Advice while waiting for VA on low Blood Saturation 79%

[MIKE13]

While waiting untill April for the VA to get me in to see a Pulmonologist, I would appreciate any feedback.  I am a 53 year old who never smoked, I have some scarring in my lungs from enviromental-Industrial hazards, but none that look like Berilium, Silicosis, or Asbestosis.  My sleep study ruled out Apnea, the Pulmonary Function Study was all red numbers but they won't discuss them untill the report is in.  I am on 3 Liter of Oxygen nocturnal and with activity. Also on BP meds, Diurectic, and Choleserol med.  What is going on?? The only time my Oxygen is at 88-90 without supplemental O2 is setting still. I also expericene extreme shortness of breath worst after first lying down. Accpmpanied by an immediate drop in O2.  Usually to 79% or lower and when walking on treadmill for two minutes at 2.5 mph it drops to 79%  To keep it above 90% I have to be on 3 liters supplemental.

[National Jewish]

The low level of oxygen in your blood suggests that you have some type of severe lung disease.  However on the basis of this information, I cannot even speculate what the nature of that lung disease might be.  As a non-smoker it is highly unlikely that this is COPD.  The term COPD is an abbreviation for chronic obstructive pulmonary disease.  COPD is a general term used to describe the chronic lung disease linked with cigarette smoking and worsened by contact with industrial dusts and other toxins.  This is also called emphysema.  It is a disease that worsens over time.  There is a relatively irreversible decrease in airflow and permanent destruction of the airsacs in the lung.  However COPD is possible if your industrial exposures were excessive and/or you have alpha-1 antitrypsin deficiency.

Alpha-1 antitrypsin deficiency is the name given to a small number of cases of COPD where there is a hereditary basis.  This can occur in people who have never smoked.  It is the result of not having enough of a major protein, called alpha-1 antitrypsin, in the blood.  A blood test that measures the amount of alpha-1 antitrypsin is used to determine if this is your problem.  Please read our Alpha-1 Antitrypsin Deficiency or Inherited Emphysema MedFact at http://www.nationaljewish.org/medfacts/alpha1.html for more information.

What is important is whether your symptoms and low level of oxygen in your blood are a recent change for you.  If this started within the past 6 months it is considered acute.  You should be seen by a pulmonologist without delay and certainly before April.  Your doctor should insist that you wait no longer for a thorough exam and treatment.

[starion]

PLEASE follow your prescription & keep your O2 at 3 lpm, as scripted until and unless it is otherwise changed by your pulmonologist.  You strain your heart & other organs when you decide to not use the O2 as directed.  79% is NOT good for your body.  
I have severe emphysema (diagnosed at age 42) from no known cause & have never been exposed to any lung irritants, never smoked, etc., so these things CAN happen.  At this point, we've pretty much given up trying to figure out WHY my lungs are this bad, but are careful to keep my O2 SATs always at or above 90%, even though that means supplemental O2 when I'm at altitude for sleep & exertion.
Not sure why you would not follow the O2 prescription you were given.  If the cannula is uncomfortable, try asking for a Salter 1616 micro cannula with Comfees foam cushions for your ears, which is thinner & more comfortable than the regular adult cannulas.  Using water-based gels like Ayr, K-Y jelly, and others the pharmacist may recommend can also help.  Using saline nasal rinse frequently can also help keep your nasal passages moistened and infection-free.
Starion

[MIKE13]

Thanks for the feed back.  It helps to know there are other non-smokers with problems.  I am trying to stay on the supplemental as prescribed, I had just experimented with lowering the rate while using a digital pulse meter to see what happened.  Looks like I'm best off on the 3 liters the VA prescribed.