6 months post-surgery today!

[HokieHaden]

Hi all - today marks my 6 month milestone following Aortic Valve Replacement (Edwards 27mm bovine tissue valve) and Aortic Root repair - together called a Bentall procedure - at Vanderbilt Medical Center in Nashville. Here are links to my initial member intro post and my detailed recap of "things I didn't know I'd experience with my surgery".

I'm thrilled to report that I'm fully recovered and mostly adjusted to my new valve. I'm an avid recreational cyclist and I'm back on the Peloton and road bike, performing near the same level as I did prior to surgery. I say near only because I need to continue getting out there and getting back into riding shape - it's not a limitation of my heart/valve. I do notice a difference in my max HR now - before surgery, I was asymptomatic with my native BAV, but I would routinely push up over 180 bpm on a tough ride/climb. After the surgery, I notice that no matter how hard I push (climbing a steep hill), my HR doesn't go above 173 or so. That may not sound like a big difference, but it's notable to me.

I'm still getting used to the really pronounced heart beat/thud. I had a strong heartbeat before surgery, but its even more pronounced now. I have pretty well adjusted to it, but it's still something I would note for those who are wondering. I know I read a lot on this forum about this experience and concern. So, I'll just confirm that it's a real thing. But, it is certainly something you can live with. And, gratefully, at that.

The only other thing I'll share is that I still at 6 months out have soreness, especially at the base of my sternum, when I cough or sneeze. I can deal with it, but I mention it because I didn't think I'd still be dealing with minor pain like this at 6 months out. I'd be interested in hearing from others whether they share this experience. I assume it's normal and I just didn't have the right expectations going in.

Finally, I just want to thank the many contributors to this forum. I have learned a TON, and continue to, from your many experiences and the resources shared here. I plan to stick around even as my life has settled back into "normal".

 

[Seaton]

Congratualtions on your half year recovery, HH! Both thumbs up to you.
Hearing that you're back on your Peloton and road bike and pushing near same levels as pre surgery, is impressive and inspiring. Long may it continue.

Sending good health thoughts and best to you going forward.

 

[HokieHaden]

Congratualtions on your half year recovery, HH! Both thumbs up to you.
Hearing that you're back on your Peloton and road bike and pushing near same levels as pre surgery, is impressive and inspiring. Long may it continue.

Sending good health thoughts and best to you going forward.

Thanks so much - I feel very grateful for the recovery thus far. I actually started back on the Peloton in Dec (maybe 6-7 weeks after surgery). I waited until cleared by my doctor to get back on the road bike, which was maybe at 12 weeks out? Thanks again!

 

[Chuck C]

Thanks for the update!

I was asymptomatic with my native BAV, but I would routinely push up over 180 bpm on a tough ride/climb. After the surgery, I notice that no matter how hard I push (climbing a steep hill), my HR doesn't go above 173 or so

I have also found that my max heart rate dropped some after surgery. This does not concern me, as I really don't like the idea of pushing my heart rate to the max with my new parts. I spend most of my training in zone 2 and once a week go into zone 4 and 5, but never to my max anymore.

I'm back on the Peloton and road bike, performing near the same level as I did prior to surgery.

I felt really good at 6 months training hard and by a year, I thought that I had probably reached my peak performance. It was definitely a little off of where I was at presurgery. But, I have continued to experience continued improvement, which has been surprising: 2 years out of surgery my cardio was better than it was at 1 year out and at 3 years out it was even better than it was at 2 years out. At this point, I believe that I am back at about the cardio level I was at pre-surgery. In fact, I think that I might be a little bit beyond where I was pre-surgery. Like you, I never had symptoms and never perceived any cardio slow down pre-surgery. This makes me wonder if my stenotic BAV valve was lowering my cardio output, but only very slightly- nothing which could be picked up on a treadmill test. My litmus test is boxing. I have returned to boxing and once a week I really push the cardio, doing about 13 or 14 rounds of sparring, which really taxes the cardio. I'm going mostly against actual fighters, pro and amateur, so these 3 minute rounds require considerable cardio, with only a 45 second break between rounds. Prior to surgery I would often feel the need to sit out a round to rest from time to time. But now, I can go the entire 14 rounds without sitting out. All of this to say that at 6 months out, you may yet see even more improvements in your cardio over the next couple of years. Mine definitely imprive from 6 months out to 3 years out.

 

[SSJ4]

HokieHade,
We have corresponded some on this board over the last 6-8 months. Glad to hear you are doing well. My surgery (same valve and aneurism as yours) was the day before yours and if I recall correctly we are almost the same age (I am 46). I can echo the heartbeat/thud post surgery as well as the soreness in the sternum. I can feel that soreness if I take a really really deep breath and some slight soreness in the sternum after sleeping on my side all night or the next day after a round of golf. I was feeling some numbness/tingling in my right pectoral muscle area and my local cardiologist explained that it was from where nerves were cut for surgery. It has improved a great deal in the last two months. Other than those items I don't feel like I am still dealing with a whole lot from surgery.

