Quote:
Originally Posted by bluesky
Hi Alice,
Wow, that's a lot of great information!! 
One of my first symptoms when I was really, really sick was severe mental confusion and memory problems. I went from being a grad student in math to not being able to follow a recipe, or remember my zip code. So, when you mentioned co2 retention my little internet ears perked up.
I hope you don't mind but I have some more questions. Some might seem kind of random or way off the mark because I am completely in the dark about how this stuff works. And I know from good old google that it is not easy to understand!! Okay, here goes:
1. Am I right or am I wrong in thinking that co2 retention could cause mental fog and memory problems?
2. Hyperventilation and co2 retention looks the same - is that right? Or rather hyperventilation is co2 retention. Do I have that right?
3. Assuming that I'm right on #2, you mentioned that hyperventilation can cause acidity in the blood. I was told last spring that my blood tests showed high lactic acid and high pyruvic acid and a high ratio of both (can't remember now which way the ratio is set up l to p or p:l). Could that be related to co2 retention or is that more of an anaerobic cell functioning thing?
4. What exactly is a respirator? Does it run on the same principal as a CPAP in that it raises the pressure of the air? I have a CPAP which I use which makes breathing in easier but breathing out harder. It really helps with the oxysats but sometimes, especially when I'm generally feeling like I have breathing difficulties I'll wake up feeling like a train hit me. I'm thinking about going in and begging for a biPAP. Anyway, I'm curious about your respirator.
5. I think I already know the answer to this one but I was thinking how nice it would be if there were the equivalent of an oximeter for co2. There isn't though, right? How come it's harder to measure co2 than it is oxygen?
Alice, if you're not comforable answering all these questions I TOTALLY understand. Also you're probably worn out. But if you do want to answer them that would be great because I am DYING of curiousity. 
Thank you!!!!
Ally |
Annie,
I am not alice either, but just use this name because I am a bit of a coward, and prefer not to mix my professional life with MG life. (although they do crossover sometimes).
I am pretty bad, though at "playing" someone else, and couldn't even be a good scarecrow in the "wizard of Oz" play in fourth grade.
although, a few neuros made me realize what excellent dramatic skills I actually have, and what an amazing ability to appear as if I was seriously ill and convince the head of the ICU to admit me there.
and after my first (And then I thougt last) hospitalization I wrote my colleagues a letter to thank them for their support, when I felt as if I was in "alice in wonderland's world", so being in "MG world" is being alice for me.
Ally,
the answer to your questions-
1. you are right, CO2 retention can cause transient cognitive problems, and also feel like depression.
2. hyperventilation is in fact the opposite of CO2 retention, but they can appear the same, to the unexperienced. hyperventilation means breathing fast and getting more gas exchange (more ventilation) which leads to low levels of CO2. in CO2 retention-you have high levels of CO2 and you have a relatively rapid and shallow breathing because your body is trying to get rid of the CO2.
what may happen is that you "overshoot" and actually get your CO2 levels below normal. you can compare this to a driver who's steering wheel goes left and then a less experienced driver will break all the way to the right.
and as Annie says, this may appear as if you are hyperventilating, eg breathing fast because of anxiety etc. and not that you have an underlying problem.
when your weakness becomes more severe, you are not able to do that anymore and then your breathing becomes slow and shallow, and your CO2 levels rise.
3. as Annie said, if those results are real (because they could be the result of putting a tourniquet and applying pressure that leads to ischemia=not enought blood reaching your arm), then this would highly suggest some metabolic abnormality such as mitochondrial myopathy.
4. a respirator, is a machine that "breathes" for you. a CPAP is more of a support of your own breathing, but the problem is that it has the same pressure all the time (continous positive airway pressure), and that may be too low for getting air in, and too high for getting it out. (as you have to exhale against some pressure).
Bipap is bilevle airway pressure, which gives you a higher pressure when breathing in and a lower pressure when breathing out. so even if you are totally paralyzed it will do the work of breathing for you.
5. there is an equivalent of pulseox. that measures CO2 and it is called a capnometer. it is very expensive and many pulmonologists don't trust it too much (because you have to blow into it and know how to do it, normally it is attached to a respirator in the ICU, but can't be attached to a non-invasive respirator). I have one and I find it very reliable, most of the time.
alice