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Tori 34

Member
Joined
Dec 2, 2009
Messages
9
Location
Hertfordshire, UK
Hello everyone!

I'm two weeks post surgery tomorrow and thought I would post my account of my experience. I had AVR at the Royal Brompton Hospital in London, UK. I was admitted to hospital the day before surgery, for pre-op tests. I just had an ECG, blood test and test for MRSA, so given I went in at 11am, I spent most of the day hanging around worrying. I met all the surgical team post 7pm the day before surgery, and all I could think was, please all of you, go home and sleep!

WED 7th: The hour before surgery was pretty hideous, because I was consumed with fear. As most people here have advised, the waiting is the hardest part, and it has very much been my experience. I went for a strategic cry in the loo, and a nurse gave me a hug! As standard practice I was given temazepam two hours before surgery, and was wheeled down to theatre at 8am. I felt very calm by this stage, thanks to the medication. Surgery went as planned and finished at shortly before 1pm. My husband was advised to come to the hospital for 4pm at which stage they intended for me to be more lucid. Unfortunately post surgery I continued to bleed, and the surgical team elected for me to be kept under pending a decision on the way forward. A blood platelet transfusion was given to me, but I continued to bleed and my husband was advised to leave the hospital at around 7pm, as the doctors were clear they were not going to be bringing me round soon. He was advised if I didn't stop bleeding before midnight I would be taken back down to theatre for them to open me up again to find out what was happening. By 11pm, the bleeding had stopped. Thankfully I was none the wiser, though I think my poor husband has aged about 10 years.

THURS 8TH: I came round in the early hours of the morning, in Intensive Care, on a ventilator. I'm so lucky to have found this site, because it had been mentioned here that this happens from time to time, so I think that in my head there was a vague, drug-addled understanding of what was going on when I stirred. It wasn't a scary experience at all, I felt very safe. I recall asking for a pen and paper. I don't recall that I then proceeded to write my husband's initial again and again and draw hearts around it, but the nurse was so entertained she kept the piece of my paper to show him when he came to the hospital! I remember my husband being at the hospital later that day, and know that the nurses plaited my hair for me. I'm told I sat in a chair for a few hours but i have no memory of it. At 5pm, 28 hours after surgery I left Intensive Care for the High Dependency Unit

FRI 9TH: Again, I can't recall much to the 2nd day after surgery. I suspect morphine doesn't help. The morphine kept the pain at bay, but I was repeatedly sick. Whilst the anti-sickness drugs worked their magic, I felt very disoriented all day. I kept on waking up thinking I must have been asleep for hours, and then I'd look at the time and see that I'd had my eyes shut for 10 minutes. It was very difficult to find a comfortable position, but the nurses really do everything they can to help. The pacing wire and chest tubes came out late on in the afternoon. I had dreaded this part, and I can assure you I have a very low pain threshold, but it proved to be very manageable. Yes, it hurts, but for about 5 seconds. I was made to walk before being able transfer to the standard ward, and I really wasn't very stoic about it. Even being wheeled down for an x-ray the whole world felt like it was spinning and my chest felt so tight. Nonetheless I must have been improving well as I moved to the standard ward in the early evening.

SAT 10TH: X-rays showed that I had a lot of fluid on my lungs and I was given breathing exercises. I built up my confidence with walking, although it really was just a shuffle to the loo. Thank goodness for the water tablets they were giving me to address the 10lb weight gain, it forced me up and about. My neck line was removed - heaven! I think having then been clear of morphine for 24 hours did me the power of good. I managed a couple of mouthful of foods, and downed water like nothing on earth !

SUN 11TH: Canula removed and I was free to move around! Shower was heaven, even though it took me an hour to complete! I had little sit downs in between shampooing and conditioning my hair! I even put a nice dress on and put some make up on ready for my husband's visit. I can't get over the difference in the way I felt between the afternoon of Day 3 to the afternoon of Day 5. The recovery was just incredible. It felt good to be able to reassure a patient who was in pain, who had the op two days before me, that it really does get better extremely quickly. X-rays showed that the fluid had just about done fro my lungs and the only issue was that their was fluid around my heart, slightly above the amount they'd expect to see.

MON 12TH: I felt so much better, when the porter(s) came to take me for an echo or an ECG, I told them that I was able to walk there myself. The doctors confirmed that they would discharge me the following day. So, 6 days post surgery I went home.


So, I've now been home just shy of a week. I was given paracetemol and codeine to take every 6 hours, but I've already been able to drop the codeine, and just take the paracetemol every 8 hours or so. I walk for a minimum of half an hour a day, and today I even managed to push my two year old son in his buggy during that time - though I was a bit out of breath afterwards! I tire very quickly, and do have a racing heart beat about once a day, but I know its normal at this stage.

