My AVR Experience!!!

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PGARG

Active member
Joined
Jul 30, 2014
Messages
40
Location
CA, USA
Hi All, I did my AVR on the 27th, and got the On-X valve via Mini Sternotomy. This forum has been a source of information, strength and hope for me. In short, my surgery went well, and recovery has been excellent so far. I spent exactly 4 days i the hospital and today is the 6th day since surgery and i am recovering at home nicely (just took my first 1 mile walk outside). For anyone interested in the gory details, here is a detailed account of my experience.

Day 1- Started about 530 AM. I was shaved from neck down and then taken to the OR. I barely spent 3 mins in the OR awake when the anesthesiologist gave me the cocktail. After that I was waking up in a room with breathing tube down my throat(as warned). Even though I was prepared for it, it was tough. I kept asking to take it out and they wanted me to breathe on my own. Problem was anesthesia, I would breathe for sometime and then lose consciousness and then the tube would kick in and reset my clock. I almost gagged one time and that hurt because ur neck and chest are very sore.
Anyway after the breathing tube was out, things were better. I had pain and stiffness, but tolerable. Worst was when they move you to ur side.
One big tip: ask for pain medication before pain gets bad...they will u that. But also plan any major maneuvers after pain med has kicked in.
I took the more serious med at night to sleep. Still they come and draw blood every hour, frm an IV line, which doesn't hurt, but wakes you.
My only other bad incident was when the nurse made the room really cool because it was running hot. It became really cool, and next time she turned me , the combination of lack of pain med and cool room, gave me shivers. It took 5 mins to settle down but those hurt. Again if she had give me my dosage before moving me, I would have been fine.
They do take very good care of you in the ICU.
You have lots of tubes and wires sticking out but that didnt scare me. Although the chest drainage tube is the worst and causes pain.
By early morning hours I got a sponge bath and was told I'm doing OK and they sat me up in a chair. It was not bad at all and they took good care of me while moving me. Again I took meds in advance so it helped.
So far in less than 24 hours, I was feeling OK and they told me they would start removing various tubes and move me to the step down unit. The chest drainage tube takes ur breath away for a brief 2 seconds, and it won't immediately feel better, but it eventually starts to feel better. I was taken for a small walk too and all those are milestones to leave the ICU, which I did by noon. They removed a lot of the stuff hanging off me, and left a couple. None of that hurts BTW.

Day 2 - almost 24 hrs after surgery im out of the ICU and transferred to a step down unit. I sit here on a chair for extended periods of time. Couple of walks....which because of cold corridors and almost no clothing, ended up in shivers that are not comfortable. So I started walking with a warm blanket. I seem to get chills 1-2 times a day. Once in the night when suddenly the room temp drops or at least my body feels that way.
I also have been getting insulin, potassium and manganese supplements, which seem normal. I've had a fever too which comes and goes.
My mechanical valve though, has been pretty quiet. I only heard it in bed late at night... Otherwise I can't tell that I have something in my body that ticks.
Sleeping has been a bit of an issue. They bother u a lot...blood draws, and vitals etc etc..plus main med wears off...so u need to plan ur sleep.
My urinary catheter was out in the morning. It's strange how soon your body forgets how to pee. It took me a while to be able to do that, but after the first time, it was easier and easier.

Day 3 : Things are better and progressing. Pain level is better and I am able to walk more and more in the hospital. Now I always take a warm blanket around me. My biggest problem is still bowel movement. Eating all my meals(small) but it doesn’t move. I am having all the relevant meds to clear the stomach, but nothing helps. By evening I start to notice that my pain level has gone down. I am now almost able to come out of bed and climb into to without too much pain or help. I am taking multiple walks during the day and spend my time sitting.

Day 4: My friends visit in the morning and keep me company for a few hours. Change of conversation helps and also this is the day pain levels drop significantly. You feel much better overall. My bowel movement is still not happening and I finally have to take a suppository. Don't know why I was scared of it, it turned out to be real easy, and did the trick. That makes you feel so much better and its another milestone. I am now being told, tomorrow I may go home. Night goes the same way. I'm hot and cold every few hours and interruptions from nurses to check my vitals or other stuff keeps happening. They did give me an Ambien again to sleep and it does help.

Day 5: Things move quickly in the morning. Surgeons assistant comes by and takes out my pacer wires. He tells me my lungs have cleared pretty much and I'm going home soon. Nurse takes my final IV line Out and now I'm totally wire free. I am handed my instructions and medication list and pretty much sent home before lunch.

If anyone has specific questions, about my experience or in general, please don't hesitate to ask. I would love to help anyone about to go through this. I myself will be asking more questions about what to expect in the future.

Thanks
Pankaj
 
Hi Pankaj,
Good news!!
All the best for your recovery.
I'm waiting for my AVR surgery on Sept 18th at cleveland clinic.

Take care,
Teju
 
PGARG, thank you so much sharing, gives me more insight on what to expect. My surgery will be this Friday, I also chose the ON-X valve.
 
Rick0329 - you are most welcome. You'll be fine. Its not as hard as the details make it sound like. Only one big advice...Understand and take ur pain meds regularly for 4 days....plans any major activities after an hour of taking pain med...and if a particular main med didnt work, tell them and try something else. It was amazing how many choices they have. Oh and don't even worry about taking too much medication...they won't let u OD in the hospital...and they know how they mix. After taking 4 days of strong meds in the hospital, my meds have come down drastically after coming back home. So, there is no award for suffering through pain....and pain will hinder ur activities...which are very critical...like breathing exercises. See you on the other side. Good luck.
 
