10 weeks post surgery

[GSman]

Hi All,
Yesterday it was 10 weeks since I got my aortic root replacement. I had chosen a mechanical valve. For those of you waiting I want share my recovery process.
I started working (high stress, office based job) part time 8 weeks after surgery, since beginning of this week I am back full time. All is going well, although I am more tired in the evenings than before the surgery. I had trouble sleeping for a long time after surgery, now I am sleeping very well.
I did never a lot of exercise, but I joined cardiac rehab and exercise now 5 times a week. Mainly brisk walks, bicycling and some weights - difficult to find the time, but making me feel good.
I still refrain myself from lifting my little boy, but plan to do that 12 weeks after surgery.
The scar healed nicely, however it is still slightly swollen on the top of the sternum and there is still a little discomfort with the muscles in that specific area.
My major challenges are my blood pressure and heart rate. Both are still too high and the bp medication I took before the surgery is not doing the job. My cardiologist plays around with drug schedules and drugs. Right now I am on vamipril slow release, micardis Plus and Minipress.
Two weeks after surgery I had a severe episode of a fib and I was put on amiodarone which stopped it quickly. I continued on that nasty drug until yesterday. Now my INR value will need to be readjusted(I had it nicely at 2.7 with 6 mg of warfarin). Any insights on weaning off amiodarone, while on warfarine are welcome.
The ticking of the valve was really bothersome in the beginning, but I slowly get used to it and it seems to be more quiet
Overall I am pleased with my recovery. Although everyone is different I hope this will help those in the waiting room.

 

[Agian]

It does. Thanks

 

[TheGymGuy]

Amiodarone has a long half-life and what we would call a self-weaning drug. You can stop it cold turkey and it will slowly, very slowly leave your system. I personally, reduced my doze on it to half the doze, and then half again, and then stopped completely. Though, this process did not matter, since the drug (amiodarone) saturates the tissues and leaves on its own.

Ok, back to INR advice. Just measure your INR once a week and work with your coumadin clinic on adjustments. Rule of thumb is to not exceed 10% increase in dose per week. So, say your INR went down to 1.9 - 2.0 (with everything else being equal) and you're taking 6g per day or 42g per week, the most you should go up safely to is 42+4 = 46g per week, or 6g x 3 days per week and 7g x 4 days per week. I'd even go to the opposite which would be 6g x 4 days per week and 7g x 3 days per week. This is not a medical advice!!!!!!!!!!!!!

You would do reverse if the INR went to 3.5, decrease by at most 10%, though most would be cautious and decrease slowly, week by week.

Hope this helps.