Mechanical Valve

[Lynn]

Redone, I also had a bad experience with a beta blocker. It was a year and a half before surgery when a doctor was sure I had blockages and it couldn’t be my valve. The beta blocker gave me headaches, lowered my blood pressure and heart rate so low I barely functioned and altered my mood big time. I took myself off it and consulted my GP. He had a similar personal experience with a beta blocker so was fine with it and referred me to a new cardiologist who eventually confirmed it was my valve and I didn’t need any of the meds prescribed by the previous guy.

Due to this experience I pushed back hard against a beta blocker after surgery. I told the surgeon I felt it would make my recovery much harder based on the way I felt the last time. In the end I went home without one, and an agreement that if anything changed and I needed it, I would take it. I didn’t end up needing it, everything went fine. It does seem to be that everyone gets prescribed one after surgery as a matter of course, and I have read conflicting studies on the need for one. I know they have their place and some people tolerate them well, but I agree with you-why take something unless you really need it.

 

[slipkid]

An interesting story about beta blockers - perhaps extreme but true.

Someone I used to work with (name of Dan) was on one for high blood pressure. Unknown to the rest of us his Dr changed his dose/prescribed a higher dose which he started one morning b4 work.

At work we were having a safety meeting, walking around the plant (I have a horrible factory job now after years of being an IT professional in office/lab settings). We broke up into multiple smaller groups. There were just 4 of us in my group, Dan, myself and 2 others.

Dan started to tell us about something on a machine and leaned over to point it out, as a safety issue. While doing this he passed out. I caught him. Thought he had had a stroke or something. As I lifted him up he "woke up" and resumed talking as if nothing had happened. We asked him if he was OK, told him he had just passed out. He had no idea what we were talking about, then passed out again. One of the other guys held him up while I ran to get a chair to put him in and the other guy called 911. He was out cold but breathing - almost snoring. I thought he was done for though.

Turned out it was the increased dose of the beta blocker that did that to him!!! You'd think a Dr would warn him about that, to not take the new dose while at work or driving etc, do so at home in case was too much. Or that as a patient he might educate himself on those dangers and ask questions. But no in either case. And this type of thing probably happens thousands of times a day (or more) from various drug reactions which Drs simply do not even concern themselves about in any way whatsoever.

The "best" is when I ask if there are any adverse effects of drug so and so and what those are and the Dr tells me "none - there are no adverse effects at all". Then I know from painful experience not to even consider taking that drug until fully educating myself about it. I understand if they don't want to paint a bad picture and cause a patient to have imaginary symptoms or be afraid to take something but fer chrissakes be honest about it, give the patient a chance to get ahead of the problem instead of killing somebody because they fall asleep while on the med driving a car or whatever....

 

[carolinemc]

I agree! Nothing has ever been wrong with my kidneys thank God I think between so many fluids and putting me on Metropolol (I'm a bit disgusted about this) as you would think the surgeon would have known my blood pressure already ran on the lower side and not being given Lasiks in the hospital, rather getting it the day I was leaving did it. When you're in the hospital do they administer Lasiks via pill, IV or is it only in pill form?

Via IV or Pill. It is used. like I am on Lasinopril, for water retention. And you should look into getting compression socks, for they will help in water loss with the Lasix. Mine comes in 10mg, 20 mg and up. And has nothing to do with Kidney or bladder problems. Good luck and be sure to look into purchasing some compression socks. I waited things got more serious before I invested in compression socks. They help.

 

[carolinemc]

An interesting story about beta blockers - perhaps extreme but true.

Someone I used to work with (name of Dan) was on one for high blood pressure. Unknown to the rest of us his Dr changed his dose/prescribed a higher dose which he started one morning b4 work.

At work we were having a safety meeting, walking around the plant (I have a horrible factory job now after years of being an IT professional in office/lab settings). We broke up into multiple smaller groups. There were just 4 of us in my group, Dan, myself and 2 others.

Dan started to tell us about something on a machine and leaned over to point it out, as a safety issue. While doing this he passed out. I caught him. Thought he had had a stroke or something. As I lifted him up he "woke up" and resumed talking as if nothing had happened. We asked him if he was OK, told him he had just passed out. He had no idea what we were talking about, then passed out again. One of the other guys held him up while I ran to get a chair to put him in and the other guy called 911. He was out cold but breathing - almost snoring. I thought he was done for though.

Turned out it was the increased dose of the beta blocker that did that to him!!! You'd think a Dr would warn him about that, to not take the new dose while at work or driving etc, do so at home in case was too much. Or that as a patient he might educate himself on those dangers and ask questions. But no in either case. And this type of thing probably happens thousands of times a day (or more) from various drug reactions which Drs simply do not even concern themselves about in any way whatsoever.

