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How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Dennis S
Date: August 08, 2019 02:50AM
I asked my doctor. He said, "Beats me." My hematologist doesn't have an answer. Since my hemoglobin was at 7.1 and all through its rise to a current 11, my pulse ox has been right at 99. Yet I'm always short of breath. My pulmonary tests and chest X-Ray were OK. My lungs are clear.

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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Sarcany
Date: August 08, 2019 02:58AM
Are you having general muscle-weakness?

Could it be that your chest and diaphragm aren't moving enough to make it feel like you're breathing deeply enough?



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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: RecipeForDisaster
Date: August 08, 2019 06:09AM
This isn't an explanation, but if you're anemic, pulse ox isn't that helpful because it's reading the saturation of the red cells you DO have. They might be fully saturated with oxygen, but there aren't enough of them. The hematologist should have explained that... sure would make sense while your hemoglobin was 7. Pulse ox can be unhelpful.

Shortness of breath can be a tricky thing to chase. In my case I get it from having a very low blood pressure, so there's little that can be done about it. So many factors can cause that sensation.
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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Speedy
Date: August 08, 2019 08:22AM
What RFD said. You are now out of shape from lack of exercise as your Hgb was plummeting. Likely your doc will keep you at around 12 because there is a risk of stroke as it increases (most of us are at 15-16.) Might not be a bad idea to ask if you should be on low dose aspirin. The feds don’t like to pay for Epogen/Procrit for Hgb above 10 due to the stroke risk in dialysis patients (obviously not your case but insurance companies follow Medicare rules on this because erythropoietin alpha is expensive.)



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Edited 1 time(s). Last edit at 08/08/2019 08:23AM by Speedy.
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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Filliam H. Muffman
Date: August 08, 2019 08:28AM
Your iron-deficient blood is fully oxygenated. It means your blood has a lower level of oxygen reserves. It limits how much oxygen can be supplied to muscles and the brain, and how fast CO2 and other metabolic waste products can be removed.

Have you had a full stress test recently? Did you have a complete lung capacity test run? If so, how do you know how you compare to the average for your age group? I don't know if a weak nerve signal to your diaphragm--or weakness in the related muscles--would necessarily show up as a low oxygen saturation.



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Edited 1 time(s). Last edit at 08/08/2019 08:29AM by Filliam H. Muffman.
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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Dennis S
Date: August 08, 2019 01:05PM
"Your iron-deficient blood is fully oxygenated."

I'm not iron deficient. Nor B12 or folate. I have anemia because my marrow is not making enough red blood cells. The disease behind this is given in my link in the OP. Also, some of the limited red blood cells are not the right size.
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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Dennis S
Date: August 08, 2019 01:10PM
"This isn't an explanation, but if you're anemic, pulse ox isn't that helpful because it's reading the saturation of the red cells you DO have. They might be fully saturated with oxygen, but there aren't enough of them. The hematologist should have explained that... sure would make sense while your hemoglobin was 7. Pulse ox can be unhelpful."

This is getting to the answer. My hemoglobin, hemocrit, and red blood cells are all low.
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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: wowzer
Date: August 08, 2019 04:00PM
Anemia means that you lack red blood cells.
Your oxygenation may be 100% if the sensor detects a high percentage of oxygen in the tense state (IIRC), causing the wavelength of reflected light to be high.

Shortness of breath is a perception by the brain (usually medulla) that you are not getting enough oxygen.

I can think of several ways you can feel short of breath, but still have 100% saturation:

1) Carbon monoxide poisoning may cause the sat to stay high, but you will feel SOB.
2) You are having a heart attack, giving you the sensation of SOB, but still have a high saturation.
3) You have a mitochondrial poison like aspirin, cyanide. Both causes tachypnea (breathing fast) and the blood oxygen is still 100%.
4) The sensor is broken (or not picking up correctly).
5) And the one you have, your are anemic which means that you don't have enough hemoglobin to carry enough total oxygen to your cells. You are feeling short of breath because your brain doesn't have enough oxygen, but your lungs will give the red blood cells enough oxygen to remain at 100%.


I'm sure there are others..



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Edited 1 time(s). Last edit at 08/08/2019 04:04PM by wowzer.
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Re: How can you have anemia, shortness of breath, but steady oxygen saturation of 99
Posted by: Buck
Date: August 08, 2019 06:21PM
Where is Dr. House?
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