Carbon monoxide not easy to detect

Dear Dr. Camardi: When we brought Dad to your clinic for dementia, we never had any idea that after you went over his case from top to bottom that you would say what you did about carbon monoxide poisoning. And I’m very deeply sorry for saying to your staff that we wasted our time in seeing you because you saved us from tragedy.

I said that because, when we told you that Dad’s weird behavior when he was home was so different from how normal and nice he was in your office, I thought you thought (though you never said it or anything else to set me off) that we were making it up.

When my brother came in from Ohio, I told him about you and he went down in the basement .

Right there in front of us, Dad used duct tape on a leaky vent on the furnace to save money. Glenn got everybody out and opened all the windows. Dad moved in with me and we got a carbon monoxide meter and put it in the basement and don’t you know, it read “high” even with the windows open. We called the heating people, and they fixed it right away.

I’m still shaking at the thought of what could’ve happened to Dad. He’s moved back into his house. I’m so sorry I was such an idiot and my family thanks you from the bottom of our hearts.

— Bent Mountain

Don’t blame yourself for not understanding something you can’t see, feel, taste or touch.

On average yearly, by some estimates: More than 400 people will die from it, more than 20,000 will go to the emergency room and that will result in some 4,000 hospital admissions.

Carbon monoxide is a gas that can kill anyone. During the winter months I tend to suspect it in patients with cardio pulmonary disease and phases of dementia when there is a change in their baseline health that varies from place to place.

Most people I have diagnosed with this form of poisoning thought they had a stomach virus because symptoms may include nausea, vomiting, headache, profound weakness, dizziness and even chest pain.

In the geriatric patient I also suspect it when the patient goes from their normal self to being confused and even belligerent for no apparent reason in one environment but then improve in another.

Carbon monoxide kills because our red blood cells take up carbon monoxide easier than oxygen. Instead of oxygen being delivered to our cells to maintain our health, this poison is and we suffer as a consequence. Even low levels of carbon monoxide over a period of time can have dire health consequences.

The good news is that it is preventable by constant upkeep and maintenance of chimney flues and heating systems.

If you suspect carbon monoxide poisoning may be responsible for making people sick, get them out of the area immediately and out into fresh air and call 911 . Simple oxygen is the treatment of choice for carbon monoxide poisoning, and it can save a life.

I think it’s very important that the patient — especially geriatric patients — be evaluated and two to three months later be re-evaluated for cognitive impairment as a result of carbon monoxide poisoning.

The first line of defense is to use carbon monoxide detectors in strategic locations within the living space. They are inexpensive and along with the smoke detectors protect us from being victims of a silent killer.

Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging and an assistant professor of medicine of the Virginia Tech Carilion School of Medicine. His column runs monthly in Extra.

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