COVID-19 vaccines: medical concerns and recommendations

[Nephrology]

I got my booster on Saturday, it was drama free.

I'm rounding out my last week with surgery but our hospital doesn't seem to be getting crushed by waves of COVID patients. We did cancel a number of elective cases on the service I am on however so has been a slow 2 weeks.

[Caballoflaco]

Any thoughts from medical folks here on the value of otc pulse-oximeters for people diagnosed with covid monitoring themselves at home?

[0ddl0t]

Any thoughts from medical folks here on the value of otc pulse-oximeters for people diagnosed with covid monitoring themselves at home?

From the prior covid thread:

My suggestions are as follows:

Stay home,

if you don't already have a pulse oximeter, see if someone can pick one up for you. Use it and your thermometer once a day to make sure your oxygen levels are good and you have no fever

Take tyelenol for fevers and headaches if you have them.

If they are persistent or worsening or of your oxygen level is consistently below 94% seek advice from your doctor.

Also take Vitamin C, Vitamin D, and zinc.

Sleep on your stomach if you can.

Don't make your favorite meals... especially of your sense of taste goes. Use that opportunity to load up on all the healthy stuff you'd never eat otherwise. Definitely don't drink alcohol. It will probably make your symptoms worse.

If you feel short of breath, call your doctor for advice. If you get swelling, pain or redness in one or both of your legs, call your doctor.

And get well soon

Back in March CrowHunter suggested an oximeter might not be worth it unless it was “medical grade”. Any guidance on how much one would need to spend to get useful measurements?

I wouldn't stress about it too much unless you have very bad peripheral vascular disease. Our employee health department sent me one that is basically the Walgreens version. it does display a waveform and a heart rate alongside a numerical reading.

The key to interpretation of a pulse ox is to ensure the waveform is consistent. It should look like the teeth of a saw and if you were to check your heart rate, the pulse ox heart rate and your manual heart rate should be similar. You should not be getting a reading of 40/min when you check your own pulse and it is 80/min.

I look more for a trend. If my SpO2 is initially 98 and it is down to 94 or 93 a week later that is a less good sign than if it were to stay consistent.

the AMZN ones seem fine enough. It's not like the hospital is spending much more. Like you point out trend is probably more important than absolute value.

I would like to take this opportunity to mention that I am not a Dr. nor have I ever played one on tv or stayed in a Holiday Inn recently. So I would NOT rely on my anecdotal observations of my own situation. 😯

I can tell you that my spo2 level was potentially below 90% but I did not really take notice of the dyspnea until I almost blacked out digging a hole with a pickaxe. I still, very stupidly waited until the next day to go to the ER because I noticed labored breathing while walking across the parking lot at work even though I suspected it might be a PE the night before because of the leg swelling and not feeling "right". It was in the mid 80's by the time I was admitted iirc. That could have killed me.

I might not have waited so long if I had a way to check my sp02 level.

If you have shortness of breath, don't fuck around. My co-worker that died last night waited after he first started having dyspnea for a couple of days to get over it before he went to the ER. He was on a ventilator almost immediately.

Not for nothing but we've seen a lot of patients with what we've come to term "ambulatory hypoxia".

This is a very broad explanation of why and Neph can give the exact specifics (correct me if I'm wrong) but your oxygen levels (PaO2) are low while your pCO2 levels are not high enough to trigger your body to notice that something is quite off.

See your body has chemical receptors for when your carbon dioxide is high. That's why when you hold your breath, your body will freak the fuck out, but if you get carbon monoxide poisoning, you won't notice until you're dead. The CO2 doesn't go up in carbon monoxide poisoning, you just have low oxygen levels.

The lungs are really quite excellent at getting CO2 out of the blood, sometimes even when they can't quite get you enough oxygen.

Because of this, the first place you'll notice profound hypoxemia without hypercarbia (elevated CO2) is going to be the brain, and usually it's because the brain says "I don't have enough oxygen so we're going to stop everything until I do"

Sent from my moto g(6) using Tapatalk

Very little to no relationship between hypoxia and dyspnea(shortness of breath).

That's why airplane decompression kills. Oxygen drops but you don't feel shortness of breath, and thus don't recognize the emergency.

Edited to add:

That's why some people recommend hypoxia as a way for execution of prisoners. No pain or discomfort.

This thread might cost me $20. Thoughts?

https://www.amazon.com/Oximeter-Fing...dp/B07QMQV3NY/

https://www.amazon.com/Oximeter-Fing.../dp/B0873BTNWD

Try something like this instead. See how it has the section where there is a little saw toothed wave? Each peak corresponds to a heart beat, but more importantly, if the wave isn't a regular wave...if it looks janky and uneven...then the numerical reading you get might not be correct. It's a way some pulse oximeters have to show interference/artifact.

My uncle and his wife seem not to be fit to make their own decisions. Yesterday my dad went to town and bought him a pulse oximeter. This morning his oxygen saturation dropped into the low 80s, so they went to the after hours clinic.

Thanks for that. I just ordered one.

I ordered one as well

[Bergeron]

I got my booster on Saturday, it was drama free.

I'm rounding out my last week with surgery but our hospital doesn't seem to be getting crushed by waves of COVID patients. We did cancel a number of elective cases on the service I am on however so has been a slow 2 weeks.

My current understanding is that waiting 8 months between the last of the two-shot series provides best protection- what would be your take on that position?

I want the booster, but I want it at the most optimum timing.

[pangloss]

My current understanding is that waiting 8 months between the last of the two-shot series provides best protection- what would be your take on that position?

I want the booster, but I want it at the most optimum timing.

Your question wasn't directed at me, but there is no data available to support any answer. In other words, there's no way to know what would be optimal. A lot of people at work, myself included, were immunized in Jan/Dec. We started seeing breakthrough cases in July (six months after the second dose of vaccine). On average, people in my small cohort have lost 90% of their antibody between March and July/August. We're finally starting to generate some T cell data, and that doesn't look encouraging either. If you have a lot of community transmission in your area, I think the best decision would be to get the boost at six months instead of eight months. I don't know of any data from any system, that says there would be a difference in response to vaccination resulting from this sort of interval change. Testing differences like this would be expensive and likely not provide much useful information.

[Caballoflaco]

@0ddl0t thanks for posting that. I’ll run one by a recently diagnosed unvaxxed friends place tomorrow, and grab one for myself to have around just in case.

[Bergeron]

Thank you, @pangloss

Isn't modern biological warfare interesting?

[RoyGBiv]

From the prior covid thread:

And the award for "Most useful and thoroughly comprehensive multi-quote goes to....."

Seriously, that was epic.

[HeavyDuty]

And the award for "Most useful and thoroughly comprehensive multi-quote goes to....."

Seriously, that was epic.

… and it inspired me to order one.

[4given]

Any idea when the 3rd shot will be offered to those of us who are 60+? I had me second dose of Pfizer mid Feb.