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My younger sister, about a month ago, got our 83 yr old mother an exercycle which she is trying to use but when she peddles for more than 10 minutes gets chest pains. The Dr prescribed her nitro and told her not to bicycle for more than 10 minutes at a time. She is overweight, has congestive heart failure, only 1 kidney and bad knees and has never exercised. My sister is pushing her to exercise so they can fly to visit her 80 yr old sister for her B'day in August. She will have a wheelchair waiting at the airport and while visiting but my sister feels she needs to get into better shape for the trip.
I feel she should not be doing this exercycle thing at all...am I wrong?

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Well mom told me today she canceled the appt on Friday...she says she is fine and doesn't need oxygen-that the oximeter says her oxygen is 92 on up even after walking around and doing exercise...I give up..she is an hour away and I only visit once a week. She also refuses to come live w. me as she says she can take care of herself....so she is back to bicycling 10 minutes and says she has not had any chest pains since. I will just make the best of the time we still have together and Let go and Let God. Yup mom hasn't flown in a few years and last time she got real upset cause she has metal in her knee so they had to pat her down and so yeah maybe she will get upset and won't be allowed on the plane. She already has edema in her legs but this is a freight train that has left the station and I can't stop it.
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floridagardener, when the the last time your Mom had flown? If it has been prior to 2001, then it will be a whole different ballgame for Mom.  Seats are narrower, the aisle down the center of the plane is also much narrower.  No in-flight lunch or dinner like they had years ago on the longer flights.

I wonder how she would react to TSA Officers searching her carry-on and purse. And how would she react to the Officer doing a required pat down or body scan? Something as simple as a metal belt buckle, or wearing a lot of jewelry can trigger an alarm.

Also, Mom would need to pack any liquids/creams in small travel size bottles that would hold only 3.4oz. If Mom uses hair spray the container can only be 3.4 oz.

Oxgyen, as per TSA website: "Personal medical oxygen cylinders are permitted through the screening checkpoint, however, the Federal Aviation Administration considers personal medical oxygen cylinders to be hazardous materials. You are not permitted to carry your own oxygen in the aircraft cabin. Please contact your airline for instructions on arranging oxygen service. Airlines are not required to provide oxygen service and many do not."

"Per the Federal Aviation Administration, certain portable oxygen concentrators are permitted onboard the aircraft, including Inogen One, Sequal Eclipse, Airsep Lifestyle. See a list of Portable Oxygen Concentrators that meet FAA specifications for inflight use"

If your Mom or your Sister get into a verbal altercation with a TSA Officer, they won't be flying that day.
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The tickets have already been purchased, BUT if mom now has some change in her medical status, if she now needs oxygen or if her doctor says she is not well enough to fly, I think your sister can get a refund. Don't let the ticket be a deciding factor. Do what is bet for Mom (as far as you can determine that.)
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Seems your sister is in denial about Mom. If the doctor says a plane ride is not good for Mom, get a note from him/her stating this. Maybe extra ticket can be used for Moms sister to visit her. If she can't go, ask if a family member can video the important parts.
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Driving with sats 80s. She is a timebomb.
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Skipping Lasix might avoid going to the bathroom, but could also contribute to edema in her lower limbs, while sitting on the flight. She can pump her ankles and alternate raising her feet and lower limbs, but I would still be concerned about edema. Does your sister understand that she could go into CHF from the excess fluid?

If her SAT rate drops into the 80's when she's up, she should already be on oxygen. If I recall correctly, she's seeing a PCP but not a pulmonary doctor yet? She really needs to be on oxygen.

