Blood oxygen levels of 90 - is the NHS being crap here?

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I just spent 7 hours in A&E. I can't get a GP appointment which is the only reason I went to the hospital. I'm sleeping pretty much all day every day, feel really unwell and have been admitted previously due to dangerously low blood oxygen levels.

This time I tested at 90. According to the NHS site that means I need to call 999. Yet I was discharged. What do I do from here?? I can't work at the moment as I'm sleeping practically all day and night. I want to get better but how do I do that? The last time they took me in they gave me an oxygen mask and a drip which really helped.

I'm missing my sister's hen do at the weekend because of this. I'm just so frustrated.

I’m sorry you’re so unwell. But no one here can give advice. We don’t know your full medical history and current details. But you have to trust that the emergency dept. did have all that info. If they feel you don’t require admission then they must be taking everything into account and not concerned you are at risk of imminent deterioration or require any treatment that needs admission. You may well feel tired and unwell with your current other diagnosis. It’s worth seeing your gp again to go over everything with them. I understand some people have difficulty accessing primary care but I would imagine your surgery would expect you to call more frequently and should be able to offer you an appointment if required. Hope you feel better soon.

I'm going by the NHS guidelines.

Guys I wasn't asking for advice. More having a whinge. My GP is so hard to get an appointment for and out of desperation I went to A&E and here I am, still the same situation.

What are your usual sats levels?

The guidelines say seek medical attention. You have, and the medics have decided you’re not in immediate need of treatment and have asked you to go to your GP. If they thought you needed treatment for something now, or your tests/obs were abnormal, then they would have done something immediately.

I'm so sorry, OP.
I didn't realise you were autistic and meant that kind of masking.

It's just weird that last time I went in, for exactly the same thing, they kept me in for several days.

It's fine. I can sort myself. Just find it a bit crap.

You don't think health care professionals ever make mistakes?
If I had been that trusting my husband would be dead now. We were told he had a "bit of a chest infection" and told off for being timewasters. He actually had two massive pulmonary emboli and ended up in Critical Care within a couple of hours of us basically being told there was nothing wrong with him. The Consultant told me he would probably have died in the night if I had been a good girl and taken him home like I was told to.
OP, do get another opinion if you don't feel better very soon.

Ahhh whinge away then, because frankly it sounds rubbish and I really feel for you. I have quite severe asthma at times and I know how much lack of oxygen impacts on quality of life (um for lack of a better way to describe it!!!)

Bizarrely, breathing problems don’t seem to be taken that seriously unless you’re actually in the process of suffocating. A few winters ago I was unable to walk and talk at the same time without absolutely gasping for breath, and I had to practically beg the practice assistant to ask my GP about it. (Fortunately he saw things differently to her and called me back the same day!)

Call again on Monday and keep calling until someone agrees to give you an appointment. It’s absolutely OK to “make a fuss”. Who cares if anyone thinks you’re making a fuss? Not getting enough oxygen is absolutely exhausting and not something you have to put up with. Be the squeaky wheel 💐

@MrsAvocet i think they know more about OP than you. And yes I think they know more about healthcare provision than you. You knew your husband so represented with him which is fine, there’s always that option. Often when patients represent its because the complaint has now worsened and the diagnosis is more clear. Doesn’t always mean the dr at that time is better than the previous. It’s fine to tell your experience. It won’t be everyone’s but it’s not that uncommon either. If people are sent home and they worsen then they go back. That’s normal.

If you are black or brown then the readings are incorrect. And treatment can be delayed as a result.
just adding here in case it’s if use to anyone now or in future.

https://www.nature.com/articles/d41586-022-03161-1

@Rummikub thank you for that, it’s so obvious once you think about it but I wasn’t aware. (It doesn’t apply to me but I shall spread the word!)

DH has just been discharged after 8 days in for pneumonia. His sats - double checked many times arterially - were 82 without support, 92 on high flow oxygen. He was kept in until he could maintain 93 without support. His BP was through the floor, hr very high and fever of 39.

He has slept and slept and slept since discharge.

