Hi again,
So it's been just over three weeks since my AVR and aneurysm surgery. I posted a pre-surgery thread about five weeks ago Two Weeks Remain, so I thought I'd follow up with you guys. As a warning I'm not going to sugarcoat anything, this whole thing was much rougher than I was led to believe. I'm not trying to scare anyone, and honestly maybe not knowing some things is better. I don't know, read at your own risk.
As a quick recap, I'm 29 (30 in October) M, born with BAV, diagnosed with a stable aortic aneurysm about five years ago (~4.9 cm), valve stenosis progressed quickly over the last two years, combined with the aneurysm I was advised to consider surgery sooner than later, I chose sooner and here we are. I chose to go with the On-X mechanical valve because that's what my surgeon recommended for the best possible chance of avoiding re-operation in my lifetime, and this type of valve has one of the lowest bleeding chances.
It's been a wild ride, that much I can say for sure. It's something that I hope I never, ever have to go through again, so I'm glad I went with the mechanical valve.
The days leading up to the surgery were tense, but not bad. I had the help of a Xanax prescription that my primary care doctor wrote me just for the last three days before the surgery to help though. Thank god for that, I think I would have been a wreck. Instead I just kinda glided through the last few days. I had to ask my doctor about it, so if you have anxiety issues like me I highly recommend it. They told me to take the meds the morning of as well. I barely remember the couple of hours before the surgery. I remember getting up, taking a shower, being driven to the hospital and... that's about it. I almost remember changing, getting the relaxing shot, and sliding on to the table. But I was so out of it, none of it bothered me. Complete zombie. Fun fact, even though I warned them that I have a tolerance for anesthetics, they were still really surprised just how hard it was to put me down. The surgeon joked afterwards, "We could have killed a horse with how much we had to give you!" Weird. Anyway, next thing I remember is "waking up" in the ICU. I was still pretty gone though. I still had the tube in my throat, but it didn't really bother me. I couldn't feel much else besides that and these leg compressing sock things that keep your blood flowing, those felt kinda good actually. I remember them telling me to cough and the tube coming out, my first word was "F**K!" because it kinda hurt, they thought that was funny.
I was in and out through the evening/night, but that's where things started to get kinda bad. As the anesthesia wore off, the pain really started to set in. I told them over and over, "I'm at a [pain scale] 6", "I'm at a 8!", "9!", "10!!!", but they wouldn't give me more pain meds saying, "The night doc doesn't believe in giving you more pain meds." That's what I'm the most pissed off about this whole thing, my night in the ICU was a living hell because some old doctor "didn't believe" in giving me stronger meds. As soon as the morning rolled around and the doctors switched, they immediately gave me the pain meds I needed and things were better. They weren't allowing my wife in the ICU because of covid, but I think if she was able to be there I would have gotten better care since I would have had an advocate. Very frustrating.
The following days were hard, but manageable. I was moved to the PCU (progressive care unit) about 32 hours after my surgery, so I wasn't monitored quite as much at that point. Pain was an issue, but I had PCA pump that helped immensely. I think I hovered around a pain level of 5 most of the first three days or so. They said that younger men have a harder time with pain because of their muscle mass? Kinda strange but okay. I didn't sleep much, and I definitely didn't eat. I don't think I ate anything for 2-3 days easy. There were nurses coming in every couple of hours to check my vitals, making nearly impossible to sleep even if I wanted to. I just watched movies and youtube on my phone pretty much all night. I eventually asked my doctor if they could lay off a bit, and they did. They gave me 6 hours to sleep undisturbed after a couple of days.
They got me up and walking the first day, which was a nice distraction. They had me use a rolling walker, mainly so they had a place to put the drainage containers. And that my friends brings me to the drainage tubes. I had FOUR Blake drains in my mid-chest area. Worst things ever. Painful, gross, cumbersome, just awful. They were the source of much of my pain and discomfort it turns out. They took the first one out two days in, and it was like I was a new man. Every time one of those things came out, I felt 100% better than I did before. It was like my recovery was tied to those stupid drainage tubes. The doctor was acting like they weren't a big deal, and that the last tube would stay in until I left, even though there was no more drainage. I had to talk them into it, but they finally took the last one out on day 4. I started quickly recovering and was up and walking around no problem at all, I was finally feeling better and started eating again. Pain was down to a 2-3 level with meds now.
