10 Weeks After Surgery, Still Cant Breathe

[jag004]

Im 10 weeks out of AVR surgery and I still cant breathe correctly.


Here are my symptoms:
- I inhale much better thru my nose. My mouth inhale is mainly where the problem lies.
- When I try to take a "deep" breath, it doesnt get all the way to the top of the breath. It comes back down and wont allow the breath to reach its height where it would become "deep". This happens about 50% of the time.
- When it does allow me to take a deep breath it seems as if there is a faint pop or click on the mid-left side of my chest. This only happens around 10-20% of the time.
- Most of the day im short of breath.....at rest and on exertion.
- Sometimes on a deep inhale I get a slight discomfort over my mid-left chest. This happens 10% of time.


Tests Ive had were Chest Xray, Echo, and Stress Test(treadmill) which all were good. I had the stress test today and the dr running my test said i did great, even better than in Aug which was 6 months before my surgery. My hr got upto 150+ without a problem. I took the pictures after and am waiting for those results which i know are crucial. Im also scheduled for a sniff test....I think its some sort of breathing test.


Here is what the experts say:
Surgeon - 7 weeks post op said that these things are somewhat still normal. A bigger, younger guy takes longer than most. I was told to get more active, and it will work itself out.

Dr Running My Stress Test - today said it may be laziness related. She recommended Cardiac Rehab.

Cardiologist - last week was baffled. Doesnt know whats wrong. Tried me on prednisone which didnt work for the breathing. He told me that if the stress and sniff test came back normal, then he'd send me for CT scan. He also said the popping may be a non-union of my sternum where it didnt grow back correctly.


Otherwise I feel good and strong. Has anyone experienced such things 10 weeks post-op? Can it be that I gotta build myself back up? Any advice or opinions would be greatly appreciated.

 

[ski girl]

Jag what kind of exercise have you been doing for the past ten weeks? Have you been doing the heaps of walking that we are all required to do? I don't understand how your stress test could be normal but yet you're short of breath all the time - how long did you go for on the stress test?

 

[jag004]

Jag what kind of exercise have you been doing for the past ten weeks? Have you been doing the heaps of walking that we are all required to do? I don't understand how your stress test could be normal but yet you're short of breath all the time - how long did you go for on the stress test?

The stress test was only 6 minutes long very inclined and fast walking. I prob could have done another minute or two at this pace, but the dr said she got all she needed. By the 5th and 6th minute I was at my limit. I was laboring hard. Believe it or not, sometimes it feels better on exertion. There was a point I was on the treadmill at the gym over the weekend, and felt totally clear of my breathing issues....but this only lasted a few minutes. No, I havent been doing the required walking, exercising, or use of spirometer. Ive been very lazy on all of them. I was doing great for the first 4 weeks with those things, then grew very lazy. Wouldnt the chest xray show lung issues? Im thinking that 10 weeks in and 37 years of age that I would be back to normal with these issues.

 

[ski girl]

I'm not an expert on xrays by any means, but unless there's obvious fluid in your lungs, the xray would probably have been clear. You've answered your own question, you're not doing the required exercise. Your lungs were collapsed during the surgery and it takes some work to get them filling to 100% again.

Being at your limit in the 5th/6th minute of a stress test is not good - get walking, cycling, whatever - but get exercising and this breathing problem should improve dramatically!

 

[yotphix]

The sensation you're describing is something like what I felt in the first couple of weeks. I couldn't really say what it is, but I did do all the of the things I was asked to, and they went away. Any chance you'll rethink your compliance? I know a lot of medical professionals, and they all say that not only to the studies show it time and time again, but their own experience shows it to be true that patient non-compliance is one of the biggest hurdles they face in trying to treat people. Why would you go to the trouble of having heart surgery, but not bother to look after yourself and recover properly afterward?
You know what you need to do. You may have other issues there, and it sounds like you've taken appropriate steps to sort yourself out. But whatever the outcome of those things, 'lazy' as you put it, isn't helping you.

 

[jag004]

Thanks for the replies ski girl and yotphix.

I will start tomorrow on my exercise and spirometer. I hope u guys are right. I hope this is all it is.

 

[sood]

I also feel a similar click or pop when I yawn. Which seems like I do a lot post surgery. I get these yawning attacks. But anyway you really need to work hard exercising. Don't slack!! It will help you tremendously.