Good luck to any of you reading that have the surgery ahead of you. One thing that I hope might help you is that I certainly won't be looking back on the surgery and my time in hospital with any regret - it has been a tremendously positive experience.
 
Tori that's great to hear! However you probably shouldn't be pushing anything, much less a two year old in a buggy. Your sternum needs time to heal so pay attention to the post op weight restrictions.

I say this because I did not pay as much attention to the post op restrictions that I was given and 11 months after my first OHS I was still dealing with searing sternal pain that would just about drop me to my knees on occasion. Then I had to have a redo valve replacement and I behaved myself after that one, and no pain. :)
 
Tori 34,

Happy for your progress. Of course it is normal to tire easily....it is only two weeks! the heart and the sternum need to be cared for with love and patience...they went through a lot.

Try to follow the discharge instructions re lifting, exercising, etc.

Go slowly and surely to keep the good recovery. :)
 
Great news Tori!. I am 12 weeks post op and better than normal. I to would advise you to pay attention to the weight limit they have given you so that your sternum heals properly. I did what I was suppose to and have had nor problems concerning my sternum. Remember to do your breathing and walking. Two weeks post op I went about 1 block or more. 12 weeks post op I am walking almost 5 miles a day! Good luck with your continued recovery.
 
Post op weight restrictions? I wasn't given any. I got given a big bag of meds and left the hospital! Obviously I'm not so daft (well at least I hope not!) to think that I could/should attempt to lift heavy objects etc, but I wasn't given any direct instructions. Given I struggle to open the back door in my home, and freezer door, I have avoided tricky stuff, and just assumed that I shouldn't be doing anything that caused me discomfort. Given I've found it okay pushing the buggy (not easy, but manageable) I imagined that there wasn't an issue. If its a well trodden ground on this website, please direct to me the right place to see what the 'rules' are. Thanks for your help!
 
They didn't give you any weight restrictions?? Geez. When I was discharged I didn't get any info about warfarin - like how often to get my INR checked, what might interact with it . . . you think hospitals would have worked out a common post-op package to give to patients by now!

Anyway, in terms of what I was told not to do, here are some things I remember:
No making the bed or vacuuming for six weeks (vacuuming is kind of like pushing a buggy which is why all of us above have thought you shouldn't be doing that!)
No lifting anything over 2kg or so for six weeks
No driving for six weeks (passenging is OK)
No bike riding for eight weeks
No real lifting (i.e. actual weights) for 12 weeks

Others may have more to add, but basically give your entire upper body a rest for six weeks, you REALLY want that sternum to heal properly! :)
 
Congratulations on getting through so easily. I'm two weeks post-op, too, so I know exactly how you feel! I second (third? fourth?) everyone else's warnings about lifting/pushing, but I would add that if pushing the buggy isn't causing you any sternum pain, it's probably okay. Especially if you have one of those super-easy-glider buggies that seem to be everywhere these days and that I wish they'd had when my kids were small....!
 
Tori,

Here is an excerpt from one website http://www.swheartlung.com/index.html

Quote:

Driving

Your doctor will tell you when you may resume driving. This usually occurs about six to eight weeks after surgery, however, time may be shorter if you had minimally invasive surgery. During this time, you may be a passenger as often as you like.

Activity

For the first six to eight weeks:

• Gradually increase your activity. You may do light household chores, but do not stand in one place longer than 15 minutes.
• Do not lift objects greater than 20 pounds (your doctor may give you a different number if appropriate). Also, do not push or pull heavy objects.
• It is OK to perform activities above shoulder level, such as reaching for an object or brushing your hair. But, do not hold your arms above shoulder level for a longer period of time.
• You may climb steps unless they have been restricted by your doctor. You may need to rest part of the way if you become tired. Do not climb up and down stairs several times during the day, especially when you first arrive home. It is better to plan activities to go downstairs in the morning and back upstairs when it is time for bed.
• Pace yourself - spread your activities throughout the day. If you become tired, rest and schedule unfinished activities for another time.
• Walk daily. Your doctor or cardiac rehabilitation specialist will give you guidelines for walking when you return home.
• Check with your doctor to confirm activity guidelines.

..............

Unquote.

:)
 
thats bad no instructions, my physo in hospital gave me leaflets and told me about what i could and couldnt lift, and made sure my wife was informed as well, hopefully you can read up about it on here, anyway glad to see your doing well,
 
.............If its a well trodden ground on this website, please direct to me the right place to see what the 'rules' are. Thanks for your help!

