Resting vs. Max heart rate

L

LisaV

New member
OK I'm going to stick my neck out here and be a bit flat footed. (Did it with my late husband and took his guff, so you guys are amateurs.)

I think you're rationalizing away your need for oxygen during exercise.
Medicare would pay for you to have oxygen according to their guidelines (see <a target=_blank class=ftalternatingbarlinklarge href="http://www.tricenturion.com/content/Doc_View.cfm?type=LCDCurr&File=lcd+for+oxygen+and+oxygen+equipment+1206.htm">http://www.tricenturion.com/co...gen+equipment+1206.htm</a> ).
"An arterial PO 2 at or below 55 mm Hg or an arterial oxygen saturation at or below 88 percent, taken during exercise for a patient who demonstrates an arterial PO 2 at or above 56 mm Hg or an arterial oxygen saturation at or above 89 percent during the day while at rest. In this case, oxygen is provided for during exercise if it is documented that the use of oxygen improves the hypoxemia that was demonstrated during exercise when the patient was breathing room air."

And let me tell you Medicare is cheap cheap cheap. (Lots of docs would like to see people on O2 once sats drop below 90.)
IMHO (and experience) It is more important to stay as strong as you can (exercise as hard as you can) than it is to stay off of oxygen.
Being desated like you are now is just damaging your heart.

Your plan of just exercising less (and less and less and less?) in order to stay off of oxygen is counterproductive to being in the best shape you can be.
 
L

ladybug

New member
LisaV,

Thanks. I kind of am starting to agree with everyone on here, but also do NOT want to come to depend on O2. Perhaps there are other factors going on that I need to consult a physician for as well.... i.e. I do have an asthma component, so maybe they'll have me take a puff of albuterol or something before exercise, etc... I just want to "run" (pun intended) down all avenues first before making that leap, since I'd probably never again be able to run without it and this bothers me.

I have emailed my CF doc and asked what she thinks and whether I should do an exercise study to see exactly what is going on.

My O2 sats when sleeping is about 94-95. Running is absolutely the ONLY thing that brings it down. I do not want to get "hooked" on wearing it and needing it more often either. I just don't.

I do not have Medicare as I'm covered under private insurance. The money is not the issue as much as necessity and also how dependant I will become on the stuff. (I know this is a totally other issue, though... the dependance thing...)

Anyway, thanks for posting the info. Did I read the article wrong? Did it say "during" in the article Chris posted? Urgh. Maybe I do loose brain cells when I run! LOL
 
L

ladybug

New member
LisaV,

Thanks. I kind of am starting to agree with everyone on here, but also do NOT want to come to depend on O2. Perhaps there are other factors going on that I need to consult a physician for as well.... i.e. I do have an asthma component, so maybe they'll have me take a puff of albuterol or something before exercise, etc... I just want to "run" (pun intended) down all avenues first before making that leap, since I'd probably never again be able to run without it and this bothers me.

I have emailed my CF doc and asked what she thinks and whether I should do an exercise study to see exactly what is going on.

My O2 sats when sleeping is about 94-95. Running is absolutely the ONLY thing that brings it down. I do not want to get "hooked" on wearing it and needing it more often either. I just don't.

I do not have Medicare as I'm covered under private insurance. The money is not the issue as much as necessity and also how dependant I will become on the stuff. (I know this is a totally other issue, though... the dependance thing...)

Anyway, thanks for posting the info. Did I read the article wrong? Did it say "during" in the article Chris posted? Urgh. Maybe I do loose brain cells when I run! LOL
 
L

ladybug

New member
LisaV,

Thanks. I kind of am starting to agree with everyone on here, but also do NOT want to come to depend on O2. Perhaps there are other factors going on that I need to consult a physician for as well.... i.e. I do have an asthma component, so maybe they'll have me take a puff of albuterol or something before exercise, etc... I just want to "run" (pun intended) down all avenues first before making that leap, since I'd probably never again be able to run without it and this bothers me.

I have emailed my CF doc and asked what she thinks and whether I should do an exercise study to see exactly what is going on.

My O2 sats when sleeping is about 94-95. Running is absolutely the ONLY thing that brings it down. I do not want to get "hooked" on wearing it and needing it more often either. I just don't.

I do not have Medicare as I'm covered under private insurance. The money is not the issue as much as necessity and also how dependant I will become on the stuff. (I know this is a totally other issue, though... the dependance thing...)

