5 days post valve replacement- heart racing, bp dropped etc?

[JustmeCori]

Hi,

My Stepfather just had a valve replacement and a bypass surgery last wednesday.

They said he was doing ok, everything was normal and then Saturday his BP dropped - the bottom # was 30! and his heart rate was somewhere near 180!
Meds werent working so they took him back to ICU and shocked his heart. It got his heart and BP all under control... he looked great. HUGE DIFFERENCE.

Now, they just released him into a regular room and it happened again! The Dr's say "its not unheard of"... but naturally we're in a state of panic. Not to mention he is now convinced he's dying cause of this roller coaster recovery. His incision is also still bleeding a little (mostly when he coughs)... and he's sweating profusely which they cant explain why- he has no temp... and they say he has air pockets in his lungs so hes still on oxygen.

Anyone out there have a similar story that can give us a ray of hope here?!?
Its so weird cause he really looked good for a few days, eating, kidding around... doing his breathing and walking a little. Its just so crazy, this up and down recovery!

 

[ALCapshaw2]

Did his surgeon (or cardiologist) say if he was having some type of arrhythmia? ...or identify the cause of his elevated heart rate?

Atrial Fibrilation is Quite Common following surgery.
There are several ways to control it and it 'usually' goes away, once the heart gets over 'being cut upon' but may require medication for several weeks.

Many of us had resting Heart Rates of 100 to 120 after surgery. Your stepdad came out on the high end of the distribution. From the patient's perspective, it is scary and alarming, but the Doc's know how to get it under control, including shock treatments and several types of medications.

I *assume* his nurse came running when his HR jumped up again, at least I HOPE so. Tell him to try to stay calm while the nurse (and doctors) work to get his HR stabilized (even if elevated).

When the heart is pumping rapidly and erratically, it is not pumping efficiently, hence the drop in BP. Once his rhythm becomes regular, effeciency goes up, BP goes back up, and he will feel MUCH better.

The Sledge Hammer of anti-arrhythmics is called Amiodarone. Even the manufacturer recommends it as the 'antiarrhythmic of Last Resort' because it stays in the body for months, even after it is discontinued, and can have some nasty side effects if continued to too long or at too high a dose. OTOH, many Doc's simply use it from the start for a few weeks because it is VERY Effective at controlling dangerous arrhythmias.

Bottom Line: These things happen every once in a while. The Vast Majority of arrhythmias are NOT fatal (but they can sure get one's attention, especially if you've never experienced them before!).

Even the Dangerous one (Ventricular Fibrilation) is not fatal when caught and treated in the first several minutes. That's why ALL patients are on a monitor with alarms that is watched 24/7.

It would be good to talk with his Surgeon and/or an ElectroPhysiologist (Cardiologist who specializes in the Electrical System of the Heart) about these events, the risks, and the treatment options.

Hopefully knowing that he is not the only one who has experienced this type of reaction (and Survived!) and that the Doctors and Nurses have 'seen it all before' and know how to get it under control will make everyone less apprehensive.

'AL Capshaw'

 

[aussigal]

I know many of us remember getting the "sweats" after surgery. I cant recall the explanation as to why but its common.

Its also common for hearts to take a while to get back to normal after surgery...many of us have an episode or two of racing heart-beats and other stuff. Being in the hospital is the best place for this to happen as they can fix it quickly and monitor his recovery. My own heart really didnt like being operated on and I spent 5 days in a coma after 3 Cardiac arrests and a further emergency surgery. Good news is I am as good as new now.

 

[JustmeCori]

Thanks Al

Thanks Al

Thanks for the reply Al.

After I posted i did some searching on the forums about a-frib (which is what they said he had/has) and saw everyones comments on the meds... I called my mom asap to tell her what i read ab the amniodarone side effects etc... but apparently they had already started him on a drip for it.

We did speak to the dr's and the ElectroPhysiologist when the a-fib happened 2 days ago... and they did say that 40% of people experience it post -op and that it *could* happen again, but they hoped it didnt. I kind of remember the ElectroPhysiologist mentioning how they were going to put him on sovalol ( i think i misspelled that).. so maybe they thought it wasnt working which is why they have him on amniodarone now?

The good thing is now his BP is stablized... so they are just worried ab the heartrate (145)-- and are transferring him AGAIN to CCU... they said if the meds dont work they may have to shock his heart again... which he is very scared about.

The Dr's and nurses are all very nice and attentive, and yes they did rush the room when his rates went up.... and they assured us that although they dont want to say its "normal" or "uncommon" its certainly not unheard of... which to us just seems like their "safe answer' lol...Im sure many of you experienced this up and down emotional rollercoaster- i dont know what answers im looking for exactly except - its all going to be ok.

