Field Notes #37: When pulse oximeters don't work well

Plus, NaNoWriMo, make-your-own seasons, and scheduling your worrying

Hello there, and hello, November! This month always seems to sneak up on me. November so far has been odd, with spring-like days, and the forecast for the weekend predicting 70s. How are you doing with the shift in seasons?

This is the Wednesday Field Notes edition, with 1 health insight, 2 quotes, and 3 links I’ve run across lately. I hope you find something useful here!

1 health insight

Pulse oximeters have been a critical tool in the COVID-19 pandemic, delivering a measurement for oxygen levels quickly and painlessly through a small device at the end of a patient’s finger. Oxygen levels have been a critical and highly watched number during the COVID-19 pandemic.

But pulse oximeters are not fail proof. They work by shining light through a finger, and as studies have shown since at least 2005, pulse oximeters are more likely to produce inaccurate readings for people with darker skin.

Learn more in this 2-minute video from STAT News:

In a STAT News article, Dr. Michael Sjoding, author of a study on pulse oximeters, explains:

“One or two points of difference on a pulse oximeter can determine if someone with a severe Covid infection is sent home from the hospital or admitted, if they are given supplemental oxygen or not, and if that oxygen is paid for, he said. Medicare will pay for oxygen if a patient’s pulse oximeter reading is 88 or 89, but not if it’s 90, meaning patients with darker skin may have to be sicker before they receive the treatment they need.”

How many patients did not get the care they needed in time because of an incorrect oxygen level reading?

“I am horrified that these deficiencies in the pulse oximeters have been known for decades,” Uché Blackstock, a Black physician-advocate and founder of antiracist health care consulting firm Advancing Health Equity, told STAT. “I would like the FDA to explain how they have allowed deficient pulse oximeters to be used across the country on millions of patients.”

Yesterday, a FDA committee met for 9+ hours to hear from researchers and healthcare professionals on this issue. The FDA regulates medical devices and currently allows oxygen readings from pulse oximeters to be inaccurate by up to 3% on average.

You can watch a video recording of the meeting here and read this interesting summary of the meeting, FDA panel asks for improvements in pulse oximeters by Usha Lee McFarling.

Let’s hope the FDA acts swiftly to fix this terrible problem. Until then, all patients, especially people with darker skin, should know that pulse oximeters readings are not always accurate.

2 quotes

“Unless someone like you cares a whole awful lot,
Nothing is going to get better.
It's not.” ― Dr. Seuss, The Lorax

“Convenience, in other words, makes things easy, but without regard to whether easiness is truly what’s most valuable in any given context.”

— Oliver Burkeman in his book Four Thousand Weeks

3 links

✏️ NaNoWriMo is here! NaNoWriMo (pronounced Nan-OH-Rhy-MO, or at least, that’s how I say it) stands for National Novel Writing Month, a fabulous, magical, global activity in which writers draft a novel in the single month of November. Yes, it sounds impossible, but the goal is 50,000 words, so that’s 1,667 words a day. Not super easy, but doable! Writers all around the world (427,653 writers last year, to be exact) are in on this project, and many gather regularly in November to write together. Why do I mention this here? Because community nourishes our health, and writing can be a balm. So you might look to see if your local library, community, or bookstore is holding a gathering (406 did last year), and maybe you’ll meet a new friend, or process something that needed processing in your writing. Here’s a guide to getting started with NaNoWriMo.

✅ You Can Do 5 Things (Sophie Lucido Johnson’s newsletter, You Are Doing a Good Enough Job) This newsletter is a delight, and in this particular edition, Sophie (illustrator, writer, teacher, mom, publisher of a neighborhood chicken newspaper, and many other wonderful roles) writes about impossible to-do lists and her revelation that 5 things is the right amount to tackle in a day. I found it wholly comforting, and also, there are many of Sophie’s fantastic cartoons.

😴 Can’t Sleep? Try Sticking Your Head in the Freezer. In a new book, a sleep scientist offers tips for better rest — without reaching for a pill. (The New York Times, gift link) This article offers sleep advice from psychologist Dr. Aric Prather, author of the new book The Sleep Prescription. Among the guidance: Schedule time for worrying so “your worries won’t seep into the night” or, if they do, you can tell yourself, I’ll think about that tomorrow in my Worry Time.

I am intrigued by the idea of scheduling worrying. Has anyone here tried this? I would think it would make my worrying much worse, not better, but who knows? Perhaps it’s worth a try.

May you have a wonderful week ahead, with extra deep sleep and 5 things on your to-do list.

To our journeys,

Brianne