3-Day Post-Op: First Thoughts

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workmonkey

Active member
Joined
Dec 2, 2013
Messages
40
Location
Brooklyn, NY
Hello Fellow Travelers:

As I sit here at NY Presbyterian/Weill-Cornell Medical Center three days after the surgery to repair my 5.1 cm aortic aneurysm and bicuspid aortic valve, I wanted to share some immediate thoughts that are fresh on my percocet-influenced mind. Specifically, questions that I've seen raised on this site and answers I was seeking myself. I'll do it bullet-point style, because who doesn't like bullet-points? Plus all this medicine is affecting my ability to form proper syntax and spelling. This site was of immeasurable value and support as I experienced this process, so I wanted to share specifics that might help people see all sides of a question to help contribute to their own personal answer process.

• CARDIAC CATH: There is some discussion on the site about when to have the cardiac catheterization: the day before surgery or earlier than that. Every experience is different, but I highly suggest doing it a week or so before the surgery if possible. I checked into the hospital on Monday for the cardiac cath, then checked into the surgical ward immediately after (the actual surgery was on Tuesday). The first thing I learned about doing the cath the day before, is they prefer not to sedate you because you'll be going under general anesthesia the following day, so they want to be minimal with their use of drugs. The cath was quick enough, albeit intrusive and not entirely pain-free. The primary issue with doing the cath the day before is checking into the hospital immediately afterwards. Spending a night in the hospital before the surgery, hearing the incessant beeps and alarms of the monitoring machines, and seeing patient after patient wheeled by you as you just sit there, waiting for your moment of truth, was way too much food for thought. I entered in a good mind frame, and started to slowly lose it over the sleepless night. Also, you can think of the cardiac cath as a "training day" that helps get you comfortable heading to the hospital and walking in, just to prepare.

• SURGICAL TIME OF DAY: My surgeon does three surgeries a day. I was hoping for the morning surgery, but was told the night before I'd been scheduled for the middle slot. Then an emergency surgery pushed me to an even later slot, so I spent the morning and afternoon alone with my thoughts. You can't control this always, but I'd try if possible. Again, I was not allowed sedation during this time, so my anxiety was as high as it been for awhile. I remained determined and knew the end of my stress was near, but I feel the hospital can manage this better. It is definitely something I'd raise with the surgeon beforehand.

• ANESTHESIA: As all have said, being pushed to the OR (without my glasses, without which I see little) was not awesome. But the anesthesiologists were great, and had totally relaxed within a minute or two. In my mind, it was only a second or two later that I was awake. In the real world, it was seven hours or so. Apparently, I awoke well before they had planned, when my eyes were still taped, etc. (This has happened to be before, as I'm a bigger guy so I think they undershoot my levels). Apparently it took six nurses to restrain me until they could sedate me again .. But I have no memory of it, and when I did become "conscious" of the breathing tube, it really didn't bother me. You can breathe through it fine, and there is no gag reflex. I'd just forget this part of the process - the amount we all spend talking about it simply doesn't justify the reality of it. It is out before you know.

• VALVE-SPARING: I was always under the impression that I was having valve-sparing surgery, so never discussed with my surgeon what to do if he found damage beyond what the scans had shown. I would definitely have this talk with your surgeon well-ahead of time, as most of you have recommended. The first time the surgeon's staff brough this up was the night before the surgery. I had the talk with my exhausted surgeon the night before my surgery, and this put pressure on me to provide an answer asap. Fortunately, I had read enough on this site to know my answer: if he couldn't spare the valve, I wanted a tissue valve, even at risk of re-operation. I'm only 38, and was prepared to have another operation over being on blood thinners. Specifically, I have faith in medical technology and will make a humble prediction that within 15 years, all valve surgeries will be endovascular, sparing us from the more painful/scary part of the process. He was, in fact, able to spare my native aortic valve. But definitely have all this thought out ahead of time to avoid surprises.

• TAKE THE WALK: The site has a consensus that taking care of your aneurysm or valve, when you learn of it, is the best choice of action. I'm officially one more person who strongly agrees. Despite any of the stresses described above, the elation of waking up immediately after the surgery knowing the primary worry of your life is gone trumps any anxiety related to the surgery itself. Really, the day of surgery plus the following two days are the cost of doing business, and for this three-day sacrifice you have a lifetime of a clean mind. One day worrying about the surgery is as bad, if not worse, as the day following surgery. And I only spent three months from the day of discovery to the surgery. That was three months too long. In a sense, they are removing pyschic-pain and stress as much as repairing a valve or aorta. And we are blessed they can offer us this freedom. Many conditions don't have same possibility.

