Could use some encouragement...

[MikeHeim]

I'm three months post-op and have been trying to get back into the exercise game slowly, but things just don't seem to be working out that well. I go biking (pretty slowly) and sometimes ride a stationary bike at the gym (somewhat more strenuous). The problem isn't that I run out of energy, it's that I still seem to get out of breath really easily. In fact, I feel like I'm having more SOB problems than I had before surgery! I was one of those "lucky" ones that felt pretty good prior to surgery. The only time I had regurgitation symptoms was during very strenuous exercise during which I would pretty much begin wheezing. I am still avoiding strenuous exercise post-op (per doctor's orders), but I'm afraid that if I did I would begin wheezing again.

Anyways, I was just hoping to get some reassuring words that everything will get better. How long did all of you wait before you were able to get into a pretty good exercise regimen? Did anyone else have shortness of breath this long after surgery? How long before it goes away? I know that it takes 6-12 months to totally recover from OHS, but I feel like I haven't seen any improvement for quite some time. Thanks!

 

[Mb]

Mike:

Please don't get discouraged.. It takes a long time to recover from this surgery, and you aren't that far into things. That being said, my husband went through the exact same thing. And, at about three months, we both realized that something needed to get checked out, as the cardiac rehab folks pretty much wouldn't let him do anything, as his heart rate would go way out of whach. This prompted some tests, where the culprit was discovered. (third leaking valve)

I personally think that at this point you know your own body. If you really think something isn't quite right, I would call the Dr.'s (cardio's) office, and get an appointment to be seen. An echo might be in order.

Marybeth

 

[Karlynn]

Mike - did you do a cardiac rehab program? If not, I would highly recommend doing that. You are monitored while you work out, so anything unusual is addressed.

Also, don't forget you had major surgery! Your body will take time to recover from the assault it had done on it. We have some "Super Patients" here who have said they felt completely back to normal 5 - 6 months out. But a year is kind of the rule of thumb. So taking that into consideration, you are only 1/4 in to your recovery.

I heard at one point in time, that it takes 6 months for the effects of general anesthesia to work out of your system.

 

[Arpy]

Keep it up

Keep it up

Mike

Hang in there mate. We are all different and the OHS can impact on us all in different ways.

At least you have the mindset of getting up and exercising and your body is just telling you that its not quite ready to go all out yet! ....and thats not surprising

Stick with it, liaise with your doctor and you will surely see improvement as time progresses and your body is ready for it.

Regards

Russell

 

[BillCobit]

I'm three months post-op and have been trying to get back into the exercise game slowly, but things just don't seem to be working out that well. I go biking (pretty slowly) and sometimes ride a stationary bike at the gym (somewhat more strenuous). The problem isn't that I run out of energy, it's that I still seem to get out of breath really easily. In fact, I feel like I'm having more SOB problems than I had before surgery!

Hi Mike

My experience is similar to yours. Five months after my surgery I did a short course triathlon that was WAY harder than one I did 5 months before surgery. It took > 1 year before I got back to pre-op performance. Not quite what I was hoping for, but that's how it went.

Check out this thread for some experience of others:

http://www.valvereplacement.com/forums/showthread.php?t=12286

Hang in, it will get better. You need to be patient. Keep the faith.

Regards,

 

[tobagotwo]

I found it does take a while to get your full wind back. I really only noticed it when I went all out and used myself up completely, but basically, I couldn't get my breath back.

However, that did fade over time. Now, I'm as good as I ever was.

Best wishes,

 

[MikeHeim]

Thanks to all for their responses. Deep down, part of me realizes that it's just too soon after surgery to exercise like I want to. The strange dichotomy (sp?) is that is that I feel like I need to work harder to get better faster. Oh well, I shall try to be patient going forward. Thanks again.

Karlynn-
My surgeon said that he typically doesn't prescribe cardiac rehab for people that he feels will "self-start" an exercise program. I was fine with that when he said it before surgery, but from what everyone on this board has said it sounds like it might have been a good idea. I'm sorry I missed it.