I am not a biker but I have been regular at the gym and working on the treadmill, elliptical and bike. While I have seen great improvement on how long I can go on those machines it doesn't always translate to other activities. I can run 15-20 minutes on a treadmill on a good day and throw batting practice to my son but then get out of breath picking up the baseballs.

I had my six month checkup on Tuesday and came away with a good report as well. Six months is big milestone and one that was special for me and my wife who was by my side through it all. Extremely grateful and relieved to be at this point in the recovery.

 

[HokieHaden]

Thanks for the update!


I have also found that my max heart rate dropped some after surgery. This does not concern me, as I really don't like the idea of pushing my heart rate to the max with my new parts. I spend most of my training in zone 2 and once a week go into zone 4 and 5, but never to my max anymore.


I felt really good at 6 months training hard and by a year, I thought that I had probably reached my peak performance. It was definitely a little off of where I was at presurgery. But, I have continued to experience continued improvement, which has been surprising: 2 years out of surgery my cardio was better than it was at 1 year out and at 3 years out it was even better than it was at 2 years out. At this point, I believe that I am back at about the cardio level I was at pre-surgery. In fact, I think that I might be a little bit beyond where I was pre-surgery. Like you, I never had symptoms and never perceived any cardio slow down pre-surgery. This makes me wonder if my stenotic BAV valve was lowering my cardio output, but only very slightly- nothing which could be picked up on a treadmill test. My litmus test is boxing. I have returned to boxing and once a week I really push the cardio, doing about 13 or 14 rounds of sparring, which really taxes the cardio. I'm going mostly against actual fighters, pro and amateur, so these 3 minute rounds require considerable cardio, with only a 45 second break between rounds. Prior to surgery I would often feel the need to sit out a round to rest from time to time. But now, I can go the entire 14 rounds without sitting out. All of this to say that at 6 months out, you may yet see even more improvements in your cardio over the next couple of years. Mine definitely imprive from 6 months out to 3 years out.

Thanks for sharing your experience, Chuck. It's inspiring to think of where I might be in 2-3 years. I've never tried boxing but I can imagine that's quite the cardio workout. You've told me before I'm sure, but remind me, do you have a tissue or mechanical replacement valve? I am "making up" that you aren't on warfarin, given the boxing, but maybe I'm wrong about that. Regardless, keep it up!

 

[HokieHaden]

HokieHade,
We have corresponded some on this board over the last 6-8 months. Glad to hear you are doing well. My surgery (same valve and aneurism as yours) was the day before yours and if I recall correctly we are almost the same age (I am 46). I can echo the heartbeat/thud post surgery as well as the soreness in the sternum. I can feel that soreness if I take a really really deep breath and some slight soreness in the sternum after sleeping on my side all night or the next day after a round of golf. I was feeling some numbness/tingling in my right pectoral muscle area and my local cardiologist explained that it was from where nerves were cut for surgery. It has improved a great deal in the last two months. Other than those items I don't feel like I am still dealing with a whole lot from surgery.

I am not a biker but I have been regular at the gym and working on the treadmill, elliptical and bike. While I have seen great improvement on how long I can go on those machines it doesn't always translate to other activities. I can run 15-20 minutes on a treadmill on a good day and throw batting practice to my son but then get out of breath picking up the baseballs.

I had my six month checkup on Tuesday and came away with a good report as well. Six months is big milestone and one that was special for me and my wife who was by my side through it all. Extremely grateful and relieved to be at this point in the recovery.

That's right - I remember you. So glad to hear you are doing well post-surgery. And yes, we are close in age - I am 49.

I do sleep on my side and have definitely felt the sternum/rib discomfort after waking in the morning.

And yes, having my wife by my side through the process was an incredible blessing and experience. I am sad for people who have to face this trial without a loving partner.

 

[pellicle]

I have also found that my max heart rate dropped some after surgery.

its an interesting point and I'm afraid I can't give data points too well (over different surgeries with different valve types), but I suspect its also related to the fact that in pure effectiveness the mechanical valve is not as good as your native healthy valve was.

Its all part of the 'parts exchange program' where we make tradeoffs.

Good news btw @HokieHade and I fully expected that. Further I'd say even at 10 years it'll all be roses; heck I'll go out to 20 (with nothing more than perhaps an arrhythmia manifesting).

Best Wishes

 

[HokieHaden]

its an interesting point and I'm afraid I can't give data points too well (over different surgeries with different valve types), but I suspect its also related to the fact that in pure effectiveness the mechanical valve is not as good as your native healthy valve was.

Its all part of the 'parts exchange program' where we make tradeoffs.

