4 weeks after 2nd OHS in 2 years

[Laurz]

Wondering if anyone can give me some words of wisdom. On July 14th I had my second OHS in as many years. The first one 2 years ago they did a mitral valve repair. Then a couple of months ago I started having sever symptoms again. After an appt with my doc he said "you have a very, very loud heart murmur." Why? It was quiet in Jan. So did all the tests that they do, echo, tee, cath, and had me in surgery immediatley. Said that the repair was just fine. It was new tissue damage. Seems I snapped a couple of the cords. So needless to say the repair was undone and I now am sporting an ATS 29mm mechanical valve. My question(s). I tire much easier then after the last surgery. Should this be normal? I am also having problems stabilizing my INR's. 2 weeks ago I was 2.9. Then this last week it dropped to a 2.4. Didn't eat anything I shouldn't have. Is this also normal? AND I am still experiencing water retention. Am taking anywhere from 40-120 mg of lasix a day. My doc says I may have to be a lifer on dieretics. Any of you have the water retention issue post surgery like this? The thought of having to be on lasix for the rest of my life is a little unnerving. Yet if I don't take what I need I feel miserable. The hands get puffy and yucky, and the strappy sandals look hideous on marshmellow feet. Is it just cause my heart isn't functioning great? Is the doc telling me inadvertantly that it will never function 'great'? I live with the fear of what the lasix is doing to my kidneys. Have been on them for 3 plus year now. Just wondering--------Laurie

 

[EireCara]

Laurie, Im sorry I dont have answers to your questions, but I just wanted to wish you well with your recovery. Im sure there will be people along very soon with some words of advice for you. VERY BEST WISHES.

 

[WayneGM]

Sorry to hear about this. Unfortunately, I can't really help you with your questions. I just wanted to wish you well.

 

[Bina]

Hi Laurie,
My INR was a bit jumpy for the first few weeks, don't stress too much about it because 2.9 down to 2.4 is not such a big deal.
Right after surgery I had the balloon feet and legs full of fluid....not fun is it.
A few days of lasix cleared most of it out.
I don't know much about MVR, but others will come along.
You can also try to do a "search" of older posts.
Best wishes.

 

[Bradley White]

Hi,

I would fully expect it to take you longer to stop feeling sluggish after your second OHS in two years than compared to your first OHS. Two traumas of that degree to the body in that short of time will take a bit of time to recover from. You are only four weeks our right now and are not expected to be full recovered. I would hope that in a few months you will be feeling just as good as you did after your first one. Hang in there.

It is very usual for INR to fluctuate between .5 of a point. Although I am not on coumadin, I have learned this from reading the posts of others on the site. I would not worry about small fluctuations like these.

Brad

 

[catwoman]

Laurie:
Can't help you with the kidney/lasix problems. I'm sure others can relate their experiences, however.

My INR didn't truly stabilize for 5-6 months. I was overjoyed when I recorded my first in-range INR -- then the next week, it was out of range, don't remember if it was under or over.

I was intrigued by your comment Didn't eat anything I shouldn't have. Just eat what you would normally eat if you weren't on Coumadin/warfarin. If you like broccoli, spinach, asparagus and green salads, don't avoid favorites such as broccoli-rice casserole, spinach salads, grilled asparagus or chicken Caesar salads.

As your body recovers and you gain energy, you will become more active. You will metabolize warfarin more quickly, leaving less of the drug in your bloodstream to prevent clots. Therefore, you will require increasingly higher dosages of warfarin to remain in range.

We've all been there, done that. Some became in range more quickly than others, some still bounce around a little from time to time.
Many of us prefer to have our INR a little higher than the range suggested for that valve. Our saying is it's easier to replace blood cells than brain cells.

My husband is on warfarin temporarily following his MV repair 2 months ago. He's always freaked out at the sudden sight of his blood. Saturday we did some yardwork and he nicked himself on a bow saw cutting tree branches. I told him, "Relax -- you're not going to bleed to death. Just wash it and bring me the bandages and I'll fix it up."

 

[Kathleen]

Laurie
Don't worry about your kidneys and the lasix unless your doctor does not call for the lab tests to keep a check on the kidney function. I have been on 160 mgs per day for over 10 years now. It does seem to run my life and there are special occasions where I will go without but then I do have to pay for it. Keep a close watch on your potassium levels. I take a aldactone tablet along with am lasix which is another fluid pill but spares the potassium. As far as not popping back after your second surgery I feel that is completely normal. Going through the muscles and bones the second time is insulting to your body. I have been through 4 and each one gets harder and harder to recover. Take time and give yourself the courtesty to rest and recoup in whatever fashion you need to. No two surgeries are alike so no two recouperations are alike. I also feel that two surgeries within a short time with the second coming quickly you may have some emotional issues with the acceptance of it all. My second one was quick and I never felt I had time to do the mental prep it takes. I think we can sometime gloss over what has happened and at times it is scary to say it outloud.
I have been on coumadin for over 22 years. It goes high it goes low and my own thoughts are my levels can go from 2.0 to 5. Gives me a larger range and does not require much change that way. I hope you are treating yourself to some fun things.
Kathleen

 

[Magic8Ball]

Can't help with most of it but 2.9 down to 2.4 is nothing, its normal.

I'm pretty stable now but have had a 3.2 drop to a 2.2 in a week and then back to 2.8 the next week.

I'm happy with 2.2 to 3.2 and wouldn't break a sweat until it broke 3.6.

Good luck, two surgeries in two years...dam.

 

[Karlynn]

Welcome! As others have said, we would expect you to be more tired 4 weeks out from your 2nd AVR. We usually tell people that it can take up to a full year to feel 100% after their first VR.

Now that you are on Coumadin, you need to really do lots of self-education on the subject. The biggest reason is that there are many so-called "Coumadin Managers" out there that really don't know what they are doing and can be the biggest reason for "unstable" INR's. But Marsha (Catwoman) is right, you probably may not be stable for a while in any case. (Although I would consider 2.9 to 2.4 stable) 2.9 to a 2.4 shouldn't be considered a drop. There can be as much as a .5 varience in INR's. It's not an exact science. This is why we have the ranges ( 2- 3 for some, 2.5 - 3.5 for some, 3-4 for others). If it was exact there would be target numbers and not ranges.

I would recommend you read this link http://valvereplacement.com/forums/showthread.php?t=17116

Take the first recommendation about Al Lodwick and visit his site www.warfarinfo.com. Al is the Coumadin users best friend.

You are only 4 weeks out and still have lots and lots of recovery ahead. The first several weeks are the hardest. Just listen to your body. Don't try to push it, but do keep walking as exercise.

 

[denobobeno]

Laurie,
Wow, I'm sorry to hear about your second OHS. That is pretty much a nightmare.
I also wouldn't worry about the fluctuating INR. One week mine will go from 3.9-2.5 . It depends on if I got off or started a new medication..how much activity I did..etc. From week to week you are probably pushing yourself a little bit more, which eats up Coumadin. It took me a year to find my perfect dosage.
Are you journaling? I think that helps to keep up with your progress and feelings of each day.
Your body is going to take a while to adjust to having your heart fixed, the whole recovery process is going to be different because your body is a little different from a year ago.
I hope you can see a bigger difference in a few weeks. Just remember not to compare yourself with anyone else. We are all different and will recover at our own rate. You just listen to your body and take care of yourself. The best thing you can do right now is rest your body, mind (watch a funny movie) and pamper yourself. God bless, Deana