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What Could Cause Variations In Oxygen Saturation Level While Monitoring A Tumor Like Growth In The Lung?

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Posted on Thu, 4 Jan 2024
Question: Hi, my husband is 88 and was hospitalized in Nov as he was coughing up blood. He had aprox. 8 oz of fluid between his lung and lung sac. Within 1 day his body absorbed the fluid. He was on indomethacin 50 mg for gout after getting an expired rabies vaccination and then getting another non-expired rabies vaccination the next day last summer. His gout flared constantly there after. He was taken off indomethacin after hospitalization and put on prednisone I use only for gout flares. It was prescribed 10 mg a day, but his gout flares have decreased over time since Rabies vaccination Over Dose. They didn't find anything else and discharged him after 3 days. In Dec. he coughed up blood again, but refused to go to hospital. Dr couldn't get him in for 2 months. I gave him prednisone, he has for gout flares, as though I was treating gout. That was the only extra med they gave him in the hospital. It seemed to help and after much ado the lung Dr. got him in the day I called his primary and informed them he couldn't wait 2 months so I began prednisone. Lung Dr. said to continue treatment I began. He ran tests and found a small tumor or cist in lung and said he wanted to watch it and if it's still there in March biopsy. He was on oxygen at night ( he smoked until he was 82), and his saturation was over 90 awake. His saturation has gotten erratic over the last week and sometimes awake will drop to 83 then sometimes it's 95. It drops even without exertion, but not always. My husband is a great man, and served our country in WWII. I know he's old, but would do anything to buy him some more quality time. He is my world and I can't stand the thought of loosing him. Do you have any explanation for what could cause variation in oxygen saturation? Do you have any advise? Would giving him the 10 mg of prednisone daily help?
doctor
Answered by Dr. Vidya KR (4 hours later)
Brief Answer:
Breathing exercises

Detailed Answer:
Hi,

I need some more information to help you in better way.
On how much liters of oxygen he is on?
Have you increased oxygen concentration?
Change in saturation level is associated with any changes in his pulse rate, consciousness?
Variation in saturation level is it sudden drop or gradually reduced ? and how long it lasted?

In a person with history of smoking there is a condition know as COPD, commonly seen.
In a patients with COPD, as its a chronic condition, body would have adjusted to reduced level of saturation, upto 90, oxygen saturation in them is acceptable with oxygen supply.
Regular breathing exercises will help his breathing capacity and saturation too.

Prednisole is useful in few situations to get time to analyse condition and start appropriate treatment.
Its not a correct treatment for his condition. underlying condition needs to be identified and treated accordingly,
Prednisolone if taken for more than a week causes dependencies and should not be stopped suddenly. Needs gradual reduction in dose to stop it.

