Low Blood Oxygen Levels

[mla032681]

Friday night we took my mother to the ER due to nausea, dizziness & being hot, when we arrived the nurse asked my mother if she only wore oxygen when she slept?  Confused we all answered that she never wore oxygen, seeing she is 51 and in fairly good health conditions.  As the evening and next afternoon slipped by we came to find out that my mothers blood oxygen levels were only reaching 80%, but she has no symptoms, no shortness of breath, no blue lips or fingers & no lose of memory.  Today is Wednesday and we brought her home to a house filled with oxygen tanks because there doesn't seem to be anyone that can diagnose the problem.  She has had well over 20 test performed on her anywhere from blood work to a heart cath. EVERY test that was performed has come back negative and that she has a clean bill of health!!!  They thought that it could be her blood gases mixing causing the levels to appear low, but after the heart cath was completed we learned that wasn't the case. They have sent us home today full of false hope, we are having a sleep apnea test done in 2 weeks because they think that might have contributed to the low levels.  She has no pneumonia, no blood clot in the lungs, no pulmonary failure ... What could this be?

[National Jewish]

The first step should be to make sure that the alleged oxygen levels of 80% is accurate.  If the instrument is deemed to be functioning normally, it might still give a falsely low reading in the presence of low hemoglobin, the substance in red blood cells that carries oxygen, especially the hemoglobin called methemoglobin.  Your mother's symptoms are suggestive of carbon monoxide poisoning but this type of instrument usually gives a falsely high oxygen reading in the circumstance of carbon monoxide poisoning, not a low reading as you have indicated.

You should ask if the heart catheterization included an examination for what is called intra-cardiac, in-the-heart, shunting and if the blood oxygen measurements, during the catheterization, were consistent with the oximeter readings of 80%.

You should request consultation with a lung specialist.  Ask that hemoglobin electrophoresis be performed.  If the catheterization did not specifically rule-out shunting, ask that an echocardiogram with a bubble study be performed.  Also ask that pulmonary function tests (PFTs) be performed to rule out chronic obstructive pulmonary disease (COPD), if not already done.  She might also need a high resolution CT scan of the lungs to rule-out interstitial lung disease, which is not apparent on a plain chest x-ray.

Good luck.