Complications post surgery, what should I be asking my doctors?

[Guest]

I had a mechanical valve put in Jan 8,2018. (On-X). I had a few complications , brutal constipation requiring an ambulance ride, and an SVT event caused by fluid around the heart.

I've been recovering pretty well up until two weeks ago, where I had what was diagnosed as a TIA type stroke. INR was reduced to 1.4 or so which supposedly was working acceptable levels for this valve.

Since then, I’ve had recurrent twinging in my face, what was diagnosed as a severe panic attack, and boughts of uncertainty. Testing at the many hospital visits showed no real signs of stroke damage based on the “look here”, “life your leg”, “squeeze my finger” type tests. Still, tingling reoccurs in my feet, nervousness abounds and a general unsteadyneas compared to my recovery before the tIA.

What should I me asking my primary care and cardiologist to do? What to look for? I am on this drug /supplement list:
Tamsolosin
metropotol
ameoderone ( just ended today)
colchesine
aspirin
magnesium citrate
saw palmetto

some are for a prostate issue. THey just gave me lorazepam for the quickly diagnosed panic attack( very scary, felt like he end etc) . Not sure what I should be asking but they don’t seem to have a solid handle on it. Cat scans, ekgs etc seem fine. Still feel a bit staggered on the left but only for parts of the day. Ideas?

 

[Juli]

I also had complications with an On-X valve and had to increase my INR to 2.5-3. I would discuss this with your doctor as the lower INR might not work for everyone and the consequences are severe.

 

[pellicle]

Hi

so sorry to read of your troubles. However:

I've been recovering pretty well up until two weeks ago, where I had what was diagnosed as a TIA type stroke. INR was reduced to 1.4 or so which supposedly was working acceptable levels for this valve.
...
Ideas?

firstly 1.4 is below the absolute bottom rung of the safe side which I understood to be 1.5
secondly not everyone is ok at 1.5 or even 1.7, and
thirdly On-X were doing weekly testing to ensure that patients were in range because anything longer than that runs the very real risk of dropping lower.

What was your INR testing frequency and how was it done?

I would simply suggest you target INR=2.5 (which in practice means a range of 2.0 ~ 3.0)

Best wishes