Mild atelectasis

[Jeri]

Hi Everyone...... I was hoping some of you could shed some light on my slightly labored breathing. I know I have a mild atelectasis in the base of the right lung. My lung sounds are diminished. Today is 3 weeks post op. I still do the spirometer but that is so diffcult for me. But I am trying to do as much as possible. I feel like I am a little behind "schedule" in my progress. I think part of this is this lung thing. When I do my 4 walks a day, it is so dificult. I can only do 5 -6 min at a time. I just wondered how long it took for your lungs to reinflate. I know this is common but very annoying. My sleep is awful also. In the hospital I took 5mg of Ambien everynight and I also took it for the first 5 days at home. It seemed to me I was tooo foggy during the day so I went off Ambien for 3 nights but I literally was up all night for 3 nights. So I found that I can cut them in half so last night I did and I slept 5 straight hours. It was wonderful. Still sleeping up my head all the up. Any input would be greatly appreciated. I hope everyone else is doing well. Thanks so much. God bless.

 

[Natina13]

Jeri
I came home on 4/20...went to the ER on 4/25, as I had vomited almost all night and had severe pain under my right rib-cage ( I really thought it was going to be my gallbladder , as I had gallstones about 10 years ago, and it felt the exact same way). They did a CT scan /w contrast, found a moderately large pericardial effusion and small bilateral pleural effusions with bibasilar subsegmental atelectasis both lungs, left greater than the right (didn't find gallstones ). The ER doc did not seem concerned, so I just assumed, it was common post OHS. He did ask me to call my surgeon in the am, let him know what the findings were, as they had been unable to reach him.
I saw my surgeon on May 3rd.......he didn't seem worried about it either... so I am assuming this must be normal. But since your having labored breathing with yours ( and it is interfering with your recovery).........you definitely should make your MD aware of the problems you are experiencing. He will either tell you how to fix it, or at least, put your mind at ease. I do not know your age or how active you were pre-op, but I am 59 and was not an athletic person before surgery. I did take walks and use my thread mill, until my symptoms became so severe, I was actually having syncope episodes,SOB and falls.
Hoping this is resolved soon for you and your progress continues . Your in my thoughts and prayers. I am sure alot of people here, have the knowledge to shed some light on this problem for you.

Renee

BAV finally diagnosed 11/2010 , 4/14/2011 AVR with a Edwards " Magna" Bovine Tissue Valve with a Triple Bypass at St.Agnes Medical Center in Fresno Ca.

 

[epstns]

Jeri, I had some diminished capacity issues in one lung, well into my 5th week after surgery. Then, with more activity, it became less and less common, then by the 6th or 7th week, it just seemed to go away on its own. Kind of felt like something was rubbing at the base of my left lung when I took a deep breath. Wierd. Like others, my doctors weren't very concerned, as long as it did not get in the way of recovery. They said it was common and should resolve. If yours is getting in the way of recovery, I would definitely discuss it with your doctors.

I also had massive sleep disruption, and still do to a lesser degree. It got to the point that I got a prescription for Ambien and filled it, but held off taking any after reading of some of the experiences others had with it. What I had some success with was suggested by my daughter (she works in the healthcare field but is not a doctor). She said that the docs where she works often use over-the-counter Benadryl as a sleep aid. It has nowhere near the side effects of Ambien and seems to be enough for many patients to get a night's sleep. I have also read that Benadryl is used to calm hyper-active children, so it can't be too bad, can it? With one Benadryl tablet at bedtime (25 mg, IIRC), I was able to get a normal night's sleep with little or no drowsiness the next day. I am now just over 10 weeks out from surgery, and rarely need any help getting to sleep at night.

 

[Jeri]

Hi Renee and Steve,
Thanks for your input...much appreciated. This morning I had so much SOB that I called surgeon and his PA told me to come in for chest x-ray and possible thoracentesis. I knew there was fluid before all this because my lung sounds were crappy....diminished and I thought I heard fluid. Chest x-ray did show this fluid and I had the thoracentesis. Well that was no walk in the park. I never thought it would hurt but now I feel so much better. I am breathing much better. He removed a little over 1200cc of fluid. What a relief to have that gone. Right now I am still coughing up alot and the site still hurts a little but I don't care...just happy to be breathing normally again. Hopefully tomorrow my walking will improve. And I haven't had a-fib since Sat. night so he took me off the Coumadin too. That made me real happy. On Monday, my INR was 5.9 and Wed. it was 3.7 so I am happy he was able to do this procedure today. Hopefully the a-fib is permanently gone. I am still on the Amiodorone until the 24th when I see him again. Thanks again for your help.
Jeri.

 

[epstns]

Great news, Jeri! Now if you can maintain (or increase) your activity level (walking, etc.), that seems to make a major difference in keeping the fluid out of places where it doesn't belong. Also, have they given you any diuretics for fluid reduction? I think I mentioned this, but I was taking up to 60 mg of lasix for the first couple of months post-op. (Got the "wonderful" potassium supplements along with it, too.)

