This is to update the Community on something initially posted by rnuara back in January, see the Forum topic titled "Hemoglobin Levels" (#1814). As reported at the time, there is now a non-invasive Hgb analyzer in the market to measure hemoglobin levels easily and instantaneously, and it's called the Ember and is made in the USA by Cercacor Laboratories, see http://www.cercacor.com/ Also, watch the video at https://youtu.be/0nODGJkr3zA The device communicates with an app downloaded onto an iPhone; the app for Android phones is under development. The technology is based on a scientific technique called absorption spectroscopy. Light in various wavelengths is shined through the arterial blood in a fingernail and the amount of Hgb in the blood is measured. The Ember is NOT an FDA-approved medical device. It is meant for endurance athletes and trainers who want to monitor their Hgb in relation to their athletic performance at different altitudes. The cost is about $500, which makes it not only a painless alternative but also a less expensive option than the HemoCue device, especially considering that the HemoCue requires lots of supplies: factory-made cuvettes, lancets, lancing device, alcohol and gauze pads. Moreover, the HemoCue is FDA-approved for use by health professionals, blood banks and hospital emergency rooms, but not by patients, so it's not always easy to procure it. Even though I own a HemoCue, I decided to buy an Ember to see how it compares in terms of accuracy, because if it proved good enough, I would just carry the Ember with me from now on: it's small, light, easy to use -- and best of all, it doesn't need supplies and it doesn't hurt. I'm pleased to report that in my experience the Ember is accurate enough. For example, I recently had a complete blood test done in my doctor's office the traditional way (with blood drawn from a vein) and my Hgb measurement came out at 16.3 g/dL. While waiting for the doctor, I drew blood from a finger and the HemoCue gave me a reading of 16.4. Then I switched to the Ember, and it gave me a reading of 16.7. These are statistically insignificant differences. The HemoCue and Ember results, obtained by me side-by-side on multiple occasions, have always been apart by just a few decimals, e.g., 16.2 vs. 15.9 or 16.4 vs. 16.2 -- again, insignificant differences. Therefore, *if you are an SCLS patient who is still at risk of having an episode*, especially if you are not receiving the recommended monthly dose of IVIG, and you want to be able to measure your hemoglobin concentration every time that you don’t feel quite normal, *I recommend that you buy and use either the Ember or a HemoCue.* If you notice that your Hgb levels are rising, say, from a normal range of 14-17 g/dL to 18, 19, or 20 and beyond, then chances are that you are experiencing an episode of SCLS. Changes measured in decimals are not meaningful. Moreover, healthy individuals experience swings in Hgb levels within the 14-17 g/dl range during a normal day, depending on when and what they've been eating and drinking. It's only major, upward departures from this range that are noteworthy for the purpose of identifying episodes of SCLS and for seeking immediate medical attention.

Thanks for this Arturo. We have the Hemocue, but very interested in this device. I had read a study that concluded non-invasive measuring was not as accurate. Is this a fairly new device on the market?

Yes, the product launch was in January; I put in my pre-release order in February; and I received the device in late June.

Thanks for doing the investigation on this. This could be a more cost effective option (the cuvette costs are difficult for us).

The US site has the price at $699. I did watch the video, and I am wondering if there is a way to get insurance to pay for this device.

Ritz, Thanks for the update on the price of the Ember. They must have given me an introductory price! Meantime, I notice that they've dropped the price on the HemoCue -- surprise! -- to less than $500, and even to less than $400, depending on the vendor. As to getting either covered by insurance, I doubt it but it's worth a try. Considering what a lifesaver either the Ember or the HemoCue could be for our most vulnerable patients, it may be a worthwhile out-of-pocket investment. The HemoCue helped save my life 7+ years ago, before I was put on a successful IVIG therapy. It was worth the price then.

The price of the HemoCue has dropped, but there are continuing use costs. The Ember is more costly up front, but there are no addition costs. Depending one your use the Ember could be more cost effective in the long run.

September 2016 update: The price of the Ember has just been cut to $399. However, it will now be “pre-loaded” with 200 hemoglobin measurements instead of the unlimited number it previously came with (at the price of $500, then $699). Beyond the 200 hemoglobin measurements, customers need to purchase additional measurement credits in increments of 25, 50, and 100 at $1 per test.

Does the Ember communicate with any Windows apps? I do not have an iPhone, but am interested in benefiting from the hemoglobin data.

Since it's a new product you are best off checking their website for updates, but as far as I know they haven't yet released an app for Android or other devices. I needed to update my phone anyway, so I dropped my Android and got an iPhone, in part to be able to use the Ember.