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View Full Version : One month post op and short of breath



greggo32
May 16th, 2002, 06:20 PM
I need some advice from other folks who have had there sternum cracked! I am one month post aortic valve replacement with a mechanical valve. Echo of the valve indicates it is functioning fine. Lungs are clear. However, I have palpatations (particularly when I stand up) and I have shortness of breath. The docs say it is normal; however, I am concerned. Any consumers out there have any input?

Truly,

Gregory Golden

RobThatsMe
May 16th, 2002, 06:47 PM
Hi Greg,

Sorry to hear that you are running into this. I don't recall that I had that condition after my surgery, but I was wondering if perhaps it may be caused by the new medication that you are taking since your surgery. Are you now on a Beta Blocker? If so, What dosage? You may want to ask your doctor if any of the meds you are on may be the culprit.

Wishing you good health,

Rob

Tom Harrison
May 16th, 2002, 07:54 PM
Hi Greg
I'm 2 1/2 months post op and still find I'm SOB on any exertion, yet prior to becoming ill last fall I had no such symptoms. I am attending a rehab program and they have me walking 1/2 hour per day at a brisk enough pace to get my heart rate to an "aerobic" level. I mentioned the shortness of breath problem to one of the nurses and she said surgery can leave iron levels low and lack of iron inhibits the lung's ability to provide oxygen. I checked and sure enough my oxygen levels are low. She recommended pre natal vitamins as they tend to be high in iron. However before I take them I want to be sure such a supplement won't interfere with my INR levels.
Anyone else heard of this ???

mainframe
May 16th, 2002, 08:15 PM
Greg,

I didn't notice those types symptoms 1 month out. Only thing I felt at that point was a little sternum soreness (I had quit taking all pain meds including tylonol) and occassional "pounding" (still feel now and then). I know it's hard to not be concerned even though the doc's don't seem to be.

I do feel a whole lot better 9 weeks out, even starting to do cardio for as long as prior to surgery, just not quite at the same level quite yet. I even played with the weights a bit, still going to wait a couple more weeks before "lifting".

Hopefully with a bit more time the SOB and palpatations will go away.

Best wishes.

Chris


Tom: The doc's suggested pre-natal vitamins for me also. I used them until I ran out, now just using a regular multi vitamin.

LUVMyBirman
May 16th, 2002, 08:53 PM
Hi Greg

Hang in there. Did they determine the type of palpation's you are having? PAC's maybe?

3 months after my MVR I started getting the 'premature atrial contractions'. My surgeon thought in part to my left upper chamber returning to normal size. It was mildly enlarged prior to surgery. These irregular beats continued for 2 years. We finally stumbled across a fix and accidentally at that. They put me on Inderal LA for migraine headaches. My PAC's disappeared.

Recently we tried to come down and off the Beta Blocker. To no avail, the PAC's returned. When having the concern, they were more pronounced when I was tired or overexerted.

Take it easy and keep us posted. It takes a good while to get that energy level back.

PS. What type of valve do you have?

Mb
May 16th, 2002, 09:03 PM
Hi!

My husband is 7 months post op, and gets SOB with mild exertion. Also gets palpitations at times, but he does have residual problems.

Just a comment:

a. Be careful with the vitamins......check to make sure the do not have K, as it will really goof up your INR.

b. Our Boston cardio is constantly telling us that mitral valve replacement vs repair, is a very difficult trauma for the heart. More difficult to recover from than the aortic replacement. I guess they have to open up the heart on the mitral, as with the aortic they just do it from the top. You really can't compare the recover periods. My husband had both done at the same time, and now his tricuspid valve has a severe leak. So his CO is compromised.

c. I understand it is common after having OH surgery to have palpitations, etc. You just have to take ist slow, and tgive it some time.

d. Watch your weight. If you gain more than 3 lbs. in 24 hours, call the cardio promptly. He will get you on a diuretic.

e. Fast heart rate is common with anemia. Most folks have anemia after getting out of surgery Mechanical valves also do some damage to the red blood cells as they shut, so most valve patients have a lowered blood count. Bottom line you need folic acid and iron....but, by Dr.'s orders only. I am certain he knows what he is doing.

f. Do not compare your recovery with by-pass surgery....and do NOT let anyone else compare it. The surgery you had was MUCH more complex, and the heart was opened. Take it easy, my friend.

