One Year and Counting—Observations

[morellib]

Last December, I had my 25mm Inspiris Resilia aortic valve put in and wanted share some anniversary observations! The valve is working great and at 71 years old, I have resumed all my pre-surgery activities and will end this year with over 3,300 miles ridden on my road bike post surgery. Looking back, I’ve had time to reflect on how thankful I am for the great surgical and ICU team of doctors, nurse practitioners, and nurses that shepherded my early days of recovery. While a consistent theme on this site is how routine and safe open heart surgery is, the myriad of detailed processes and actions that have to all come together in a coordinated fashion for success is impressive and shouldn’t be taken for granted. I found that working through some of the psychological aspects of recovery was as hard as the physical recovery. Can I push my valve during exercise? What’s that random twinge in my sternum? Is my heart rate OK? Will my post-op aFib come back? As the year ends, all of these thoughts have subsided though tend to still pop to the surface at times. I also found it necessary to advocate for myself and my goals with both my GP and cardiologist when it came to medicines and dosages. They had me on a prophylactic dosage of metoprolol because I had had post-surgical aFib despite no detected aFib subsequent to 30 days post surgery. When I suspected that the metoprolol was causing leg muscle fatigue and making me dread going out for a bike ride, I worked with them to wean me off of metoprolol. They supported my risk analysis (risk of aFib coming back versus cutting back on the cycling hobby which has been so crucial to my overall health and weight control) for which I am grateful. To sum up my anniversary feelings for those facing surgery , and as many have said on this forum, focus on what you can control (attitude, fitness, following post surgery instructions, putting full effort into cardiac rehab) and you’ll end up with a successful surgical outcome….

 

[3mm]

Bill - Great news! I had my surgery 3 months ago, so you provide a vision of what I think I may experience during the next year.

 

[Chuck C]

Congratulations and thanks for sharing your experience and insights. That is always helpful to others

I also found it necessary to advocate for myself and my goals with both my GP and cardiologist when it came to medicines and dosages.

When I suspected that the metoprolol was causing leg muscle fatigue and making me dread going out for a bike ride, I worked with them to wean me off of metoprolol. They supported my risk analysis (risk of aFib coming back versus cutting back on the cycling hobby which has been so crucial to my overall health and weight control) for which I am grateful.

I like the relationship that you have with your GP and cardiologist. In my view it is vital for patients to self advocate. Good that they took your points into consideration and worked with you to get you off of metroprolol. I had a very similar situation with my cardiologist and he worked with me to wean me off both amiodarone and metroprolol. Our relationships with our physicians should ideally should be such that these things can be discussed, with the physician listening to the feedback and concerns of the patient. Well done and good for your physicians as well.

 

[morellib]

I’m blessed with a medical team that listens to what my goals are willing to adjust their recommendations to help me achieve them. Of course, there are times when they feel strongly about a certain course of action and once we’ve discussed it I follow their advice. I was also blessed with a surgeon who was excited to able to place the largest valve possible to assist in my cycling. Her first action when she saw me after surgery was to show me a picture she had taken of my stenotic BAV before she removed it and said the surgical team were all surprised I had thousands of miles on my bike on the crappy valve prior to surgery!

 

[pellicle]

Hi and great news

...While a consistent theme on this site is how routine and safe open heart surgery is, the myriad of detailed processes and actions that have to all come together in a coordinated fashion for success is impressive and shouldn’t be taken for granted.

its always good to be conscious of and thankful for the dilligence of the systems we have in place

I found that working through some of the psychological aspects of recovery was as hard as the physical recovery.

totally agreed! Indeed Its a mistake to simply push it back in your mind out of sight and allow it to form bad habits or things which verge on psychosis ... it can take years for them all to surface and indeed talking about it helps.

Can I push my valve during exercise?

yes ... but not in terms of pressure, but in terms of heart beat rate. So right now I'd say that your heart muscle tissue is the weak link in the chain. I'd be governed by exersize heart rate and zones. Get a training strap type watch (because they are more accurate still) and be conscious of the HR "zone" that is recommended for your age group, then push it a little tiny bit past that and see how you feel the next day in recovery.
Don't over train.

What’s that random twinge in my sternum?

mostly its just that, probably the cartilage healing where the wires penetrated it.

Will my post-op aFib come back?

it may ... but who knows.

I also found it necessary to advocate for myself and my goals with both my GP and cardiologist when it came to medicines and dosages.

well done

They had me on a prophylactic dosage of metoprolol because I had had post-surgical aFib despite no detected aFib subsequent to 30 days post surgery. When I suspected that the metoprolol was causing leg muscle fatigue and making me dread going out for a bike ride, I worked with them to wean me off of metoprolol.

well done and really good to hear.

... To sum up my anniversary feelings for those facing surgery , and as many have said on this forum, focus on what you can control (attitude, fitness, following post surgery instructions, putting full effort into cardiac rehab) and you’ll end up with a successful surgical outcome….

a message well worth sharing.

Best Wishes for an ongoing smooth recovery and also Merry Christmas mate!!

 

[HokieHaden]

Love this, Bill. Congratulations on a great first year of recovery and getting back to the things you love, like road cycling. I’m looking forward to taking you up on the offer to ride together here in the Nashville once I’ve recovered enough. Kudos also to VUMC and the well deserved shout outs you’ve given to the care team there.

Merry Christmas and a Happy New Year!