everyone on TGR was on Medicare?

[bagtagley]

Glad you’re okay, man.

After a couple incomplete diagnoses between my wife and I, If it was me, I’d be getting my shit lined up for a visit to the Cleveland Clinic. It could be argued that we’re a little trigger happy with the second opinion, but it’s paid off in the past, and worst case, it only costs time and money. And side benefit, you get to talk smack about Ohio to BMills. My old man got his valve replaced there and I was impressed by every aspect of that operation.

[Core Shot]

I thought most everyone on TGR was on Medicare?

Nice comic relief. Heh.

Seems like yesterday we were all in our late twenties early thirties and newschoolers were the young punks.

[Kevo]

@Crashidy- good to know about DNA testing. Please let me know what service you used if you get a chance.

It's definitely nice that I was able to see specialists and get extensive workups done in a 20 hour period. I'm really thankful for all the medical providers that I saw and I agree that I received excellent care.

I have exceptionally good health insurance by US standards because my company is owned by an international megacorp. My out of pocket cost for 20 hours of medical care will be at least my in network out of pocket maximum, which is $2,200 (very low by US standards). There is a good chance that several of the providers that I saw were out of network, so I'll be on the hook for another $4,400. As of a year ago balance billing for emergency care is illegal in Idaho, so I likely won't have too many additional costs outside of my out of pocket maximum.

$6,600 total out of pocket costs for a single medical event is workable for me. I do realize that many people have much higher out of pocket maximums and/or don't have savings to cover such an event. Having lived through periods of my life where I legitimately couldn't afford to see any doctor, I'll withhold too much praise for a healthcare system that regularly bankrupts poor and middle class families.

[Timberridge]

Nice comic relief. Heh.

Seems like yesterday we were all in our late twenties early thirties and newschoolers were the young punks.

Medicare is a great deal. My dad's $100K heart attack only cost him $1800. I hope it's still around someday.

My SIL gave us a dog DNA test kit for Xmas one year. The one where they tell you what your dog is made of and if prone to particular diseases. The report had a gene marker for high altitude acclimation. I would guess some humans have it too. My dog doesn't have it even so his ancestors came from Tibet.

[fastfred]

big difference between thinking your going to die and knowing your going to die

[old goat]

Didn't we see the same sort of thing a few weeks ago on a football field?

[snapt]

Did Kevo’s buddy slug him in the chest?!

[mangle]

Just for reference - spo2 values as a function of altitude in the general population:

https://thorax.bmj.com/content/thora...10598.full.pdf

[Trackhead]

Wait, you had multiple syncopal episodes and never had CT head/MRI, or CT angio head/neck?

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.

^^^ vasovagal syncope looks a lot like that, except when people pass out they can have long cardiac pauses that look like asystole and scare everyone in the room, until that awesome little sinoatrial node wakes the fuck up and so does the patient. I've seen this plenty of times when people vagal out while getting an IV started while on a cardiac monitor.

Vasovagal syncope is in the differential (benign). Did your GF witness seizure like activity (common with both sinister and benign syncope). When people die of v-fib, etc, they often display seizure like activity initially, so do folks having vasovagal syncope.

How high was D-dimer, was troponin included?

[Kevo]

I did have a CT scan and an echocardiogram. Both were negative for any abnormalities.

No idea how high DDIMER was except that it was high enough that PE had to be ruled out. Also not sure if troponin was included.

No seizure like symptoms either.

[Trackhead]

Right you had CT chest to rule out PE, but did you get any imaging of your noggin in the ER?

[Kevo]

Negative on head CT.

What would that be for? Checking for aneurism or blood clot?

[Trackhead]

Yes. Any unexplained loss of consciousness that isn’t obvious cardiac in nature.

[highangle]

Hey Kevo, did your blood workups show normal ferritin levels?

[Kevo]

Yes. Any unexplained loss of consciousness that isn’t obvious cardiac in nature.

For whatever reason this didn't happen. All seven doctors that I saw were focused on this being somehow a cardiac issue.

Hey Kevo, did your blood workups show normal ferritin levels?

I had a ton of blood tests done (i think they pulled a total of 4 or 5 viles), but I'm unsure as to what exactly was tested other than DDIMER, since that was the only thing mentioned as being out of whack. Oh, and they did mention that my lipid profile looked fine.

[Trackhead]

For whatever reason this didn't happen.

They did do CT head which is standard ER protocol.

[highangle]

For whatever reason this didn't happen. All seven doctors that I saw were focused on this being somehow a cardiac issue. I had a ton of blood tests done (i think they pulled a total of 4 or 5 viles), but I'm unsure as to what exactly was tested other than DDIMER, since that was the only thing mentioned as being out of whack. Oh, and they did mention that my lipid profile looked fine.

Not a doctor, but understand the protein Ferritin is the iron battery, controlling blood iron levels, which are in turn related to RBC count and blood O2. Seems like the docs would prob look there [or a different measure of blood iron] a long time ago if the complaint is "Low SPO2"? Still, if blood ox is the ongoing question, it seems like you should know your ferritin levels?

[Trackhead]

Without anemia, little reason to check ferritin level unless considering inflammatory processes (covid, etc).

Low hanging fruit is pulmonary function testing as outpatient.

[highangle]

Thanks. All I got is anecdotes involving runners, both of whom initially felt like they might be experiencing overtraining syndrome, or worse. They're both having some success managing it with their diets [and prob treatment] and have found that making greater/less demands on their bodies didn't seem to correlate with their ferritin levels.