 

[ski girl]

Jag - start TODAY!!! Write yourself a 'training plan' and stick to it. I.e. Monday 2 laps walking around the block steady pace, three times a day; Tuesday 2 laps with 30 second bursts of faster walking . . . etc.

 

[yotphix]

Jag: I just re-read what I wrote last night, and it sounded a little harsh to me. Sorry for that. But good for you, for recognizing what you need to do. It's not easy, and if you are suffering the effects of a post surgical depression, it must be even harder. The thing is, that it's really just a matter of establishing a routine, which really only takes days, then following it. Is there a cardiac rehab program available to you as you begin to improve? If so, the guidance can be invaluable. As I recall, mine didn't take me in until I was about 10 weeks out, where you are now.
Also, if there is anyone in your life who's willing and able to kick your but, that can be a big help. I had the good fortune to have a wife who was terrified that if I didn't follow the rules, I'd die! Plus, we moved into a small apartment in my sister's home for the recovery and she's not only a nurse, but a bit of a control freak (in a good way) so I couldn't very well go upstairs and tell her that I wasn't doing my exercises and such.
Last, I forgot to mention that I had popping at various times, and not infrequently for the first six months, and I still get the odd pop, (maybe every 6 or 8 weeks?) 4 years later. I don't know what it is, but it doesn't hurt, and I've become accustomed to it. I always assumed that it was connective tissue fighting with wires or some such thing. It does take a while to sort out that whole 'cut in half' business.
Hang in there, the tough stuff is behind you. Now you just need to keep moving.

 

[epstns]

jag - I didn't have any random popping from my sternum, but the breathing issues you describe do really sound like your lungs haven't yet fully re-inflated. Mine didn't really start to improve until about 4 weeks after surgery, and improved rapidly when I re-doubled my use of the spirometer. That thing really helps your lungs to inflate fully. Once you get that back on track, I'll bet that your general recovery will accelerate rapidly and you'll be back where you should be.

I wasn't able to start formal rehab until 12 weeks, due to some complications, but I was walking most days for a mile or more, pushing myself to keep up a good pace. This helped me to be good and ready for rehab when I started.

 

[jag004]

Thank you all for the replies.

yoyphix - I didn't take it as harsh at all. But, maybe the kick in the butt is what I need. I just said to someone a few days ago that I'm very content on sitting on the recliner all day....that I don't even want to go out in that heat. Maybe that is a form of depression holding me down.

The thing that started this was when I seen a fill-in cardiologist 3 weeks post-op, because mine was on vacation that week. When I told him that I can't breathe on either rest or exertion he said, "your breathing should have come back by now. For some people the new valve has them breathing instantly". From that point on I had thought that there was something terribly wrong, because I had been doing my exercise and spirometer.

I can get that spirometer ball to the top every time I do it, and the surgeon said my lungs looked and sounded clear. So, then I really thought that there was something terribly wrong.

I go back to work in 2 weeks so ill need a cardiac rehab that might have later or night hours. Do they even exist?

I belong to a gym, too. Does anyone have any tips or exercises that I can do until I get myself into rehab? How often do I exercise? How many times per day? How hard or relaxed should I push it?

Thanks.

 

[ski girl]

Jag make an appointment with one of the personal trainers at your gym - they will probably have someone who specialises in injury rehab (as opposed to just weight loss). By now your heart should be healed just fine - although make sure your cardiologist agrees - and it's just the sternum that needs to finish healing.

At this point cardio is probably more important than doing weights, IMHO anyway!

 

[sood]

Jag,

Try to start walking on the treadmill and doing some bike exercises. You should be able to do 30 minutes on the treadmill and 15 minutes on the bike. Gradually increase the incline and speed on the treadmill each exercise and same with the bike. I've been exercising about 4-5 days per week. If you can't breathe start off with less time on the treadmill and maybe not start with the bike at first.

 

[epstns]

jag - All of the advice on exercise is good - just start gradually and increase the intensity every few days. The simple act of exercise will help your lungs to fully inflate if they are not yet doing so.

My rehab (in suburban Chicago) had its final session of the day at about 6 PM. That was one of their busiest sessions, but that's what many working folks had to choose. I was lucky enough to be able to leave work early 3 days a week to get to a 3:15 PM rehab (but I did start work at 6 AM. . . ).

As the others also said, at this point the cardio exercise is more important than weights. Rehab will likely bring you into some light free-weight work, so you can wait for them to do it first.