The "best" is when I ask if there are any adverse effects of drug so and so and what those are and the Dr tells me "none - there are no adverse effects at all". Then I know from painful experience not to even consider taking that drug until fully educating myself about it. I understand if they don't want to paint a bad picture and cause a patient to have imaginary symptoms or be afraid to take something but fer chrissakes be honest about it, give the patient a chance to get ahead of the problem instead of killing somebody because they fall asleep while on the med driving a car or whatever....

Strokes are very tricky, cause usually they affect the left or right side and affects speech and motor function. I had the other kind, it stopped at my left eye, causing blurry vision and slowed the cataracts in that eye. And on adverse reactions with a doctor, he/she should be very well be versed on the medications that they dispense.

 

[carolinemc]

Lasix (brand name) is usually given as Furosemide ( generic) in tablet form from 20mg to 80mg tablets. What dose are you on? This is a very old diuretic, tried and true. Might want to increase dosage to speed the loss of fluid retention. I went into surgery at 165lbs. and gained around 18lbs of fluid. It was very uncomfortable. I recall it took 2 to 3 weeks to get the weight off and stayed on Furosemide for maybe one month. Keep drinking plenty of water too, to help flush kidneys.
I understand that the fluid retention is more of swollen tissue from the body's response to surgery trauma, then from the IV's. Every body responds differently and takes different time frames to recover. I had never been over 167lbs. in my lifetime so it was a shock for me as well. Hang in there. Your old fit body will return. Muscle has memory and will come back. Patience! Since you were in great shape prior to surgery, you should recover back to normal quickly after that excess fluid is gone. Hang in there!

I take Linsopril for fluid retention for around the heart and in the legs and feet. Not from trauma of surgery, nor from IV use in Hospital. Many people have different types of fluid retention. I use compression socks and drink enough water. I will always take a lassix type of medication due to genetics, I get the water retention from my father. And I wear compression sock for to keep the fluid build up down from the legs.

 

[slipkid]

Strokes are very tricky, cause usually they affect the left or right side and affects speech and motor function. I had the other kind, it stopped at my left eye, causing blurry vision and slowed the cataracts in that eye. And on adverse reactions with a doctor, he/she should be very well be versed on the medications that they dispense.

Operative word is "should". In my experience sometimes they are 100% clueless (I can give some examples but no time right now for me to ramble like usual!)...

 

[Redone]

Via IV or Pill. It is used. like I am on Lasinopril, for water retention. And you should look into getting compression socks, for they will help in water loss with the Lasix. Mine comes in 10mg, 20 mg and up. And has nothing to do with Kidney or bladder problems. Good luck and be sure to look into purchasing some compression socks. I waited things got more serious before I invested in compression socks. They help.

Thank you! I have compression socks for hiking, but since Sunday have been losing 7 - 8lbs a day and am now back to presurgery weight, which feels so good! Being athletic this was so uncomfortable!

 

[Redone]

Redone, I also had a bad experience with a beta blocker. It was a year and a half before surgery when a doctor was sure I had blockages and it couldn’t be my valve. The beta blocker gave me headaches, lowered my blood pressure and heart rate so low I barely functioned and altered my mood big time. I took myself off it and consulted my GP. He had a similar personal experience with a beta blocker so was fine with it and referred me to a new cardiologist who eventually confirmed it was my valve and I didn’t need any of the meds prescribed by the previous guy.

Due to this experience I pushed back hard against a beta blocker after surgery. I told the surgeon I felt it would make my recovery much harder based on the way I felt the last time. In the end I went home without one, and an agreement that if anything changed and I needed it, I would take it. I didn’t end up needing it, everything went fine. It does seem to be that everyone gets prescribed one after surgery as a matter of course, and I have read conflicting studies on the need for one. I know they have their place and some people tolerate them well, but I agree with you-why take something unless you really need it.

Thank you for sharing your experience Lynn! It was horrible! My cardiologist said, "there's no way Metropolol caused your blood pressure to go down that much and it's always used". I don't want to sound negative, but I hope this valve lasts me the rest of my life because I doubt I would want to go through this surgery again. There's no doubt from what I've read of others experiences as well that this drug is not healthy for so many people. I sure hope they come up with other options!

 

[Redone]

I did not gain as much weight as many report. I was approximately 8 pounds heavier the morning after surgery. I have a little story about that, and it dovetails with your advice to be your own advocate, which I totally agree with.

In the ICU, it is their standard practice to put all OHS patients on IV diuretic so that you start eliminating the excess fluid from surgery. A couple of hours after being put on diuretic, I went into afib. The labs showed that my potassium dropped below the safe threshold after the diuretic, as reducing electrolytes is how the diuretic works to reduce body fluid. It turns out that afib is a well-known potential side effect from diuretics.

