kiltedscotsman
Member
After putting this off for several weeks, I am finally sitting down to put my experience into writing to share with others. In the weeks leading up to my surgery, I found great comfort in reading the experiences of others on this forum, it is only right that I now contribute. I had open heart surgery on July 17, 2013 to replace my bicuspid aortic valve and ascending aortic aneurysm. I received a 27mm On-X valve and 26mm aortic graft at the Heart & Vascular Institute of Memorial Hermann hospital in Houston, Texas. Dr. Anthony Estrera was my surgeon. I can not speak highly enough of Dr. Estrera. The first time I met him in September 2012, he immediately gained my complete confidence and left no doubt in my mind that I had chosen the right place to treat my disease.
I am a 32 year old male from Canada, diagnosed with a bicuspid aortic valve at the age of 7. Since it was something I was aware of for most of my life, I never thought much of it and never let it limit my lifestyle. I exercised, lifted weights, played hockey and always heard the same thing at my follow ups - no change, your condition is still mild. At the age of 22 I became a police officer, a career I had always aimed for, and disclosed my condition to my employer. The mild nature of my disease at the time was not an issue for them.
In 2011 during a routine follow up it was discovered that my condition had progressed where I now had a moderate insufficiency and an aneurysm in my ascending aorta at 42mm. My duties as a police officer became limited, which I accepted as necessary but found very frustrating and quite boring. My cardiologist in Canada told me very plainly that I had to accept that I was no longer a young man, and would never be an operational police officer again. A tissue valve would not give me the longevity I would require in my profession, and a mechanical valve would require anticoagulation therapy that would put me at risk for life threatening bleeding - an unacceptable risk. I was not willing to give in based on one doctor's opinion.
After much research of various facilities around the world, many telephone conversations and some in person visits, I finally ended up at the Texas Medical Center in Houston in September 2012. For the first time, I was given hope to save not only my life but also my career. Dr. Estrera explained the ongoing studies of the On-X valve and low intensity anticoagulation therapy. This was exactly what I wanted to hear and decided to continue my follow ups there while the studies continued, seeing Dr. Siddarth Prakash as my cardiologist. Again, I have nothing but praise for this doctor as well.
In April 2013, I returned to Houston for a follow up. In the time since my last follow up, I had started experiencing various symptoms including chest pain, palpitations, shortness of breath, and increased migraines (not sure if those were from my condition, or the stress of it all). Dr. Prakash informed me that my valve was leaking considerably more than my previous examination, and was concerned with the rate at which it had deteriorated. My aneurysm was now 44mm and he recommended that I start considering surgery, although he did not feel it was urgent as of yet. I decided to move forward with the surgery, and booked a surgery date of July 17.
The weeks prior to my surgery were rather stressful for me. Despite the reassurance of doctors and family that the odds were overwhelmingly in my favor, the knowledge of what lay ahead wrecked havoc on my mind. I was obsessively reading the experiences of others, and there I found some reassurance. If so many other people had powered through it successfully, then so can I. It helps knowing you're not alone. Oddly enough, as soon as I arrived in Houston and had my pre-surgery appointment with Dr. Estrera, I felt totally fine with it all. I realized it would be difficult, but felt certain it would all turn out well. I enjoyed a couple days touring around Houston with my wife and parents, who all came to support me, and I felt nothing but relief that I was finally fixing this.
Surgery day. I was taken into the pre op area where I put on the hospital gown and hopped onto the bed. Various doctors who would be assisting the surgery arrived, spoke to me briefly to introduce themselves, then left. My family was allowed in to sit with me while we waited for go time. Eventually, it was time for my family to leave. The anesthesiologists gave me a shot of something in my IV, no idea what it was, but I felt rather blissful as they wheeled me out of the room. Rolling out of the pre op room is the last memory I have. If I was awake at all after that moment, then it is erased from my mind. I suspect there was something more to that concoction they gave me!
