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🧵 Thread (32 tweets)

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UltimApe@ultimapeover 4 years ago

You think not being able to have a soap dispenser detect the color of your skin is bad, wait till you hear how often doctors don't realize skin color gives misleading readings in SPO2 measurements.https://t.co/aqxj6HJaTf

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"Be aware that multiple factors can affect the accuracy of a pulse oximeter reading, such as poor circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish."https://t.co/t4dXeFRA5m

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Nurse told my diabetic GF that SPO2 was fine.>" Elevated blood HbA1c levels lead to an overestimation of SaO2 by SpO2, suggesting that arterial blood gas analysis may be needed for type 2 diabetic patients with poor glycemic control" https://t.co/ILdwnwzDyt

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

My GFs "asthma" not isn't responding to inhalers. Waiting to know what lung doc found. "Glycated hemoglobin A1c-based adjusted glycemic variables in patients with diabetes presenting with acute exacerbation of chronic obstructive pulmonary disease" https://t.co/FH1xkNhac2

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Both me and my GF are pale skinned. I am just mad a at how collectively ignorant the health industry is. If her situation is an example of someone in a privileged position, I can only imagine how shit it must be for a dark skinned person w/ diabetes type II & lung issues.

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"He said the O2 level would show up lower than it actually is on a diabetic patient so since mine shows 97-98 if it's a mistake the level is actually higher"EXACTLY WRONG?!😭

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Going to learn to do my own blood gas test tonight.

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4/27/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Does anyone know if there are studies using Arterial Blood Gases to monitor patients with COVID? Ties between stress related pathways and insulin are interesting here.https://t.co/Lb6bNFh0rE

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

If a literal lung specialist working on diagnosing COPD in a diabetic type II patient has the process EXACTLY WRONG, then I wonder how many others are ignorant of these dynamics.https://t.co/aDuBH9nBIk

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UltimApe@ultimapeabout 5 years ago

@vgr Hearing disturbing reports of covid patients suddenly developing complications despite O2 readings not showing any problems, particularly among those at risk of complications (diabetes).I wonder why... 😰

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"There exists substantial evidence to support that Black skin has a higher TEWL, variable blood vessel reactivity, decreased skin surface pH, and larger mast cell granules compared with White skin. [...] further evaluation needs to be done."https://t.co/yyKvNv7kQP

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"Asian and black skin has thicker and more compact dermis than white skin, with the thickness being proportional to the degree of pigmentation." [2016]https://t.co/H1nbuBBa1S

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"This study confirms that there are widespread connective tissue changes in diabetes mellitus, although the biochemistry needs further elucidation." [1989]https://t.co/ZIHGKvF0IG

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"Skin thickness is affected by age, pubertal status, gender, BMI, and anatomical site. Such differences may be important when considering appropriate sites for dermal/subcutaneous injections and other transdermal delivery systems." [2014]https://t.co/7xcj6Legtn

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

This is what people mean when they talk about structural racism in the medical system?Trivially correlatable changes in skin & blood o2 in standard measurement paradigm, leading to plausible widespread measurement error that impacts direct patient outcomes?

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

How does one measure blood gasses? I found out I could probably have my dad (trained phlebotomist) take the sample. I just need to figure out how to DIY assay.https://t.co/83TTm8j7GM

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

You ever spend 20 minutes to reverse engineer how SPO2 meters work and realize skin thickness and emissivity would impact measurements; causing error.Then find out no one seems to understand it?https://t.co/M97OlDZbOZ

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UltimApe@ultimapeover 5 years ago

@cigardubey Polar's optical sensors seem the best on the market from what I can gather, but the chest strap still seems the most reliable. Tho Apple's & Garmins are nice. If I didn't already have a free fitbit I'd be looking at Garmin's for the Sp02 feature.

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

This shit is seems trivially calibratable. But I doubt it's on anybody's radar."The mean percentage error between the two measurements was 13.12%. We conclude that fat thickness can be efficiently measured using the simple sensor module." [2009]https://t.co/egIkzuvlaQ https://t.co/k7De2b3TGV

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Skin emissivity seems to be constant regardless of skin pigmentation https://t.co/fLsgoKhs8e

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

for SPO2: Does reflectivity matter? Or is it purely about penetration and scattering? I am not sure.This seems to be the most thorough paper on the subject of skin I could find.https://t.co/1B7QiidNVa https://t.co/aWCjiK7nY4

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

To be clear, I mean the effective emissivity of the skin *after* bouncing light thru the dermal layer to estimate blood o2. Not sure I'm using the right word for that here.

