3rd OHS surgery done - VEST

[DByrner]

Hi all

I first contacted this group a few months back concerned about my 3rd OHS that came out of nowhere. I’m 43 and have had the 3 in the past 10 years going A-bovine to A-mechanical and then a Mitral cherry on top last week. This was also complimented with two bouts of endocarditis kicking off with a cat scratch. Oh the joys!

Firstly, thanks for all the great advise then and since then. It was great to know that there were people out there like me living normal lives. The op was long seemingly because of scaring so I was pretty mashed after it but getting stronger by each day.

Couple of questions just in case anyone has had the same. I had this op in a different hospital where everyone gets a Posthorax vest leaving. Honestly it’s killing me sleeping so just wondering if it’s worth the trade off? Or indeed if there is a good way to sleep with the vest? I’m still operating on night sweats so it’s a bit uncomfortable.

Anyway, any help much appreciated.
Dylan

 

[pellicle]

No experience with that vest, but indeed as you say everything is a compromise.

Best Wishes

 

[pellicle]

Just some bedtime reading as I'd wanted to ask:

This was also complimented with two bouts of endocarditis kicking off with a cat scratch

now I'm no friend of cats, but how did this diagnosis come about? I hope it wasn't from the hospital because it seems very unlikely (unless the scratch turned into a large festering sore).

Endo usually comes in from somewhere close to the heart (so the mouth, which is more commonly a festering wet mess despite the illusion that we clean out teeth and spray nice smelling things in there). The causes of Endo are most commonly things which are found in the mouth, not so much on the skin but I confess I don't know what sort of muck is under cats claws.

I'll be interested to hear if you get a report of causal bacterial identification from the hospital.

A list of the usual culprits:

from:
https://www.researchgate.net/public..._Years_of_Experience_at_a_Children's_Hospital
also a good review:
https://tmedweb.tulane.edu/pharmwiki/doku.php/treating_infective_endocarditis
So while not trying to let the cat off the hook, I'm thinking this is more just a coincidence of events (but blame the cat just in case I say).

Best Wishes on a smooth recovery.

 

[DByrner]

Just some bedtime reading as I'd wanted to ask:

now I'm no friend of cats, but how did this diagnosis come about? I hope it wasn't from the hospital because it seems very unlikely (unless the scratch turned into a large festering sore).

Endo usually comes in from somewhere close to the heart (so the mouth, which is more commonly a festering wet mess despite the illusion that we clean out teeth and spray nice smelling things in there). The causes of Endo are most commonly things which are found in the mouth, not so much on the skin but I confess I don't know what sort of muck is under cats claws.

I'll be interested to hear if you get a report of causal bacterial identification from the hospital.

A list of the usual culprits:
View attachment 889629

from:
https://www.researchgate.net/public..._Years_of_Experience_at_a_Children's_Hospital
also a good review:
https://tmedweb.tulane.edu/pharmwiki/doku.php/treating_infective_endocarditis
So while not trying to let the cat off the hook, I'm thinking this is more just a coincidence of events (but blame the cat just in case I say).

Best Wishes on a smooth recovery.

Just some bedtime reading as I'd wanted to ask:

now I'm no friend of cats, but how did this diagnosis come about? I hope it wasn't from the hospital because it seems very unlikely (unless the scratch turned into a large festering sore).

Endo usually comes in from somewhere close to the heart (so the mouth, which is more commonly a festering wet mess despite the illusion that we clean out teeth and spray nice smelling things in there). The causes of Endo are most commonly things which are found in the mouth, not so much on the skin but I confess I don't know what sort of muck is under cats claws.

I'll be interested to hear if you get a report of causal bacterial identification from the hospital.

A list of the usual culprits:
View attachment 889629

from:
https://www.researchgate.net/public..._Years_of_Experience_at_a_Children's_Hospital
also a good review:
https://tmedweb.tulane.edu/pharmwiki/doku.php/treating_infective_endocarditis
So while not trying to let the cat off the hook, I'm thinking this is more just a coincidence of events (but blame the cat just in case I say).

Best Wishes on a smooth recovery.

Hello and thanks for your good wishes

I know it’s crazy but cats it was. This was my first OHS in 2014 where I had been feeling unwell for a few months before having to be taken to hospital. On the last day in hospital the head of infectious disease in my hospital told me it was “bartonella”,caused by a cat scratch. Seemingly all cats carry it at some stage and it’s usually harmless, but when I got scratched the bacteria went to the weakest part of my body ( I had a murmer that was being monitored annually since I was young). Just a one in a million.