Now I was mainly just staying in the hospital to get my INR in check. I'd been on Warfarin for three days and my INR just wasn't budging for some reason. Finally, on day 4 it was finally starting to go up. They told me if it was climbing fast enough the next day, I could go home. Unfortunately, no dice, it was still too low. That night was extremely rough for some reason and I had a mental break down. Living in the hospital, not being able to sleep, and not being able to go outside was really starting to get to me. When they told me my INR was still too low for me to go home, I told them I couldn't do another night here. The cardiologists talked it over and told me that they could send me home with several days of Lovenox injections if 1. my insurance approved it and 2. I felt comfortable giving myself the injections. Yes please god yes anything to get me out of here. The insurance company approved it and I was sent home the afternoon of the 5th day. I had to give myself a shot in the lower abdomen twice a day for two days while my INR stabilized. They hurt, but it beat being in the hospital!
Coming home was harder than I thought it would be. I was still in a lot of pain, I still couldn't really sleep, and eating was still a chore. I think I ended up losing about 15lbs (185lbs -> 170lbs), and I'm already thin. I just tried to take it slow, walk when I could, do the breathing exercises, etc. Everyday I saw improvement. Yeah there were some bad days where I was wiped out, but there was not too many of those. I stayed on the narcotic pain meds about four more days, then was just on Tylenol 1000 mg every six hours, which did the trick. I started rapidly improving about 10 days after surgery. I was taking longer and longer walks, eating and sleeping were better.
That continued until we arrive at today, over three weeks later. I feel pretty normal for the most part, I walk about an hour a day, trying to get my endurance back. I started work again on the 31st of Aug (software engineer), and had my first session of cardiac rehab today. Sleep is still kinda an issue, but that's pretty much it. The beta-blocker I'm on kinda screws with my blood pressure and makes me feel lightheaded at times, but they said they'll take me off that soon. I'm down to 500 mg of Tylenol every 6 hours. The metallic "ticking" sound of the valve is definitely there, and loud enough that other people can hear it. It already doesn't really bother me. And when going to bed, it's pretty easy to get away from it. Laying in a number of positions completely silences it, which I found kinda surprising.
Things are really on the up and up. Really great prospects for the future, no activity restrictions after three months. I really feel like the worst of this is over.
I know that was SUPER long, but maybe it will be of some use to someone. And I enjoyed sharing this, I think this is the first time I actually really reflected on this experience as a whole. Best advice I think I can give is to let go and jump into it, try your best to not overthink it, and advocate for yourself! I think sometimes doctors will act like something isn't a big deal until you tell them it's important to you.
Good luck with your own adventures everyone, I wish you the best!
PS: Here is a picture of me on the day I got to go home.
So it's been just over three weeks since my AVR and aneurysm surgery. I posted a pre-surgery thread about five weeks ago Two Weeks Remain, so I thought I'd follow up with you guys. As a warning I'm not going to sugarcoat anything, this whole thing was much rougher than I was led to believe. I'm not trying to scare anyone, and honestly maybe not knowing some things is better. I don't know, read at your own risk.
As a quick recap, I'm 29 (30 in October) M, born with BAV, diagnosed with a stable aortic aneurysm about five years ago (~4.9 cm), valve stenosis progressed quickly over the last two years, combined with the aneurysm I was advised to consider surgery sooner than later, I chose sooner and here we are. I chose to go with the On-X mechanical valve because that's what my surgeon recommended for the best possible chance of avoiding re-operation in my lifetime, and this type of valve has one of the lowest bleeding chances.
It's been a wild ride, that much I can say for sure. It's something that I hope I never, ever have to go through again, so I'm glad I went with the mechanical valve.
The days leading up to the surgery were tense, but not bad. I had the help of a Xanax prescription that my primary care doctor wrote me just for the last three days before the surgery to help though. Thank god for that, I think I would have been a wreck. Instead I just kinda glided through the last few days. I had to ask my doctor about it, so if you have anxiety issues like me I highly recommend it. They told me to take the meds the morning of as well. I barely remember the couple of hours before the surgery. I remember getting up, taking a shower, being driven to the hospital and... that's about it. I almost remember changing, getting the relaxing shot, and sliding on to the table. But I was so out of it, none of it bothered me. Complete zombie. Fun fact, even though I warned them that I have a tolerance for anesthetics, they were still really surprised just how hard it was to put me down. The surgeon joked afterwards, "We could have killed a horse with how much we had to give you!" Weird. Anyway, next thing I remember is "waking up" in the ICU. I was still pretty gone though. I still had the tube in my throat, but it didn't really bother me. I couldn't feel much else besides that and these leg compressing sock things that keep your blood flowing, those felt kinda good actually. I remember them telling me to cough and the tube coming out, my first word was "F**K!" because it kinda hurt, they thought that was funny.