Hi Tori,

One of our stickies under "Post Surgery" forum contains a detailed informative PDF about "What to expect after surgery", from "THE SOCIETY OF THORACIC SURGEONS" website (http://www.sts.org/sites/default/files/documents/pdf/whattoexpect.pdf)

You can find this sticky under our "Post surgery forum" :

http://www.valvereplacement.org/forums/forumdisplay.php?12-Post-Surgery

For your ease of reference, here are some of the recommendations:
Quote:

Activity

stop any activity immediately if you feel short of breath, notice irregular heart beats, feel faint or dizzy, or have chest pain. rest until the symptoms subside. If they do not subside within 20 minutes, notify your doctor.

showers

you can take showers after your pacing wires and staples are out. avoid soaking in baths until your incisions are healed. avoid extremely hot water.

Dress

Wear comfortable, loose fitting clothes that do not put undue pressure on your incisions.

rest

you need a balance of rest and exercise for your recovery. plan to rest between activities and to take short naps as necessary. resting also includes sitting quietly for 20-30 minutes. rest 30 minutes after meals before exercising.

Walking

this is one of the best forms of exercise because it increases circulation throughout the body and to the heart muscle. It is important to increase your activity gradually. Walk at your own pace. stop and rest if you get tired. each person progresses at a different rate after heart surgery. physical therapists will provide you with an individual plan for exercise before your discharge. It is important to pace your ac- tivities throughout the day. Do not try to do too many things at one time. In poor weather, lower than 40 degrees or above 80 degrees, you can walk at indoor shopping malls. In cold weather, wear a scarf or mask around your mouth and nose.

stairs

unless your doctor tells you differently, you can climb stairs. take them at a slow pace. stop and rest if you tire. When using the handrail, do not pull yourself up with your arms. use your legs.

lifting

you should not put too much strain on your sternum while it is healing. avoid lifting, pushing, or pulling anything heavier than 10 pounds for six weeks after surgery. This includes carrying children, grocer- ies, suitcases, mowing the grass, vacuuming, and moving furniture. Don’t hold your breath during any activity, especially when lifting anything or when using the rest room.

......

exercise guidelines:

stop any exercise if you experience shortness of breath, dizziness, leg cramping, unusual fatigue, and/or chest pain (angina). notify your doctor if these symptoms persist.
If your post-exercise pulse rate is more than 30 beats faster than your resting pulse rate you have exercised too hard.

In order to correct these conditions, you will need to modify your next exercise session.

Unquote

If you like and when you have time, you may want to browse throughout the six beneficial pages
 
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They didn't give you any weight restrictions?? Geez. When I was discharged I didn't get any info about warfarin - like how often to get my INR checked, what might interact with it . . . you think hospitals would have worked out a common post-op package to give to patients by now!


Your comment about the lack of info on warfarin rang a bell for me too.....I have a tissue valve, and the surgeon told me on the day before the operation that I would take warfarin for 6 weeks post op. When I got home, having been discharged from hospital, there was no warfarin in my bag of medication. I called the ward and spoke to the nurse that had discharged me, and she said that as I had a tissue valve there was no need for me to have warfarin. She said that I had been given warfarin injections whilst in the hospital because I was relatively immobile, but that should not be an issue any longer. I accepted her explanation, but a day later the issue was still nagging at me as I was certain it was at odds with what the surgeon had said to me, so I called the surgeon's secretary to pass a message to him asking for clarification. I received a call back saying the nurse was incorrect, and I should have been prescribed warfarin. That said, given the time that had already elapsed, and the fact I don't live near to the hospital, I should go to the pharmacist and get aspirin to take daily for the next 6 weeks. So glad I called to verify the info I'd been given.

I also still don't have my discharge notice from the hospital as the printer wasn't working the day I left. I've called to ask for it to be sent to me twice now, but still it hasn't materialised - so I don't see to have done to well on after care one way or another! That said, I very much appreciate all the advice people have posted here about post op restrictions. Extremely useful, and they will be heeded. Thank you everyone!
 
I have a tissue valve also, and was not prescribed any warfarin on discharge. I didn't even ask about it. But when I see my cardiologist in two weeks (which will be four weeks post-op) I will ask him, because I have seen on these forums that people who get tissue valves are typically put on warfarin for six weeks or so.
 
I have a tissue valve also, and was not prescribed any warfarin on discharge. I didn't even ask about it. But when I see my cardiologist in two weeks (which will be four weeks post-op) I will ask him, because I have seen on these forums that people who get tissue valves are typically put on warfarin for six weeks or so.
Like you, I was given no mention of Warfarin after my tissue valve, and when I asked, my surgeon said it wasn't necessary. I think there are lots of different medical opinions about many of the details of heart surgery.
 
Hi Tori 34,
I am in the same boat as Heather Anne and dg Moore. I have a tissue valve as well and the surgeon and cardios, indicated no Warfarin - only aspirin. I realize you are at a distance from your surgeon, but I think you really need to have this clarified just to put you at ease. Best of luck to you, Nita
 
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