Asthma/Pulse-Ox meters

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Re: Asthma/Pulse-Ox meters

Postby denvermikey » Tue May 14, 2013 2:20 pm

Teresa Gergen wrote:Did you do a methacholine challenge test or just a spirometry test? A methacholine test will confirm that it's asthma and not something more serious that might require a different form of treatment. Just a spirometry test. My doc has asthma so I was comfortable with her diagnosis. I am trying to get into a test/trial group with NJ right now.
The only times I have had symptoms (tight chest, coughing, wheezing, etc) were my last few climbs last year. All of them afterwards, not during.
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Re: Asthma/Pulse-Ox meters

Postby unclegar » Tue May 14, 2013 3:31 pm

I started feeling gurgling or wheezing in my lungs when I was getting close to the summit of Challenger Point in 2010. I had taken a week off from work and it was my 5th 14er in 6 days. I've always wondered if that was a contributor to the symptom. I noticed the same thing on subsequent climbs and when not climbing. Now I have some wheezing almost daily. I took the methacholine challenge and it was negative. Currently I just use a rescue inhaler if I feel some rattling in my lungs and cough up a bit of phlegm and I'm good until next time. This never happened before 2010. My Dr. thinks I have asthma but I'm not convinced. I don't really have 'attacks'. Just the crud in my lungs until I cough it up. I also don't do anything special before hikes and usually feel fine except for the chest rattling.
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Re: Asthma/Pulse-Ox meters

Postby Mark A Steiner » Tue May 14, 2013 5:03 pm

About 20 years ago I had a PFT and the doc said my function was low. That probably explains why I tire more quickly at altitude. I do not have wheezing and have never experienced attacks - just get winded. Chest congestion associated with uppper respiratory drainage during colds is about as bad as I have experienced.

Teresa's thorough explanation in Page 1 provides good guidance. I have family members with asthma and that affliction is a whole different deal from just being winded. She is right about medication: doctors may dispense inhalers to pacify, not necessarily treat asthma.
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Re: Asthma/Pulse-Ox meters

Postby BillMiddlebrook » Wed May 15, 2013 5:34 am

Just going to a regular doc for what you think is asthma might not be enough. I learned this about 8 years ago after dealing with asthma-like symptoms for a few years and just using albuterol, prescribed by my local doc. Then, I did full-on PFT at National Jewish and was diagnosed with asthma and pretty severe small-airway trapping. While my lung function is still less than 80% of normal, the maintenance medications I use for trapping have definitely helped over the years.

Oh, and I don't carry pulse-ox.
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Re: Asthma/Pulse-Ox meters

Postby bergsteigen » Wed May 15, 2013 10:00 am

I think I have a more inflammatory asthma condition that used to really hamper my hiking trips. Espescially as I have exercise, allergy and cold temp induced asthma. But since I've switched my diet to Paleo (very anti-inflammatory) and started taking over the counter Bronch-aid (ephedrine), I have virtually no symptoms and have never been stronger or faster at altitude. I've had very poor experiences with doctors only wanting to give me more and more medications and inhalers. I prefer my more natural route with only a simple anti-histimine.
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Re: Asthma/Pulse-Ox meters

Postby zdero1 » Wed May 15, 2013 5:23 pm

It certainly wouldn't hurt to bring one. It can be nice to have an objective measurement to provide you with more insight into your physiological capabilities, and you could also relay this data back to your health care team. I'm probably going to bring mine just to see what my 02 saturation while exerting at altitude (I work in sub-acute rehab) on the next hike or two.
Normal range for 02 saturation = 90-100. For people with respiratory issues, normal range is 88-100%. I'm sure my range is lower than normal at altitude.

It's certainly not necessary, but unless you're a minimalist it may be something to consider.
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Re: Asthma/Pulse-Ox meters

Postby Rarefied » Thu May 16, 2013 6:50 am

‘A question for those who know such things. Suppose a hiker measured 95% oxygen saturation at a trailhead at 10,000‘ and then summited at exactly the 14,000‘ mark. While that’s a 14.6% reduction in atmospheric pressure, is there a way to use that known change in pressure to forecast the hiker’s saturation level after having moved up 4,000‘? (It would seem that the hiker would have to be non-asthmatic in order for such a calculation to serve as a valid baseline.)