So they took me off the IV diuretic and got me back into sinus rhythm. I get on my PC in the ICU doing my homework about diuretics after OHS. It turns out that while diuretics after OHS has a benefit for high-risk patients with heart failure and patients with kidney problems, that there is no evidence of any benefit for better outcomes for low-risk patients without kidney issues. In fact, a two-armed trial concluded no outcome benefit at all for such low-risk patients from diuretic.

So, the next morning the nurse came in to give me my meds, including an oral diuretic. Given what I had learned and given that afib is a known potential side effect from the diuretic and given that I already went into afib once from the diuretic, I decided that I wanted to follow the evidence and not use a diuretic. It was a simple risk vs reward analysis. I was very nice about it, but firm. The ICU doctor then came to talk to me about it- you know the non-compliant patient who would not take his medication.

We had a good discussion about it. I explained my risk vs reward thinking and had him read the only published trial on low risk patients for diuretics. I told him that if he could give a good reason as to why I should take the diuretic that I would be happy to, but could see no reason to risk afib again without a good reason. He actually agreed with me and said that in his view, given that I went into afib from it before, it was the right decision to not take the diuretic. At the same time, they would be watching for hypertension and signs of abnormally high fluid retention. I fully agreed that if I showed signs of either I would go back on the diuretic.

I was doing great peeing off the excess fluid. They keep close track of how much you drink vs how much you pee out, and I was peeing off about 1.5 pounds per day. It is cute how they treat you when they come and see the full urine bottle. “Wow, you filled up the bottle all the way! Good job!” Kind of like when you are first training a toddler to use the toilet. It got to the point where I looked forward to the positive affirming remarks on how good a job I did filling the bottle.

However, with every 12-hour shift comes a new nurse and a new nurse practitioner for the floor and each new shift the new nurse practitioner would prescribe the diuretic again. I was well on my way to normal weight with normal blood pressure, so I always refused. Still they would tell me that their goal was to release me from the hospital at the same weight that I came in at, despite the lack of evidence that this is necessary. Sometimes there will be policies that they have in place that might not apply to every patient from an evidence based standpoint. It's kind of like- well, a lot of OHS patients have heart failure, so lets give them all diuretics to play it safe. But, afib is nothing to take lightly and I was determined not to go into it again for a blanket policy not backed by evidence.

Anyway, I held my ground and by the time I was released I was only about 2 pounds above where I was when I checked in. I do believe that often you have to be your own advocate and sometimes that can mean digging in your heels.

I'm still taking the diuretic and my cardiologist suggested taking it for a month longer to be sure the water was completely down. I have lost 7 - 8lbs a day with the exception of Wednesday and today, which was about 4lbs each day. I feel so much better being my size again. If I hadn't taken it I assume it would have taken months to get it off. I don't feel great taking it though. Lately, I've been freezing cold a lot. I always thought I had Raynauds, bit this has been insane especially when I take the diuretic. I can't imagine going into afib! Can't say I feel myself since coming home. A lot of odd things have occurred. Sometimes feels like really low blood sugar, feet and hands ice cold, sharp pains from time to time in my shoulder blades, sleeping like I'm in a Coma or not being able to sleep, vision is not as good. Hopefully, things will get better! Last thing I want is to go through all that and suffer a stroke.

 

[Chuck C]

Can't say I feel myself since coming home.

Thanks for the update.

Glad to heare that you are back to your normal size again.

It seems that having trouble with sleep is something that most people experience- I certainly did. I don't remember exactly when this started to normalize, but it was probably about at 6 weeks.

Shoulder and back pains are also very common. This has to do with how our bodies are manipulated for the surgery and kept in that position for hours. This abated pretty quickly for me, but others have shared that these issues persist a bit.

The first few weeks are definitely the most challenging. You should feel significantly better each week, hopefully more and more yourself as you heal.

 

[Redone]

Thanks for the update.

Glad to heare that you are back to your normal size again.

It seems that having trouble with sleep is something that most people experience- I certainly did. I don't remember exactly when this started to normalize, but it was probably about at 6 weeks.

Shoulder and back pains are also very common. This has to do with how our bodies are manipulated for the surgery and kept in that position for hours. This abated pretty quickly for me, but others have shared that these issues persist a bit.

The first few weeks are definitely the most challenging. You should feel significantly better each week, hopefully more and more yourself as you heal.

Thank you Chuck! I never had any Sternum, back or shoulder pain in the hospital at all. I suppose it could also be related to sleeping on my side, which is just a dream! Can I ask when you began taking Coumadin did you ever feel like you were in a coma (right after it seems I'm completely out of it). Currently, my INR is at 2 and I'm taking 2.5mg over the weekend until I have it rechecked again on Monday.