I do also know the cat and see her regularly…my good friends who looo after don’t know however


Bartonella clarridgeiae infection in a patient with aortic root abscess and endocarditis

 

[pellicle]

Morning (just got back from morning walk_

On the last day in hospital the head of infectious disease in my hospital told me it was “bartonella”,caused by a cat scratch. ... Just a one in a million.

well, that's "lucky" (sorry, but black humour there ;-)

something else for your entertainment
https://cjeastwd.blogspot.com/2014/05/the-great-delvin.html
wow ... I see from the date that will be 10 years ago soon enough. I'd a thought for sure I'da been back sooner than that.

Time Flies

 

[DByrner]

Morning (just got back from morning walk_



well, that's "lucky" (sorry, but black humour there ;-)

something else for your entertainment
https://cjeastwd.blogspot.com/2014/05/the-great-delvin.html
wow ... I see from the date that will be 10 years ago soon enough. I'd a thought for sure I'da been back sooner than that.

Time Flies

Haha yes very lucky indeed. Thanks again for the reply’s and for sending on such a nice link. It’s not a bad place you should definitely make the trip back , Best

 

[pellicle]

It’s not a bad place you should definitely make the trip back

agreed, it was easier (and cheaper) when I lived in Finland to do that ... and now there's also COVID to make flight and airports worse
(Thanks for the free gift China)

 

[Deepak khanka]

Hi all

I first contacted this group a few months back concerned about my 3rd OHS that came out of nowhere. I’m 43 and have had the 3 in the past 10 years going A-bovine to A-mechanical and then a Mitral cherry on top last week. This was also complimented with two bouts of endocarditis kicking off with a cat scratch. Oh the joys!

Firstly, thanks for all the great advise then and since then. It was great to know that there were people out there like me living normal lives. The op was long seemingly because of scaring so I was pretty mashed after it but getting stronger by each day.

Couple of questions just in case anyone has had the same. I had this op in a different hospital where everyone gets a Posthorax vest leaving. Honestly it’s killing me sleeping so just wondering if it’s worth the trade off? Or indeed if there is a good way to sleep with the vest? I’m still operating on night sweats so it’s a bit uncomfortable.

Anyway, any help much appreciated.
Dylan

Warrior

 

[slipkid]

Wow. Bartonella. I'm familiar with it as a tick borne illness, didn't realize you could get it from a cat scratch! Sheesh.

 

[Chuck C]

Welcome to the other side Dylan!

You've been through a lot these past 10 years with 3 open heart surgeries.

I noticed that you chose a tissue valve at age 34, for your first surgery. Did you choose tissue because you wanted to have children? It looks like it lasted about 6 years, which would be fairly typical for someone in their 30s. At the time, did they give you any guidance as to how long it should last?

Also, some studies have been done which suggest that pregnancy may accelerate SVD:

“Conclusions: The outcome of pregnancy was similar for women with mechanical valves or bioprostheses. Warfarin treatment was safe and effective and was not associated with embryopathy. Heparin treatment was associated with more thromboembolic complications and more bleeding complications. Bioprostheses deteriorate rapidly during pregnancy.”

Outcome of pregnancy in women with valve prostheses - PubMed

And also:

“The freedom from structural valve deterioration at 10 years was 23.3% +/- 14% for the pregnancy group and 74.2% +/- 8.5% for the nonpregnancy group”

https://pubmed.ncbi.nlm.nih.gov/1865693/

 

[DByrner]

Welcome to the other side Dylan!

You've been through a lot these past 10 years with 3 open heart surgeries.

I noticed that you chose a tissue valve at age 34, for your first surgery. Did you choose tissue because you wanted to have children? It looks like it lasted about 6 years, which would be fairly typical for someone in their 30s. At the time, did they give you any guidance as to how long it should last?

Also, some studies have been done which suggest that pregnancy may accelerate SVD:

“Conclusions: The outcome of pregnancy was similar for women with mechanical valves or bioprostheses. Warfarin treatment was safe and effective and was not associated with embryopathy. Heparin treatment was associated with more thromboembolic complications and more bleeding complications. Bioprostheses deteriorate rapidly during pregnancy.”

Outcome of pregnancy in women with valve prostheses - PubMed

And also:

“The freedom from structural valve deterioration at 10 years was 23.3% +/- 14% for the pregnancy group and 74.2% +/- 8.5% for the nonpregnancy group”

https://pubmed.ncbi.nlm.nih.gov/1865693/

Hi Chuck

The original decision was made in 2014 when I had endocarditis and was in hospital so it wasent something I did massive research into. The below 3 reasons directed my decision.
1) It was hoped that the valve would last about 15years - It didn’t unfortunately due to another bout of endocarditis in 2020. What can you do.
2) I didn’t think the surgery would be as bad. I thought I’d wake up in a room full of flowers and chocolates and then kick on to my life. Blissfully ignorant. The reality is that’s it’s a tough gig that affects the people around and puts them through the mill.
3) Warifin - I didn’t want to take anything that was so restrictive. It embarrassing but I still wanted to go out with my friends and drink alcohol go on weekends away etc. I also played sport. Thankfully since I got my 1st mechanical I’ve learned to live with it.