Best wishes.

Marybeth

LUVMyBirman
May 16th, 2002, 09:39 PM
Great advice Maryann!

On the vitamin front, beware of B vitamins if you are taking Coumadin. Specifically B-6. Coincidentally, it was suggested by my internist that I take it to boost my energy. The only thing it did for me was 'boost' my INR over 5.0! At the time we were still fine tuning so they had me hold for two days which brought it down to 1.2. Then they admitted me for 2 days. Placed me on the Heparin until the levels came up. All over a vitamin:mad:
Lesson learned. Holding my Coumadin for two days does not work for me.

Still to this day, and it has been 3+ years have a difficult time getting my doctors to believe that my INR bottoms out if I hold the 2 days. 4.0 - 5.5 and I half my dose for one day it Brings me back into range. 4.0 I leave it alone and have a salad. It truly works for me.

Johnny Stephens
May 16th, 2002, 11:22 PM
Hi Greg, I had my surgery the same day as you. I've had no palpitations since coming home (I had 4 episodes in hospital), but I am slightly short of breath. I notice it if I start to walk too quickly after standing up. I too was told that anemia was the culprit. I'm on a multivitamin (no vitamin K) to build up the iron.

I also notice that it is much worse after I take my morning cocktail of meds. Some of the meds will be discontinued next week, so they think my SOB will likely improve a bit then.

RobThatsMe
May 17th, 2002, 03:54 AM
Hi again Greg,

I read through the posts and found Tom's interesting regarding the low oxygen levels and suggestion to take "Iron" .

My surgeon wrote me a script for "Iron " pills and I had to take them for 2 weeks after surgery, along with many others. Down to only 3 now. But I do take a multivitimin, Centrum.

My daily pill intake these days consists of; 5 mg Coumadin, 50 mg Atenalol, 325 mg Aspirin, 1000mg vit "C", 400 iu "E", and a Centrum multivitimin.

My INR is stable, and is problably adjusted to my vitimin routine. It has been no problem staying within my recommended range.


Regards,
Rob

greggo32
May 17th, 2002, 09:00 AM
My hemoglobin and hematocrit are now in the normal range so my shortness of breath isn't likely to be due to the oxygen carrying capacity of my red blood cells. I placed another call to my surgeon's nurse to discuss this with her. I also went out and walked for 15 minutes today despite my symptoms. I am really out of shape and need to walk. My heart rate was only 90 after excercise and my blood pressure was normal too. I hope this is just the healing process. If this lasted I don't know what I would do!!! I wonder if they left a sponge in me or something.

Thanks for your feedback on this issue as it is very scary to be going through it and I really don't want to go into this with my friends because it doesn't help. It is a medical problem. My dad (physician) said to me, "Do you think you need to see a psychologist". I told him that I would if these symptoms didn't abate!

Thanks,

Greg

Nancy
May 17th, 2002, 11:09 AM
Greg-

Pursue this very carefully with you cardiologist and keep on pursuing it until you get satisfaction. Marybeth is right on all the things she has said. Mitral valve surgery is difficult. While shortness of breath is not unheard of after valve replacement, it shouldn't be causing you such distress, there might be things that need to be tweaked, your meds, your diuretic, maybe you need a chest x-ray to look for fluid.

Irregular heartbeats can sap your strength and cause shortness of breath, too. Have your doc look into this more carefully.

