PDF from STS What to expect after OHS

[newarrior]

Jason you want to stay out of Hot Tubs and any steam baths etc as that puts added strain on the heart ......you will find you get tired in any EXTREME situation either hot or cold

Is this a permanent thing where we need to avoid that or only shortly after the surgery? I haven't been in a hot tub since I got diagnosed with moderate aortic valve stenosis 3 years ago

 

[Chuck C]

Is this a permanent thing where we need to avoid that or only shortly after the surgery? I haven't been in a hot tub since I got diagnosed with moderate aortic valve stenosis 3 years ago

Hey Newarrior.

Greg made that post over 11 years ago, so I'm not so sure that you will get a reply. But, personally, I was given no instruction to avoid hot tubs or saunas and I do both. I can think of no reason why someone who has a prosthetic valve needs to avoid hot tubs. In fact, I enjoyed a hot tub twice this past week and I'm still here to talk about it.

 

[pellicle]

Hey Newarrior.

Greg made that post over 11 years ago, so I'm not so sure that you will get a reply. But, personally, I was given no instruction to avoid hot tubs or saunas and I do both. I can think of no reason why someone who has a prosthetic valve needs to avoid hot tubs. In fact, I enjoyed a hot tub twice this past week and I'm still here to talk about it.

I've been to sauna more than a few times too

 

[PAN]

Hey, just to be avoided while healing up so the wound is kept clean.. Take advice from the hospital about getting back into a tub/pool...

P

 

[newarrior]

Hey Newarrior.

Greg made that post over 11 years ago, so I'm not so sure that you will get a reply. But, personally, I was given no instruction to avoid hot tubs or saunas and I do both. I can think of no reason why someone who has a prosthetic valve needs to avoid hot tubs. In fact, I enjoyed a hot tub twice this past week and I'm still here to talk about it.

Hey thanks man--In 2011 it was stated that too much heat puts pressure on the heart...my doctors here in Thailand have said the same thing--they may be referring more to pre op patients like myself..I know that a lot of heat can also spike blood pressure

 

[carolinemc]

Hey, just to be avoided while healing up so the wound is kept clean.. Take advice from the hospital about getting back into a tub/pool...

P:

Doctors and surgeons have always advised us of that. Due to the chlorine and germs in the tub/hot tub/pool.

 

[newarrior]

I want to go walking in the pool

 

[newarrior]

I've been to sauna more than a few times too

Awesome !!))))))))))))))

 

[Chuck C]

Is this a permanent thing where we need to avoid that or only shortly after the surgery? I haven't been in a hot tub since I got diagnosed with moderate aortic valve stenosis 3 years ago

To be clear, I did not do hot tub or sauna for at least 3 months after surgery. Make sure to ask your surgeon and/or cardiologist when you can start resuming activites such as hot tubs and follow their guidance to the T.

 

[pellicle]

I want to go walking in the pool

well I'm pretty sure you'll need to NOT do any swimming at all for at least 8 weeks, too much strain on the sternum.

After that the skin will be healed and the skin is the primary barrier to infection. So you should be fine.

I'm going to say you should be doing walks every day, a few times a day from the first day out of hospital.

I don't know what your valve choice is, but I'm going to say (having known you here for some years now) that you should pick a tissue valve, I'll venture that the Edwards Resilia is probably the best bet. At your age it should see you out. Especially given your anxiety levels you are psychologically not a good candidate for a mechanical NOR managing your INR properly.

Best Wishes

 

[newarrior]

Jason you want to stay out of Hot Tubs and any steam baths etc as that puts added strain on the heart ......you will find you get tired in any EXTREME situation either hot or cold

How long after surgery do we need to avoid saunas/hot tubs ?

 

[newarrior]

I looked to see if this is listed somewhere but didn't find it (its from 09) but there is a pretty good PDF put together by the "The Society of Thoracic Surgeons to help answer some questions that patients and their families often ask after heart surgery or, sometimes, before their surgery so that they are better prepared for recovery. Remember: If your doctor's instructions differ in any way from those listed here, always follow your own doctor's specific instructions"

I thought it was pretty good and mentions alot of things people ask about that doctors don't think to mention, like the lump /bump at the top of the incision (yes it is normal) your taste may be off, trouble sleeping ect
http://www.sts.org/documents/pdf/whattoexpect.pdf

This link isn't working anymore. This is exactly what I'm trying to find.

 

[MdaPA]

This link isn't working anymore. This is exactly what I'm trying to find.

After 14 years since the OP posted that link, you can expect that things may have changed/moved around a bit.

Perhaps this is the link to the doc you were looking for?

What to Expect After Heart Surgery

 

[pellicle]

After 14 years since the OP posted that link, you can expect that things may have changed/moved around a bit.

I don't think david looks at things carefully ... be it dates, be it advice, be it anything. Then there's the issue of processing.

