A couple of questions

[Paleowoman]

I've got a couple of questions that have been on my mind and wondering if anyone can help please:

1) As the pressure gradient across the heart rises does blood pressure as measured on an arm cuff go up or down or isn't it affected ?

2) When you've had the op, in the immediate days following, what happens to the sternum if you sneeze or cough - does it get damaged ?

Anne

 

[Adrienne]

Hi Paleogirl. As for question number 2, I don't know anyone whose sternum got damaged from sneezing or coughing (although we were all told to hold a cushion against our sternum in case we cough or sneeze). However, I can tell you - sneezing causes "exquisite pain"!!!

 

[drivetopless]

Question 1- I have no idea on this.
Question 2 - I had a LOT of coughing post surgery because I ended up with some fluid in my lungs. Sounded like I had bronchitis. I can tell you that I was really worried with the hacking cough that my sternum was wiggling too much to heal. I sneezed for the first time at about week 4, and it is an "exquisite" pain. I literally felt my breastbone pop out with the sneeze and after the sneeze I had new center chest bone pain for about 2 weeks.

However, now at 8 weeks post op, I seem to be fine with no permanent damage done from the sneezing/coughing. Not much pain now, though I still support the sternum with my hand or a pillow if I have a sneeze coming on. I can lay on my sides again, too.

Your sternum is wired back together for support, so I don't think the sternum is so much the issue as movement of the ribs attached to it.

 

[Greg a]

There is a movement underfoot to use talons or krytonite glue to secure the sternum instead of wires that can come loose with sneezing, coughing and even laughing and in RARE circumstances tear the sternum http://www.valvereplacement.org/forums/showthread.php?35336-Kryptonite-Bone-Cement-for-Sternum-Closure-no-Acrylates!&highlight=talons

 

[Paleowoman]

Thanks for the replies everyone.

That's interesting that there are different methods of securing the sternum. I wonder if I'll be able to discuss such technicalities with the surgeon when the time comes ? I can't imagine a patient in the UK discussing which type of thing the surgeon can use, or even which make of valve - tissue or mechanical yes but not which manufacturer - I don't know we Brits get a choice. But you can bet I shall ask very candid questions based on the knowledge I am gaining here I am already bookmarking links

Anne

 

[sweetmarie]

I've got a couple of questions that have been on my mind and wondering if anyone can help please:

1) As the pressure gradient across the heart rises does blood pressure as measured on an arm cuff go up or down or isn't it affected ?

2) When you've had the op, in the immediate days following, what happens to the sternum if you sneeze or cough - does it get damaged ?

Anne

I cannot help you with question 1 but can with #2.

I can honestly say that coughing and sneezing is no fun the first few weeks. Gets a little better after that but I'm 11 weeks post-op and don't have to hold my sternum anymore. Keep a pillow close by at all times and hold it tight against the sternum. If you can pinpoint the exact area, that's where you want the pillow.
I would recommend some tricks that worked for me. Trying to avoid coughing and sneezing is the key. Wear sunglasses and try to hide the sun from your eyes, the sun was always a sneeze trigger for me. Stay away from pepper too, this can make you sneeze big time. I love pepper but had to stay clear of it for months. If you can feel the start of a cough, rather try and bring the phlegm up from your throat by rasping rather than waiting to cough. And always spit out anything. I know this sounds gross but I don't know how else to describe this to you.

 

[Rocky]

For the first few weeks I would use the heart pillow I got post op from the hospital and hold it as tightly as I could across my chest.

Now I hold my upper arms against the side of my chest and put pressure on it that way.

What I find is important is to not to try and control the sneeze by holding it in, and do just the opposite by opening my mouth and letting the air escape. Of course, doing it in public will get you a lot of looks as people are now taught to sneeze into your elbow.

 

[Jason]

In answer to your first question, I don't know. I THINK that the pressure gradient across the valve is localized, and doesn't cause higher blood pressure at the cuff, but I don't know that for a fact. Perhaps someone more knowledgeable here will weigh in.

To the second question, I used my pillow for any coughing for 3-4 weeks, and coughed very gingerly. I can now cough without it, although I still feel pressure inside my chest when I do this. As far as sneezing, I haven't sneezed since my surgery. I plug my nose by pinching on both sides if I feel a sneeze coming. I have TRIED to sneeze twice, and both times my body unconsciously blocked the sneeze even though I wanted to let it go. A blocked sneeze hurts like nothing I have ever felt, so I avoid them now at all costs. I look forward to the day I can sneeze again!

 

[Eva]

As for the 2nd question and in addition to what is recommended, you may also hug yourself, if there are no pillows around.

Good luck.

 

[Paleowoman]

Many thanks again for everyone's replies. I hope I get one of those pillows.

I happened to see my endocrinologist recently and he always takes my blood pressure, so I asked him how the pressure gradient across the heart affects the cuff pressure. Apparently as the stenosis/pressure gradient gets worse that causes the blood pressure as measured on the cuff to get lower, at least the systolic one gets lower. So lower blood pressure isn't always a good thing.

Anne

 

[Lynlw]

Many thanks again for everyone's replies. I hope I get one of those pillows.

I happened to see my endocrinologist recently and he always takes my blood pressure, so I asked him how the pressure gradient across the heart affects the cuff pressure. Apparently as the stenosis/pressure gradient gets worse that causes the blood pressure as measured on the cuff to get lower, at least the systolic one gets lower. So lower blood pressure isn't always a good thing.

Anne

IF your hospital doesn't give out the pillows, you can just use a regular throw pillow (like you put on a couch for decoration) or something about that size. Justin used "uglydolls" his last couple heart surgeries, because he thought it was a good size. We always get brand new ones before each surgery,so its nice and clean.

 

[Eva]

.............. Apparently as the stenosis/pressure gradient gets worse that causes the blood pressure as measured on the cuff to get lower, at least the systolic one gets lower. So lower blood pressure isn't always a good thing.

Anne

Anne,

No wonder why my cardio always encouraged me to keep an eye on my BP, and to keep him informed of the deterioration. You are right: low BP isn't always a good thing...not for heart patients!

Good luck to you.