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

I mean..."One of the critically important areas in medicine is the misdiagnosis of disease in people with darker skin types due to implicit bias and the lack of awareness among physicians in recognizing the disease pattern."https://t.co/mKYktMPn3vhttps://t.co/74mWCcGjqi

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UltimApe@ultimapeover 4 years ago

I come from Vermont and am a cis white male with a mostly mixed heritage, so I can't really speak for others well. But I can say that I see a lot of narratives floating around on this space, and they all bother me.

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4/28/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

"This is not a problem with one algorithm, or one company — it’s a problem with how our entire system approaches this problem"https://t.co/JZhV32t9Kjyes, yes it is.https://t.co/A6GJvIoqaC https://t.co/IITeBVM37b

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UltimApe@ultimapeover 8 years ago

I want my poop on a blockchain. But here's an article from 1914 about legislation on standardizing hospital records: https://t.co/huZG5DIj19

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5/5/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Tying billing and medical diagnosis together for reimbursement purposes is literally built in to the way healthcare is regulated by the United States government.https://t.co/iGiqL7byV8 https://t.co/ErC0gX2xSU

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5/5/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

I made a rant on mastodon back in 2018 on the absurdity of medical billing practices being used to model healthcare outcomes. This problem is at the core of my obsessions with Quantified Self.Will bundle it up in to an https://t.co/pvfP6oVwFv entry soon.https://t.co/iPbq04HizX

3 0
5/5/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

Do you ever wanna get access to every local news paper ever published to get statistics on obituaries and correlate it with healthcare trends and back fill it with data from EMR records and FDA drug authorizations and pharmacy insurance reimbursement logs?

3 2
5/5/2021
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UltimApe@ultimapeover 4 years ago
Replying to @ultimape

“If the call handler was well-trained, and you said you were black, they should know not to pay too much attention to that question [of blue lips]. You’d be asking other questions, about breathing, whether [they were] rousable”https://t.co/xmXE4wNCrZ 🤬https://t.co/fvsmWtnOtS

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UltimApe@ultimapeover 4 years ago

If one of the symptoms of trouble breathing to look for is pale skin and blue lips... Are these symptoms harder to detect with darker skin?probably https://t.co/xmXE4wNCrZI hate this.https://t.co/2YWVm9k9fp

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1 1
5/11/2021
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UltimApe@ultimapealmost 4 years ago
Replying to @ultimape

Good: someone is acting on this bullshit.https://t.co/LVpjOpp5ENhttps://t.co/nEfksSWSXS

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11/21/2021
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UltimApe@ultimapealmost 3 years ago
Replying to @ultimape

FDA made another announcement about potentially bad readings from SPO2 devices for people with dark skin.https://t.co/cSh2uDLrQF https://t.co/WjaJ4Gvr3b

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9/21/2022
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UltimApe@ultimapealmost 3 years ago
Replying to @ultimape

Been thinking a lot about this while dealing with the Candida / Thrush infection that my GF has been having. Every single doctor is asking if her throat hurts. It's become a ritual for her to say "but I don't feel pain like most people" after every one.https://t.co/sjOa0Rwc5M

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UltimApe@ultimapeabout 8 years ago

"I had no idea that what I was feeling was not what everyone else felt.”https://t.co/jSBs65F6ql https://t.co/hn2VqlTbUL

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9/21/2022
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UltimApe@ultimapealmost 3 years ago
Replying to @ultimape

I believe a dark-skinned person w/ thick skin from diabetes, combined w/ poorly controlled blood sugar (a complication from covid itself!) might explain doctors reporting patients suddenly going from good SPO2 to bad on short notice.But I have no evidence. I am not a doctor.

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9/21/2022
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UltimApe@ultimapealmost 3 years ago
Replying to @ultimape

I wish saying this stuff on twitter wasn't risking my account getting deleted for misinformation after I literally cited the FUCKING FDA.

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9/21/2022
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UltimApe@ultimapealmost 3 years ago
Replying to @ultimape

Don't worry, the way the FDA measure of covid during booster trials was defined as...*checks notes*"peripheral-blood oxygen saturation level"🤦‍♂️🤦‍♂️🤦‍♂️https://t.co/Zy7FCBWI8c

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UltimApe@ultimapealmost 3 years ago

What THE Fuck."The FDA definition was based solely on the peripheral-blood oxygen saturation level"https://t.co/nkwSGUJuDc https://t.co/Ct05CF9H0R

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9/21/2022