Anyway, thanks for posting the info. Did I read the article wrong? Did it say "during" in the article Chris posted? Urgh. Maybe I do loose brain cells when I run! LOL
 
C

cdale613

New member
Hi Sonia,

The National Lung Health Education Program has a lot of useful info, although most of it is directed at the larger COPD/emphasema crowd.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlhep.org/resources/Prescrb-Hm-Oxygen/Introduction-2.html
">http://www.nlhep.org/resources...n/Introduction-2.html
</a><a target=_blank class=ftalternatingbarlinklarge href="http://www.nlhep.org/pdfs/lt_oxygen.pdf
">http://www.nlhep.org/pdfs/lt_oxygen.pdf
</a>
The National Heart Lung and Blood Institute also has a lot of non CF specific lung information:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nhlbi.nih.gov/index.htm">http://www.nhlbi.nih.gov/index.htm</a>

-------
Sorry to hear about the living in Vegas... I lived in Washington DC for a couple years, and it was horrible. Sounds like you are better off inside...

-------
Your current routine sounds good, but since your sats drop off so sharply, you might need to make it more gradual inorder to keep your sats higher.

I'd suggest tring five minute increments of: walk, slow jog, run, slow jog, walk. That should keep your workout time about the same, but lessen the intensity... see what your sats do then and go from there.
--------

Sure - the 60 beats thing is a rule of thumb, but not everyone's thumb is the same... The 60 beats thing makes an assumption that your standing heart rate is around 60-80 (which is considered "normal") and that your max is somewhere in the high 180-190s. Its an easy tool that people in gym classes and what not can use without having anything other than their fingers and a stop watch, without having tested their max. heart rate or V02 max, and who know nothing else about their cardio-vascular system, which gives it a degree of universality.

However, you've given us a lot of information that says this rule doesn't strictly apply to you. Your resting heart rate is somewhat high, and when you add 60 beats to it, you know your sats are slightly lower than they should be, indicating that you're above your aerobic threshold at that point.
---------
I definitely agree that your CF doc might not be the best resource for these questions; however, an exercise physiologist who knows nothing about CF won't necessarily be a huge help either. To really get precise answers, you would need a combination of the two. My recommendation is to see what tests your CF docs can give you ... maybe an ECG?, and to work with him/her to find the answers you're looking for. At the least, make them explain to you why they aren't concerned.

Hope this helps!

Chris

26 m w/cf
 
C

cdale613

New member
Hi Sonia,

The National Lung Health Education Program has a lot of useful info, although most of it is directed at the larger COPD/emphasema crowd.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlhep.org/resources/Prescrb-Hm-Oxygen/Introduction-2.html
">http://www.nlhep.org/resources...n/Introduction-2.html
</a><a target=_blank class=ftalternatingbarlinklarge href="http://www.nlhep.org/pdfs/lt_oxygen.pdf
">http://www.nlhep.org/pdfs/lt_oxygen.pdf
</a>
The National Heart Lung and Blood Institute also has a lot of non CF specific lung information:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nhlbi.nih.gov/index.htm">http://www.nhlbi.nih.gov/index.htm</a>

-------
Sorry to hear about the living in Vegas... I lived in Washington DC for a couple years, and it was horrible. Sounds like you are better off inside...

-------
Your current routine sounds good, but since your sats drop off so sharply, you might need to make it more gradual inorder to keep your sats higher.

I'd suggest tring five minute increments of: walk, slow jog, run, slow jog, walk. That should keep your workout time about the same, but lessen the intensity... see what your sats do then and go from there.
--------

Sure - the 60 beats thing is a rule of thumb, but not everyone's thumb is the same... The 60 beats thing makes an assumption that your standing heart rate is around 60-80 (which is considered "normal") and that your max is somewhere in the high 180-190s. Its an easy tool that people in gym classes and what not can use without having anything other than their fingers and a stop watch, without having tested their max. heart rate or V02 max, and who know nothing else about their cardio-vascular system, which gives it a degree of universality.

However, you've given us a lot of information that says this rule doesn't strictly apply to you. Your resting heart rate is somewhat high, and when you add 60 beats to it, you know your sats are slightly lower than they should be, indicating that you're above your aerobic threshold at that point.
---------
I definitely agree that your CF doc might not be the best resource for these questions; however, an exercise physiologist who knows nothing about CF won't necessarily be a huge help either. To really get precise answers, you would need a combination of the two. My recommendation is to see what tests your CF docs can give you ... maybe an ECG?, and to work with him/her to find the answers you're looking for. At the least, make them explain to you why they aren't concerned.

