Erratic heartbeat after surgery

[SatoriFound]

My hubby's heartrate is all over the place and they are saying if they can't get it under control they might shock him to try to get it to go to normal. Is this something that could cause him to have to also get a pacemaker if it doesn't clear up on it's own, or is it common to have issues getting the heart into a normal rhythm? He has the pacer wires and they also did an atrial clip on the left atrial appendage, to prevent clot formation there from Afib.

He also still has the chest tubes. It stinks because yesterday they thought they would be removing them and he would be going to recovery. He also now has a sore throat and cough. He thinks he has a cold. Could it be residual from surgery and not an actual cold? Like sore throat from the intubation and cough/congestion from the fluid accumulation after surgery? He wants to walk, but with the chest tubes and all the stuff he has to haul with him they have only gotten him walking twice. He did great that first time, and I was under the impression from reading here walking is very important and he should be doing it as much as possible.

I went home last night because you are only allowed to stay one night in ICU and because we have an 11 year old at home. His older brother (28) is helping us out throughout this, but he needs his parents too. LOL I am so torn. Hubby needs me and feels better when I am there, but our son needs me too, although not in the same way. I can't bring our son to visit him because the cut off for visitors is 12 years old. He doesn't seem to be upset or need reassurance his dad is fine, but I don't know what's going on inside his head. He is on the spectrum and doesn't react to certain things like others. He seems to be taking it in stride, but... ARGH!!!

Going home also means that I am missing hearing about what is going on from the doctors and nurses mouths and getting it second-hand from hubby. He tends to forget things and is spotty about relaying information. LOL He also doesn't want to bug the nurses and will go a long time before asking for what he needs. When I was there I could run and get him more water, or tea or help him use the stupid pee bottle. He was having a heck of a time with that! It seems like it should be easy, but not so much for him to maneuver it. ROTF So I am about to get dressed and head over to the hospital for the day. I want to try to get some first hand information and keep him company and pamper him a little bit.

You guys are a wealth of information and I am SO glad we found this site. I even showed it to our surgeon. I was telling him how you guys had helped to dispel the fear around Warfarin for us. The surgeon said something about it being rat poison and we laughed. I mean shoot, it even stopped killing the rats. HAHA Apparently it makes a better medical treatment than a rat poison since even the rats stopped dying from it. And hey, chemo is poison and people don't even question jumping on that to save their lives.

 

[ncw3642]

My hubby's heartrate is all over the place and they are saying if they can't get it under control they might shock him to try to get it to go to normal. Is this something that could cause him to have to also get a pacemaker if it doesn't clear up on it's own, or is it common to have issues getting the heart into a normal rhythm? He has the pacer wires and they also did an atrial clip on the left atrial appendage, to prevent clot formation there from Afib.

In my experience, it depends.. If it's just a normal sinus tachycardia (normal rhythm but elevated rate) they likely won't shock him and might adjust medication to lower the rate.

If it's an abnormal rhythm (SVT or A-Fib) for instance, they may do a procedure (cardioversion) either through medication or "shocking" to restore normal rate/rhytem.

Independent of either, this is fairly common after surgery. For me, my heart rate at rest was 100-110 immediately post-op and for 2-3 weeks. This has since subsided and now my resting rate is back to my normal of 60-70BPM 15-weeks post-op (still on my Beta Blocker- if I miss a dose of Metoprolol it does creep back up to 80-90BPM at rest). The heart has a lot of inflammation and irritation post-surgery (again, expected) so it takes a bit to restore normal rate/rhythem. Post-Operative A-Fib can also be common and might resolve with time on its own as well. Nothing to be too concerned about- although that's easier said by me than done by you .

He also still has the chest tubes. It stinks because yesterday they thought they would be removing them and he would be going to recovery. He also now has a sore throat and cough. He thinks he has a cold. Could it be residual from surgery and not an actual cold? Like sore throat from the intubation and cough/congestion from the fluid accumulation after surgery? He wants to walk, but with the chest tubes and all the stuff he has to haul with him they have only gotten him walking twice. He did great that first time, and I was under the impression from reading here walking is very important and he should be doing it as much as possible.