 

[MikeHeim]

Ugh. Again.

Ugh. Again.

I have one other question for this thread. Could some of you explain your experiences with (or definition of) shortness of breath? The way I would describe mine is that I suddenly feel like my lung capacity has dropped in half. While I'm working out, I just can't seem to take a deep breath. If you would have asked me five years ago, I would have told you that shortness of breath was heavy panting after I finished working out (more like not being able to catch up). The symptoms I had as my valve leakage got worse was more the feeling of not being able to breathe deeply to the point where I would actually begin to wheeze when I went running. It was very scary and it was the thing that sent me to the doctor - where I got my initial diagnosis. Thanks again and sorry to keep bugging everyone...

 

[Christina L]

Mike -

Mike -

Goodness you are only a few months out from surgery. Give yourself a LOT more time to get your exercise tolerance back.

As for the SOB, you might still be retaining fluid. Are you on Lasix - are you watching your salt intake - not cutting it out entirely, but cutting back on it.

Anyway, I had water retention problems for a while after surgery that I attributed some of my SOB to.

I know what you are saying about not being able to draw a deep breath and there have been threads on that subject here on Vr.com - I personally believe it is anxiety that causes that - I have it quite frequently. When I am relaxed and not worrying about things, I will notice that my breathing is regular and the breaths are full.

Please-please-please slow down. Your body is telling you to do just that - it has been through major trauma - a regular assault.

You're going to be fine if you take it slow and easy at least for another couple of months.

Christina L

 

[BillCobit]

I have one other question for this thread. Could some of you explain your experiences with (or definition of) shortness of breath? The way I would describe mine is that I suddenly feel like my lung capacity has dropped in half. While I'm working out, I just can't seem to take a deep breath. If you would have asked me five years ago, I would have told you that shortness of breath was heavy panting after I finished working out (more like not being able to catch up). The symptoms I had as my valve leakage got worse was more the feeling of not being able to breathe deeply to the point where I would actually begin to wheeze when I went running. It was very scary and it was the thing that sent me to the doctor - where I got my initial diagnosis. Thanks again and sorry to keep bugging everyone...

Mike -

The "capacity" / wheezing symptoms sound like maybe you have exercise-induced asthma? Just a thought.

Bill

 

[DLH]

Mike,

I think this varies a lot from person to person. I had my mitral repair Nov. 18 and like you had no significant symptoms prior to surgery. I am a bike rider and after surgery for rehab I did breathing exercises with the meter, walking daily and at about 5 weeks after surgery stationary riding. I am now riding every other day on the trainer or on the road for an hour and will continue to increase my miles and time. These are not leisure rides, I try to ride at an avg speed of 18-20mph with my heart rate up in the 125-150 range. I had concerns about SOB, because prior to surgery they mentioned that I had slight pulmonary hypertension. So far I have not had any noticeable SOB other than what I feel is normal after OHS. My cardiologist has given me the green light on pretty much all activities and besides riding I am playing softball. I will have a follow-up echo in May to see how everything looks 6 months after surgery. I think everything will probably improve for you over time, just keep doing your exercise on a regular basis. Try using a heart rate monitor also, you will find that you have a range where you can ride comfortably without getting really SOB. Stay in that range and over time you will notice improvement.

 

[Marguerite53]

Hi Mike. I'm still pre-surgery, as you know (thanks for your honest and helpful remarks in my heart cath thread ). As I was reading, I was thinking as Bill just mentioned that it might be exercise induced asthma. I experience SOB from the stenotic aorta and for me it's just more a heavy breathing thing at the end of anything remotely (insignificantly ) strenuous. It's a windedness thing. No wheezing. It's as if I've tried to do something really strenuous and so the repsonse is out of line with the very simple activity (walking up a flight of stairs) warrants. If I pushed myself (which I don't these days) I might feel some gulping for air sensations, but since it's a gradual sensation, I don't let myself get to that point. At no time have I ever felt like I needed assistance breathing, (oxygen) just that I felt like I was walking around with 3 other people on my shoulders.

