Another setback - back in the hospital

[Agian]

How you feeling now?

 

[canon4me]

I am laying in bed writing this now and am feeling pretty good. Thank you Percocet! When I take a fairly deep breath, it hurts pretty good. This is the pericarditis. I am really hoping the medication will lessen the fluid around the heart so I don't have to go into the surgical room for needle aspiration of the pericardium. It would be nice to have a handful of things go as planned. At this point, my sternum is really secondary with not a lot of pain coming from there. I realize now and after reading other patients accounts, that AVR requires up to a year or longer when you can truly say you are feeling "regular" again.

 

[Agian]

Sounds like things will work out. The heart wound will heal up and allow your body to resorb the fluid that was oozing from it. What time is it over there? You should get some sleep.

 

[epstns]

Jon, Pericarditis is another of those fairly common issues in recovery. Many of us have had it to one degree or another. All of us (at least the ones who are here) have survived it. Some have even had recurrences of it long after surgery. It is treatable once detected. Often the primary treatment is ibuprofen or another NSAID to reduce inflammation, which was the original cause for the fluid accumulation. Only in a relatively small percentage of cases do they need to physically drain the fluid. Those patients who have had fluid drained have reported near-immediate relief of their symptoms, with only minor discomfort in the procedure. I cannot speak from personal experience, but perhaps others who can, will.

Bouncing back into the hospital can shake our confidence in our bodies and our recovery, but unless the reason for re-admission is cited as life-threatening, another couple of days in the hospital is just an inconvenience. Keep your eyes (and mind) focused on the long-term objective, which is a strong recovery. Don't worry a lot about short-term issues. Let the docs deal with them so that you can move on into another phase of recovery.

 

[dwhist]

I had the fluid build up 10 weeks after AVR. Ended up in emergency surgery to have a pericardial window put in. They open the pericardial and drain fluid and then leave opening in pericardial so fluid does not build up again. I have been told it will close up again over time. I read up and some surgeons leave the pericardial open after AVR to prevent cardiac tamponade which is what I had, but according to info on the web this makes further surgeries harder as the heart may fuse to the back of the sternum. Others like my surgeon close it back up.

When I was being prepped for this surgery, same surgeon who did the AVR came in to tell me he was doing the surgery and not to worry as it would only take 15 minutes once I was knocked out. They added to the scar on my chest at the bottom about 2 inches and another drain hole. They told my wife they took out 1 liter of fluid and had rushed because heart was at a state where it may stop and they could not resuscitate until fluid was out. I even ended up with same anesthesiologist. They put drain tube in and kept me for 3 days putting me on prednisone and let me go back to work the day after I was released. Yes I felt better and have not had a problem since with fluid buildup.

One of the things I had mentioned before on here is right before they took me in for the surgery, I noticed my fingernails were blue. To this day when I am not feeling great and worry, I check my finger nails to see if blue. If they are not blue I squeeze one and watch how quick it changes from white to red again to see if any issues with blood flow.

So, yes once fluid is out and they get it to stop accumulating, you will feel great again.

 

[kimcdougc]

Jon, I hate to hear of any problems for you. Sometimes life just sucks. We just have to roll with the punches and do the best we can. I will be thinking of you and will pray for easy breathing and quick healing.

 

[canon4me]

Nail beds turning blue indicate different things. That is called cyanosis and often the lips turn blue also. Patients with lung cancer often get cyanosis of their nail beds and get "clubbing" of the thumbs because of pulmonary insufficiency.

 

[AmyR]

canon4me. I just pray and send you the best of wishes for a super fast recovery. Prayers, positive vibes everything possible good your way. Keep us updated.

 

[Agian]

Why don't they routinely put in a 'pericardial window' when they replace the valve, to prevent this from happening? (Dumb question)

 

[canon4me]

Why don't they routinely put in a 'pericardial window' when they replace the valve, to prevent this from happening? (Dumb question)

I think it is a valid question and makes me wonder the same thing.

 

[Jkm7]

I am glad you asked that. Cleveland discharged me on Coumadine because I was in AFIB. That's not bad in itself. However, after surgery and before discharging me from the hospital, they NEVER did a follow up echo to see if the valve was leaking and if they had they clearly would have seen I was starting to suffer from pericardial effusion (pericarditis) and accordingly would have gotten my Afibs under control rather than dismiss me on Coumadin, which hastened the collection of blood/fluid in the pericardium. This is speculative of course, but one view which my cardiologist put forth.

I'm not sure it is routine to do an ECHO prior to discharge home after valve replacement.
I did not have an ECHO until several months after my replacement and all was well. Mass General does not automatically do them without specific need so maybe Cleveland is not unusual with their routine.

I so sincerely hope things turn around quickly for you. I've read of your set backs and hope you pass through these 'bumps in your recovery' and get to a smoother recovery from here forward.

 

[dwhist]

Why don't they routinely put in a 'pericardial window' when they replace the valve, to prevent this from happening? (Dumb question)

I want to remember the surgeon said the window would eventually close up. I had asked what if this happpens again and he said he would go in thru the ribs next time and do a different procedure. I had a follow up echo about 3 weeks after surgery to see if any fluid had built up. So, maybe it closes up in just a week or two?

I tried searching internet for more info on how long it would take to close up with no luck.


Also, I was told the blue nails indicated how low the oxygen level was in my blood showing the heart was not performing well. Color was back after surgery.