I've crossed the line into severe and need to make a decision

[Chuck C]

That is one small wimpy scar! Kidding. Great job, that will disappear fast. And welcome home!

Thank you! It is so good to be home. The only hard thing is that I have an amazing German Shepherd and he is so happy that I'm back and wants to give me a great big dog hug. Unfortunately, I need to stay away from him because he could injure my incision.

When I finally got released from the hospital. Or as they say in England and Australia, "released from hospital" That just sounds so off to me without "the", lol, I sent this to all my friends and family as my announcement:

 

[Chuck C]

Almost unavoidable. After all, you ARE human.

Case in point. About an hour after I posted the above message, I needed a towel from upstairs and I bounded right up them as I use to do. Oops! No light headedness or anything. I actually had a conversation with my surgeon's nurse practitioner today and she said stairs are no problem as long as I listen to my body. So, from now on I go up them like the old days.

 

[pellicle]

Can still see the drain tube scars too, only 3?

I did some enhancement to make it clearer

in the lower set there is an almost barely visible on on the right and there are three drain holes (different operations) up there on the right. The original two are up closer to the scar. A closer look at the bottom bunch will see duplicates just below the most recent ones, so that's a row of 6 or 8 ...

Anyone who's a hunter or grazier used to dressing and butchering a kill will know what a PITA scar tissue is when "operating" and I was told they can't put a drain down directly through scar tissue with great success.

Perhaps you see why I frequently advocate for younger patients to NOT have multiple operations ...

 

[Denjun]

Thank you for taking the time to respond! I had to look up SAVR ! Thats how new I am to all this!
Take care and good luck.

 

[Unicusp]

Thank you! It is so good to be home. The only hard thing is that I have an amazing German Shepherd and he is so happy that I'm back and wants to give me a great big dog hug. Unfortunately, I need to stay away from him because he could injure my incision.

When I finally got released from the hospital. Or as they say in England and Australia, "released from hospital" That just sounds so off to me without "the", lol, I sent this to all my friends and family as my announcement:

Excellent! Welcome back. Give the dog a hug! Just be careful. I have a little Bichon and he likes to stand on my chest with his 2 front paws when I lay on my back. Now he only weighs about 17 lbs., but the pressure was alot the first time he surprised me after surgery.

 

[pellicle]

"released from hospital" That just sounds so off to me without "the", lol,

to perhaps clarify " The is used to refer to specific or particular nouns; "

"so released from hospital" is general and not specific.

To correctly use the you'd need to be specific:
"released from the hospital on the corner of 5th and Main"

its like if I said "I read today that the scientists have made a new discovery." it would sound strange to an English language speaker. This is because the is expected to be specific

Using the : "the scientists at the Jet Propulsion Lab at Pasadena" implies (and sort of requires) a previous mention of which ones.

Removing the from this "scientists at the Jet Propulsion Lab at Pasadena" is thus general and not implying a specific team.

I do realise that the USA broke its colonial ties to England some time before we did (we haven't) and so having quite a number of Euro non English speakers making up your population (by the late 1700's) its not surprising that American has drifted from the source language of English

;-)

 

[Unicusp]

I did some enhancement to make it clearer
View attachment 887675

in the lower set there is an almost barely visible on on the right and there are three drain holes (different operations) up there on the right. The original two are up closer to the scar. A closer look at the bottom bunch will see duplicates just below the most recent ones, so that's a row of 6 or 8 ...

Anyone who's a hunter or grazier used to dressing and butchering a kill will know what a PITA scar tissue is when "operating" and I was told they can't put a drain down directly through scar tissue with great success.

Perhaps you see why I frequently advocate for younger patients to NOT have multiple operations ...

I see them now. My original mini had only 2 drains higher up too, and the full had 4 in a row like your lower 3.
Fully agree, minimize number of surgeries where possible!

 

[Chuck C]

"I do realise that the USA broke its colonial ties to England some time before we did (we haven't) and so having"

And here I was just about to give you a hard time about waiting until 1986. You still haven't gotten around to it?