So please look into the possibility that the symptoms might be asthma. Maybe someone else with asthma experience will chime in.

I think at the very least, you should discuss it with a physician......even maybe a doctor's nurse. You'll feel better if you do. Keep us posted, then.

Be well. Marguerite

 

[RCB]

Mike,
I agree with the others, you might just being too hard on yourself.
SOB is somewhat subjective, but most often it is described as having
to take deep breaths or need for more air in situation where a person would be confortable taking normal breaths. Climbing one flight of stairs, talking and walking at the same time should normally not result in an increase of breathing. Having you been using your spirometer? Also, I wouldn't rule out a lung problem or excess fluids, as well as havng your meds adjusted. Let your doctor know how you feel. He might be able to do something about it or maybe just tell you "it is normal, relax!" I hope so, good luck.

 

[tobagotwo]

Yes, Mike, that's how it feels - like you're missing a lobe or two of lung. It does go away.

Building yourself up is good, but please don't push yourself too hard. You're not taking a normal specimen and bringing it up to speed. You're rebuilding a system that had a broken heart. Like rebuilding an engine: push it too hard before it's fully balanced, and you'll throw a rod. Bring yourself up to speed incrementally, and allow all your parts time to catch up with each other.

Examine your motives. Wanting to get back to normalcy is normal indeed. These sudden, impulsive rushes of need to get to top physical shape instantly sound more like someone running away from a recent brush against the cold robe of the Reaper, than someone running toward a tangible goal.

We all get that same chill now and again, because we have all been forcibly taken to that dark place in our minds. We have all been confronted with our wretched selves at some point in this, fighting the frantic need to claw far away from death.

You're still dealing with some post-traumatic shock, which I'm sure you realize on some level. Remind yourself that you've received a gift of time from this surgery. Remember that the length of your life was never a certain thing, with or without a heart valve issue. We have all come to realize through this harrowing experience how precious and fragile our physical life can be, but we mustn't hold life so tightly that we become afraid of it: we win by reveling in it instead.

Try to determine whether your excessive push is fear-driven or constructive. If it's not doing you good (and it sounds like it isn't), then figure out which part of your brain is going to rule this new beginning to your life.

Be well,

 

[tobagotwo]

My opinion about cardiac rehab is mixed.

Cardiac rehab is excellent for those who have been physically inactive, who like working with a coach, who want the reassurance of medical monitoring while they start out, or who are tentative about the results of their surgeries. Rehab builds confidence, and extends people's assumptions about what they can do. And it starts people on the road to getting back in shape (just the start, mind you).

If you're already confident in your physical capabilities and exercising on your own, I agree with your cardiologist: self-starters need not apply. If you feel like you've missed something in the way of exercise, any gym can provide a good all-around cardio workout plan. That's who worked it out for the rehab centers. However, it sounds more like you're second-guessing yourself than like you are in need of any more exercise than you're already doing.

Best wishes,

 

[BillCobit]

Cardiac rehab is excellent for those who have been physically inactive, who like working with a coach, who want the reassurance of medical monitoring while they start out, or who are tentative about the results of their surgeries. Rehab builds confidence, and extends people's assumptions about what they can do.

If you're already confident in your physical capabilities and exercising on your own, I agree with your cardiologist: self-starters need not apply.

Best wishes,

Although exception vs. rule (thankfully), complications of surgery can include cardiac ischemia and arrhythmia which may become evident upon physical exertion. I agree that rehab does build confidence, but I submit it's more than just a psychological exercise designed to reassure, and that telemetry used to monitor HR and rhythm while exercising provides legitimate clinical data, as opposed to just being a placebo. I'm not willing to say that if you're motivated and confident, there's no underlying risk.