That is frustrating that there is a delay in removing the chest tubes! You do feel 100x better once they are removed however there is good reason they are still intact (it means they are still draining fluid or think there is a need that necessitates it being left in). You don't want it pulled prematurely and have to re-place them later on down the line.

Re: Sore Throat/Cough-- I am thinking more intubation related vs. Cold. From my speech therapist wife and from my experience, the breathing tube will cause some throat inflammation and irritation for a while- normal. I had a lot of fluid in my lungs. I also had atelectasis (worse in my L than R lung) which contributed to my difficulty breathing, coughing and fluid retention in the lungs. This will improve with time but make sure he is using his incentive spirometer- use it more often than you think you need to- it's the no 1 thing to assist with returning those lungs back to normal (aside from walking- of course). Is he being seen by PT yet? As a PT, we try to mobilize patients (yes even with chest tubes and lines) multiple times a day at my hospital. We aren't scared of managing all the lines-- assuming the chest tubes are not required to be on constant suction, he should be okay to mobilize as much as he feels fit to- advocate for that someone will be comfortable and able to handle it- I promise.

Going home also means that I am missing hearing about what is going on from the doctors and nurses mouths and getting it second-hand from hubby. He tends to forget things and is spotty about relaying information. LOL He also doesn't want to bug the nurses and will go a long time before asking for what he needs. When I was there I could run and get him more water, or tea or help him use the stupid pee bottle. He was having a heck of a time with that! It seems like it should be easy, but not so much for him to maneuver it. ROTF So I am about to get dressed and head over to the hospital for the day. I want to try to get some first hand information and keep him company and pamper him a little bit.

Does your health system have a MyChart or other form of virtual EMR? If so, you can see in real-time doctors notes/PA notes/NP notes/Therapist notes etc. from his hospital stay. It's a good way to ensure you are staying up to date. Since these notes often have a lot of medical jargon in them, I personally am happy to help interpret anything you read to help you better understand/I know many others here can help you as well. See if you can get access to hospital notes through some type of EMR and if you cannot, usually if you ask the nurses when you are up visiting, they can look in the chart and provide some context/information.

Advocate for him to call for the nurses when he needs them . They are happy to help (might take a few mins to get into the room if it's a non-emergency) that's what they are there for- especially if no family is there to otherwise help!
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Hang in there! It sounds like normal, expected road bumps to a full recovery! I also always like add a little blurb that you, as a caregiver, also need to take time for yourself. It's so easy to want to be always up there helping/staying the night/assisting that you can forget about yourself and your needs. Take a break at times, make sure you are eating/drinking and ensuring you have time to take a "mental minute" for yourself.

You can only help him if you are also helping yourself stay well!


All the best! Let us know if you have more questions/concerns! We are here for you!

 

[Lisa from LJ]

My surgery was in 1998 so things have changed and I don't remember all the details. I had 4 chest tubes - two large and two small. The last large one wasn't removed until the day before I left the hospital - Day 5. None of them bothered me. They left my catheter in until I was moved to a regular room on Day 3. That has changed to avoid infection.

My heartbeat was erratic the first night, but steadied after that, although I still have PACs at times, more pronounced when I'm tired or stressed. I have heard of people getting pacemakers shortly after surgery, but they usually try to let it resolve on its own before going that route. I had tachycardia for a while after surgery and they eventually put me on a beta blocker about 3 months after the surgery to slow it down. Part of that depends on what shape the heart was in before surgery. Mine had been significantly enlarged for 22 years and is still enlarged, but not as much. I went off the beta blocker after about 2 years and my average resting heart rate was 84, the same as pre-surgery, until I went through menopause. Now it's about 64.

Sore throat is probably related to the tube. Other sinus issues may be related to the surgery as well, but it's hard to say because your body reacts to being stressed by focusing on the "damaged part" and ignoring other things. Something your husband won't have to be concerned about - my cycle started on Day 2, even though the surgery had been scheduled to avoid that happening and I had just finished one a week earlier!

All in all, his recovery sounds pretty normal, although frustrating.