 

[Redone]

Thank you Chuck! I never had any Sternum, back or shoulder pain in the hospital at all. I suppose it could also be related to sleeping on my side, which is just a dream! Can I ask when you began taking Coumadin did you ever feel like you were in a coma (right after it seems I'm completely out of it). Currently, my INR is at 2 and I'm taking 2.5mg over the weekend until I have it rechecked again on Monday.

I'm sorry 5mg 2 x 2mg and. 5

 

[pellicle]

I'm sorry 5mg 2 x 2mg and. 5

I know this was to Chuck, but what does this mean?

above you say " my INR is at 2 and I'm taking 2.5mg over the weekend..."

so is your INR now 2 and you're taking 5mg daily?

next, I've ever heard anyone say anything about feeling faint after taking warfarin, there was one lady report gagging reaction (her husband didn't) but I'm 100% certain that is psychological.

remember, the sole purpose for taking warfarin (is the Coumadin brand even sold anymore?) is INR, intention should be to keep INR on target, which for an Aortic valve should be INR = 2.5

 

[Redone]

I know this was to Chuck, but what does this mean?

above you say " my INR is at 2 and I'm taking 2.5mg over the weekend..."

so is your INR now 2 and you're taking 5mg daily?

next, I've ever heard anyone say anything about feeling faint after taking warfarin, there was one lady report gagging reaction (her husband didn't) but I'm 100% certain that is psychological.

remember, the sole purpose for taking warfarin (is the Coumadin brand even sold anymore?) is INR, intention should be to keep INR on target, which for an Aortic valve should be INR = 2.5

My INR was a 2 yesterday and the visiting nurse told me to get to 2.5 so I am taking 5mg. Sorry, but I'm not one of those types who makes up symptoms. I am however an athlete that perhaps may have low iron, B12 or something else. My recent blood panel does show low sodium. Maybe an electrolyte imbalance...not sure.. After I take the Coumadin in the evening I feel very, very sleepy. I will get to the bottom of it when I see my PCP in 2 weeks. It could also be that I need to rein my nutrition in because my mom is making a different meal for me every single night, which is not typical of my diet. I'm usually very consistent, but since being home I'm very cold especially when taking the Lasiks (feet and hands) and then it passes.

 

[Chuck C]

Can I ask when you began taking Coumadin did you ever feel like you were in a coma (right after it seems I'm completely out of it

Hi.

I never noticed any side effects which correlated with taking Coumadin. It has a long half life, so if there was a side effect, I would not expect that it would correlate with the time you take it.

But, as I think I've shared, I did have side effects from the Metroprolol, usually within about 15-30 minutes of taking it. Feeling off and often light-headed.

 

[pellicle]

Sorry, but I'm not one of those types who makes up symptoms

I never said you were ... but in my entire exposure to this and of the perhaps hundreds of articles and reports I've never once seen that ...

as to your INR, what target do you wish to be at?

 

[pellicle]

... It has a long half life ...

I'm going to say it has a Goldilocks half life, not too long (to make adjustment easy) and not too short (to leave you uncovered)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3971980/

Of these three coumarins, phenprocoumon has the longest elimination half-life of 110–130 h ... Warfarin half-life varies from 24–33 h for S-warfarin to 35–58 h for R-warfarin [and people seem to think its unimportant when changing brands] ... Acenocoumarol [eg Sinthrome] has the shortest half-life. ... S-acenocoumarol (1.8 h). The elimination half-life of R-acenocoumarol is 6.6 h​

Which perhaps explains why warfarin is the most commonly used (when you count countries that use it). I know where I'd rather be ...

 

[Redone]

Hi.

I never noticed any side effects which correlated with taking Coumadin. It has a long half life, so if there was a side effect, I would not expect that it would correlate with the time you take it.

But, as I think I've shared, I did have side effects from the Metroprolol, usually within about 15-30 minutes of taking it. Feeling off and often light-headed.

Hi, I'm no longer taking Metropolol since my blood pressure is good. That was only given to me during and the day after surgery. I haven't had a constant temperature since being home other than an occasional low grade fever, but it seems at night I'm getting a slight fever of 99.3. This is the culprit. I watched food tonight, payed really close attention to how I was feeling and felt really warm and tired after taking Coumadin as usual, so took my temperature and couple of Tylenol. It's definitely better than previous nights!

 

[Chuck C]

It's definitely better than previous nights!

Hoping that trend continues and you feel better each night.

 

[Redone]

Hoping that trend continues and you feel better each night.

Definitely feeling better! Now it's freezing all the time an unable to sleep through the night without help. So grateful to be alive!