 

[Chuck C]

"I do realise that the USA broke its colonial ties to England some time before we did (we haven't) and so having"

Don't worry, we're sendng some of our revolutionaries over right now. You'll be free in no time

 

[pellicle]

"I do realise that the USA broke its colonial ties to England some time before we did (we haven't) and so having"

And here I was just about to give you a hard time about waiting until 1986. You still haven't gotten around to it?

I'm no fan of the English (maralinga) but the idea of letting a pack of constitutional lawyers loose with a free hand and public funding to produce a constitution to replace what we have is frankly scarier....

 

[Chuck C]

Day 8 of recovery

Today was my second day at home.

They did an ECG about 30 minutes before I left UCLA yesterday, so the result was unknown at the time I was discharged.

Results came in this morning to my health portal: Diagnosis: Inferior infarct, acute

Not what you want to see. Very bad: Teasing Death in Acute Inferior Infarct

But, I am happy to report that this was apparently a false positive. Had a bit of a damper there for about an hour until I received a call back from my surgeon's nurse practitioner and she assured me that it was a false positive. Apparently, inflammation from the surgery can sometimes lead to an ECG false positive. Relieved to say the least.

Felt good today. With the NP's approval I added stairs to my exercises. I felt good so I upped the pace and suddenly felt light headed. So I made my way to the bottom of the stairs cautiously and laid down flat on the tile floor. My thinking was to leave zero elevation between my head and the tile floor, so that in case I did lose consciousness my head would have nowhere to fall. I next quickly checked my pulse and BP. BP 110/70 and pulse 57. That is very low for having just done some stairs. I am on meds to lower my blood pressure and heart rate to keep things easy on the heart during recovery. Consequently, I can't increase my cardiac output too much when exercising which is needed to keep a certain pace up the stairs. So, I slowed down the pace and it was fine.

I learned a couple of lessons today. These meds that lower your heart rate and blood pressure are no joke.
My lightheadedness came about an hour after I had the second dose for the day and I did not put enough time between my morning and evening dose. The prescription says 2x per day, morning and evening. But, I think much better to space them close to exactly 12 hours apart.

Also, the lightheaded episode happened about an hour after my second dose, while it was likely in full effect, and I was likely still getting some influence from the morning dose. My pulse after the stairs of 57 was very low for having just done stairs. I have been around 62-70 since the operation most of the time. I picked the worst time I could have to try to increase the pace.

 

[Chuck C]

I'm no fan of the English (maralinga) but the idea of letting a pack of constitutional lawyers loose with a free hand and public funding to produce a constitution to replace what we have is frankly scarier....

Yeah, it could end up going bad. It's not like they are putting huge taxes on your tea and stamps or anything

 

[pellicle]

... I am on meds to lower my blood pressure and heart rate to keep things easy on the heart during recovery. ...
I learned a couple of lessons today. These meds that lower your heart rate and blood pressure are no joke.

yep ... modern meds are like a whole different level to all the millennia old rubbish that "herbal remedies" promote.

https://en.wikipedia.org/wiki/Pharmacology
Don't even start me on Chinese mystical fluff

 

[Chuck C]

Update Day 10 of recovery

INR 9.6!

How did this happen?

Released Monday with morning INR of 3.1. My INR had been very stable in the hospital the last 4 days:

2.8 2.8 2.9 3.1 So things were looking good.

Since I was stable no need to test on Tuesday at home, but will be visited by a mobile nurse on Wednesday to draw blood to deliver to Quest labs.

Home nurse screws up. He does not draw enough blood and Quest will not accept his sample, because he was supposed to have it filled to a certain point in the tube and he had not.

Reschedule with home nurse Thursday morning. He screws up again and can't get more than a drop. He tells me that my blood is too thick. That is BS. He is incompetent.

I call the Coumadin Clinic at UCLA and they tell me that the Coumadin doc in the clinic is not worried because I was so stable. I press the issue and ask him to place an order for an INR test at Quest labs and I will go there myself. He agrees.