Im expecting my second child in Sept and I want him there to experience it with us. He and my mother are only married a little over a year - after we lost my father of to a long battle with colon cancer...and my stepfather has just been a huge blessing to us, he's an amazing man.. to my mother, my siblings (12 and 14), all of us... and all that is totally off topic, and irrelevant I know- but if i seem a little winded, panicked, or overwhelemed... its cause Ive been through a loss only 4 yrs ago and cant imagine going through it again... and it could be a mix of the hormones too

Either way, thanks for listening.

 

[ALCapshaw2]

A-Fib (short for Atrial Fibrilation) is Not Fun but is also not on the High Danger List.

I *assume* (and hope) that they have him on Coumadin or Heparin for anti-coagulation to prevent Clot formation which can result from prolonged A-Fib.

Many of us had multiple isolated incidents that can come on after a few days out to several weeks. Mine usually cleared after 3 hours regardless of treatment (or lack thereof).

There are many possible triggers for A-Fib, including Stress, caffeine (coffee, cokes, CHOCOLATE - my downfall), nicoteine, and others I have forgotten.

Many of our members have had good success with Sotalol which is the Generic Form of BetaPace and has fewer and milder side effects (mostly some slight dizzyness that clears after a few weeks). It may take a while for it to become fully active. That could be why the Doc's went to Amiodarone. That and the fact that your stepdad did have a 'more intense level (i.e. higher HR) than most'.

It sounds like the Nurses and Doctors are doing all the appropriate things in a timely manner.

ALL of us who have had OHS (with and without the 'bumps in the road to recovery') had to make a Leap of Faith. It helps to BELIEVE that all will be OK in the end.

I hope that you all (or should I say y'all can take some comfort in his good care and learn to take these 'bumps in the road' in stride. (and I KNOW that's not always easy!)

Remember, just about every member here is either a SURVIVOR or Family Member of a SURVIVOR.

Valve Replacement Surgery has evolved to a highly refined art with a very high rate of success (1% morbidity 1% mortality) for first time surgeries on a national average. The odds of your stepdad not making it after a successful surgery are extremely low. Developing a Positive Attitude and Outlook is KEY to success.

You may find some inspiration from the posts by our member Nancy whose husband survived 3 Heart Surgeries, 2 Lung Surgeries, and many other co-morbidities, finally succumbing to multiple organ failure at age 75 (after some Doctors had suggested he wouldn't make it past 50). His Heart and Valves were Still Beating soundly till the end.

One thing to look for are signs of Depression. That is another 'not uncommon' effect of Major Surgery. It too can be treated effectively with Counciling, Medication, EXERCISE (starting very gradually with simple walking), and a Positive Attitude conveyed by Staff and Family.

Feel Free to come back to the Forums as often as you need or want to for feedback or moral support. You're all part of our Extended Heart Valve Family now!

'AL Capshaw'

 

[AngelaR]

Hi Cori

I can't offer any experiences and it seems Al has been of great assistance to you. I just wanted to throw in that if you have some down time read as much as you can on here that way if something else pops up you can reference it. Before my husband had his surgery this was where I camped all day at work (shhhh, don't tell my boss!)

It really helped when little things would pop up and I would say that's normal, so and so on vr.com had that too =) Like the sweats. Ray doesn't have them anymore at night but that first week he would wake up soaked and then get chilled. I'm not sure why either. My guess would be the body is still learning how to stabalize a temperature after being bulldozed. Our bodies are like pendulum's and you swing it too much to one side it is going to swing all crazy until it finds equillibrium again. You just have to be patient. Just make sure your step-dad is drinking plenty of fluids to replenish from the sweats.

I'm sorry to hear your family is having such a tough recovery and about the loss of your bio dad. =( Especially from cancer. I hope everything quiets down and you can take him home soon!

Good luck with the new baby too!!!

 

[JustmeCori]

Thank you all for offering your supportive words.

We have been keeping positive the whole time (with exception of my stepfather who's been a nervous wreck most of the time). I know in my heart its going to be ok- we all do... but the ups and downs in the recovery sometimes make you second guess yourself - as Im sure many of you have experienced.

Yesterday was just a crazy day for all of us, hopefully today will be much better

I will keep you all posted as to his progress.

Thanks again!

 

[Bina]

Cori, your stepDad will be fine....many of us have this roller coaster ride for a while. My HR (while sleeping), had reached 170 and it was taken care of quickly and efficiently. Some arhythmias may still occur occasionally and Sotalol is a great med for that. The heart just needs more time to heal and re-model. Best wishes.