My first memory thereafter is of the nurse saying my name and telling me to breathe as I regained consciousness after surgery. The intubation tube was still down my throat, and breathing with that thing in was not exactly easy. She told me that they would take it out once they were sure I could breathe on my own. I was still only semi conscious at this stage and had difficulty keeping my eyes open for any length of time, but I was aware. Breathing with that tube in was like fighting for breath constantly. I suppose that is maybe on purpose to make sure your lungs have the strength, but it is no fun at all. The thirst was intense at this time, all I wanted in the world was to get that tube out and have a drink of water. I have no idea how long it was before they finally removed it but it felt like 2 hours or more. My sense of time was not reliable yet. In the meantime, they brought my family in to see me. Though I could not quite open my eyes, I let them know I was aware of them with a series of hand squeezes.
The intubation tube was removed, my family sent out of the room while they did this. The tube removal was uncomfortable, but did not hurt. Fearing that I would vomit if they gave me any significant quantity of liquid, I was limited to one small ice cube every 15 minutes. It took a few minutes to recover my voice after the tube removal, but once I did I was watching the clock like a hawk and reminding whoever was nearby that 15 minutes was up for the next couple hours. The thirst was almost unbearable. My overall pain level was minimal as long as I didn't move. Any movement at all did cause me some pain, though the nursing staff in the ICU were fantastic at keeping me up to date with pain medication. All in all, considering what my body had been through a few hours before, I was in relative comfort. My resting heart rate at this point was around 90-95 bpm. I was told that tachycardia after surgery is not uncommon, and that it should correct itself in time. In the days following, once I was able to stand, my heart rate would jump to 120-125 as soon as I got up to walk the 6 feet to the bathroom. In the following few weeks, my resting heart rate slowed down to around 75-80 bpm, only 10 or so bpm from where it was pre op.
I must say I was surprised at the amount of tubes and lines attached to me. A probe in my neck, another probe in my right wrist. An IV line in each arm. Pacing wire. 2 drainage tubes in my chest. Catheter. Prior to surgery I figured there would be a tube or two in addition to the intubation, nobody had given me the full list though. The following day, the probes, pacing wire and catheter were removed. Not very painful, just slightly uncomfortable when all of this was done. Probably the fentanyl and vicodin to thank for that! Another thing that surprised me was how strong my heartbeat felt. I could feel and hear the thumping in my chest. 4 weeks later I can still feel it, but it is much less noticeable. I don't know if this is because it is calming down or if I'm simply getting accustomed to it. Either way is fine with me.
1 day post op, an x-ray revealed the top of my right lung had collapsed. My first 2 drainage tubes were removed since they were not in a position to help, and a new drainage tube was inserted into my right side. They timed this procedure shortly after a fresh dose of my regular pain meds and used some local anesthetic as well, so I felt absolutely nothing of the procedure. The lung doctors visited regularly to make sure I was continuing my breathing exercises. I was, although taking the deep breaths so soon after your sternum is compromised is, at times, excruciating. They asked for 10 breaths into the "incentive spirometer" every hour. Discouraged by the pain, I probably averaged less than 5 an hour. I hated that contraption initially, but as time went on and my volumes increased, it got easier.
2 days post op I developed pericarditis. It started as tightness and intense pain in my chest, the ICU staff reacted quickly with x-ray, ultrasound and EKG to rule out any other complications then treated me with anti inflammatory medication and a little extra pain relief. No big deal there.
In all, I spent 5 days in ICU until my right lung re-inflated and the pericarditis was managed. I was then transferred out to MCU where I remained for 3 more days until my INR was in range. On the 8th day I was discharged, and walked out of the hospital. That was an awesome feeling.
Since my discharge, my INR has been steady inside the therapeutic range of 1.5 - 2.0 for the On-X valve, a low intensity anticoagulation that will allow me to return to regular patrol duties as a police officer instead of surfing the desks. Since my discharge from hospital, I have had some pre ventricular contractions and what feels like the occasional skipped heartbeat, but Dr. Prakash and Dr. Estrera both advised me that this is normal and nothing to concern myself with. If it continues long term or worsens then it should be investigated further.