There are always adjustments after this kind of surgery. I'm sure in time things will get ironed out.

sylviayasgur
May 17th, 2002, 11:31 AM
hi greg!
my husband, joey, was sob for quite awhile after surgery. i remember him saying to me " i can't believe i'm even shorter of breath than i was before!! something is wrong!!" luckily, nothing was wrong.
i had to remind him to be patient and as his sternum healed, his sob decreased and he became able to do much more without getting winded. (he had a very hard time being patient and wanted his recovery to be instantaneous).
this, however, doesn't mean that it is the same case with you. please follow up if you see no progress over time.
nancy has a point in that palpatations/irregular beats means your heart is not beating or functioning as efficiently as it should_this could also be contributing to your sob.

tom,
joey's crit level was also very low and he was on iron pills for a few months. the docs said this also contributed to his shortness of breath, just as you mentioned.

in any case, please let us know what happens. hope you feel better,
sylvia

greggo32
May 17th, 2002, 12:02 PM
Dear Sylvia/Nancy and everyone else who has given me advice-

I guess I also have to keep in mind that this is the second time that I have had heart surgery. I am also going to consult with a pulmonologist if I don't see progress over the next week.

Perrster
May 17th, 2002, 02:27 PM
Greggo,

I don't remember much since it's been over two years, but I distinctly recall my re-hab nurse (former operating room head nurse) telling me to give it a YEAR! I think full recovery maybe took even longer!

I didn't even know about vr.com until at least 6 or 8 months post surgery and then it took me awhile to get into it and converse with all these incredible people. Anyway, once I got my personal routine going and new life in order I started to naturally come around. I went through a very long, dark period being challenged by vampire bats for Protimes.

I'm glad that I didn't push myself. Who knows where I might have ended up?!

I'm still learning stuff, too (from vr.com). Thanks to Marybeth I just learned about the difficulty of the Mitral operation. Heck, if I would have known that, I might have saved myself $4,000 because my insurance would not accept the surgeon's bill (said it was above their reasonable and customary guidelines). I could have explained in better detail about the complexity (we tried to fight it for over 6 months). He billed $4K above somebody's guidelines, because he did two valves at once. The insurance idiots would have had me in two separate surgeries because it would look better on paper!?@!!

Live strong and prosper, Greg. Be patient too. You will be fine.

Regards,

Nancy
May 17th, 2002, 03:36 PM
That's good Greg, keep after it. I think sometimes, when you have had a long stint of heart problems, your lungs get lazy and accustomed to a weak situation, when you get your heart fixed up, it puts more pressure on the lungs to "get moving, you lazy so and so" and that's why they push the spirometer so much in the hospital, plus they don't want anyone getting pneumonia. Everything has to get in sync, it will sooner or later

Sounds like you have a good plan to see the pulmonologist.

Mara
May 17th, 2002, 04:14 PM
Greg-
I was glad to see your post about going to see a pulmonary specialist. I hope that helps. Have you been doing your post-op breathing exercises?
Because this is your second surgery the by-pass pump may have had more impact on you this time. Give yourself a break, you've been through a major trauma!
Recovery is a slow process sometimes. You'll get there.

Good luck with the pulmonologist.
-Mara

McCln
May 17th, 2002, 05:36 PM
Just take things one day at a time. Also good to talk to a doctor. I had the same thing, aortic valve replacement bypass. You have been through a trauma of surgery, so go slowly and buildup carefully. You will be alright and the palpatations will eventually go away. I have weird sensations when I would move when I first came home. But you will be better soon. Hang in there.

Caroline
09-13-01
Aortic valve replacement
St judes valve

Johnny Stephens
May 17th, 2002, 11:17 PM
Greg, since I posted yesterday, I've had a followup with the docs to look at my medicines. One look at me and they said I was completely waterlogged, saying I was packing several extra lbs of water!

They immediately dismissed the meds, scrambling to get me an echo (I kept hearing "STAT!") to check for fluid around my heart. Good news, heart looked great. But, they could actually see large amounts of fluid in my abdomen. They said "no wonder you feel sluggish."

They came up with an agressive diuretic plan, which they started me on last night. I've spent most of the last 24 hours in the bathroom, shedding 5lbs overnight and another 2 during the day today.

