Hi Scottie-
This is going to be a long explanation, so don't fall asleep, LOL.
Regarding Joe's anemia: He has 2 mechanical valves, one of them being an old model mechanical made by Bjork-Shiley which is 25 years old. In those days they made 'em big, rough and tough. But it's still chugging away. It is a "cage and ball" designed valve which is very old fashioned by today's standards, and it tends to chop up the blood (hemolysis). When he had his St. Jude mitral valve, the combo made it worse. Now, having said that, St. Jude makes a really good valve, and it is as kind and gentle to your blood as any mechanical can be, but I guess that the combination of the two is what is causing his anemia. When he developed a paravalvular leak his anemia hit bottom. The leak also contributed to chopping up the blood. Now that the leak is fixed, his anemia is better.
During the bad anemia, he was on folic acid once a day and iron 3 times a day. It was hard on the digestive tract, to be sure, but it kept him alive. He is off the iron now, but will have to take folic acid for the rest of his life.
It's possible that after your surgery, your anemia will improve. I would ask your doctor if this is possible, but you know that with heart valve problems there are no guarantees.
Metamucil helped Joe to keep things moving digestion-wise, maybe that's another thing you could ask your doctor about. I'm not sure they have that brand where you are.
Take care.