Wildly fluctuating O2 levels

Wow, that's quite a fluctuation - I am very surprised you were able to stand with O2 sats athat low. Did you look at your fingers or lips at that point? What color were they? Have you ever seen those readings in the doctor's office or ER?

I am going to make a semi-educated guess here. My husband does a blood pressure clinic weekly in our winter home, and for most people it includes a pulse oximeter reading as well. Just before Covid struck, we started seeing some "wonky" readings on the meter, especially mine. Now, pulse ox readers have often been an issue for me because I have small arthritic fingers, fluctuating breathing issues and occasionally tremors. But then he saw it on others as well. Changed the battery and it didn't improve. Got a new one and began to compare readings - it was obvious the meter was failing.

So unless the docs are seeing these readings as well, or you are actually turning blue, maybe you could try a different meter.

Thanks for the reply, Sue.
No, I was not blue and if I hadn’t checked it I would not have known other than maybe slight shortness of breath or lightheaded ness. I’ve seen readings like that before on a different meter. I think it’s me. Another possibility is that they suspect I have Reynaud’s and the circulation to my fingers was not good. I have seen my palms and the soles of my feet turn blue intermittently(they were cold). Oddly, at that time the readings were normal if I recall right. If I start moving around the cyanosis goes away.
No, such readings have not been noted in the doctor’s office. It’s usually high 90’s in there.
If I hadn’t gotten pictures on my phone I don’t think they would have believed me. I have a series of pictures taken in a span of 60-90 seconds that go from 75-98. I was standing and talking on the phone during the whole thing.
I wonder if this is postural, something like pots or orthostatic hypotension. I do have lowish blood pressure that fluctuates quite a bit.
I also notice low readings in the car after I’ve been sitting still though not that low-maybe 91. Although I was sitting very still in the car looking at a map and caught a reading of 77 back in March. Didn’t last long. Shallow breathing?
I’m also looking at when it happens. Right now I’m taking a close look to see if it correlates with exertion at all. I’m a gym rat and if it’s happening, it’s either intermittent or I’m just not catching it. I’ve checked the oximeter while on treadmill and stepclimber and it stays high 90’s except for occasional dips into high 80’s that are transient.
It’s very wierd. I’ve had it dip into the mid 80’s walking around a parking lot, felt nothing, and kept walking. Took a few minutes but came back up to high 90’s and stayed there.
The really odd thing is that it doesn’t seem to last long.
Sorry this is so long, but it’s a wierd thing that’s mysterious.
Can’t wait to get to Mayo. If anybody can nail it, they can.

There are oximeters that record via app on the phone such as masimo - hospital grade. Pricy but there are others out there.
If you can avoid ed, dont go unless your levels of o2 sustained at all times and below 88%

Parenchyma damage in lungs can lead to o2 drop, air trapping. You can ask for high resolution ct with dynamic expiratory imaging which can show air trapping.
One other test is gas exchange and 6 min walk test
Good luck, try to go by how your symptoms are. Are you lightheaded all the time? There might be some correlation with heart - lung cycle of pumping blood/o2 & blood/co2 and timing of pumping blood a bit off andproduces quick drop in o2

Update: I felt lightheaded a little bit ago, checked o2 and got 80. Took meter off and on to check for good contact, and got 83. It climbed within about a minute to 99. Again I was standing still and had been talking. Blood pressure was not low. Checking frequently right now and it is fluctuating a lot both up and down. Wierd.
The good news is it doesn’t appear related to exercise as I took a rest day from the gym yesterday.

Thanks!
No, I’m not lightheaded all the time.
At the Er they did a ct scan and xrays, I reread the X-ray report and it did mention a moderate amount of air trapping. Tests do mention minimal bilateral atelectasis
I had a 6 min walk test done in Miami which came out very well. The only problem is that the tech only checked o2 seated before and after-it was 99, but who knows what happened in between?
No, I’m not going back to the Er unless I start looking like a smurf.
Yes, I do have heart issues: a bovine mitral replacement which is holding up well
and arrhythmia- frequent pvc’s and nonsustained v-tach.
Until recently I was taking Amiodarone but stopped when my latest pft indicated reduction in tlc and rv.
What is parenchyma?
The heart lung cycle being off makes sense to me. Is that the same as ventilation/perfusion mismatch?

Infact, I bought two oximeters, different brands, to be sure one was not failing. Reading customer comments I saw that they do fail. I have my oxygen levels checked during cardio rehab, and even their more sophisticated oximeter must be held correctly. And I need to take deep breathes. Oxygen levels go down with more exertion because using muscles takes more oxygen - my problem is that it goes down too much

Infact, I bought two oximeters, different brands, to be sure one was not failing. Reading customer comments I saw that they do fail. Also, one should wait a few seconds for the reading to stabilize.
I have my oxygen levels checked during cardio rehab, and even their more sophisticated oximeter must be held correctly. And we have to wait a few seconds for it to normalize and I need to take deep breaths. Oxygen levels go down with more exertion because using muscles takes more oxygen obviously. In my case, it is acceptable for me to keep at 88 or above during exercise. If it goes below 88 then I have to ease up. When I am just sitting, I am low to high 90s

The lung parenchyma is that portion of the lungs involved in gas exchange. The most prominent structure in this region is the alveolus. if there is scarring in small airways it will trap the air.
I am surprised pulm md didn't order high resolution CT as this one of most accurate for air trapping. please ask for it.

proper 6 min with oximeter on. if your hands cold, it can be taped to the ear.
the whole point of the test is to measure exertional hypoxia. pre and post is not the accurate results of the test.
https://pubmed.ncbi.nlm.nih.gov/32023887/
Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test

looks like the study I referred above. they also checked pre and post o2.
but I have read other studies where it was done during the walk. its common sense to keep oximeter on while walking 6 min.

Well, now you know why I’m going to Mayo.
I will say they did a ct with contrast, if that’s any help. As for testing o2 levels during the walk, I had a boss who used to say “there’s nothing common about common sense”🤪
I woke up with a cough and scratchy upper airways and running a low grade fever. This could have something to do with my lower than usual levels today, but not all the time.
I did an at home Covid test; it was negative.
I have an appt tomorrow with my pcp and I will talk to him.
BTW, my DLCO was normal on the test.