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.

OP posted she had liver cancer then edited the post to say she had liver disease. Then in a later post said cirrhosis.

Can you take someone with you who can help you advocate OP? If you go again?

She could just be changing details slightly to avoid being identified

I’m aware she may be changing the details slightly. I was just explaining to the poster I quoted why the pp thought OP has liver cancer.

I don't know what area you are in OP but it does seem tough at the moment. I have a bad sinus infection that was causing severe pain in my face, couldn't see a Dr 2 days in a row, then given appointment with nurse who couldn't do anything. Then sent to the pharmacy who can now apparently prescribe, except no appointments available this week. Told I can go to another pharmacy but when you don't drive and are in pain that isn't very easy!

I wish I had insisted it was urgent when the receptionist did the whole 'we are only seeing urgent ailments', mental note to be more forceful in the future.

Bless you OP, it’s very scary when you have something that you know to be dangerous and 999 worthy and yet you’re discharged from hospital?

Do you suffer with healthy anxiety? Not saying that from a judgmental place, just it is easier to disbelieve medical professionals in that case. + having a life limiting illness like cirrhosis may be making you more health anxious.

Are you feeling very unwell in yourself? It sounds as if you are. Maybe call 111 and explain if it would help you feel reassured?

Wishing you all the best & WELL DONE for your sobriety, huge accomplishment.

Well I wasn't sure of the diagnosis but I knew he was really ill as he was breathing very fast and shallow, looked blue, had a heart rate that was sky high and was sweaty but didn't have a temperature. And he said that he felt like he was dying which I thought was something of a red flag as he's not normally over dramatic. He'd had covid some weeks before but recovered well and then very suddenly got worse again and I knew that fitted with a possible blood clot.

Gosh MrsA well done for advocating and yes surprised he wasn't taken more seriously with that presentation. It's all crazy in hospitals at the moment isn't it. I had an all night sit in a and E recently and I think unless people have seen it it is hard to believe.

They did the basic tests. Then told me I had a blood oxygen levels that warranted a 999 call, literally according to the NHS website. The same blood oxygen levels that previously put me in hospital on oxygen and a drip for a week. This was only in January.

Same hospital, same symptoms.

Forgive me if I am losing faith in the NHS. I know people are doing their best but ffs.

I think this isn't about masking. It's about the overall picture. The nurses and doctors will have been observing your respiratory rate, your rhythm of breathing, depth of breathing, whether your chest expanded evenly, your colour, whether you could speak in full sentences, whether you could breathe in a relaxed posture or needed to splint your chest, or sit forward, etc.

They would have checked your blood pressure, your heart rate, your temperature.

All of those things combined has reassured them that despite a low SPO2 reading, you were otherwise well.

If you don't feel well, and are worried, you should return.

Maybe try some breathing exercises to increase your blood oxygen level, get a home monitor. If there is no underlying problem breathing better may help.

No health anxiety really (I mean I'm worried about the cirrhosis and how crappy I feel at the momentbut I'm not sat there on dr Google). I have no desire to be sat in A&E for 7 hours unless it's needed.

I've called 111 hence the paramedic callout.

Thank you x

I think it’s really unfair to blame the NHS and then say you were “masking”. They made a clinical judgement that you were ok, how were they to know you were “masking”? You were happy enough to take yourself to A&E so I’m confused as to why once there you’d downplay your symptoms?

Its not down playing, as another poster sets out there are a number of involuntary reactions and presentations that will be part of assessment.

OP could have sat there as I said with 'dressing gown of doom' presentation, but her results wouldnt have been different, unless people are suggesting she started faking the breathing, or started faking gasping etc etc

You can sit there and engage with health staff, smile etc, it doesnt mean that no one is going to see you as ill if your bp, heart rate, breathing, other tests are not right.

You can sit there and engage with health staff, smile etc, it doesnt mean that no one is going to see you as ill if your bp, heart rate, breathing, other tests are not right.

Not sure I entirely agree. It is a matter of how ill and whether deteriorating, which putting a brave face on may disguise. The results may be the clinically same but as they do not know your behavioural norm in comparison.

It can't hide objective observations. There is an inherent bias towards 'white health' - medical guides talk about going pale, which isn't necessarily a given. Nobody thought that Sats probes might be inaccurate for people with different skin tones, etc. However, somebody sick will be objectively sick.

I nursed plenty of people in HDU who were chatty and friendly, reading newspapers, chatting to friends on the phone. They were still very sick, objectively.

Have just relayed this to GP husband who is astounded that you were sent home. There is nothing that a GP could do to help in this situation as it is so severe - you need to be in hospital. He would categorise this as a failed discharge and complain to the hospital if you were to appear in his surgery. That said, he’s had everything from a heart attack to a broken shoulder batted back to him from our local A&E recently, so God knows what’s happening out there.

It’s pretty difficult for anyone to know what to say if you have a range of physical and mental health conditions.

But A&E do get it wrong… I was sent home by mistake from A&E and if I hadn’t gone back in and complained and asked to be assessed again that same evening I could have died. Not trying to be dramatic but just trust your instinct.

The thing is if you where hospitalised in January for the same thing and the test came back clear and your fine they won't hospitalise you again for the exact same thing because its just your normal. I have a high heart rate that I was hospitalised for initially I still have that high heart rate but I can't just live in hospital so I now see a cardiologist as an outpatient and have any treatment and tests sorted via him.

I know someone with autism who went to a & e in agony, but masked his pain. He was dismissed and a week later had an emergency op.
I think if you can try not to mask, I wouldn’t. I know it must be hard for you. Do they know that you have autism and do this?
I wish you well.

Sorry you’re feeling so unwell.
Just a thought, is it worth emailing your liver consultant ? They might want to check you in case your symptoms are related. ( close friend has a long term health condition and has done this when she’s had other symptoms and felt unwell ) And may see you sooner than a GP.

OP I want to say well done for your abstinence. Breaking such a difficult addiction is not easy. I think they discharged you because you are not life threateningly unwell. That doesn't mean you are well. For some people, with some health conditions, SATS as low as that are quite standard. It is very frustrating that you can't get a GP appointment when you feel you need one. I moved GP practice - for different reasons, mine gave appalling advice when I was acutely unwell with a lot of red flags. But the new GP is much easier to get an appointment with. Might there be somewhere near you which is better?

this probably doesn’t help much but get yourself a pulse oximeter from Amazon and ensure it is calibrated. Also ensure no gel /acrylic nails on. Rest for 5 minutes and take your reading wait another 5 and do it again.

when I had covid the first time I was told anything below 92 and go to hospital but when I had it for the second time my readings were lower around 89 and I was told not to go, im also asthmatic. My daughters were lower still last December when she had pneumonia and we ended up in A&e but they were happy that she could come home and we keep an eye on it (it improved).

having a monitor at home can be hugely helpful but if they have checked your chest and there is no infection and it is viral then you have to ride it out.

@Lougle by definition those in hdu are very ill. In a and e some are , some aren't. Assuming that those who present as well and chatty are less seriously ill and are lower priority, despite clinical evidence, is very risky.

Absolutely, which is why objective observations are made. If @Predictablenamechange1 told the staff that she is sleeping all day and night and feels very unwell, I would hope that would have been paid attention to.