AVR is done. Going home.

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svAdagioME

Active member
Joined
Sep 30, 2022
Messages
31
Location
Maine
I had an On-X valve put in on Friday morning and now it’s Monday afternoon and I’m going home. Great job by the Maine Medical Center. I was in the ICU for one night and the cardiac care ward for two. It turned out that my valve was worse than expected and my aorta was fine and didn’t need anything. Now my INR is over 2 and I am being sent home. I expected to be here for 5 days. I think if you do exactly what they tell you it makes a difference. The pain is not bad now and I am just taking Tylenol. In full disclosure I have to say that waking up on the ventilator was a freaking nightmare I do not want to repeat. And the pain at first was not good. But my memory of the worst of it is already starting to fade.
 
Congratulations and welcome to the other side!

Out in just 3 days? That's impressive!
Yeah the doctors seemed surprised they were letting me out after 72 hours but everything was in place, and it was their call.

MY ADVICE:

Get off the pain meds as soon as you can. I learned this through a number of knee surgeries. Oxycodone is a bad drug. Fentanyl is hard. The pain from this surgery in my case at least was not as bad as a knee replacement or knee reconstruction (day 1 was worse, after that not as bad). I absolutely needed pain drugs through the first two nights after AVR. I tried to dial it back after night one and that backfired. As soon as I thought I didn’t need Oxycodone the morning after night two I stopped, used Tylenol, and I was out of the hospital the next day.

You have to do exactly what the doctors and nurses tell you to do. EXACTLY. I also learned in the past that if I manage my recovery based on how I feel, it will not go as well as if I just do exactly what they tell me to do. The heart lung machine definitely made me cognitively a bit slow, even now, so managing things is harder, so don’t do what you think or what your family thinks. Do what you are told.

They won’t let you go until you are pooping again, and getting that restarted is difficult because of the Oxy. If you stay on Oxy it will be fighting you the whole way. It’s miserable. So I got off the Oxy and started on the Miralax and stool softeners asap. 24 hours later, kablaam.

Lastly I suspect there is an advantage to getting AVR done sooner rather than later, when you can withstand it. I was tested as severe but some of the things were in the moderate range. My cardiologist said I was a judgement call, and that some doctors would wait longer. As it turned out the valve was far worse than the echos showed so I am glad I did not have to wait.
 
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Yeah the doctors seemed surprised they were letting me out after 72 hours but everything was in place, and it was their call.

MY ADVICE:

Get off the pain meds as soon as you can. I learned this through a number of knee surgeries. Oxycodone is a bad drug. Fentanyl is hard. The pain from this surgery in my case at least was not as bad as a knee replacement or knee reconstruction (day 1 was worse, after that not as bad). I absolutely needed pain drugs through the first two nights after AVR. I tried to dial it back after night one and that backfired. As soon as I thought I didn’t need Oxycodone the morning after night two I stopped, used Tylenol, and I was out of the hospital the next day.

You have to do exactly what the doctors and nurses tell you to do. EXACTLY. I also learned in the past that if I manage my recovery based on how I feel, it will not go as well as if I just do exactly what they tell me to do. The heart lung machine definitely made me cognitively a bit slow, even now, so managing things is harder, so don’t do what you think or what your family thinks. Do what you are told.

They won’t let you go until you are pooping again, and getting that restarted is difficult because of the Oxy. If you stay on Oxy it will be fighting you the whole way. It’s miserable. So I got off the Oxy and started on the Miralax and stool softeners asap. 24 hours later, kablaam.

Lastly I suspect there is an advantage to getting AVR done sooner rather than later, when you can withstand it. I was tested as severe but some of the things were in the moderate range. My cardiologist said I was a judgement call, and that some doctors would wait longer. As it turned out the valve was far worse than the echos showed so I am glad I did not have to wait.
Thank you very much for the advice i will keep them in my when i get my AVR done.

I hope i get fast release from the hospital like you, wish you the best recovery.
 
Thanks for the update and the suggestions.

