Am I Flunking the Incentive Spirometer?

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auricula

Active member
Joined
Jan 15, 2011
Messages
28
Location
Maryland
I am 19 days past AVR and am having trouble breathing deeply. I have severe obstructive sleep apnea and don't know if that is a factor. I am 69 and do not have coronary artery disease. I think that very briefly I was able to reach 1500 mL but am now in the 750-900 range. Can anyone tell me what a goal number should be? I was not given one in the hospital. I'd be interested in hearing your experiences with gains made using the IS. I will see my cardiologist tomorrow and discuss this with her. Thanks, Pat
 
Pat, to my knowledge there reallty is no pass or fail as so much depends on individual situations eg body type and prior conditioning and in my case after the second procedure my diaphram was partly included in my pectoral flap,,,,so I am glad to hear you are seeing your cardio Monday
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and will get more input ...are you walking at least 20 mins daily ?
 
Hi Greg, I am trying to take three 10-min walks a day around the house and it's really boring. Was anything done to free your diaphragm?
 
Hi Pat,
Is pain a factor in how deep you can breathe? That could be a symptom of fluid buildup.
Will you be doing cardio rehab? That is a good place for monitoring and questioning.
Glad you will be seeing your cardio.....that should answer questions!

Pat (in MN)
 
Howdy:

Im only 45 dont have CAD and 19 days post-0p I couldnt get over 1000 at gunpoint! Im now 11 weeks and am at almost 4000. Take your time and focus on proper technique, it will get better. Like you, I was pretty bummed so much so that I called the suregons office concerned that I was improving very much post op. They told me exactly what Greg said, Just keep doing it and let your body have all the time it needs to heel up.
 
Like Bina, I detested the IS and paid no attention to the numbers. I am in the same age range as you, and did have some trouble regaining what the medfolk deemed adequate oxygen intake, but personally never saw much connection with the spirometer. I agree: just do the best you can, don't overly worry about it, and talk to your doc tomorrow.
 
Thanks, everyone, for the responses and encouragement. To patw: pain may be a factor; I have a lot of neck/shoulder/upper back tension, probably from the positioning on the table that led to the hand palsy. You were correct about fluid buildup. I went off Lasix when the visible swelling disappeared and immediately started gaining weight. Yesterday my cardiologist heard fluid sounds around (not in) one lung and she said to go back on Lasix and the potassium supplement. A real incentive to lick this problem is to avoid having my lung "tapped" (no idea what this involves but it sounds scary). I hope to do rehab but will not see my surgeon for 3 weeks and will have to wait for approval. Jake, getting to 4000 from my usual 750-900 would be awesome and I am glad to have your example. Superbob and Bina, it's good to hear of your IS aversion. I am wondering if you did any exercises or walking and found that your breathing improved without laboring with the IS? Yesterday was my first day out of the house since my homecoming 12 days ago and there was a very warm strong wind that I found extremely stressful. After having breathing problems on exertion for months pre-surgery I had hoped to have comfortable breathing magically restored but I see that this will take a lot of hard work. I was not able to do much in the way of "prior conditioning" as Greg mentioned because even my favorite refuge, a warm-water therapy pool, was impossible in the last month when the weight of the water on my body became unbearable.
 
Hi, Pat, I just read your follow up post. You are right to watch for rapid weight gain because it is most likely caused by fluid retention. It is best to monitor weight daily (or even twice daily) until you are no longer retaining fluid and to report to your doctor any patterns you see. Fluid around the lungs may not be as bad as fluid inside the lungs but it would still make breathing more difficult and probably painful. I'm glad to hear that you are once again using lasix to help deal with that. Perhaps, with a reduced fluid load, you will find it easier to walk which will also help restore your breathing. My surgeon wanted to me move the spirometer to 3500 which took me about a month but I had great weather for walking and little fluid retention at the time thanks to the lasix. I wouldn't worry so much about comparing your progress to anyone else's, Pat, because we each have our own issues that set limits on our recovery.

I also wanted to suggest that you consider a massage therapist for your neck, shoulder & back issues. After my AVR, I had no serious chest pain but the back and shoulders were a different matter. Massage really helped me get past that. You are probably also one of the people who might benefit from starting Cardiac Rehab as early as your doctor allows. The physiologists at Rehab will start you out very gently but even that very mild exercise will help both your breathing and the back problems.

Take care, Pat, and let us know how you are doing.

Larry
 
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Thanks, everyone, for the responses and encouragement. To patw: pain may be a factor; I have a lot of neck/shoulder/upper back tension, probably from the positioning on the table that led to the hand palsy. You were correct about fluid buildup. I went off Lasix when the visible swelling disappeared and immediately started gaining weight. Yesterday my cardiologist heard fluid sounds around (not in) one lung and she said to go back on Lasix and the potassium supplement. A real incentive to lick this problem is to avoid having my lung "tapped" (no idea what this involves but it sounds scary). I hope to do rehab but will not see my surgeon for 3 weeks and will have to wait for approval. Jake, getting to 4000 from my usual 750-900 would be awesome and I am glad to have your example. Superbob and Bina, it's good to hear of your IS aversion. I am wondering if you did any exercises or walking and found that your breathing improved without laboring with the IS? Yesterday was my first day out of the house since my homecoming 12 days ago and there was a very warm strong wind that I found extremely stressful. After having breathing problems on exertion for months pre-surgery I had hoped to have comfortable breathing magically restored but I see that this will take a lot of hard work. I was not able to do much in the way of "prior conditioning" as Greg mentioned because even my favorite refuge, a warm-water therapy pool, was impossible in the last month when the weight of the water on my body became unbearable.

At 3 weeks post op I was still a wreck but the docs checked my breathing, HR and BP, and said I was okay.
My breathing felt clear and un-restricted but my lungs felt very weak. I tried to sit up most of the day and took
short walks in the house and occasionally outdoors with my husband since the fall weather was so cold.
Whenever my husband would point to the IS device, I would glare at him and walk the other way. ;)
(I'm a horrible patient)
 
My Surgeon's Assistant recommended using the Incentive Spirometer for 10 minutes every 2 hours.
It WORKED !

I could actually hear and feel fluid being squeezed out of my chest cavity at the end of each breath.
 
Here are some excerpts from an email I just received from Steve, a nurse at my athletic club who had wanted me to let him know how my surgery went:

On A-fib--"Unfortunately A-fib is common post op on valve replacement because of so much cardiac tissue manipulation which can agitate the conductive pathway."

On breathing difficulty: "One thing you might do to facilitate deep breathing and to help the nerve situation is to work on keeping your shoulders back. With the insult that you have had to your sternum, it is natural to want to round your shoulders forward to take pressure off that area as it pertains to the pectoral muscles. Resist this by executing good posture as you can. Standing with your back to the wall and trying to get your shoulders back can help to open your chest area to facilitate deep inspirations and prevent the muscles from shortening and putting more pressure on the cervical plexus."
 
Your friend, Steve, has written what many of us were told by our doctors and nurses. That is exactly the information I was given both of my surgeries.
 

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