89% spo2 increased to 95% after exercise

[ithkuil]

My mother has a rapid irregular heartbeat (recently, sometimes even despite Metoprolol and Warfarin) and supposedly mild COPD with a possible touch of pneumonia and was hospitalized this weekend because she was saying she was having palpitations and was too tired to sit up and it was too hard for her to breath laying down.  

Today we went to the doctor (primary care) and after I asked for him to prescribe oxygen (since she had reported in the emergency room that it was very effective), he tested her oxygen saturation on her finger and it was 89% resting, having been sitting in a wheelchair and not walking around since she gets out of breath easily.  She walked with the nurse down the hallway and back and was short of breath as usual after any exertion recently, but her spo2 was reported as 95%.  So she seemed short of breath with faster, shorter, more difficult breathing but her oxygen saturation was supposedly greater.  To me this indicated that perhaps her respiration was adequate but her heart was not performing.

Anyway, the doctor put her on continuous oxygen at 2 (liters?) and reduced her Metoprolol by half to 1 tablet twice a day since her blood pressure had been extremely low when she came in.  We are to monitor her blood pressure and pulse.  

My question is, should she be on oxygen, and why did her saturation level increase after the walk up and down the hall.  That seems to be a reaction a healthy person might have?  Or just atypical for someone with her other symptoms?  I thought we expected it to go down either a tiny bit or a little, but not to go up.

We are supposed to have a referral to a cardiologist although I don't know when we will hear from them.

[ithkuil]

Yes, I am pretty sure they are saying its a-fib.  The second time she took her pulse/blood pressure today the pulse was 89 which is great.  She was at 118 this morning.  The problem is when she tries to walk around it goes up and I guess she gets a-fib because she is out of breath fairly quickly.  She has been on different doses of the Metoprolol and Warfarin to try to fix that.  It was too much though because her blood pressure was ridiculously low so they reduced the dose yesterday.  She says she is feeling fine today but she still can't walk around and do things without getting out of breath though.  We have an appointment with a cardiologist, soonest we could get was a couple of weeks away.

[itdood]

p.s., do you know why her heart rhtym is messed up?  I didn't take that into account in my post.  If she's in a-fib then it sounds like they need to get better control of it because that will lessen her heart output.  

[itdood]

Mine does that too. I have an spo2 monitor at home.  Mine will sometimes go down to 95ish when I just sitting around.  If I get up and walk around it will go up to 99-100.  I'm not on any meds.   My wild guess is that more circulation is occurring.

I agree with your guess that her lungs are doing well, her circulation needs to be improved.  Walking does this, especially for your legs.  I've heard feet called the "2nd heart" because of the way veins run though them, and how vascular valves are setup, as you walk on them blood is pumped back up the leg to assist the heart.  As you place weight on you feet and walk forward it squishes blood back up the leg veins.  The valves in the our veins keep it from falling back, so in effect it's like pumping the blood.

I've read that 90 - 100 spo2 is fairly normal.  They start to worry < 90 and each % below 90 is more worrisome.  ex, a drop from 98 to 92 isn't a big deal, but a drop from 89 to 86 is a very big deal.

Her getting up and about is probably very important and might even be healing.