1 Week Post-op

[adpace]

I am a 35 year old female and had a tissue AVR.

I am 1 week and 1 day post-op! I'm still in a lot of pain, though, and wondering if someone can give me an idea of how normal this is. I'm still taking large amounts of Norco, especially at night when I need to sleep. I try to space it out more during the day and take smaller doses in the daytime since I generally feel better. My surgery might have been a slight bit more intensive just for the fact that they tried to do a minimally-invasive surgery first. So they prepped me for that and cut into me. Then it was determined my arteries were too small to make the minimally-invasive surgery work. So I now I have 3 incision sites (plus a lot of scratches and bruises from all the many tubes/ports/IVs)!! The anesthesiologist also apparently had difficulty getting a port or IV into the first place she tried, so I guess I might have some extra stuff from that, too. I'm not really worried about the scars or anything, but I'm wondering how long this recovery may take.

My stomach also is looking like I'm 9 months pregnant right now. Can anyone relate? I think it must be fluid retention. I didn't get out of ICU for 5 days because there was still so much drainage from my chest tubes. They actually finally released me to a regular room before those came out (the day before I left the hospital). My surgery was Thursday last week and I finally got to leave Wednesday. Anyone else experience bloating like this?

I was told over and over again in the hospital that I looked really good and that I was coming along right on, or even ahead of schedule. However, reading other recovery posts, I feel behind. I'm still in so much pain a lot of the time although I'm really trying to strictly follow all orders from exercise to being careful not to use my arms to lift/push/pull. I also left the hospital with some fluid on my left lung. I'm desperately fighting that and trying to use the spirometer very, very often. I still only get to about 1000 on a good breath. What's normal there?

And my upper back/shoulders are hurting some. I feel hunched over all the time, but straightening up is a bit painful. I try to do it for short periods - I don't want to be permanently hunched over! With my stomach so large, my chest is practically resting on my stomach. Just doesn't feel right. Hopefully that will resolve soon?

So, all that to say that I came through everything pretty well, but I'd love to hear some of your experiences and how maybe they relate to mine. I was really positive during most all my time in the hospital, but I'm starting to feel a little down about where I'm at right now. Talking about going back to work in 2-3 weeks just doesn't even seem possible right now. I know it gets better everyday, so maybe it will start to seem possible soon. I don't know. Can y'all give me some insight how things went for you?

 

[tom in MO]

Sorry I sympathize but can't really say a lot about your fluid retention. I too had an AVR (at 55), but w/o any fluid retention. I would talk to your surgeon's nurse or PA if you have not already discussed it.

I had real pain in my sholder and neck area from the arm imobilization, etc. during OHS. In hospital, a physical therapist was ordered and they gave me some light neck exercises that helped. It bothered me to sit up straight as well. I would force myself to get up and walk around every hour and take a longer walk outside about 3 times a day. I was in pain for awhile afterwards and took the full dose of prescription pain pills for the first week home and didn't taper down until the second and third week home.

I would say it's "normal" not to want to go back to work until the 6 week mark. Everything will resolve itself as your body heals and things become "normal." My priest is a phsychologist and he likes to say "Normal is just a setting on the washing machine."

 

[adpace]

Thanks for your input Tom. It definitely helps to hear a little about others' experiences and to know that maybe my pain level is normal. Can't wait to be able to sleep on my side again. . .

Well, last night I started running fever - no bueno. It has broken now, but seems to come and go - don't know what that's about. If it becomes a problem, I'll call the doctor. It was only up to 99.8 last night, so I didn't call since the discharge instructions say a fever 102 that is persistent. I checked all my incisions, which look fine. And we changed the dressings and cleaned where the tubes were, which also appeared to be ok.

As far as being bloated, I'm thinking after doing some searches on this board that it may be pleural effusion. After all, I did have my chest tubes in for some time as took the drainage a long while to clear up, and I did leave the hospital with fluid on one lung. I'm looking a bit less bloated today and have actually lost nearly 2 lbs in the last 24 hours, so I'm guessing that's the deal. I'm just hoping the rest clears up on its own so I don't end up with tubes in again. Can anyone else comment on pleural effusion? Did it clear on it's own after a time?

My breathing is the slightest bit better today. I can now get the spirometer a little past the 1000 mark, but not to 1250 yet. That is my next goal. As long as it continues to go up and not down, I'm going to assume that progress is good.

 

[Paleowoman]

Hi adpace - just read your post as I have been away on holiday and not been able to get on forum. I had my AVR last January. I can certainly relate to the pain. I was in a lot of pain for several weeks post op, and, of course, it was a lot worse the first two or three weeks. Immediately post op in ICU things were fine, I felt good and had no pain - I was on morphine. When they moved me to high dependency I was switched to Tramadol and Dihydrocodeien which didn't help very much at all and caused side effects, especially fluid retention. I know fluid retention is normal after this surgery, but the pain meds definitely increased it for me becasue when I stopped them - I had to after one week due to the side effects - the fluid left my body within a few days and my blood pressure dropped badly low with very low sodium levels ! After that I could had no pain relief as all the opiates caused me problems and the non-opiates didn't work. I can still remember how awful the pain was - I was sitting at home trying to distract myself watching DVDs and I couldn't concentrate at all due to the pain. I had never imagined pre-surgery that I would have pain. I think it might have been bad becasue I have a slightly depressed sternum so there may have been a lot more manipulation, plus I had so called minimally invasive surgery but the incision I have is more than twice as long as the usual minimaly invasive incision - no explanation has ever been given to me about that.

I had pleural effusions on discharge too - I have copies of the discharge x-ray. I was annoyed with the hospital because they didn't do anything about this and I have small airways disease. No one ever listened to my chest even ! No spirometer either. When I stopped those pain killers the pleural effusions began to clear up quite fast.

I don't think anyone can think of going back to work within two or three weeks of surgery. More like 8 weeks, thoguh everyone is different and heals at different rates. You really do have to give yourself time to heal. It is major surgery. At about four weeks I remember my cardiologist telling me that this surgery is the same as if you have been hit by a car. Prior to surgery we are not really told these things are we ? Are you in touch with your GP or cardiologist ? They can check you out. My GP was very good, even prescribing nutritional drinks because I lost so much weight post surgery that I got very underweight. You might need to consult your GP about your fever. I had a fever during the first week post-op which was at first put down to having had surgery but then they discovered I had a urinary tract infection so I had to go on antibiotics.

All the best for your recovery, hope it gets smoother for you soon.

 

[adpace]

Thank you so much for sharing all of that Paleogirl! I decided to try and only take my pain meds at night due to other problems I'm now experiencing. It's good to know the fluid retention dropped when you stopped them. I'll hope for the same result!

I can't believe the experience you had! Sounds like they should have been more on top of things. I have asthma, so I was surprised they sent me home with fluid on my lungs, as well. I feel they kind of fell down on the job with some of the discharge instructions, too. I wouldn't have known how much aspirin to take even if I had not asked.

Well, hopefully the worst of this nearly over! Thx for the input.