Good news btw @HokieHade and I fully expected that. Further I'd say even at 10 years it'll all be roses; heck I'll go out to 20 (with nothing more than perhaps an arrhythmia manifesting).

Best Wishes

Just curious, when you say "mechanical valve" do you mean mechanical or tissue (any replacement valve)? I'm only asking because I'm curious as to whether there could be any difference.

@pellicle, your advice and exhaustive knowledge on this forum was (is) a tremendous help in my journey here. I know we debated a bit on the whole mechanical vs. tissue valve option, but I fully respect the knowledge (and obvious study) you bring to this community. Thank you, sincerely!

If I get 20 out of this bovine valve, I'll be ecstatic. But, I do hold out that hope and pray I'm here to tell the tale at ag 69 (in 20 years). I make that comment with a bit of a heavy heart, as my father died of melanoma at 43. If I've learned anything in life, it's that we are not guaranteed tomorrow. But, I try to live each day to the fullest.

 

[Chuck C]

Thanks for sharing your experience, Chuck. It's inspiring to think of where I might be in 2-3 years. I've never tried boxing but I can imagine that's quite the cardio workout. You've told me before I'm sure, but remind me, do you have a tissue or mechanical replacement valve? I am "making up" that you aren't on warfarin, given the boxing, but maybe I'm wrong about that. Regardless, keep it up!

I have a mechanical valve. And I’m on warfarin. Yes, I do box. I self test and only box if I’m at the very low end of my range, which I intentionally target before boxing.
I also choose my sparring partners wisely. In sparring we hit each other in the face, but you’re not throwing with 100% intensity. Also, very different from boxing matches, standard for sparring is to use 16oz gloves which decent padding.

 

[pellicle]

Hi

Just curious, when you say "mechanical valve" do you mean mechanical or tissue (any replacement valve)? I'm only asking because I'm curious as to whether there could be any difference.

I mean mechanical, but while there is a marginal difference in flows in the favour of a bioprosthesis we know that in the long term that advantage goes away and after 10 years (speaking statistically) the mech will pull ahead.

@pellicle, your advice and exhaustive knowledge on this forum was (is) a tremendous help in my journey here. I know we debated a bit on the whole mechanical vs. tissue valve option, but I fully respect the knowledge (and obvious study) you bring to this community. Thank you, sincerely!

you're welcome, and to be clear I have no interest in "convincing" anyone, I just do my best to present the facts and my experience. If it sounds like I'm leaning one way then perhaps that may be just the evidence talking.

I recall our discussion and IIRC I think you chose a bio, but I can't be certain. Either way it is none of my business what you choose nor will it effect me. I just do what I can to facilitate the facts and may make counter argument which is always backed by medical evidence (if I see that non-factual arguments are presented).

I see below that you picked a bovine. I see nothing wrong with that and equally I see nothing wrong with needing a reoperation in the future. The very least of this is that you may be then in a different stage of life and view it differently and so got time away from accepting too many big changes at once. We both know that ACT is a big change and for some personality types is not a good choice.

Best wishes

 

[HokieHaden]

Hi



I mean mechanical, but while there is a marginal difference in flows in the favour of a bioprosthesis we know that in the long term that advantage goes away and after 10 years (speaking statistically) the mech will pull ahead.


you're welcome, and to be clear I have no interest in "convincing" anyone, I just do my best to present the facts and my experience. If it sounds like I'm leaning one way then perhaps that may be just the evidence talking.

I recall our discussion and IIRC I think you chose a bio, but I can't be certain. Either way it is none of my business what you choose nor will it effect me. I just do what I can to facilitate the facts and may make counter argument which is always backed by medical evidence (if I see that non-factual arguments are presented).

I see below that you picked a bovine. I see nothing wrong with that and equally I see nothing wrong with needing a reoperation in the future. The very least of this is that you may be then in a different stage of life and view it differently and so got time away from accepting too many big changes at once. We both know that ACT is a big change and for some personality types is not a good choice.

Best wishes

That’s right. After consulting with my surgeon, it felt most likely I’ll be a candidate for TAVR in 15-20 years when I hope to be at the end of this tissue valve. I know there are no guarantees, but that’s the plan I’m planning on.

 

[3mm]

still at 6 months out have soreness, especially at the base of my sternum, when I cough or sneeze.

I am 7 months post surgery. On Sep 14, 2023 I had a full sternotomy for mitral repair and installation of an On-X mechanical aortic valve. I don't feel any pain or discomfort in my sternum anymore. 2 months ago (5 months post op) I would feel some discomfort and pulling on my chest. My sternum has improved over time.

I am still much weaker and have lower peak aerobic performance than before my endocarditis. This is improving as I continue to exercise as intensively as I can, given my limits. In December (3 months post surgery) I could only hang from a pull up bar. Now (7 months post surgery) I can do 8 chin ups in a set. Time and appropriate hard work will heal the body.