Hope this helps!

Chris

26 m w/cf
 
C

cdale613

New member
Hi Sonia,

The National Lung Health Education Program has a lot of useful info, although most of it is directed at the larger COPD/emphasema crowd.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nlhep.org/resources/Prescrb-Hm-Oxygen/Introduction-2.html
">http://www.nlhep.org/resources...n/Introduction-2.html
</a><a target=_blank class=ftalternatingbarlinklarge href="http://www.nlhep.org/pdfs/lt_oxygen.pdf
">http://www.nlhep.org/pdfs/lt_oxygen.pdf
</a>
The National Heart Lung and Blood Institute also has a lot of non CF specific lung information:

<a target=_blank class=ftalternatingbarlinklarge href="http://www.nhlbi.nih.gov/index.htm">http://www.nhlbi.nih.gov/index.htm</a>

-------
Sorry to hear about the living in Vegas... I lived in Washington DC for a couple years, and it was horrible. Sounds like you are better off inside...

-------
Your current routine sounds good, but since your sats drop off so sharply, you might need to make it more gradual inorder to keep your sats higher.

I'd suggest tring five minute increments of: walk, slow jog, run, slow jog, walk. That should keep your workout time about the same, but lessen the intensity... see what your sats do then and go from there.
--------

Sure - the 60 beats thing is a rule of thumb, but not everyone's thumb is the same... The 60 beats thing makes an assumption that your standing heart rate is around 60-80 (which is considered "normal") and that your max is somewhere in the high 180-190s. Its an easy tool that people in gym classes and what not can use without having anything other than their fingers and a stop watch, without having tested their max. heart rate or V02 max, and who know nothing else about their cardio-vascular system, which gives it a degree of universality.

However, you've given us a lot of information that says this rule doesn't strictly apply to you. Your resting heart rate is somewhat high, and when you add 60 beats to it, you know your sats are slightly lower than they should be, indicating that you're above your aerobic threshold at that point.
---------
I definitely agree that your CF doc might not be the best resource for these questions; however, an exercise physiologist who knows nothing about CF won't necessarily be a huge help either. To really get precise answers, you would need a combination of the two. My recommendation is to see what tests your CF docs can give you ... maybe an ECG?, and to work with him/her to find the answers you're looking for. At the least, make them explain to you why they aren't concerned.

Hope this helps!

Chris

26 m w/cf
 
L

ladybug

New member
Thanks, Chris!

I will keep ya'll posted what my CF doc recommends. My hope is that she'll realize we need to all work together on which tests to do, etc...

I recently had an entire gammut of heart tests done (not while exercising though) ... EKG and ECHO and met with a cardiologist for heart palpatations. Everything checked out fine. So, unless they'd do an EKG, etc. WHILE running, I don't know that my heart needs further checking into.

As for the tests, PLEASE tell me they won't do blood gasses when I'm running! OR AFTER for that matter. I HATE those things and garauntee that unless they give me valium with my run I will NOT have good results. My HR goes to 150 just THINKING about that test!!!
LOL
 
L

ladybug

New member
Thanks, Chris!

I will keep ya'll posted what my CF doc recommends. My hope is that she'll realize we need to all work together on which tests to do, etc...

I recently had an entire gammut of heart tests done (not while exercising though) ... EKG and ECHO and met with a cardiologist for heart palpatations. Everything checked out fine. So, unless they'd do an EKG, etc. WHILE running, I don't know that my heart needs further checking into.

As for the tests, PLEASE tell me they won't do blood gasses when I'm running! OR AFTER for that matter. I HATE those things and garauntee that unless they give me valium with my run I will NOT have good results. My HR goes to 150 just THINKING about that test!!!
LOL
 
L

ladybug

New member
Thanks, Chris!

I will keep ya'll posted what my CF doc recommends. My hope is that she'll realize we need to all work together on which tests to do, etc...

I recently had an entire gammut of heart tests done (not while exercising though) ... EKG and ECHO and met with a cardiologist for heart palpatations. Everything checked out fine. So, unless they'd do an EKG, etc. WHILE running, I don't know that my heart needs further checking into.

As for the tests, PLEASE tell me they won't do blood gasses when I'm running! OR AFTER for that matter. I HATE those things and garauntee that unless they give me valium with my run I will NOT have good results. My HR goes to 150 just THINKING about that test!!!
LOL
 
N

NoExcuses

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>ladybug</b></i>

Are there any studies that you know of that show WHEN to test??

