The 6 Minute Walk

As you all know, Bob is enrolled in the 8 week Pulmonary Rehab class at El Camino Hospital. The class started on Tues. Jan. 12 and is held on Tuesday and Thursday each week. However, Tues. this week was the annual Cardio Pulmonary lunch at Michael's Restaurant at Shorline so the class will be extended to the 9th Tuesday so that they have a total of 16 classes.

A couple of weeks ago when Bob and I went to Costco, he got extremely winded pushing a grocery cart from the parking lot into the store. When he got into the store he pushed the cart to one side and leaned over the cart catching his breath. One of the staff wanted to help and said he could sit on one of the motorized carts. Bob declined and said he would be OK and continued to lean on the cart. In retrospect, he should have had his Combivent Inhaler with him and used it. After he caught his breath I led him to a place where he could sit down while I picked up the items we had gone there for. When we got home he tried taking his blood pressure and, at first, neither of the 2 devices would give him a BP reading. The 1st one just kept giving him the "Error" message. The other one finally gave a reading of 148/143 which is not reasonable. So he waited a while and finally got a reading in his normal range.

Since he keeps a log of his exercise activities for the class, he noted on the log that he had had a problem with his breathing and had therefore not done as much exercise as recommended. When he took the log to class apparently the staff wanted to know all about it and subsequently notified his pulmonologist, Dr. Beck, and his cardioologist, Dr. Galli because both offices called Bob here at home. So we set up an appointment with the Pulmonology Lab at El Camino hospital for him to have this "6 minute walk test" at 11 this morning. When I set up the appt. they indicated that the whole thing would take about 20 min. Since Dr. Galli's office did not call until about 5:30 Friday evening, the woman who called asked us to call on Tuesday to set up an appt. for an ICD check.

So Bob had me take him in for the 6 min. walk test. Since we were early they started the test about 5 min. early. The staff lady put an oximeter on Bob's finger. The meter was attached to a pack that she then put around his neck and resting on his chest and off they went. When 20 minutes had passed and they had not returned, I figured that they had probably had to put him on oxygen. Sure enough, when they showed up he was pulling an oxygen tank behind him and had the tubing attached to his nose. He sat down next to me in the lobby and the staff lady went in the back and had a male staff member (Thomas) come out to talk to Bob.

In the course of the conversation Bob revealed that in bed at night his fingers frequently get all tingly. Thomas indicated that tingling in the fingers is one sign of insufficient oxygen in the blood. Then Bob told him about the leg cramps that he had been getting at night but that he had been having less of a problem with them since he had been taking the rehab class. Thomas told him that a build up of lactic acid in the legs, caused by less circulation, was probably the cause of the cramps. He explained that, if the level of oxygen in the body gets too low, the system pumps less blood to the extremities and more blood to the vital organs so that the vital organs get the oxygen that they need. So lactic acid builds up in the extremities because the blood is not moving adequately. Thomas will inform Dr. Beck's partner of the results of the test since Dr. Beck is out of town until next Monday.

Next Thursday Bob has an appt. in the afternoon to see Dr. Beck and an appt. at Dr. Galli's office for an ICD check. It is highly likely that the episode at Costco involved some atrial fibrillation since neither blood pressure cuff wanted to give a BP reading until after Bob had been sitting in the chair for an extended period of time. The ICD check will tell them if there was atrial fibrillation involved.

Before we headed to the hospital for the 6 min. walk test, Bob had commented that he was feeling better today than he usually feels.

Prior to the Costco episode Bob had ordered an oximeter for home use and he has been checking his blood oxygen level a lot.

After Bob sees the doctors next Thursday I will do another post.