 

[Lynlw]

Hi Renee and Steve,
Thanks for your input...much appreciated. This morning I had so much SOB that I called surgeon and his PA told me to come in for chest x-ray and possible thoracentesis. I knew there was fluid before all this because my lung sounds were crappy....diminished and I thought I heard fluid. Chest x-ray did show this fluid and I had the thoracentesis. Well that was no walk in the park. I never thought it would hurt but now I feel so much better. I am breathing much better. He removed a little over 1200cc of fluid. What a relief to have that gone. Right now I am still coughing up alot and the site still hurts a little but I don't care...just happy to be breathing normally again. Hopefully tomorrow my walking will improve. And I haven't had a-fib since Sat. night so he took me off the Coumadin too. That made me real happy. On Monday, my INR was 5.9 and Wed. it was 3.7 so I am happy he was able to do this procedure today. Hopefully the a-fib is permanently gone. I am still on the Amiodorone until the 24th when I see him again. Thanks again for your help.
Jeri.

I can imagine how much better you must feel without all that fluid pressing on your lungs, I know Justin was always so much more active when they drained his pericardial fluid. Do thy have you on anything like Motrin to help keep the fluid from coming back?

 

[Duffey]

Jeri, glad to hear that they were able to drain such a large amount of fluid. I hope this takes care of the situation and you are up to full speed soon.

 

[epstns]

Jeri, Lyn beings up a good point. When I was having issues with fluid build-up, my cardio told me to take ibuprofen at the dosage stated on the label (regular drug-store stuff), saying that this would help reduce the inflammation that was causing the fluid in the first place. Might be worth a talk with your cardio. They may say to use ibuprofen, or they may prescribe steriods.

 

[Jeri]

Steve,

That sounds reasonable except because of GI reasons, I was never able to take Ibuprofen. I got so sick from it. So I don't think that's an option for me. I had a better day today. I can now do a 10 min walk without getting SOB. And I did it 3 times today. I was so proud of myself. I actually dropped more weight after this procedure. Of course I was 20 lbs too much after my surgery. I normally weigh around 99 lbs and I was 19.5 when they weighed me 2 days post op. I was horrified when i saw thia. I begged the doc for Lasix that day and he was reluctant but did give in. So I got 20mg IV for the duration of my hospital day. With this procedure yesterday, I lost those finally few lbs and I am breathing better. I am using that spirometer and still can't hold it for more than 3-4 seconds. It is torture (I know I am being a baby...lol). But I now get pain at the thoracentesis site as well as my incision. So maybe that will take more time to take deeper breaths but I am trying. They also told me that I have a little fluid around my left lung too. So I want to clear that on my own along with the Lasix. He put me back on it indefinitely. But your reasoning sure makes sense with the Motrin. I just don't think I would be able to tolerate it. But so far he hasn't suggested it. Thanks for much for everyone's support and input in this problem.

Jeri

 

[esvaja]

Hey Missy !!!!

Good to hear from you! I also had over 1 liter of fluid removed & had a cath in place for 5days to continue draining another 1/2 L. It was WORSE than the AVR. I still have some fluid I'm trying to lose, however the SOB isn't like an elephant sitting on my chest like before. Now I just got over 5 days of a non-specific (tests & all) fever over 100 F. Very wearing. And there is more pain in my lung area & new "hole" than after the AVR. Nothing like another "bump" on the road!!!!
Take Care & Best wishes on your further recovery!!!!
Daiva
PS I'm on motrin & some kind of GOUT medicine to keep the site from inflaming again

 

[Jeri]

It sounds like I should be on Motrin or something like it. But my surgeon never even mentioned. But in the past, it has made my stomach sick and I had dizziness along with it. Although I have had two bouts of dizziness today only lasting a few minutes each so it is probably no big deal. It is a relief to have all that fluid out of my chest. I can walk a little longer and use that tortuous spiirometer a little better. But I am on the Lasix for this excess fluid so hopefully it will clear up the rest of the fluid in my left chest wall. Thanks again for everyone's help.

 

[epstns]

Jeri - The lasix helped A LOT with general fluid retention, but it wasn't until I started walking a lot more that the last of the lung discomfort subsided. I guess that with your recent relief you should try to walk a lot more, which will help lose the last of the fluid, making it comfortable for you to walk even more than you had been, and so forth.

I'm about at week 11 now, and I regularly walk everywhere I need to go in daily activities, including stairs, and THEN I go to the gym and "speed walk" a couple of miles at 4 to 4.6 miles/hour after work. I think I became more able to walk because I walked more. Try it if you are able.

 

[Jeri]

Yes Steve...you are absolutely right. Today I gave my husband a grocery list but then I decided to go with him. I did really well. We are walking a good 15-20 min. I was so happy with myself. Before that I did 2 10-min in my house. It's been raining here like crazy so walking outside wasn't an option. I am looking forward to cardiac rehab and then I will really know what I can do. But thanks for the advice. I do my best to walk more. It even helps my frame of mind. And I think that left lung is a little better. I still heard rales with diminished sound. The right one (that doc drained) sounded much better than before. I am on my way.
Jeri

 

[epstns]

Jeri - You bring up a good point as to how to get to walk in bad weather. Several times when it was very cold and snowy here, I would go to the store with my wife and walk all of the store aisles with her. This helped me in two ways -- first the exercise and second it helped me to realize that there was still a real world out there that I would soon "rejoin."

Glad you're making faster progress. Remember. . . "The better you get, the faster you get better."

 

[Jeri]

I think it is so important to get out of the house. Today I did a 15 min walk in our Towne Mall with my sister. I plan to do another one this afternoon. That is all I am allowed to do but that's OK because I was really tired afterwards. I have also started some light house-cleaning and I am working on my client's accounting but not on their computers yet. Thanks for everyone's input. I am feeling positive again...what a great feeling.

Jeri