11:30 sample at Quest. Afternoon reading of 9.6! It went from 3.1 upon my release to 9.6 3 days later. It appears that somehow no one noticed that one of the drugs they put me on Amiodarone interferes with the clearance of warfarin.

The treatment. Hold my Thursday (today) dose and take 2.5 mg of vitamin K- a prescription is written for it. Had to go all over town to get it filled because it is not common. Note to self to always have a dose of vitamin K handy in case this happens again.

The nurse also suggested that I have a spinach smoothie. So, filled the blender with about 1/2 pound of spinach and made one.

What upsets me is that I plan to self test, and thought about getting my device before my surgery so that I could start right away. I wish now that I had done that, as this would not have happened.

It sounds like I will live, but this could have gone really bad if I listened to the clinic and waited another day or two before testing again, because I was so "stable in the hospital"

Also, be your own advocate with everything. They all missed the fact that amiodarone could cause a big problem with warfarin- even the pharmacist.

I'll have the Coumadin clinic order a bunch of standing orders for INR tests at Quest and get tested as soon as they open tomorrow and again later in the day, to see which way things are headed. The vitamin K should help a lot.

I have also been told that I should be fine as long as I do something to cause a bleed. I won't.

Other than that, I woke up feeling great. I do not feel like I had surgery 10 days ago and it is easy to forget at this point.

 

[newarrior]

Keep us posted...sorry to hear..reminds me that even USA medical professionals are error prone

 

[BillDaThrill]

Am learning a lot. Wish it wasn't through you having to go thru these, ummm, 'ordeals'. Sounds like you are doing great and hoping your INR levels get back to good and stable soon.

 

[Chuck C]

Am learning a lot. Wish it wasn't through you having to go thru these, ummm, 'ordeals'. Sounds like you are doing great and hoping your INR levels get back to good and stable soon.

Thanks. I’m waiting for them to call my name right now at quest diagnostics to have my morning INR tested. Since I’m loaded up pretty good with vitamin K and held my warfarin dose yesterday I expect (hope) to see considerable improvement

 

[newarrior]

Update Day 10 of recovery

INR 9.6!

How did this happen?

Released Monday with morning INR of 3.1. My INR had been very stable in the hospital the last 4 days:

2.8 2.8 2.9 3.1 So things were looking good.

Since I was stable no need to test on Tuesday at home, but will be visited by a mobile nurse on Wednesday to draw blood to deliver to Quest labs.

Home nurse screws up. He does not draw enough blood and Quest will not accept his sample, because he was supposed to have it filled to a certain point in the tube and he had not.

Reschedule with home nurse Thursday morning. He screws up again and can't get more than a drop. He tells me that my blood is too thick. That is BS. He is incompetent.

I call the Coumadin Clinic at UCLA and they tell me that the Coumadin doc in the clinic is not worried because I was so stable. I press the issue and ask him to place an order for an INR test at Quest labs and I will go there myself. He agrees.

11:30 sample at Quest. Afternoon reading of 9.6! It went from 3.1 upon my release to 9.6 3 days later. It appears that somehow no one noticed that one of the drugs they put me on Amiodarone interferes with the clearance of warfarin.

The treatment. Hold my Thursday (today) dose and take 2.5 mg of vitamin K- a prescription is written for it. Had to go all over town to get it filled because it is not common. Note to self to always have a dose of vitamin K handy in case this happens again.

The nurse also suggested that I have a spinach smoothie. So, filled the blender with about 1/2 pound of spinach and made one.

What upsets me is that I plan to self test, and thought about getting my device before my surgery so that I could start right away. I wish now that I had done that, as this would not have happened.

It sounds like I will live, but this could have gone really bad if I listened to the clinic and waited another day or two before testing again, because I was so "stable in the hospital"

Also, be your own advocate with everything. They all missed the fact that amiodarone could cause a big problem with warfarin- even the pharmacist.

