Sunday, May 17, 2020

A Primer on the N95 Mask

A few months ago, most of us had never heard of an N95 respirator or mask.  I had never heard of it. It is an essential element of Personal Protective Equipment, or PPE, which we have all heard so much about.

The N refers to ‘non-oil’, meaning that the mask should not be used in the presence of oil-based substances.  The 95 means that 95% of airborne particles are screened out if the mask is worn properly.  Keep in mind that 95% is less than perfect.  It means that the mask will fail 5% of the time.  And, if the mask is not worn with a tight seal, the efficiency percentage will drop further.  And, the mask wearer is instructed not to adjust the mask during use which will break the seal.  So, the 95% standard is likely under idealized circumstances. 

As of this writing, I have only worn the N95 mask on two occasions.  My initial experience donning the mask was for a fit testing by an occupational health specialist to verify my proper mask size.  The objective, I learned later, was not comfort, but to obtain a tight seal.  The fitting took less than 5 minutes.

After weeks of performing telemedicine from home, I was called into the workplace for the first time this past week to perform a day long marathon of procedures.  I hadn’t touched a scope in over a month, the longest I had been separated from my flexible friends since they first let me loose 3 decades ago.  Hopefully, performing colonoscopy is like riding a bicycle.  Along with my amazing team of medical professionals, I performed 17 procedures without incident.

PPE in place

Scope doctors like me are prone to various aches and pains.  We can be standing for hours which can be tiring.  Our necks can become stiff.  And, we do all sorts of repetitive twisting maneuvers with  both hands which can give rise to various ailments.  There is an actual condition called colonoscopist’s thumb.

But, during this scope jamboree, I became very sorely acquainted with a new malady.  My nose was crying out for relief.  A great contest of Man vs Mask commenced, and it was not a fair fight.  I now know that the N, which I had thought mean ‘non-oil’ really stood for Nasal torture. The N95 mask was burrowing into the bridge of my nose hour after hour.  For those who have not donned the N95, here is some guided imagery to assist you.  

Imagine you are seated cross legged in a pastoral meadow. The sounds and aromas of spring abound.  A sunbeam pierces the clouds as a gentle breeze laps against you. Now imagine that your head is encircled tightly with sharp barbed wire that crosses your nasal bridge.  Now, imagine that every few minutes that the circle tightens...

By the end of the day, my proboscis looked like I either needed plastic surgery or I had just had it performed.  I queried my colleagues and learned that my experience was not unique.  We’ve all seen the photographs of medical personnel whose faces at the end of their shifts are marked with deep grooves and crevices.  

I realize, of course, that my nasal assault is but an inconvenience compared to the suffering of front-line medical professionals and afflicted patients.  But, I was not prepared for the slow grind of a nasal buzz saw.  I have 2 other endoscopy session this month.   I think I know who will prevail in the N95 vs Nose competition.  


Anonymous said...

All I can say is God Bless You!! I am praying for a miracle for a quick end to all of this!!
Please join me!
Stay safe. Stay Healthy!

bluerose said...

Even wearing a mask of paper or cloth is uncomfortable. I am living under lockdown and must wear a mask if I leave my apartment and especially if I go outside to walk or see doctors, etc. Cloth ones are hot and never achieve a tight fit. The paper ones are not as good I am told but they are the easiest to obtain. Stay Safe.

Michael Kirsch, M.D. said...

@bluerose, I'm quite sure that folks with talent like yours could bring artistry and messaging to facemasks. They could become fashion statements and cultural touchstones! Wishing you the best, MK

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