No recovery at 8 months

[dell3865]

In late July 2016 I had a calcified, two-leaflet aortic valve replaced along with resection of a 4 cm. aneurysm in my ascending aorta, replaced with a graft. I am still unable to exercise, cannot lift 20 pounds or walk 15 -20 feet without being completely out of breath. My brother had the same two-leaflet valve replaced but only a "tiny" aneurysm that they take a look at once a year. However, he doesn't recall being short of breath for very long. I am a 73-year-old family medicine physician (still working) and the non-interventional cardiologist I see for post-op care doesn't seem to know why I haven't recovered. He has scheduled me for a lung scan today. We both know I don't have a pulmonary embolism but he's hoping to get some clue to help with diagnosis.

What I would like to know from others is whether or not this long period of recovery is 'normal'. Has anyone here had a similar experience? Thank you, dell3865

 

[pellicle]

...

What I would like to know from others is whether or not this long period of recovery is 'normal'. Has anyone here had a similar experience? Thank you, dell3865

Wasn't how it went for me. How old is / was your brother at surgery?

Have you mentioned this to your surgeon? I would...

 

[dornole]

You can't walk 15-20 feet? Like, inside your house? And you had surgery last July?

That sounds like an epic fail on the surgery, or you have something else that is being missed. How do your echos look?

 

[epstns]

Dell, with all due respect, I would be looking for another cardiologist by now. Although I guess it is possible that your heart was already damaged prior to surgery, we don't see many around here who don't see at least some improvement after surgery. How was your heart/lung function prior to surgery? If it was compromised, then prior damage may be possible. If you were "fine" before, you should be evaluated at a top cardiac care center by someone who is a specialist in these issues. You haven't said, but is your cardio "one of the boys" in your local practice, or maybe a friend?

That said, it may take some time to regain your strength - especially if you had any complications during or after surgery. I had arrhythmia, pleural effusion, edema of the extremities as well as near-complete digestive system shut-down after my valve surgery. These issues so impeded my recovery that I was not cleared to start cardiac rehab until 3 months after surgery. Once these issues were addressed, though, I was able to make up the lost ground and became the poster-boy of my rehab class, even going to my own fitness center on the days I didn't have rehab.

You definitely deserve some answers, and it doesn't seem like you are ever going to get them from your current care team. I think it is time for some second opinions. Personally I think I would start with another cardiologist - one who has some experience with valvular heart disease. Have they done an echo since surgery? I had a TEE about 3-4 weeks post-op, just to ensure that there was nothing growing on my valve, etc. The echo would also verify the performance of your new valve. They also might want to do another angiogram (maybe this time ask for the CT angiogram to avoid injury to the newly replaced tissue) to ensure that there are no blockages, as these could cause symptoms such as yours. If your lungs were fine before, I would want to fully evaluate the heart prior to any lung testing, but that's just me.

There are many possibilities, dell, but the fact is still that you are only going to get relief if you find someone who knows how to evaluate them and act on them. Keep us posted - we'll be here.

 

[honeybunny]

I had pleural effusion after surgery and, like you, couldn't walk 10 feet without stopping to catch my breath. But my cardio diagnosed it quickly and I had about 2 liters of fluid drained a few weeks after surgery and another liter drained about 2 weeks after that. Made all the difference in my recovery. If pleural effusion has not been ruled out for you I'd definitely see another cardio or pulmonologist.

somehow I posted this FOUR TIMES so I'll delete the other three

 

[dell3865]

Thank you to all who replied. I feel kinda stupid now. If I am caring for a patient, I always will go through all the possible diagnoses when they tell me their story but, with my own health, I barely pay attention to symptoms and just live with the problem until it gets serious. While my shortness of breath (understatement) has been present since surgery, I just kept thinking it would go away with recovery from the surgery. Now I believe Steve Epstein and Honeybunny have made the diagnosis!!!
I can hardly wait to see the cardiologist. Thank you both. I will follow-up after treatment.

 

[epstns]

You GO, Dell! Go in there with your list of questions and ask them in a calm manner. If you get answers (real answers, not hand-waving and place-holders), then you have information on which to base your next steps. If all you get is hand-waving (bogus non-answers designed to get you to stop asking), then it may be time to seek help elsewhere. Most docs will answer questions, I've found. All it takes is a calm, personable approach and clear statements of your questions.

Keep us posted. We worry about the family when things aren't clear.

 

[spartangator]

Good for you, Dell. Indeed, care providers are often the worst about caring for themselves!

All the best finding some answers, as epstns suggests. You're very a thoughtful GP, it sounds, and I'm sure your patients also look forward to you being back at full speed.

 

[judy bee]

good luck.hope you feel better soon .

 

[judy bee]

good luck.hope you feel better soon .

 

[judy bee]

good luck.hope you feel better soon .

 

[judy bee]

good luck.hope you feel better soon .

 

[mikeccolella]

Well how is going Dell?