Also, ask them for some Miralax (or some other mild laxative). It is surprising just how "bound up" your digestive system can become from all the anesthesia and pain meds. It can get really painful if you let it stay that way too long. (This from experience - I had to be re-admitted to the hospital 4 weeks post-op to straighten this out.)
 
For me the hospital was on top of making a bowel movement happen. They said its a big milestone. So they started with mild laxatives and kept increasing them until it happened. I think they should do the same for everyone. I think the issue is when you reach home, its on you to take care of it. I am drinking prune juice, syllium husk and fiber rich diet. All those and walking help ur stomach process food better. Its real important.
 
For me the hospital was on top of making a bowel movement happen. They said its a big milestone. So they started with mild laxatives and kept increasing them until it happened. I think they should do the same for everyone. I think the issue is when you reach home, its on you to take care of it. I am drinking prune juice, syllium husk and fiber rich diet. All those and walking help ur stomach process food better. Its real important.
 
Thanks for sharing your story. All best wishes to you for a smooth recovery the rest of the way. Yep, the narcotic drugs bring on constipation -- I remember Colace, the stool softener, helping me out.
 
Thank you everybody for the great comments, I will remember to ask for laxatives and pain meds when needed. Yesterday I went for my pre-op testing. Got my first look at the inside of the hospital. Tomorrow (Friday) is the big day, I must report to the hospital by 5am. I will be the first surgery of the day. Still somewhat calm and trying to catch up on any last minute things that need to be done. It looks like the hospital does have wi-fi so during my recovery I will try to have my wife bring my laptop to the hospital. If I feel well enough I will send out an update in the post surgery section.
 
Good deal, rick! We'll be here watching for your update. If it is anything like my first couple of days, it may not make much sense - but we will understand. When I looked at some of my posts from my hospital bed, I was dumfounded. Did I really write THAT? Of course, I just blamed it on the silly auto-correct feature of my iPhone. . .
 
I also feel colder than normal. It is 4 weeks, and very hot in MA, but I do not mind it. I stopped taking the Percoset fairly soon because I prefer a bit of pain to a lot of constipation. Good luck.
 
Today is my 2 week Post Op anniversary. I feel pretty good overall and i can easily walk a couple miles both morning and evening. I am now just on Tylenol for the past 3-4 days and seem to be doing ok. I think a little pain is actually helpful because its a reminder to myself to not push and that my chest is not stable yet. Can't wait to start driving in 2 weeks and being completely independent. I also feel my sensitivity to cold has slowly gotten better. I would be shivering earlier at the slightest cold and now i am getting better at tolerating it.
My INR was close to 2 at last checkup, and thats my goal ...so i'm looking for it to get stable and settle down. Although i understand it takes time to really settle down. Overall i feel grateful that so far things have gone without any major hiccup. Hopefully i can put all this behind me and remember it just as a bump in the road. This forum has been great and i will try to contribute to it on an ongoing basis.
 
Congratulations on your speedy recovery.......and do stay in touch with this forum. Like you did a few months ago, a lot of new folks come to this forum looking for support and encouragement concerning OHS......and stories like yours are very comforting......and you are right, it is only a bump in the road.
 
Today I complete 3 weeks post op. Mostly it has gone well. The rate of improvement slows overtime but still everything is improving. I am walking 4-5 miles a day broken up into 3-4 walks. I don't feel tired at all, so that's pretty good. I have stopped any pain meds during the day, but am taking a Tylenol around 8 PM. Hopefully i'll stop that too in a week.The one issue i seem to have is, when i take a deep breath, even when i'm sitting, my chest pounds, and my valve gets loud. It almost feels like my heart is rubbing on my ribs and causing them to vibrate. I'm not sure what this is yet. I was told by a surgeon that in the short term my heart will become inefficient because now i have a one way valve. My Left Ventricle was enlarged quite a bit due to leaking valve. I wonder that now that leakage has stopped, the dynamics of blood flow has changed, and it is causing all this. Anyone else experience this post surgery.
 
I've been meaning to post another update here for posterity. I'm 2 months post-op now and i feel almost 95% normal. I still had some chest pain (doing only certain things) and that is beginning to also go away. I am back to work 100% (3rd week actually), and most days i forget i had heart surgery 2 months ago. Of course i am reminded of that when i take my Coumadin, but that's becoming a chore too.
Overall, i think things have gone almost as well as i could have hoped. I am working out now,not at full strength, but that's deliberate. I had a really enlarged LV, in the 7.1 cm range. In just a month, my Echo showed i was back to 6.1 (still slightly enlarged, but on the right track). My INR is not yet 100% settled, and still varies, but thats normal and its slowly getting there. It takes time because post surgery, the diet, excercise levels etc keep changing and they affect INR. As i get closer to my normal schedule and life, the INR is settling.
Overall this site has been wonderful and i keep coming back and reading posts and responding when i can. Hope to continue that. Onwards and Upwards....
 
Congratulations. Everything looks really good, what else can someone ask for.
How long was your LV enlarged for (at 7.1cm or >6.5cm) prior to the surgery?
Once again enjoy your new lease on life and continue to do well.
 

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