Hope this helps you.
Feel free to ask further related query.
Wish him a good health.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Vidya KR (57 minutes later)
Hello and thank you for being there. Sorry for jumping right in before I'm very worried. I am excited to have a place like this and think it's incredible. I am even considering getting a smart phone for use here and I've never even had a cell phone. XXXXXXX is on 2 liters of oxygen at night. He didn't need it in daytime before. We saw his primary care Dr. Renderler on 3-11-14 and they walked him and couldn't get saturation to drop below 91. The last week and 1/2 his saturation is sporadic in day time ranging from 83 to 95 even at rest. I kept the liters at 2 and am putting it on him when saturation drops checking every 15 min to 30 min when it's off. At 2 liters his saturation is 95 and seems steady. After testing his lung Dr. XXXXXXX said XXXXXXX didn't have COPD on 2-5-14, however he said XXXXXXX has a small cist that wasn't there in Nov. 2013 and wants to check it again in March 2014. XXXXXXX was given an expired rabies vaccination in July of 2013 and had to have another the next day. His gout only flared once a year prior to that, but after flared constantly until recently. He was put on indomethacin, but was taken off that in Nov. 2013 when he was hospitalized coughing up a small amount of frothy bright red blood. They said indomethacin at that dose could cause internal bleeding. XXXXXXX had 8 oz. of fluid between lung and lung sac. They couldn't get a sample with needle because of location. He absorbed the fluid overnight and we opted not to have surgery as his breathing wasn't inhibited nor did he have an infection, so there was no sample of fluid. His new prednisone prescription is for 10 mg daily. XXXXXXX coughed up blood in Dec 2013 again, but refused to go to hospital. The pharmacist said as gout flares have decreased to go back to old use of prednisone for occasional gout flares, 30 mg for 3 days then 20 mg for 3 days then 10 mg for 3 days then 5 mg for 3 days, until we see rheumatologist again. His inside ankle and left calf are swelling now too. He is resting with feet & legs above heart and I can't reach primary care Dr. until Monday. His liver and kidneys tested good in November, in spite of consuming around 12 oz. of whiskey almost daily most of his adult life. I don't know if swelling (edema?) could be related to oxygen saturation. When I push ankle it takes 30 seconds for finger prints to disappear and it feels squishy. Should I try to take him to hospital or wait until Monday and call primary? He isn't in any pain and feels normal. He agreed not to drink alcohol until swelling subsides and has gone with out booze and didn't have DT's recently. Will alcohol affect swelling? Could this be gout and should I give him prednisone for treating gout as mentioned above. He always rallies when he gets steroids, but I don't know if it will hurt with the swelling. P.S. What kind of breathing exercises, deep breathing or in to 5 count hold 6 count exhale 7 count or something else? Thanks again
doctor
Answered by Dr. Vidya KR (1 hour later)
Brief Answer: ECG and cardiac enzymes to be done Detailed Answer: Hi, thanks for follow up query. saturation is maintaining with oxygen and dropping on discontinuation shows need to continue oxygen treatment. As he is on 2 lit you should not stop giving oxygen, you need reduce oxygen to 1 and half lit and see for saturation,let him at same oxygen concentration for 3 hours, if he maintains saturation well, then you can reduce oxygen still further to 1lit. repeate the cycle to make him feel comfortable at room air. Breathing exercise to increase his lung function like deep breathing, as much as he can, slowly increase duration of breathing. Presence of edema remaining after night sleep signifies cardiac problem, could be cause for low saturation too, better to get him toER and get ECG and cardiac enzymes done, chest examination also. Hope this helps you. Wish him a good health Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Vidya KR (39 minutes later)
Thanks I will try that. Hopefully he'll have a miraculous recovery overnight and we won't have to go to ER. He's itching like crazy now all over torso so I'm signing off and going to rub some hydrocortisone on him. Thank You, XXXX
doctor
Answered by Dr. Vidya KR (7 minutes later)
Brief Answer: Antihistamine cream. Detailed Answer: Hi., thanks for follow up query. I am happy for his recovery and wishing him a good health. Antihistamine cream will be a better option for to reduce itching. Hope this helps you. Feel free to ask further related query. i will be glad to answer them. If satisfied with my answer close the query and rate it. Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Vidya KR (11 hours later)
Is antihistamine cream a prescription or over the counter? If it's a prescription can you phone it in? XXXXXXX uses Safeway Pharmacy south and their # is (719)561-4407. I have a camera on computer, but no smart phone. He has little red bumps (like pimples not hives) and areas that are real red from scratching I think. I could try to get pic on computer and send, but I haven't got a smart or cell phone. Thanks, XXXX
doctor
Answered by Dr. Vidya KR (9 hours later)
Brief Answer: Need Description of lesions Detailed Answer: Hi, thanks for follow up query. I need few more history regarding lesions, wen did they start, where are they present, wat are all treatment you have tried? itching is present 24 hour or only particular time like day. or night. Is there any white scaly things over lesions, or does it appear like a dry skin. Examination of lesion required for concluding lesion,try to upload a pic, if possible. Get back to me with these description of lesions. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Vidya KR (48 hours later)
Hi, I am sorry it took so long to respond. I can't figure out how to use camera on computer. A friend is coming by tomorrow to help. I would like to send pics. Dan's itching is constant, he even scratches in his sleep. We went to Dr.'s for 2 years and got no where with rash. A acupuncturist said she thought it was candida, but we couldn't get a prescription for thrush medicine for 2 months. No one ever biopsied and we gave up. It seems when I give him 2 ounces of colloidal silver a day itch goes away, but when we stop colloidal silver it returns with in days. We use hydrocortisone, calamine lotion and a script he got triamcinolone cream .1%. I use the triamcinolone on arms as his skin is so thin there and hydrocortisone thins skin. We use hydrocortisone on torso and legs. I'll send pics as soon as I figure camera out. Thanks, XXXX
doctor
Answered by Dr. Vidya KR (4 hours later)
Brief Answer: continuous use of steroid is not recommended. Detailed Answer: Hi, Thanks for follow up query. Continuous use of steroid ointment is not good, as it causes skin thinning and other problems. These local application what you are using are not useful for fungal infection. Once you upload picture it will be easier for me to help you better. Regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Vidya KR

General & Family Physician

Practicing since :2011

Answered : 1664 Questions

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What Could Cause Variations In Oxygen Saturation Level While Monitoring A Tumor Like Growth In The Lung?

Brief Answer: Breathing exercises Detailed Answer: Hi, I need some more information to help you in better way. On how much liters of oxygen he is on? Have you increased oxygen concentration? Change in saturation level is associated with any changes in his pulse rate, consciousness? Variation in saturation level is it sudden drop or gradually reduced ? and how long it lasted? In a person with history of smoking there is a condition know as COPD, commonly seen. In a patients with COPD, as its a chronic condition, body would have adjusted to reduced level of saturation, upto 90, oxygen saturation in them is acceptable with oxygen supply. Regular breathing exercises will help his breathing capacity and saturation too. Prednisole is useful in few situations to get time to analyse condition and start appropriate treatment. Its not a correct treatment for his condition. underlying condition needs to be identified and treated accordingly, Prednisolone if taken for more than a week causes dependencies and should not be stopped suddenly. Needs gradual reduction in dose to stop it. Hope this helps you. Feel free to ask further related query. Wish him a good health. Regards