Lastly I suspect there is an advantage to getting AVR done sooner rather than later, when you can withstand it. I was tested as severe but some of the things were in the moderate range. My cardiologist said I was a judgement call, and that some doctors would wait longer. As it turned out the valve was far worse than the echos showed so I am glad I did not have to wait

This was very similar to my situation. When I became severe I did not yet have symptoms, and I was told by my cardiologist that it was my decision to get surgery now or wait for symptoms. Your cardiologist was correct in that many doctors would wait longer- in my case, wait for symptoms. I agree with you that there is an advantage to getting AVR sooner rather than later. After consulting with my cardiologist and my surgeon, I decided to get my surgery sooner rather than later, as you did. Something which I told every cardiologist that I consulted, since my diagnosis, is that I would rather get my surgery 3 months early than 3 months late. That is still how I feel. But hey, I'm not a doctor, so what the heck do I know. :)

BTW, like you, it turned out that my valve was worse than believed. My surgeon showend me actual photos of my highly calcified valve from the operation, and told me that my valve was beyond severe, and was, in fact, critical- that it was amazing that I never had symptoms and that I was a ticking time bomb, prior to surgery. I'm very glad I opted for sooner rather than later.
 
Thanks for the update and the suggestions.



This was very similar to my situation. When I became severe I did not yet have symptoms, and I was told by my cardiologist that it was my decision to get surgery now or wait for symptoms. Your cardiologist was correct in that many doctors would wait longer- in my case, wait for symptoms. I agree with you that there is an advantage to getting AVR sooner rather than later. After consulting with my cardiologist and my surgeon, I decided to get my surgery sooner rather than later, as you did. Something which I told every cardiologist that I consulted, since my diagnosis, is that I would rather get my surgery 3 months early than 3 months late. That is still how I feel. But hey, I'm not a doctor, so what the heck do I know. :)

BTW, like you, it turned out that my valve was worse than believed. My surgeon showend me actual photos of my highly calcified valve from the operation, and told me that my valve was beyond severe, and was, in fact, critical- that it was amazing that I never had symptoms and that I was a ticking time bomb, prior to surgery. I'm very glad I opted for sooner rather than later.
I did actually have symptoms. I was worried about it. But I had a stress echo that was “severe” and a regular echo by another guy that was “moderate”. These tests are looking through a glass darkly. So a cardiologist with good experience is important.

I also got pictures. I feel lucky after seeing that.
 
Welcome to the other side and here's to an uneventful recovery!

3 days is a quick pitstop! Wow!..... I was in for 8 days all up, but stayed for two days extra till my INR got above 2.0 (coumadin jail)

My advice on recovery, walk everyday, celebrate the small wins and have a routine.

Are you self managing your INR?
 
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Welcome to the other side and here's to an uneventful recovery!

3 days is a quick pitstop! Wow!..... I was in for 8 days all up, but stayed for two days extra till my INR got above 2.0 (coumadin jail)

My advice on recovery, walk everyday, celebrate the small wins and have a routine.

Are you self managing your INR?
Thank you good advice. No I am not self managing it. We are using a visiting nurse to do the tests now and I will start using the Coumadin lab next week. I am using all the resources they have! I suspect I will self manage it some time in the future. But not in a hurry.
 
Glad you're home! I was given Fentanyl one time in ICU, after that only on Tylenol. I was being released on the 3rd day too but then I had an Afib that morning, which kept me in 4 extra days. It's awesome you're home!
 
Thank you good advice. No I am not self managing it. We are using a visiting nurse to do the tests now and I will start using the Coumadin lab next week. I am using all the resources they have! I suspect I will self manage it some time in the future. But not in a hurry.

Nice one!

I think I started to self manage about 2 weeks post operation. And its easy once you get the hang of it. A few wasted test strips starting off with though :D

Keep us posted on your recovery.
 
I'm so glad for you. Good to hear good stories. I'm 2 weeks out for my RAVR. I'm not sure how to slow down but evidently this is going to do it. I see alot of great stories on here but still I have to say, i'm still nervous.
 
I'm so glad for you. Good to hear good stories. I'm 2 weeks out for my RAVR. I'm not sure how to slow down but evidently this is going to do it. I see alot of great stories on here but still I have to say, i'm still nervous.
I was very nervous. But you just go through it. A few days later I am already forgetting the hard parts.
 

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