I have a really uncomfortable feeling about this trip.
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I have already begged and pleaded w.my sister to not do this trip but she already bought the tickets...yes the 80 yr old is in much better shape and can travel to FL. This was a surprise gift from my sister and I know she means well but mom also only has 1 kidney and has to wear depends when traveling that much. She will skip her lasix to keep from having to run to the bathroom
and that puts even more stress on her heart. Mom mentioned to me that her fingertips get numb and her pulse looks very irregular on the oximeter. I will mention to the GP that she should also be referred to a pulmonary dr as well. My dear sister just does not understand that mom should not be traveling. It could end up being a disaster that could ruin her own sisters B'day. Yes her oxygen drops to the 80's when she is up and walking around her own house and she always seems out of breath when outside in this Florida heat. She can still drive and make it from her car and walk into her house but then must sit down and rest. She says she can get up from a wheelchair ride up to the airplane door and walk to her airplane seat. Luckily it is a nonstop flight at night but it will be a very stressful day of traveling for her. If I can get mom on oxygen then maybe my sister will realize that trying to ad oxygen to the trip will make it a very cumbersome situation.
I know they are not traveling first class and are only taking carry on luggage.
Thanks everyone for the input.
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Knowing her activity sats seems to explain a lot. Good pick up Florida. There is time to get her in shape as long as you can get all appointments in on time to qualify for oxygen . She will need to show a Sat of less than 88% for up to 5 minutes to qualify either resting or with activity.  Keep expressing the deadline when the appointments are made to qualify her for oxygen. Otherwise delay the flight. She will start having symptoms during flight if things are not worked out. Oxygen levels are always lower inside the plane so she may need a slightly higher dose of an extra liter per minute in flight.  All of the planning for oxygen needs can be worked out with her supplyer who should be able to guide you for the airlines. Once that is fixed, her workouts should improve including her quality of life in general.
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Another option is for someone who's Skype literate to arrange for them to "meet" through Skyping. If there are Skype literate people who can help each one of them and facilitate that, they can connect in the future as well.

It's a lot safer than traveling.
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I am not in favor of your Mom flying on the plane to see her 80 year old sister, but I made the suggestions that I did because I am very concerned that your dear, sweet, "misguided" sister is going to try to take your Mom to see her sister NO MATTER WHAT. So I wanted you and your Mom to be prepared in case your sister does attempt the plane trip.

If your Mom's 80 year old sister is in better health, maybe she can come see your Mom. How far apart do they live? Could you arrange a meeting somewhere in-between?

I am glad that you are checking your Mom's oxygen saturations (O2 Sats). What are your Mom's O2 Sats when she is resting and when she is walking?

Normal range is 94-100%. However, some doctors don't get concerned until the O2 sats are in the high 80's. If your Mom's O2 sats are in the 70's while walking, then she definitely needs oxygen.

Keep a chart of your Mom's activity along with the Oxygen Saturation during the activity and show the information to the doctor on Monday. It will help him understand what is going on better, and also, ask him what HE THINKS of your Mom taking a plane trip to see her 80 year old sister. I hope that you and your sister can find a "Happy Medium" so that your Mom can see her Sister this summer. Good Luck.
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I'm sympathetic to your younger sister's goal of Mom attending her sister's birthday celebration. That is sweet! Sweet, but maybe not safe or practical.

How is the health of the birthday sister? Is she in better shape to travel? Maybe bringing her to visit your mother is a better solution.

The only time we took our wheel-chair bound mother out of the nursing home (other than for walks in the neighborhood) was for her sister's 100th BD celebration. We hired a medi-van so she did not have to get out of her wheelchair. We made sure she was well-padded for possible incontinence problems, and we had the van wait so she could return as soon as she showed signs of tiring. The sisters were close and all their relatives were very pleased they got together. We have pictures to preserve our memories.

So I say, get those sisters together if at all possible. But don't attempt the impossible to do it!
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"Way down" such as in the 80's, 70's?

Is she on oxygen now? If not, in my experience, a pulmonary doctor first orders a sleep study to measure SAT rates at night. If too low, Medicare will pay for an oxygen concentrator. It can still be used during the day if necessary, but we had to go through a second test in order to be approved for daytime use, which is when the portables and backup tanks can also be paid for by Medicare.

Does she have a pulmonary doctor? That's the person who should be scripting for oxygen. Medicare regs on that are very precise; I wouldn't want to rely on a GP to interpret those regs, besides, a pulmonary doctor should be treating her anyway if she needs oxygen.

Good luck with the appointment.
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Saw mom today and she made an appt. w.her GP for Monday morning and I plan to go w.her and suggest physical therapy and an oxygen concentrator. Thanks for mentioning the physical therapy as that makes more sense.
He also has to see her first before she can get referred to her old heart dr that she hasn't seen in 2 years. I checked her w.an oximeter and she is fine when sitting in her lazy-boy but once she gets up and moving it drops way down...and she says - hmmm that explains why I am always out of breath.
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JoAnn raises a good point about oxygen. And whether or not the concentrator would provide enough air for a flight depends on the specific model. (Factor in waiting time at the airports.)