I did have two kids in the middle of this, now 3 and 2 years old but my wife did all the work there .

Would I go back and change my decision if I could??
I don’t think I would being honest. You gotta live with these decisions and inbetween the 3 OHS I’ve had some amazing times and consider myself very lucky. Hoping this one though is my last.

Thanks for the interest

 

[Chuck C]

Warifin - I didn’t want to take anything that was so restrictive. It embarrassing but I still wanted to go out with my friends and drink alcohol go on weekends away etc. I also played sport. Thankfully since I got my 1st mechanical I’ve learned to live with it.

Thanks for explaining Dylan.

Now that you are on warfarin, you should know that those of us on warfarin still drink alcohol if we want to, go away on weekends (or even weeks and months) and play sports. It sounds like you've been on warfarin for a few years, so you probably already know all that by now. If not, and if you are restricting your life because you are on warfarin, I would encourage you to read some of the threads here in which folks discuss all the activities that they do on warfarin, despite some of the myths that still seem to be so prevalent.

Best of luck with your recovery and please keep us posted.

 

[pellicle]

@DByrner
just wanted to second this

Now that you are on warfarin, you should know that those of us on warfarin still drink alcohol if we want to, go away on weekends (or even weeks and months) and play sports.

as well as eat greens and pretty much anything except over indulge in grapefruit juice.

It sounds like you've been on warfarin for a few years, so you probably already know all that by now

but its worth saying anyway because its wrong to assume

 

[Chuck C]

as well as eat greens and pretty much anything except over indulge in grapefruit juice.

Last weekend, took the family to pick apples, followed by wine tasting. I was actually offered a glass of grapefruit wine- yes, apparently that's a thing. I took a pass, due to being on warfarin. I expect that I probably would have been fine having one glass, but, to be honest, it really did not appeal to me anyway. For me, giving up grapefruit has not been a sacrifice

 

[pellicle]

For me, giving up grapefruit has not been a sacrifice

 

[DByrner]

Thanks for explaining Dylan.

Now that you are on warfarin, you should know that those of us on warfarin still drink alcohol if we want to, go away on weekends (or even weeks and months) and play sports. It sounds like you've been on warfarin for a few years, so you probably already know all that by now. If not, and if you are restricting your life because you are on warfarin, I would encourage you to read some of the threads here in which folks discuss all the activities that they do on warfarin, despite some of the myths that still seem to be so prevalent.

Best of luck with your recovery and please keep us posted.

Many thanks Chuck,

Yes the warifin thing was definitely a bigger issue in my head. I bought myself a INR machine to self test and get monitored by the hospital also. Looking forward to recovering so I can get back to living life to the fullest. This group has been very helpful.

best
D

 

[d333gs]

A cat scratch or worse a cat bite can cause an infection and spread rapidly . My wife got bit brushing our old cat and with in hours you could see the infection climbing up her arm . Strong antibiotics were needed

 

[V__]

as well as eat greens and pretty much anything except over indulge in grapefruit juice.

And warfarin is not even unique in this respect. Other drugs have the grapefruit contraindication as well.

 

[Gail in Ca]

I’m glad to hear you’re doing well. I’ve had 3 surgeries in 20 yrs and thought it was a lot! I had to look up the vest, as I never was recommended to wear one.
I did have my sternal wires removed after my 2nd & 3rd surgeries. This was very helpful for bony me!
I’ve had a cat always. It was informative to read that you got endocarditis from a bacteria the cat carried. The bacteria I got was rare as well but didn’t come from my cat. He is an Ocicat and such a good boy. I always trim his nails. I never get scratched from him. Once in awhile he goes to nibble toes but we say no bite and he stops!!
Anyway, I have to live with pets because they make life wonderful!
Recover well!

 

[DByrner]

I’m glad to hear you’re doing well. I’ve had 3 surgeries in 20 yrs and thought it was a lot! I had to look up the vest, as I never was recommended to wear one.
I did have my sternal wires removed after my 2nd & 3rd surgeries. This was very helpful for bony me!
I’ve had a cat always. It was informative to read that you got endocarditis from a bacteria the cat carried. The bacteria I got was rare as well but didn’t come from my cat. He is an Ocicat and such a good boy. I always trim his nails. I never get scratched from him. Once in awhile he goes to nibble toes but we say no bite and he stops!!
Anyway, I have to live with pets because they make life wonderful!
Recover well!

Thanks Gail

Sorry to hear that you have had to go through this 3 times also. It’s a hard slog.

Really appreciate you taking the time to look up the vest. Being honest, I don’t wear it much now, it’s just too uncomfortable. I do feel my sternum getting better like before so I’m just going to eat well and do my exercises.

I agree btw, Pets are wonderful and make every day better. I was a 1 in a million.

Have a lovely day
Dylan