The 6-minute walk test brings me a sense of familiarity and comfort
Since my PH diagnosis, I've come to enjoy the noninvasive test
Thirty-eight thousand, seven hundred, and ten feet. That’s the length of about 107.5 football fields, including their end zones. It’s also a ballpark estimate of the distance I’ve walked during six-minute walk tests since I was diagnosed with pulmonary hypertension (PH) in 2016. What a journey!
A six-minute walk test (6MWT) measures aerobic performance by monitoring a person’s heart rate and oxygen saturation while they walk as far as possible during the allocated time. It’s considered a common, noninvasive test to monitor some measures of health for people with conditions like PH.
The 6MWT is part of my quarterly PH medical checkup routine, and over the course of seven years, I’ve come to really look forward to it as an important component of my care. I completed my most recent walk test during my quarterly appointment in March.
The disease, which affects the heart and lungs, can throw such unpredictable circumstances at us. PH-related flare-ups are a hallmark of life after diagnosis, often involving shortness of breath, fatigue, unexpected dizziness, and chest pain. I find myself craving moments of predictability when I can know what to expect based on past experiences or behaviors. I think that’s partly why I’ve developed a certain amount of relief, even positive anticipation, for the familiar walk test.
I receive the majority of my care at the hospital where I was diagnosed with PH. While that means I’m never too far from memories of that initial hospitalization, it also means that I’ve been able to reclaim and redefine who I am whenever I walk through those hospital doors.
It’s also allowed me to develop a level of comfort with where and how I do the test. When I close my eyes, I can see the hallway course where I walk. I see the big windows that allow for plenty of sunshine to fill the space, the two orange cones that mark the course’s start and turn points, and the Borg Rating of Perceived Exertion scale posted on the wall. I can hear the Velcro pull of the headband used to monitor my vital signs as the respiratory technician fits it snug around my head.
Another reason I enjoy the walk test is the simple taste of healthy competition. Now, I’m only competing with myself here, but I can’t seem to pass up the opportunity to compare results and try to reach a new personal best with each test. Sometimes I don’t walk as far as I did in previous tests, and other times I exceed my own expectations for how much distance I can cover. That I’m able to walk for six minutes without stopping also brings its own sense of accomplishment.
A focus on fitness
When I take the test, I use anywhere from 4 to 6 L of oxygen. After about two minutes of walking, most of the perceived exertion doesn’t come from my difficulty breathing, but rather a tightness that develops in my leg muscles. One of my biggest struggles in managing PH is maintaining a steady exercise program. There’s a general understanding among doctors who treat PH patients that regular exercise is part of managing one’s disease.
According to the Pulmonary Hypertension Association, experts discussed the importance of exercise at the 2018 World Symposium on Pulmonary Hypertension in France. “It was the first time there was agreement that exercise was beneficial to people with PH,” said Jim White, MD, PhD, who works at the University of Rochester in New York.
Many physicians had been advising PH patients against exercising since the 1980s because it made them short of breath. “The idea that people needed to be packed in egg crates was slow to die,” White said.
White’s comments illustrate how approaches to PH management have evolved in the past few decades. A recent study featured on Pulmonary Hypertension News found that noninvasive tests like the 6MWT, when used in conjunction with other assessments, could help diagnose PH in people who have interstitial lung disease. The study caught my attention because my journey started with a physician recognizing my interstitial lung disease — long before I had a right heart catheterization to confirm the PH diagnosis or ever did a walk test.
While the results from my recent 6MWT were by no means a personal best, they remained in an acceptable range for me, and more important, for my doctor, and that feels like a win. The test will continue to be an essential component in tracking my PH-related health.
I’m proud of making it through seven years of these walk tests, and I’ve already set my sights on the next one on the horizon.
Follow Mike on Twitter: @mnaple.
Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.