From the Desk of Robin Ellen Leder, M.D.
The most important thing I wanted to share with you, though you may well be familiar with it from the news, relates to how the disease (at its worst) progresses, and how to monitor your status and more accurately time the need for aggressive intervention. Actually, again, one of my amazing patients shared an article he read about this in the news, and I will share the link for the whole article with you. In essence, it makes clear that, well before the symptoms of the disease become critically severe and call for hospitalization and ICU level care, a good deal of destruction to the lung tissue and function may have already occurred while symptoms are mild. This damage to the lungs slowly and silently may begin to impair the transfer of oxygen into the body via the lungs (i.e., impeding their very function), potentially ultimately destroy in the tissue beyond viability/functionality completely. This explains why those put on a ventilator when in need, due to severe shortness of breath, too often end up succumbing to the virus, never to recover. Apparently, it is not really ventilation that they need at that point; what they need in fact is viable lung tissue, something no machine or medication can provide.
In order to prevent this downward slide into dramatic consequences, the article points out that, prior to the very grave destruction phase, the "early onset of destruction" phase is detectable by the use of a pulse oximeter, a fairly inexpensive device that readily monitors ones “blood gas” level, i.e., the level of oxygen circulating in their blood. This simple device, which clips onto the finger, can be used at home as soon as someone has ANY of the symptoms that may make them suspect early coronavirus, be it a cough, sore throat, headache, or diarrhea. Because it is so easy to use - and non-invasive - there is NO GOOD REASON not to test it repeatedly, until and unless symptoms go away. It does appear that even when oxygen saturation (level) in the blood starts to decline, a person may well have no idea that there is any problem, as they may simply compensate for this with deeper and more rapid breathing. And the change may occur so imperceptibly and slowly that it is not noticeable to that individual or even to those around them. By the time breathing becomes severely labored, the person has already suffered considerable damage to the lung tissue, often so severe that recovery becomes difficult or impossible.
Here is the article to read in its entirety:
https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html?action=click
The point: it is probably well worthwhile to buy a pulse oximeter, and use it to evaluate whether you need to start to institute any therapy beyond normal flu or cold measures. It is an especially good idea if you or anyone in your family is in a higher risk category, where additional monitoring is warranted and may be life saving.You will immediately note that the article does not go further to say what to do once you see that the oxygen saturation is indeed dropping. It only tells you that this is an early warning sign that real trouble may lie ahead and prompt action should be taken. It seems to me at this time that the decline in oxygen saturation, if noted, should trigger the use of any or all of the protocols that we have discussed in our prior emails, or a trip to the hospital, asap, depending on one’s underlying health status, other symptoms, and age.
OK, this is what I wanted to share. If you have questions about this or anything else, as always, be in touch. Share any of your own thoughts, we are a smart, open-minded community of true health experts. I always enjoy learning from you, and will make an effort to pass your wisdom on to others when you share it with me.
Stay safe, stay strong, stay smart, stay healthy, stay aware!!!
Dr. Robin Ellen Leder