Jul 062020
 

August 2019 at the gym

July 6, 2020 — Today was my third session back at the hospital’s cardiopulmonary gym since the pandemic started. I’ve been going to this remarkable place since late spring 2019 when I began the cardiopulmonary rehab program. After my “graduation,” I started in the after-program. I’ve had asthma for 29 years, which had morphed to chronic asthma, which had morphed to severe asthma and several other related problems of my lung. I initially lost 25 pounds over the first six months and need to lose at least another 25. Honestly, weight loss isn’t my primary reason for being there; the exercise is to strengthen my lungs and my mental agility.

I’ve learned so much from the staff and the other patients there, strategies for dealing with life on oxygen. For example, I used to struggle with taking a shower.  I learned that I could do several things, take my oxygen into the shower with me (as long as it doesn’t get wet), get a shower chair (which I’m not ready to do), or sit down on the commode to towel off.  Now, why didn’t I think of that?

Aspects of my disease that I struggled with or caused me shame were everyday talk in rehab.  I used to arrive 15 minutes before class for the bull session.

Who had the best portable concentrator?  Where did you get that backpack?  Who is your doctor?  How do you like Dr. X? How do you handle the hot, humid weather?  How are you doing today?

I missed the gym and especially the people for the past four months. I had stopped going last November when the flu was rampant.  I returned in February, and the gym was shuttered in early March. Since it is a physician-referred rehab program, everyone who exercises there has a heart or lung problem. There are also several pre- and many post-transplant patients. (The pre-transplant patients wore masks before the pandemic.) I have some eye problems, so I feel uncomfortable walking in our hilly neighborhood, so I didn’t exercise. From May through the beginning of October, the air quality here is also terrible.

So, as soon as I received the information that the rehab program was opening, I was psyched. My first day back was last Monday. I stood in a socially-distanced line to get into the hospital.. Masks are required; if you don’t have one, the hospital gives you one. I signed-in, had my temperature taken, answered questions, and got my daily “hall pass.”  One of the regular questions is, have you had a bad cough today?

I said no, though I’ve had a bad cough all day, every day for the past quarter-of-a-century.  I wanted to quote Inigo Montoya from “The Princess Bride” to my questioner, “I do not think it means what you think it means” about my cough.

I punched the elevator button with my elbow and went to the gym’s floor.

I thought I had prepared well. We are required to wear our oxygen into the gym and then switch to a green hospital canister. The canister is continuous oxygen, instead of the pulse oxygen of my portable oxygen concentrator. Continuous oxygen is better for breathing, especially when exercising. (At home, I have a super-sized concentrator that pumps out continuous oxygen into tubing that goes all over our upstairs and even down the stairs to the family room. The big tank is known as Big Tanko, and weighs 41 lbs.)

But, I hadn’t quite figured out the logistics, with the new pandemic rules. There aren’t enough hands to change from one oxygen to the other while dealing with a mask. I had made a mistake. Usually, I would unplug the six-foot tubing from my portable concentrator and plug directly onto the hospital’s tank. In the age of COVID, that was a bad idea, so I brought a clean tube from home in my bag. I brought an easily cleaned plastic bag. But to take my old tubing off and put the new tubing on, I HAD TO TAKE OFF MY MASK. That’s a no-no (so I did it quickly). I wasn’t near anyone, but I still felt terrible about it.

I did do something correctly. I brought the bag, needing a clean place for my concentrator (I call him ‘Lil Tanko.) ‘Lil Tanko, who weighs six pounds, might get contaminated. He has a fabric cover that can’t be washed. I usually put him on a chair, but that seemed risky. I put ‘Lil Tanko inside the bag and hung the bag on the coat rack.

Exercising in a mask is a challenge, and the first two times, I struggled. I knew my strength and stamina diminished, but I was hoping to make progress rapidly. Today, I figured a way to improve my stamina. The oxygen in the green tank is cool, while the room air is warm, sometimes even a little stuffy on humid days. I could use the “One crocodile, two crocodile” breathing technique I learned on my first day at the gym.

Breathe in through your nose and say to yourself, “One crocodile, two crocodile.” Breathe out and repeat.

Please don’t do it too fast or you’ll hyperventilate, especially in a mask. I made a conscious effort to breathe regularly (always a good plan), and today was a better day. (My concentrators give off a nasty beep if I’m not breathing often enough, but the inert hospital canisters do not.)

Only half the typical class was allowed in, so it wasn’t crowded, and yellow signs noted the machines we couldn’t use.

Today, a man next to me nearly passed out on his treadmill because of his mask. He didn’t have it over his nose, which isn’t allowed. I told him about the one crocodile, two crocodile thing (which also works with alli-ga-tor), but he wasn’t doing well. The nurse came over to talk to him and remind him about the mask.

He wasn’t someone I met before so that he may have been a new person, first time at cardiopulmonary rehab. I hope he is okay. (Because of the HiPPA laws, you don’t know why people are at this gym unless they tell you. Nor can the staff discuss patients. Several of my classmates have disappeared, and later I’ve discovered their obituary in the newspaper.)

I finished my work-out and reversed my procedure from before, cleaning all my equipment with the wipes provided, and cleaning my hands and everything I touched.  I took an extra wipe to use to open the gym door and hit the elevator button.  I used it for the inside elevator button, hit “1”, and went to one of the four markers in each corner.  An older man came running in, and the door almost caught him.  I quickly moved to the front of the elevator, and held the door for him with my leg and stepped back to the rear of the elevator.

Immediately he took off his mask.

“I can’t breathe in this thing,” he said.

I didn’t know what to say.  We are in a hospital.  He is there as a patient (patients must be unaccompanied) or an employee.  I didn’t see a nametag. The floor he was on has only physician’s offices and the rehab program.

He put the mask back on.

I don’t live in a hot spot (today), but it made me mad.  I want to go back to the gym, and I’m taking care of myself and others.  But, I think I’ll start using the stairs.

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