As I write this I am now 4 weeks post op, to the day. Now that the pain of surgery has faded, I am amazed at how good I feel. Rather than spending the last 2 years limiting my lifestyle, I should have just had this done right away. Yes, the recovery is painful and uncomfortable, but it is also amazingly quick. Already the memory of the pain is fading from my mind. It is such a short term thing, and the reward is huge.
If you are reading this while waiting for your surgery, don't fret too much. It's a bit of a rough go, but nothing you can't handle.
I am a 32 year old male from Canada, diagnosed with a bicuspid aortic valve at the age of 7. Since it was something I was aware of for most of my life, I never thought much of it and never let it limit my lifestyle. I exercised, lifted weights, played hockey and always heard the same thing at my follow ups - no change, your condition is still mild. At the age of 22 I became a police officer, a career I had always aimed for, and disclosed my condition to my employer. The mild nature of my disease at the time was not an issue for them.
In 2011 during a routine follow up it was discovered that my condition had progressed where I now had a moderate insufficiency and an aneurysm in my ascending aorta at 42mm. My duties as a police officer became limited, which I accepted as necessary but found very frustrating and quite boring. My cardiologist in Canada told me very plainly that I had to accept that I was no longer a young man, and would never be an operational police officer again. A tissue valve would not give me the longevity I would require in my profession, and a mechanical valve would require anticoagulation therapy that would put me at risk for life threatening bleeding - an unacceptable risk. I was not willing to give in based on one doctor's opinion.
After much research of various facilities around the world, many telephone conversations and some in person visits, I finally ended up at the Texas Medical Center in Houston in September 2012. For the first time, I was given hope to save not only my life but also my career. Dr. Estrera explained the ongoing studies of the On-X valve and low intensity anticoagulation therapy. This was exactly what I wanted to hear and decided to continue my follow ups there while the studies continued, seeing Dr. Siddarth Prakash as my cardiologist. Again, I have nothing but praise for this doctor as well.
In April 2013, I returned to Houston for a follow up. In the time since my last follow up, I had started experiencing various symptoms including chest pain, palpitations, shortness of breath, and increased migraines (not sure if those were from my condition, or the stress of it all). Dr. Prakash informed me that my valve was leaking considerably more than my previous examination, and was concerned with the rate at which it had deteriorated. My aneurysm was now 44mm and he recommended that I start considering surgery, although he did not feel it was urgent as of yet. I decided to move forward with the surgery, and booked a surgery date of July 17.
The weeks prior to my surgery were rather stressful for me. Despite the reassurance of doctors and family that the odds were overwhelmingly in my favor, the knowledge of what lay ahead wrecked havoc on my mind. I was obsessively reading the experiences of others, and there I found some reassurance. If so many other people had powered through it successfully, then so can I. It helps knowing you're not alone. Oddly enough, as soon as I arrived in Houston and had my pre-surgery appointment with Dr. Estrera, I felt totally fine with it all. I realized it would be difficult, but felt certain it would all turn out well. I enjoyed a couple days touring around Houston with my wife and parents, who all came to support me, and I felt nothing but relief that I was finally fixing this.
Surgery day. I was taken into the pre op area where I put on the hospital gown and hopped onto the bed. Various doctors who would be assisting the surgery arrived, spoke to me briefly to introduce themselves, then left. My family was allowed in to sit with me while we waited for go time. Eventually, it was time for my family to leave. The anesthesiologists gave me a shot of something in my IV, no idea what it was, but I felt rather blissful as they wheeled me out of the room. Rolling out of the pre op room is the last memory I have. If I was awake at all after that moment, then it is erased from my mind. I suspect there was something more to that concoction they gave me!
My first memory thereafter is of the nurse saying my name and telling me to breathe as I regained consciousness after surgery. The intubation tube was still down my throat, and breathing with that thing in was not exactly easy. She told me that they would take it out once they were sure I could breathe on my own. I was still only semi conscious at this stage and had difficulty keeping my eyes open for any length of time, but I was aware. Breathing with that tube in was like fighting for breath constantly. I suppose that is maybe on purpose to make sure your lungs have the strength, but it is no fun at all. The thirst was intense at this time, all I wanted in the world was to get that tube out and have a drink of water. I have no idea how long it was before they finally removed it but it felt like 2 hours or more. My sense of time was not reliable yet. In the meantime, they brought my family in to see me. Though I could not quite open my eyes, I let them know I was aware of them with a series of hand squeezes.