Most likely a number of unknowns would be involved such as how the given hiker adapts even if non-asthmatic. Still, it would seem there is probably some method for estimating at least a range that the oxygen level on the 14,000‘ summit should be. Should it still be about 95%? Or more like 90%? Or perhaps even 80%? The point is how would either a non-asthmatic -- or an asthmatic -- hiker know that whatever his meter shows at 14,000‘ is good, bad, or indifferent without knowing how to factor in the altitude change?

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Re: Asthma/Pulse-Ox meters

Postby madbuck » Thu May 16, 2013 7:25 am

Rarefied wrote: The point is how would either a non-asthmatic -- or an asthmatic -- hiker know that whatever his meter shows at 14,000‘ is good, bad, or indifferent without knowing how to factor in the altitude change?


Good observation.

I found this table for oxygen saturation:

As well as a neat calculator:

The calculator is pretty cool because it gives you a feel of the impact of elevation as well as respiratory rate and tidal volume. For accuracy, one would want to understand realistic personal numbers and physiological increases at elevation, but it gives an idea of ranges. (SaO2 likely still in the 90%+ range).

Like others said, though, the pain/tightness/wheezing from asthma was always my primary indicator (with childhood asthma, anyway, and now only intense short efforts in dry weather).
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Re: Asthma/Pulse-Ox meters

Postby Rarefied » Thu May 16, 2013 8:19 am

Nicely played, madbuck! That’s what I was seeking but couldn’t find with my own Google efforts. :oops:

I scaled off that first chart and it shows nominal SaO2 levels of ~93% at 10,000‘ and ~85% at 14,000‘ for a drop of about 8%. And since that’s roughly half of the 14.6% drop in atmospheric pressure between the two elevations -- and the chart is fairly linear -- it seems like “Change in O2% level = apprx. half change in atmospheric pressure” might be a crude rule-of-thumb.

It also supports a value I ran across for Everest. After my first post, I recalled reading somewhere that O2 levels way up there have been found to be in the 60% range. :shock: So I Googled that and did find references to that being the case. And, sure enough, the 8800 meter point on that chart lines up with about 63% on the SaO2 level. So that crosschecks well and the above “rule-of-thumb” still seems to be in the ballpark as the O2 percentage drop (from 10k’ to 29k’) is about 32% or around half of the 55% drop in atmospheric pressure between those same two elevations.

Again, thanks for the effort & info, madbuck.

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Re: Asthma/Pulse-Ox meters

Postby sunny1 » Thu May 16, 2013 8:32 am

To the OP, see a Pulmonologist. Get a good work up. A solid diagnosis is key to appropriate management.

I do not have asthma, but had low oxygen levels this winter-spring, have had to wear O2 and had to measure my oxygen levels with an oximeter.
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If you have asthma, I'd agree with other posters who suggest you'll know when your lungs are tight and you need to use an inhaler rather than focusing on periodically checking oxygen levels and responding to those.
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Re: Asthma/Pulse-Ox meters

Postby Wildernessjane » Thu May 16, 2013 6:24 pm

I have asthma and I have used a pulse-ox on the mountain only because I have had access to one. Typically, my saturation level only goes down about 5 points or so at altitude on a 14er. When I was having a lot of problems with allergies and asthma, it dropped down to 78 on the mountain one day and I never would have known it. I was REALLY dragging that day but I wouldn't have realized how much trouble I was in. Is a pulse-ox necessary? Probably not. A peak flow meter would probably meet your needs and it's cheaper. Can a pulse-ox be useful? Maybe it's a lot of fun to play around with (you can have competitions with your friends).
Last edited by Wildernessjane on Sat May 18, 2013 3:35 pm, edited 1 time in total.
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Re: Asthma/Pulse-Ox meters

Postby atbaritone » Sat May 18, 2013 6:11 am

As a friend of Screeman57 (who has posted replies to this subject already) we have taken a pulse/ox into the backcountry on numerous occasions for fun and for mildly scientific research. He has asthma, I don't. We have nearly the same fitness levels and endurance levels. He is 4 years older than me. We both live at 7,200 feet elevation. While screwing around with the pulse/ox, many times his O2 saturation is the same or higher than mine, while his heart rate is the same or lower than mine. This especially seems to be true while moving at or above 13,000 feet. In camp, resting, we are often exactly the same or fluctuating on either side of each other's measurements. His theory is that all his years of wheezing while growing up forced his body to learn how to utilize O2 more efficiently, while I , being a trained singer used to taking large breaths while hardly moving, had more than ample O2 available for the past 20 years of my life.

All conjecture, and ultimately unprovable, but fun to think about while choking down yet another camp dinner of teriyaki noodles and salmon.
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