He had immediate chest x-rays, then CT scan and swabs/sputum tests for type of infection.

Did they say anything about why they think your oxygen is low? DH's entire care was based around the diagnosis of double pneumonia and improving sats sat alongside treating the infection.

Why do they think you have lower oxygen levels?

Yes please do! I mention it whenever I see a doctor. Many are not aware. I think my dad was undertreated as they just kept going off the figures

Please say you're not a medic!

Many things affect accurate pulse oximetry measurement. I wonder if your previous admission and tests mean that the 'normal range' for you has been assessed to be different to the norm - this can happen for people with various conditions - e.g cardiac conditions/COPD

"Most pulse oximeters are accurate to within 2% to 4% of the actual blood oxygen saturation level. This means that a pulse oximeter reading may be anywhere from 2% to 4% higher or lower than the actual oxygen level in arterial blood.

A number of factors can impair the functioning or accuracy of a pulse oximeter. Nail polish and artificial nails may block the red and infrared light emitted by the device. Certain dyes used for diagnostic tests or medical procedures can also hinder light transmission. Excessive motion—shivering, shaking, or other movement—can also cause erroneous readings.
Skin temperature and thickness can also reduce the accuracy of pulse pulse oximeters, and whether a person smokes tobacco can affect the device’s accuracy. Pulse oximetry can be less accurate for people who have dark skin pigmentation. Recent evidence suggests that pulse oximetry more frequently fails to detect hypoxemia—low blood oxygen levels—in Black patients as compared to white patients"

https://www.yalemedicine.org/conditions/pulse-oximetry#:~:text=Excessive%20motion%E2%80%94shivering%2C%20shaking%2C,can%20affect%20the%20device's%20accuracy.

Not a medic but I think some of the answers on this thread are quite dangerous.

You should definitely be checked out in a hospital with blood oxygen levels of 92 or less. Hopefully they did an arterial blood gas and other tests to see your blood ph and dissolved carbon dioxide levels.

However, OP, you do seem a bit secretive about your conditions and what they actually did at the hospital.

Do you have a discharge letter?

If you are genuinely at 90% consistently, I would have thought you would need oxygen, either at home or in hospital.

If they did tests and explained why you were being discharged, then YABU. If they were complacent and didn’t test you properly, then YANBU and should go back and ask for proper tests.

I feel for you. It’s horrible feeing ill and exhausted and knowing something is wrong but having now answers. If you can pay private do. If you can’t tbh you need to go to a different a&e and ACT the way you’re feeling. It really is the only option - I have had on many occasion had two very different responses from drs when masking compared to acting the way I feel. The problem remained the same but one got me being told I require treatment, the other had me shooed out the door.

I'm not being secretive so much as embarrassed.

I have cirrhosis. Abstinent now for a long time but obviously it has lasting effects (well, I'm stage 4 so that's pretty much it)

I also have many mental health diagnoses (BPD, OCD, CPTSD, bipolar, autism) which may explain why I struggle sticking up for myself/fighting my corner in situations like this, and maybe making myself clear on this thread.

They didn't provide a discharge letter. They don't do that when you're discharged from A&E. They just did the standard tests (as mentioned above). I think it's because I can come across as perfectly well even when I'm not.

Sorry your not well OP, we have a small oxygen sats monitor at home ,cost about £15 and Dh who is not well uses it a lot.

It helps us to decide what to do medically wise.

hope you get some answers and feel better soon.

Please don’t be embarrassed OP. Ill health is ill health, there’s no blame to be placed. As I said it sounds rubbish. I’m not surprised you’re struggling with all of this. It can be hard enough to advocate for oneself at the best of times, and when you’re ill it’s certainly not the best of times!

Well, if you are masking then how do you expect them to know that you are not feeling well? Reminds me of my friend who was complaining about her GP never testing her for sleep apnea even though she wakes up gasping for breath. I asked her if she mentioned it to her GP and she said she didn't...

It's strange you have liver cancer and they haven't looked into this further.

Erm do you know anything about autism? Apparently not.

Liver cirrhosis is not cancer.