• OUR COMMUNITY: This site was invaluable during the process, so thank you to all. Again, because I am younger, there were few if any people I could talk to about this face-to-face. I did a lot more reading than posting, but without this site I'm convinced I wouldn't have gone through with it, or the process would have been 10 times worse. It is a community, and I'll walk proudly with my scar from here on out.

Anyway, long message, but I have long, boring night of pokes and prods ahead of me, so it's not like I'm going anywhere. Every day is better than the last, and I don't just mean from the surgical date. It is a new beginning for us all, and to anyone still grappling with fear of this procedure, I'll remind you what others reminded me. It is one "mind-second" of time for a lifetime of freedom. It's a great deal that you can make with confidence, as many of us here have.

Have a good, restful night.

Mark
 
Mark, A pretty lucid recollection; especially since it's only been 3 days. I am curious; Since you have had your original valve put back in, are you good to go for life ? No re-op needed ? I hope that is the case. Wish you a speedy recovery.
 
Mark, A pretty lucid recollection; especially since it's only been 3 days. I am curious; Since you have had your original valve put back in, are you good to go for life ? No re-op needed ? I hope that is the case. Wish you a speedy recovery.

Hi Enkaynj - Yeah, I've gone light on painkillers today, as I found they made me so tired I wasn't able to walk around much. So I'm more lucid than I've been since Tuesday (still not nearly all there mind you). And once I was able to take my first walk, it gave more energy and optimism than anything else up until that point. I found that walking hurt-like-hell while i was doing it, and I constantly felt short-of-breath .. But once I got back to the room and was able to catch my breath, I immediately felt lasting relief from the lung pressure. You know those spirometer machines? I've been pushing that as well, as I need to break the feeling of something sitting on my chest, and that seems to do the trick.

The valve-sparing touch-up that Dr. Girardi performs comes with no long-term promises obviously. Basically, he explained that my bicuspid had some regurgitation (I had no stenosis). So he tried to "match" the length of two cuspids, so they clasp together tighter, avoiding the regurgitation. I think he also smoothed out the flaps to avoid the backwash. This is his thing, as he known for trying to spare the valves whenever possible. It might last for 30+ years, it might not ... But I wanted to give it a go since he explained any replacement valve he gave me wouldn't be too much higher functioning (obviously a mechanical would last 135 years, he said with a smile ... but when taking the added effort of blood thinners into account, it becomes a wash). Also, plenty of bicuspids go a whole lifetime without surgery, so I thought it was worth it. If it wasn't for the ascending aortic aneurysm, I wouldn't have had this surgery in the first place, so why take away what was still technically working?

Again, I apologize for the lengthy writing. I'm one of two patients in this room, and even though it is almost 9PM, the other patients whole family is here in full conversation .. So sleep won't be coming anytime soon, and reading is harder than I had thought. (which is another piece I took from this site .. You really don't need to bring much to the hospital with you ... you are too out of it the whole time to do much other than lay there.) Thanks for the kind words and support! I see you had a repair in 2012, how has your long-term recovery gone?
 
hi Mark,
First of all congratulations on a VERY successful surgery. You must be so relieved.
And I appreiate you taking time so soon, not only to share with us of your well-being, but also your wisdom about the anxiety over the surgery that some of us in the waiting room feel. Your systematically organized message, in a very thoughful manner, tells us about the speed of your recovery.
Please enjoy your time with the family and kids, and a worry-free life, as you go home soon.
And please do keep writing. Your writings will remind us of your success and the confidence that we need.
Have a speedy, rest of recovery.
 
Hi Mark and welcome to the other side of the mountain ;)
What a brilliant and wise report of your experiences so far, it sounds like you are improving at a great speed.
I look forward to hearing more about your recovery.
Take care, rest loads and take deep breaths.
Deb xxx
 
Mark thanks for sharing your early experiences post-op. I'm really encouraged by your progress as I'm in the waiting room for another few weeks. I just hope I'll be as lucid as you are so soon after surgery!
Wishing you a full speedy uneventful recovery.
Anya
 
I think it is great that you get your thoughts and experiences down before they are lost in the past. Although everyone's experiences are different, there is always someone that is close to your age or symptoms that can benefit from your experience. You are helping others while you are laying there in your hospital bed and that is very rewarding. I hope your recovery is short and your good health is long. Take it easy. Thanks for sharing.
 