</end quote></div>


At any point of your exercise, or your existence for that matter, you do'nt want to desat.

Doesn't matter in the beginning, middle or end.

I know this is tough for you and it seems like you are trying to come up with any reason under the sun not to need O2, but if you're de-satting, you're not doing your body a favor by avoiding what's going on.

I hope you come to terms with this sooner rather than later for your body's sake <img src="i/expressions/brokenheart.gif" border="0">
 
N

NoExcuses

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>ladybug</b></i>

Are there any studies that you know of that show WHEN to test??

</end quote></div>


At any point of your exercise, or your existence for that matter, you do'nt want to desat.

Doesn't matter in the beginning, middle or end.

I know this is tough for you and it seems like you are trying to come up with any reason under the sun not to need O2, but if you're de-satting, you're not doing your body a favor by avoiding what's going on.

I hope you come to terms with this sooner rather than later for your body's sake <img src="i/expressions/brokenheart.gif" border="0">
 
N

NoExcuses

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>ladybug</b></i>

Are there any studies that you know of that show WHEN to test??

</end quote></div>


At any point of your exercise, or your existence for that matter, you do'nt want to desat.

Doesn't matter in the beginning, middle or end.

I know this is tough for you and it seems like you are trying to come up with any reason under the sun not to need O2, but if you're de-satting, you're not doing your body a favor by avoiding what's going on.

I hope you come to terms with this sooner rather than later for your body's sake <img src="i/expressions/brokenheart.gif" border="0">
 
L

ladybug

New member
The following is EXACTLY what my CF Nurse Practitioner e-mailed me today after I e-mailed her the exact same concerns I've been chatting about on this thread...

<i>I can give you a nurse perspective on your questions, I am not an expert. First of all, you have had an echo, right? Secondly, when your O2 sats drop, your heart rate will automatically increase. It is not unusual to have an increase like you have when your resting heart rate is a little high. The fact that you feel energized by your workouts is a most important sign, and the fact that you return to normal quickly is excellent, showing signs of good aerobic fitness, but it may be wise to use O2 during exercise and see if it helps. Do you have access to O2 right now? I thought you had O2 at home. I believe it is a little premature for an exercise study or stress test, but you could approach the Dr. with that on your next clinic visit. Feel assured that there is no immediate concern, that when you become symptomatic during exercise, it will be time to look into further testing. </i>
 
L

ladybug

New member
The following is EXACTLY what my CF Nurse Practitioner e-mailed me today after I e-mailed her the exact same concerns I've been chatting about on this thread...

<i>I can give you a nurse perspective on your questions, I am not an expert. First of all, you have had an echo, right? Secondly, when your O2 sats drop, your heart rate will automatically increase. It is not unusual to have an increase like you have when your resting heart rate is a little high. The fact that you feel energized by your workouts is a most important sign, and the fact that you return to normal quickly is excellent, showing signs of good aerobic fitness, but it may be wise to use O2 during exercise and see if it helps. Do you have access to O2 right now? I thought you had O2 at home. I believe it is a little premature for an exercise study or stress test, but you could approach the Dr. with that on your next clinic visit. Feel assured that there is no immediate concern, that when you become symptomatic during exercise, it will be time to look into further testing. </i>
 
L

ladybug

New member
The following is EXACTLY what my CF Nurse Practitioner e-mailed me today after I e-mailed her the exact same concerns I've been chatting about on this thread...

<i>I can give you a nurse perspective on your questions, I am not an expert. First of all, you have had an echo, right? Secondly, when your O2 sats drop, your heart rate will automatically increase. It is not unusual to have an increase like you have when your resting heart rate is a little high. The fact that you feel energized by your workouts is a most important sign, and the fact that you return to normal quickly is excellent, showing signs of good aerobic fitness, but it may be wise to use O2 during exercise and see if it helps. Do you have access to O2 right now? I thought you had O2 at home. I believe it is a little premature for an exercise study or stress test, but you could approach the Dr. with that on your next clinic visit. Feel assured that there is no immediate concern, that when you become symptomatic during exercise, it will be time to look into further testing. </i>
 
N

NoExcuses

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>ladybug</b></i>

but it may be wise to use O2 during exercise and see if it helps. Do you have access to O2 right now? I thought you had O2 at home. </i></end quote></div>



Sounds great! Very wise idea
 
You must log in or register to reply here.
Top