My $0.02, I know there are some cardiologists and patients who do share my perspective, some who don't.

I went to an abbreviated rehab (I didn't need no stinking motivation or lifestyle counseling), long enough to ascertain I could rev the engine w/o any ill effects. Guess you could say that proves I didn't need it. Sort of like term life insurance, in that respect.

 

[Barbara Stewart]

Could use some encouragement

Could use some encouragement

You asked what it felt like when others of us had SOB. Before my second surgery I would have to stop to get my breath. I felt like I was going to pass out. Now I'm doing cardiac rehab (I really recommend it) and yesterday I really pushed myself and I was breathing hard, but I didn't feel like I was going to pass out nor did I need to stop to get my breath. That's how it was for me.
Regarding cardiac rehab; just because you are self motivating doesn't mean you wouldn't benefit from it. I'm also self motivated, but I have a tendency to overdo it and push too hard. Because I have unrealistic expectations I get discouraged. Try the CR. You can work as hard as you want and know it's OK or not. I have no doubt that you'll get back to where you were before, maybe even better, but don't expect too much too soon.
I would also give my doc a call.
Good luck.
Barbara

 

[tobagotwo]

I don't think I obviated your use of rehab, Bill.

I went to an abbreviated rehab (I didn't need no stinking motivation or lifestyle counseling), long enough to ascertain I could rev the engine w/o any ill effects.

It seems to me that your description of your use of Cardiac Rehab fits rather neatly into those "who want the reassurance of medical monitoring while they start out." You wanted to rev it up with someone watching, in case things didn't go smoothly. It's a perfectly reasonable approach.

So is starting out slowly and building your way up on your own. I still agree with Mike's cardiologist on that. I'm not at all trying to hint that cardiac rehab is any kind of weakness or a bad thing in general. It's just different strokes for different folks.

However, it should be pointed out that going to cardiac rehab doesn't mean that you won't get arrhythmias a week after you're out. Most new valvers do have occasional bouts of arrhythmias for up to a year after surgery. Ischemias are far less common, but they can happen the day after you finish rehab, too.

In reference to Mike, who has already revved his engine extensively, I don't see how there would be more benefit to his exercise if he were wired to a nurse tomorrow. If he seeks his heart target rate, which I again opine should be treated as a moving target during OHS recovery, he can buy a monitor with a 9-volt battery that does the same thing. He's already past the "will I break?" stage.

Best wishes,

 

[MikeHeim]

I've been away for a couple days, but I appreciate all the responses.

Tobagotwo-
"like you're missing a lobe or two of lung" - Perfect description! I couldn't be more glad (perversely) that someone has felt the exact same thing and to hear that it gets better.

I've changed my tune on cardiac rehab. When my surgeon originally said that he doesn't prescribe rehab for people who he thinks are exercise program self-starters, I totally agreed. I exercised all the time, my blood pressure was low, my cholesterol was low, and my weight was right in the middle of the target range for my height and age. The last thing I felt like I needed was "lifestyle coaching" and someone showing me how to use a treadmill. However, after going through the post-op process, I would definitely like a couple sessions if I ever had to go through this again (knock on wood). I would fit in the category of people who would like to know that I'm not hurting myself as I get going. As a once and future marathon runner, I'm used to pushing myself long past when my body says to stop. After surgery, I found it extremely difficult trying to develop an entirely different mindset.

One other question (if anyone's still reading this thread): How long did you continue to use your Spirometer after surgery? At three months, I still use mine about once per day (usually at night before bed). I tried looking through my discharge literature, but it doesn't really give a time period. I figure it can't hurt, so I'll probably keep using mine until it breaks.

 

[Georgia]

We had a discussion about this a long time ago - I can't remember what the general opinion was, except that you need to be careful with that thing now because it can become contaminated after a while (unless you're cleaning it). You might want to call your cardio's PA and see what the recommendation is.