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

[Predictablenamechange1]

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.

If you're still unwell and don't feel need further review after A&E discharged you I'd persist with trying to get a GP appointment.

Ultimately if you attend A&E with a presentation that they feel should have been sorted by your GP they may (especially when busy) not fully examine you/essentially exclude immediately life threatening cause of your symptoms and then discharge you for GP to undertake the next tests.

If your saturations are normally >96%/no respiratory problems normally then if they've discharged you with saturations persistently averaging around 90% then I would find that unusual as you're indicated for supplementary oxygen at that level. However if you're a heavy smoker for example further testing may have satisfied them that the low sats are now normal for you due to the lung damaged caused and that you can be left with sats of 90% being normal for you. But this should have been well explained if this was the case (i.e. tell you you've been diagnosed with COPD/emphysema).

OP, do you have someone who could go back with you to advocate for you while you’re there? It’s hard to really say much else because no single test should be used in isolation. It’s about building up a clinical picture using all the information available. Sats of 90% are not within normal range unless you have COPD though, so I would be wanting to know the reason for that has been properly investigated and a treatment plan put in place. If you haven’t had that and you feel like something isn’t right then you need to go back or go to a different hospital. And take someone who can advocate for you.

I am autistic and while I appreciate everyone is different, my autism never stopped me from seeing that in order to get the outcome I am hoping for, I need to give accurate information.

I don't. I have cirrhosis and I have twice yearly checks/ultrasounds etc. It's been looked into very thoroughly. Just at the moment I'm feeling very unwell due to the low blood oxygen.

I'm really not up for dealing with troll hunting right now.

If you feel you are not being listened to can you take someone with you to advocate on your behalf? There will be discharge notes, probably via nhs app.

I agree. My dad was sent home from a&e one morning after being diagnosed with a chest infection. Despite not being able to walk, my mum took him home, as was doing what she was told. I lived an hour at the time. That evening, when my dh got in from work, I drove up to see how he was (we had young dc). Luckily, being a qualified nurse, I was able to see he was very ill, did he observations etc and rang an ambulance. They took him in but were told by a&e not to go as we could probably take him home. Umm, no, it's not happening. The next day went in. He was still ill. It was only me questioning them further. They did more tests and found it was not a chest infection at all, but encephalitis. He is lucky to be alive.

You know what they say: if you’ve met one person with autism… you’ve met one person with autism.

I gave accurate information but I did it with a bright smile and being talkative etc. So they thought I was fine. I realise this was a mistake.

@Predictablenamechange1 if you don't feel "right" go back.
It's a long time to wait until Monday morning and be able to contact your GP.
Be completely honest to the drs about how you feel.
Take someone with you if you have someone who can.

I was replying to your comment which stipulated that I don't know anything about autism. Please do let me know how my experience of autism means I do not know "anything" about autism. I guess what you meant to say is that I don't understand anything about the OP's autism which would be correct but then neither do you because it is impossible to fully understand another person's experience even if you have the capacity to consider that their experience may be different from your own.

I had similar and that was at a hospital in Canada in which I was paying for treatment. I had glandular fever and an oxygen level of 82%. They still discharged me as I was young with no underlying conditions and otherwise expected to recover.

You know, I’m on this thread to try to help the OP a little. Your comment wasn’t particularly helpful; in fact it came across as quite accusatory. If you want to fight with someone you’ll need to look elsewhere because I don’t wanna play.

the context is everything here though and no one on MN has any of the information needed to say whether it seems a sensible decision or not. The cirrhosis may well be a bit of a confounder and means that the sats need more than mumsnet level interpretation. If you have a contact in your liver team then it may be worth getting in touch with them as another option.

When my son was critically ill they had him on fast flow oxygen in the icu as he wasent msintaing his oxygen sats, they were talking about putting him on a ventilator as his sats kept dropping below 90 so im not sure your advice is correct .

I’d absolutely seek a second opinion and have done before. Especially if you’re not feeling great and that’s not your usual sat levels.

OP@Predictablenamechange1 has anything else changed or got worse recently? Any issues with swelling in your abdomen or in your legs? Do you already take any meds for any associated conditions eg.diuretics, BP tablets? Sometimes when you get abdo swelling it can impact on your breathing pattern and make it harder to take a deep breath. I think it can be hard when you are stage 4 for people to see past the “stage 4 diagnosis”…if you are still working and normally active and independent they may not appreciate this is not the norm for you.

In what way are you masking, you're sleeping all day and turned up to hospital, so what is being masked exactly?

I don't smoke and never have.

I didn't want to get into this as I'm inevitably going to be called a troll or called out

I had paramedics called around the other day and after their checks they thought I may have a collapsed lung. They tried to get me to go to hospital there and then but for some stupid reason I refused. I was just too tired.

I told the hospital this but they didn't do any follow ups other than the blood oxygen levels.

I'm just scared of dying. Well not dying per se, dying painfully.

Hey OP

I think you should keep on seeking help. The whole way you’ve written your posts is apologetic and I understand why but you need and deserve proper medical attention.

Sorry OP this sounds awful

Could you purchase a small Sats probe for occasional checking over the weekend ?

Get some rest , eat a little and sleep as you need to

When you feel up to it - please take the time to write down your exact symptoms and sats results , in full - exactly how you feel and what you've been going through

Take that to GP Monday and let them read it

Seems like you need a full assessment, not just snap shot recordings which are quite inaccurate at best

And as you obviously know your own body well - if things are not good , you feel worse , have any chest pain , shortness of breath , pain /redness /swelling in calf or anything else troubling please call 111 or go back to AE

Good luck OP💐

But you weren’t ’faking being ok’. You had taken yourself to A+E. Where I assume they did some tests, the results of which can’t be faked.

not a doctor but I am a mum to a NICU baby who had breathing issues, and it was quite common for her to be in the 90s. When she had a chest infection recently it was back in the 90s and we were sent home with antibiotics. When the o2 sat level was in the 80s they were concerned. I hope you are feeling better/getting the help you need.

I see what you meant by masking in later posts OP

But you can present your symptoms in a manner which is ok, its then for them to see what the symptoms are by testing and taking note of what they are

Theres no need for a dressing gown of doom presentation to say you're ill, that would be performative.

The guidelines say to seek advice, you did seek advice and they have reviewed you and sent you home, it now needs follow up by the GP with referrals presumably to the right departments, presumably about this possible lung issue.

But A+E as others have said is for accident and emergency, so they're not going to keep you there, or admit you to another ward if theres no medical need for it.

@MrsAvocet Gosh I'm so pleased you didn't give up.

What made you sure it wasn't a chest infection? I was misdiagnosed as having a PE last year and told it was a chest infection and now each time my asthma "goes to my chest" or I have a sore leg I am so anxious it could be a PE and is missed. I have several risk factors but they always.seem to assume I'm fine due to age 🙄.

first job many years ago after graduating as an engineer was as a design engineer for a manufacturer of medical instruments, my area of expertise was sphygmomanometers - blood pressure meters (in fact I have my name on a couple of patents on aspects of them).

Just like pulse oximeters they are plagued with accuracy by the way they make an imperfect external "connection" to the patient.

With a sphygmomanometer, even with the right cuff, perfectly fitted you can be +/- 2 to 5 mmHg each end depending on the patients physiology and operator skill.

Pulse oximeters likewise can be influenced by skin tone / density and so are not 100% accurate.

90% is not emergency territory, it might warrant further investigation if the physician suspects a sinister cause, into the 80's of concern, 70's immediately very worrying etc...