waiting for nodule biopsy - low O2 readings

Posted by happydappy @happydappy, Nov 7, 2023

My pulmonologist has been tracking a lung nodule for 10 months. It's about 1.6 cm with multiple satellite nodules. He suspects non TB mycobaterial infection but differential includes rheumatoid nodules or malignancy. I've been coughing pretty badly for over three months now and he had me do a large dose of oral steroids and recently put me on a Symbicort inhaler. He scheduled a 3D robotic bronchoscopy to get a biopsy and that's in three weeks. In the meantime I've been tracking my pulse oxygen at home. It generally ranges between 94-98 but last night I got two readings of 92 and one of 93 and I wasn't feeling great at the time. This morning it was again 92. At what point should I call the pulmnonlogist's office?

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Sue, Volunteer Mentor | @sueinmn | Nov 7, 2023

@happydappy Has the pulmonologist ordered a sputum culture? If you are able to produce sputum, this is the less invasive way to determine if you have a non-TB mycobacterial infection.
As for you O2 readings - they are all within the normal range, especially for someone with a cough and nodules. My instructions (asthma & bronchiectasis) are to call the doctor if my O2 falls below 90% and remains there after 5-10 minutes of deep slow breathing.
Did you know we have an entire group here dedicated to NTM (also referred to as MAC) and it's associated lung disease, known as Bronchiectasis?
https://connect.mayoclinic.org/group/mac-bronchiectasis/
Here's a good place to get started:
https://connect.mayoclinic.org/discussion/resources-for-the-abcs-on-bronchiectasis-and-mac-ntm/

I'll be off-line much of today, but other members there will happily answer any questions you may have!
Sue

happydappy | @happydappy | Nov 7, 2023

Thanks for the information @sueinmn. The pulmonologist is planning to get wash samples while doing the scope and he's also sampling several enlarged lymph nodes while in there. He wants a biopsy of the nodule to get a definitive diagnosis whether that be infection, inflammatory (rheumatoid or sarcoidosis), or malignancy since it did increase in size since January. Thus the more invasive scope procedure.

Thanks for the info about O2 levels and that makes perfect sense. I'll keep monitoring and call the triage nurse if needed.

otter2154 | @otter2154 | Nov 8, 2023

I had some very serious Covid related breathing issues about three years ago (fast-forward to now and I’m greatly improved), and I bought my own in-home oximeter from the local drug store. I became obsessed with checking my numbers routinely … to the point where I finally had to bury the thing in a desk drawer and leave it alone. In home, “affordable” monitors can be in accurate, and you’ll get a lower number if you have been lying down, plus other factors that influence accuracy. My doctors at the reminded me (when I brought this up for discussion) that my O2 levels were always idea when checked in the office.