I'll have the Coumadin clinic order a bunch of standing orders for INR tests at Quest and get tested as soon as they open tomorrow and again later in the day, to see which way things are headed. The vitamin K should help a lot.

I have also been told that I should be fine as long as I do something to cause a bleed. I won't.

Other than that, I woke up feeling great. I do not feel like I had surgery 10 days ago and it is easy to forget at this point.

Ticking ? Pain ? Sternum ? Wires ? Sensation of new valve in body ? Energy ? Moods ? Feel more mortal ? PTSD ? Sleep ? cheers

 

[Eva]

Update Day 10 of recovery

INR 9.6!

How did this happen?

Released Monday with morning INR of 3.1. My INR had been very stable in the hospital the last 4 days:

2.8 2.8 2.9 3.1 So things were looking good.

Since I was stable no need to test on Tuesday at home, but will be visited by a mobile nurse on Wednesday to draw blood to deliver to Quest labs.

Home nurse screws up. He does not draw enough blood and Quest will not accept his sample, because he was supposed to have it filled to a certain point in the tube and he had not.

Reschedule with home nurse Thursday morning. He screws up again and can't get more than a drop. He tells me that my blood is too thick. That is BS. He is incompetent.

I call the Coumadin Clinic at UCLA and they tell me that the Coumadin doc in the clinic is not worried because I was so stable. I press the issue and ask him to place an order for an INR test at Quest labs and I will go there myself. He agrees.

11:30 sample at Quest. Afternoon reading of 9.6! It went from 3.1 upon my release to 9.6 3 days later. It appears that somehow no one noticed that one of the drugs they put me on Amiodarone interferes with the clearance of warfarin.

The treatment. Hold my Thursday (today) dose and take 2.5 mg of vitamin K- a prescription is written for it. Had to go all over town to get it filled because it is not common. Note to self to always have a dose of vitamin K handy in case this happens again.

The nurse also suggested that I have a spinach smoothie. So, filled the blender with about 1/2 pound of spinach and made one.

What upsets me is that I plan to self test, and thought about getting my device before my surgery so that I could start right away. I wish now that I had done that, as this would not have happened.

It sounds like I will live, but this could have gone really bad if I listened to the clinic and waited another day or two before testing again, because I was so "stable in the hospital"

Also, be your own advocate with everything. They all missed the fact that amiodarone could cause a big problem with warfarin- even the pharmacist.

I'll have the Coumadin clinic order a bunch of standing orders for INR tests at Quest and get tested as soon as they open tomorrow and again later in the day, to see which way things are headed. The vitamin K should help a lot.

I have also been told that I should be fine as long as I do something to cause a bleed. I won't.

Other than that, I woke up feeling great. I do not feel like I had surgery 10 days ago and it is easy to forget at this point.

Correct me if I’m wrong: you had your surgery on March 22nd! You have two mechanical valves?!
in my case with two mechanical valves (or just me) it took over two months to start seeing a stability in my INR. I was even kept 13 days at the hospital (for that reason, as I was told)! I had mine at UCLA too.

Don’t fret, you’ll be ok. One night I took my 10 mg warfarin twice. I panicked and called the poison center at 11pm. They calmed me down that I’d be ok. And I was ok.
Were you on Amiodarone at the hospital when you were discharged? If you were was the dose changed since your discharge. Did they give you discharge instructions?
My UCLA Electrophysiologist warned me to check my INR more often than once a week when I was put on Amiodarone last April because of its effect on INR!
stay healthy and safe.

 

[Unicusp]

Thanks. I’m waiting for them to call my name right now at quest diagnostics to have my morning INR tested. Since I’m loaded up pretty good with vitamin K and held my warfarin dose yesterday I expect (hope) to see considerable improvement

Sorry to hear Chuck. That's high! They're not making it easy for you! Definitely agree one must be own advocate, question and challenge everything.
Easy to get standing order at Quest from your PCP. I've had one since getting home. You should test every 2 to 3 days now until INR is closer to target. With the massive K influx, amiodarone, and holding Warfarin, you're going to see variability for awhile. Hang in there!