I feel MUCH better already. Shortness of breath is greatly improved!! I took a 20 minute walk around the block today, on Tuesday I could only make it to the corner (about 200 ft).

I'm able to get my breath now, but I'm still out of shape.

Are you retaining water or do you have any edema in your feet / legs?

greggo32
May 18th, 2002, 06:51 AM
Dear Johnny,

I was wondering why Florida is in a drought, all the water was in you. That is quite a story! My God, 5 pounds of water. My surgeon told me to follow a no-low salt diet for 6 weeks post surgery. I don't have any edema and I'm not retaining water. I'm just getting ready to take a short walk and see how I do. It was nice to get your letter and I hope that you are doing well.

Greg

Don
May 18th, 2002, 09:56 AM
I'm now 5 weeks post op (4/12/02) and still get a little short of breath when I first start my daily slow walk (approx 3 mph). I just slow down my walking speed to almost nothing until the sob goes away, and then speed it up a little with no further problems. My biggest really annoying problem is when I get up from a seated position, including car seats. Feels like I have to be real carefull or I might pass out. It takes a couple of minutes to "come back". Also I had some palpatations when I first got home but they have largely subsided.
My local card indicated that I may need to reduce my BP meds (two prescriptions.) I'm 69; your much younger; I do not know how that effects the comparability. Perhaps my expectations are lower than yours; maybe not. I just finished walking 3 miles in one hour on somewhat hilly terrain at 4,200 ft altitude for the first time since my AVR. Felt good. Oh yes, I had some palpitations after I first returned home but they have subsided.
Don
AVR 4/12/2002 Cleveland Clinic; Carpentier-Edwards PERIMONT Aortic Pericardial Biologic Valve 25 mm

Greg T
May 26th, 2002, 09:05 AM
Hey Rob:

I too have been using iron supplements and a multi-vitamin (One-a-Day...No vitamin K). The effect has been amazing. I have been using them for a week and I have noticed a dramiatic increase in my energy levels. A blood test I had prior to the start of the supplements confirmed that my red bood cells among others were low.

I read read the Centrum label and noticed that it contains vitamin K. I guess you have made the needed adjustments in your coumadin.

Thanks for the iron/vitamin info.:cool:

Greg T

Tom Harrison
May 26th, 2002, 01:22 PM
I started with a pre-natal vitamin supplement the size of horse pills, found them hard to get down. Kept looking and found Centrum "50 plus". They are chewable plus seem to have the highest iron content other than the pre-natal variety. Vitamin K is not listed on the bottle and the pharmacist assured me they were ok. I have been having problems regulating my INR levels so I am going to run the use of these by my doctor next week.

jenny
May 29th, 2002, 07:33 PM
HI I have been here a couple of times before, but have not checked in for a very long time.. I am just coming off of a medication called Sotonal....has anyone one here been on this? I have had the feeling of sucking on a straw when I breath in. I had a MVP repair done in 1996....Thank you .....:) Jenny

sylviayasgur
May 30th, 2002, 06:55 PM
hi jenny!
is that sotolol you mean?
welcome to this site, it's a great place and the people here are just wonderful, warm, informative and caring.
you've come to the right place and i'm sure someone familiar with this will come forward.
joey took sotolol (betapace) for a few years to keep his afib at bay (it worked!) . why don't you ask your cardio or pharmacist if there are side effects (maybe mention to your cardio how you are feeling)? there are numerous other meds that can be substituted for it. please inquire.
please let us know what happens.
be well, sylvia

jenny
May 31st, 2002, 03:35 AM
Hi Sylvia, First of all, thank you for the welcome....I did check with the doctor and now he wants me to take Diltiaz..ugh, I get so depressed when the swithch meds for my body is so sensitive to them. Has anyone here heard of the medication? I went to the emergency room last night for I was very short of breath for many hours..I was wheezing ect........Now they have to investigate what that is all about. It was not heart related...I guess I have to take a bunch of breathing tests....Like , Gilda Radner, said "It is always something!!!!!!!" Ugh , thank you for answering me.....:))))))))))))))) Jenny