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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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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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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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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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"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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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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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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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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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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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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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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