I was in and out through the evening/night, but that's where things started to get kinda bad. As the anesthesia wore off, the pain really started to set in. I told them over and over, "I'm at a [pain scale] 6", "I'm at a 8!", "9!", "10!!!", but they wouldn't give me more pain meds saying, "The night doc doesn't believe in giving you more pain meds." That's what I'm the most pissed off about this whole thing, my night in the ICU was a living hell because some old doctor "didn't believe" in giving me stronger meds. As soon as the morning rolled around and the doctors switched, they immediately gave me the pain meds I needed and things were better. They weren't allowing my wife in the ICU because of covid, but I think if she was able to be there I would have gotten better care since I would have had an advocate. Very frustrating.
The following days were hard, but manageable. I was moved to the PCU (progressive care unit) about 32 hours after my surgery, so I wasn't monitored quite as much at that point. Pain was an issue, but I had PCA pump that helped immensely. I think I hovered around a pain level of 5 most of the first three days or so. They said that younger men have a harder time with pain because of their muscle mass? Kinda strange but okay. I didn't sleep much, and I definitely didn't eat. I don't think I ate anything for 2-3 days easy. There were nurses coming in every couple of hours to check my vitals, making nearly impossible to sleep even if I wanted to. I just watched movies and youtube on my phone pretty much all night. I eventually asked my doctor if they could lay off a bit, and they did. They gave me 6 hours to sleep undisturbed after a couple of days.
They got me up and walking the first day, which was a nice distraction. They had me use a rolling walker, mainly so they had a place to put the drainage containers. And that my friends brings me to the drainage tubes. I had FOUR Blake drains in my mid-chest area. Worst things ever. Painful, gross, cumbersome, just awful. They were the source of much of my pain and discomfort it turns out. They took the first one out two days in, and it was like I was a new man. Every time one of those things came out, I felt 100% better than I did before. It was like my recovery was tied to those stupid drainage tubes. The doctor was acting like they weren't a big deal, and that the last tube would stay in until I left, even though there was no more drainage. I had to talk them into it, but they finally took the last one out on day 4. I started quickly recovering and was up and walking around no problem at all, I was finally feeling better and started eating again. Pain was down to a 2-3 level with meds now.
Now I was mainly just staying in the hospital to get my INR in check. I'd been on Warfarin for three days and my INR just wasn't budging for some reason. Finally, on day 4 it was finally starting to go up. They told me if it was climbing fast enough the next day, I could go home. Unfortunately, no dice, it was still too low. That night was extremely rough for some reason and I had a mental break down. Living in the hospital, not being able to sleep, and not being able to go outside was really starting to get to me. When they told me my INR was still too low for me to go home, I told them I couldn't do another night here. The cardiologists talked it over and told me that they could send me home with several days of Lovenox injections if 1. my insurance approved it and 2. I felt comfortable giving myself the injections. Yes please god yes anything to get me out of here. The insurance company approved it and I was sent home the afternoon of the 5th day. I had to give myself a shot in the lower abdomen twice a day for two days while my INR stabilized. They hurt, but it beat being in the hospital!
Coming home was harder than I thought it would be. I was still in a lot of pain, I still couldn't really sleep, and eating was still a chore. I think I ended up losing about 15lbs (185lbs -> 170lbs), and I'm already thin. I just tried to take it slow, walk when I could, do the breathing exercises, etc. Everyday I saw improvement. Yeah there were some bad days where I was wiped out, but there was not too many of those. I stayed on the narcotic pain meds about four more days, then was just on Tylenol 1000 mg every six hours, which did the trick. I started rapidly improving about 10 days after surgery. I was taking longer and longer walks, eating and sleeping were better.
That continued until we arrive at today, over three weeks later. I feel pretty normal for the most part, I walk about an hour a day, trying to get my endurance back. I started work again on the 31st of Aug (software engineer), and had my first session of cardiac rehab today. Sleep is still kinda an issue, but that's pretty much it. The beta-blocker I'm on kinda screws with my blood pressure and makes me feel lightheaded at times, but they said they'll take me off that soon. I'm down to 500 mg of Tylenol every 6 hours. The metallic "ticking" sound of the valve is definitely there, and loud enough that other people can hear it. It already doesn't really bother me. And when going to bed, it's pretty easy to get away from it. Laying in a number of positions completely silences it, which I found kinda surprising.
Things are really on the up and up. Really great prospects for the future, no activity restrictions after three months. I really feel like the worst of this is over.
I know that was SUPER long, but maybe it will be of some use to someone. And I enjoyed sharing this, I think this is the first time I actually really reflected on this experience as a whole. Best advice I think I can give is to let go and jump into it, try your best to not overthink it, and advocate for yourself! I think sometimes doctors will act like something isn't a big deal until you tell them it's important to you.
Good luck with your own adventures everyone, I wish you the best!
PS: Here is a picture of me on the day I got to go home.