Our DME last year switched brands from a portable concentrator with removable batteries to one with a built-in battery, and only about a 2 hour life before needing to be recharged. The removable and rechargeable batteries each lasted about 2 hours, and with the 4 that we had, could then last 8 hours.

The concentrators with only about a 2 hour life (on 2 liters) would have to be recharged on the flight. The only backups are tanks.
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Just read this

"In general, patients whose symptoms are poorly controlled should not travel on airplanes. All patients who have congestive heart failure should first consult their doctors before traveling but as a general rule should be able to walk 100 yards and climb 12 steps if they are to attempt a long plane flight."

Your Moms overweight has to be figured into this. Planes are not comfortable for people without Moms problems. Can she sit in a cramped space. Could her sister come to her. I agree, your sister is looking at how nice it would be, not what has to go into this. Can Mom be transferred from a wheelchair to the seat. How is she going to be able to use the bathroom if needed. Oh, just found this

"Obtaining oxygen for air travel — The Federal Aviation Administration (FAA) does not allow travelers to carry their own oxygen tanks or liquid oxygen aboard commercial aircraft. Instead, most patients can use a Department of Transportation approved battery-powered portable oxygen concentrator."

Sister may want to think about this.
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You can help prepare for home therapy, preferably ordered and monitored by her cardiologist, by getting and using a blood pressure cuff and pulse oximeter to measure oxygen saturation.

They won't specifically provide information on her exercise pain, but they can give clues to the nurse who starts home therapy, and to the therapists for when they start home PT and OT.

Perhaps she just needs to exercise more slowly and take more breaks.
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Dear FloridaGardener,
Your younger sister needs a reality check ASAP about the health of your Mom!!! But I am afraid that whatever you say will fall on deaf ears :( So…the next best thing you can do is to get your Mom as prepared for the plane trip as possible.

I agree with the others about asking the doctor to order physical and/or occupational therapy for your Mom with the GOAL OF BEING ABLE TO FLY to visit her sister in August. Medicare should pay for the therapy.

Tell your sister that if she is going to be responsible for your Mom during the trip, then she (your sister) needs to attend at least 2-3 of the physical & occupational therapy sessions so that she knows what your Mom’s limitations are and so that she can make any necessary preparations or changes to the trip based on your Mom’s limitations. Ask the physical and occupational therapists for suggestions for your Mom’s plane trip and what precautions she will need to take while traveling.

How many flight changes will your Mom have to make during the trip? Because your Mom will need the w/c (wheel chair) each time she changes planes during the trip and not just at the beginning and at the end of the trip.

Have your MOM SEE THE DOCTOR 7 DAYS PRIOR TO THE TRIP so that he can verify that your Mom is physically able to take that plane trip. Require your younger sister to attend that doctor’s appointment with your Mom and you so that she can ask any questions about any restrictions (and any medications —Nitroglycerin tablets) your Mom may need while on this plane trip.

Maybe with the right preparation, your Mom will have an enjoyable trip to see her 80 yr old sister. I know that your younger sister is trying to do the “right thing”, she just hasn’t thought everything through. You need to look out for your Mom’s health and safety because it is obvious that your sister isn’t. Also, make sure that your Mom takes along a list of her medications, surgeries and health problems and insurance cards on the trip in case she has to go to the hospital. Let us know how your Mom is doing with therapy and getting ready for the plane trip. Good Luck and God Bless!
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Ask the doctor to order her physical and/or occupational therapy. If she has original Medicare it will be paid for and she will get the exercise she needs and be properly monitored while she does it. Exercise is great for CHF and bad knees if it’s done properly. Unless you or your sister are a physical therapist please get her the proper support.
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floridagardener, I agree with you, I also don't think the exercycle is the right thing for your Mom to use at this point in time, maybe later on.

Since your Mom never exercised, she needs to have a professional physical therapist come to the house to direct her on what exercised would be best suited for her. Your Mom's primary doctor could write out a script recommending Mom have a physical therapist, that way Medicare could pay for some or all of the cost. The physical therapist would come to the house a couple of times a week. This is NOT a do-it-yourself project.

Let us know what happens.
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The doctor instructed her not to bicycle for more than 10 minutes at a time; that is the answer.

Has her doctor been notified of the chest pains while exercising? They might have suggestions for gentler exercises for your mother.
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