The intubation tube was removed, my family sent out of the room while they did this. The tube removal was uncomfortable, but did not hurt. Fearing that I would vomit if they gave me any significant quantity of liquid, I was limited to one small ice cube every 15 minutes. It took a few minutes to recover my voice after the tube removal, but once I did I was watching the clock like a hawk and reminding whoever was nearby that 15 minutes was up for the next couple hours. The thirst was almost unbearable. My overall pain level was minimal as long as I didn't move. Any movement at all did cause me some pain, though the nursing staff in the ICU were fantastic at keeping me up to date with pain medication. All in all, considering what my body had been through a few hours before, I was in relative comfort. My resting heart rate at this point was around 90-95 bpm. I was told that tachycardia after surgery is not uncommon, and that it should correct itself in time. In the days following, once I was able to stand, my heart rate would jump to 120-125 as soon as I got up to walk the 6 feet to the bathroom. In the following few weeks, my resting heart rate slowed down to around 75-80 bpm, only 10 or so bpm from where it was pre op.
I must say I was surprised at the amount of tubes and lines attached to me. A probe in my neck, another probe in my right wrist. An IV line in each arm. Pacing wire. 2 drainage tubes in my chest. Catheter. Prior to surgery I figured there would be a tube or two in addition to the intubation, nobody had given me the full list though. The following day, the probes, pacing wire and catheter were removed. Not very painful, just slightly uncomfortable when all of this was done. Probably the fentanyl and vicodin to thank for that! Another thing that surprised me was how strong my heartbeat felt. I could feel and hear the thumping in my chest. 4 weeks later I can still feel it, but it is much less noticeable. I don't know if this is because it is calming down or if I'm simply getting accustomed to it. Either way is fine with me.
1 day post op, an x-ray revealed the top of my right lung had collapsed. My first 2 drainage tubes were removed since they were not in a position to help, and a new drainage tube was inserted into my right side. They timed this procedure shortly after a fresh dose of my regular pain meds and used some local anesthetic as well, so I felt absolutely nothing of the procedure. The lung doctors visited regularly to make sure I was continuing my breathing exercises. I was, although taking the deep breaths so soon after your sternum is compromised is, at times, excruciating. They asked for 10 breaths into the "incentive spirometer" every hour. Discouraged by the pain, I probably averaged less than 5 an hour. I hated that contraption initially, but as time went on and my volumes increased, it got easier.
2 days post op I developed pericarditis. It started as tightness and intense pain in my chest, the ICU staff reacted quickly with x-ray, ultrasound and EKG to rule out any other complications then treated me with anti inflammatory medication and a little extra pain relief. No big deal there.
In all, I spent 5 days in ICU until my right lung re-inflated and the pericarditis was managed. I was then transferred out to MCU where I remained for 3 more days until my INR was in range. On the 8th day I was discharged, and walked out of the hospital. That was an awesome feeling.
Since my discharge, my INR has been steady inside the therapeutic range of 1.5 - 2.0 for the On-X valve, a low intensity anticoagulation that will allow me to return to regular patrol duties as a police officer instead of surfing the desks. Since my discharge from hospital, I have had some pre ventricular contractions and what feels like the occasional skipped heartbeat, but Dr. Prakash and Dr. Estrera both advised me that this is normal and nothing to concern myself with. If it continues long term or worsens then it should be investigated further.
As I write this I am now 4 weeks post op, to the day. Now that the pain of surgery has faded, I am amazed at how good I feel. Rather than spending the last 2 years limiting my lifestyle, I should have just had this done right away. Yes, the recovery is painful and uncomfortable, but it is also amazingly quick. Already the memory of the pain is fading from my mind. It is such a short term thing, and the reward is huge.
If you are reading this while waiting for your surgery, don't fret too much. It's a bit of a rough go, but nothing you can't handle.