Mark,

I echo everyone all you have said, take care. I have an aortic aneurysm , and watching it, and waiting. I am glad your recovery is going so well.
 
First of all, so glad to read that you are on the 'other side' and wishing you all the very best with your recovery. I am truly amazed by your lucid and detailed post only 3 days post op! I don't think I was even putting full sentences together let alone posting 3 days post op. :)
 
Glad to hear that your surgery went so well. I too had my BAV spared. The bottom line was that it was working well and so it really is better than any replacement. My surgeon thinks there is a 50% chance it will fail some day. If it does I'll deal with it then.
 
Glad to hear that your surgery went so well. I too had my BAV spared. The bottom line was that it was working well and so it really is better than any replacement. My surgeon thinks there is a 50% chance it will fail some day. If it does I'll deal with it then.

Thanks everyone for the supporting words. I hope to return the favor to each of you that are nearing your surgery. As we know, this forum creates the positive and supporting world we need to handle this surgery and recovery with as much optimism as possible.

I'm waiting in my room now for final discharge. I may have left tomorrow, but (yet another) NYC storm pushed up the schedule, which I have no complaints about. A few final thoughts, to be sure I don't leave them at the hospital with my bandages:

• Day 4 (the day after my post) was probably the most challenging recovery-wise. You've tasted a walk, and tasted a decent breathe, and want more of them. It makes you want to be back to normal immediately. But you are far from that, and the pain inevitably settles back in. It starts to gnaw at you like your neighbor's annoying dog that never stops barking. It is never unbearable, it is always just there … In those times, just focus on the gains ...You may be down in the dumps one hour, but the next will be better .. Focus on the minute in front of you, not anymore than that. This forum held my hand during those moments as well. Positive thoughts about the better days to come will get you through.

• Walking, even when every part of me wanted nothing to do with it, was the best thing I did. I never returned from a walk without more energy. I was short of breath, light-headed, and in pain .. but once getting back to the room, all that went away and your spirits would soar.

• Getting unhooked from all your monitors is scary. It is the leash to safety. This bothered me more than I thought.

• I had the greenlight from the surgical team to eat whatever I wanted for a month or two after the surgery (medically, they say that anemia is a result of the surgery due to blood loss, so red meat is a great counter to that). The reality is the first few days you'll have little appetite. But when you do get hungry, I found myself craving things easily eaten and small. I had friends bring smoothies, and had a box of crackers nearby … Don't worry about what you are eating, but just that you are eating. Even if it is french fries! Hospital food really does earn its reputation for being unappetizing .. and when you're appetite is already low, you're in trouble.

• All of us who are or were waiting for surgery know that all we think (or thought) about was the surgery itself. The actual procedure, the valve we would select, the breathing tube … The reality is this is much more than that. Again, this forum is invaluable in that respect. It is filled with people who are on every stage of the journey, and there will always be someone to support you. I'm starting the long process to recovery, which will be as a big a part of this as everything before. Just remember to lean on those that have come before. They'll get you through, as they are getting me through.

Mark
 
Hi, Mark!

Thanks for the great reporting! Not too lucid? What do you write when you're fully lucid? Your remarks are very clear and most interesting.

The one thing that comes through loud and clear is that the old advice that "They don't fix aortic valves" may no longer be as true as it once was. I don't think I've heard of more than 4 or 5 aortic repairs in my years on board here, but if your case is any indication, then there can be more in the future. That is a great option for those who fit the mold, and I thank you for telling us all about it.

It sounds like you're on a good path toward recovery. Keep up the great work, and keep us posted.
 
Awesome posts, Mark. Thank you.

The part about the aortic valve repair is timely for me as well. Today I found out that my surgeon thinks he might be able to fix mine too. It was referred to as "unusual." (Gee, great time to be special, eh?) It's not bicuspid though. I'll get the details from him on Wednesday.

Good luck for a continued smooth recovery!
 
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