 

[newarrior]

After 14 years since the OP posted that link, you can expect that things may have changed/moved around a bit.

Perhaps this is the link to the doc you were looking for?

What to Expect After Heart Surgery

After 14 years since the OP posted that link, you can expect that things may have changed/moved around a bit.

Perhaps this is the link to the doc you were looking for?

What to Expect After Heart Surgery

.

 

[newarrior]

Scary AF

 

[newarrior]

Jason you want to stay out of Hot Tubs and any steam baths etc as that puts added strain on the heart ......you will find you get tired in any EXTREME situation either hot or cold

For how long after surgery?

 

[SatoriFound]

I wanted to ask the forum about resources and perspectives they have used to cope with long-term post-surgical cognitive changes. I would like to learn what has helped others remain positive and hopeful. I thought I would also share things that have helped me over the last two years; I have already been asked for this information by multiple people, so I thought I should post it. This should probably be a new topic but I am not authorized.

The 'What you can expect after surgery' pamphlet stated that the patient might experience short-term memory loss, which as it turns out does not mean ‘short-term/temporary loss of memory’ but ‘possible permanent damage to short-term memory’. I was told my cognitive problems would dissipate with time, but later was told, maybe not. Newman showed that after five years long-term cognitive decline was experienced by 42% of cardiac patients http://www.ncbi.nlm.nih.gov/pubmed/11172175.
An article by Wang is a good jumping off point for people to discuss risks and preventive steps with their surgeon or cardiologist, Postoperative Cognitive Dysfunction: Current Developments in Mechanism and Prevention http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206478

There are at least three things going on at the same time, which make it difficult to deconstruct and understand cognitive change:
1. The brain injury
2. The surgical insult, manipulation of the heart in particular
3. Adaptation to a 'new' heart, specifically cerebral blood pressure regulation

Several cognitive issues were immediately obvious to me post-surgery. The crippling anxiety was gone, leaving me with eerie silence in my head. I had a strange abundance of oxygen. And I could neither feel nor hear my heart beating. It turns out that people who hear their hearts are different from those that do not. It turns out there is a not too often mentioned role of the heart in cognition.
http://www.bbc.com/future/story/20141205-the-man-with-two-hearts

The post-surgical referral process takes persistence:
One month after surgery I asked my primary medical provider for a neuropsychological test (4 hrs); she performed a Mini-mental status exam (MMSE) (10 min). Cardiac rehab started at almost two months, where I realized I could not remember any instructions. I went back to work two months post-surgery. My cognitive/emotional stress became more of a problem as I recovered from the surgery, and my provider recommended antidepressants. I serially tried four of the standard medications, the side-effects to each being intolerable. I was referred to a psychiatrist who suggested that a brain injury may be the issue. She ordered the neuropsychological test and referred me to a neurologic physiatrist (9 months post-surgery). He ordered a CAT scan to ensure I had not had a major stroke. He recommended exercise, Tai Chi, light social interaction, dietary supplements and probiotics, acupuncture, afternoon naps, and meditation. He referred me to an ophthalmologist because I was having difficulty processing visual information. He referred me to a speech therapist who usually works with people who have had strokes (12 months post-surgery), and the speech therapist helped me distinguish what cognitive abilities I had lost. She helped me to stop comparing myself to who I had been before, and helped me let go of that person. Physical therapy stressed tests showed that my blood pressure increased to 250/157 with light elliptical machine exercise; seated bicycling was ok. It took me about a year to get the referrals I needed.

What is short-term memory loss mean?
I strain to compile information in a way that helps make sense of the world. Short-term or working memory is the compiler, and if the compiler is too small, context is easily lost. My most vivid post-surgery memory was looking at a tree, which looked to me almost two-dimensional, as if it were a drawing by a child on a white background.

Reading is difficult. When I look at text, I see only letters. I have lost whole word recognition and struggle with acronyms. I have trouble following speech when proper nouns are not repeatedly used; pronouns are hard.

I carry ear-plugs and sunglasses because of sensitivity to light and noise. I try to avoid busy highway driving. I become exhausted by mental strain. I find I can loosen that knot with humor, naps and meditation. Dopamine triggers vasodilation and reduces vascular inflammation.

Diet:
Although they appear to help with the stress and fatigue, the foods to avoid (alcohol, caffeine, salty foods, sweets/refined sugars) accelerate neurological decline. The link below has reasonable dietary advice for people with TBIs but does not replace a dietician.
http://www.brainline.org/content/20...brain-nutritional-tips-to-speed-recovery.html
Dietary supplements are not all good or equivalent, but I have found the following helps manage stress and inflammation:
Probiotics
Tinctures of hawthorne and lemon balm
Curcumin/Tumeric
Unsweetened electrolyte drinks



Brain injury resources:
Brain injuries are all different but the best literature I can find in terms of treatment relates to post-concussion syndrome (PCS). Where rest and cognitive adaptation used to be advised, it is recognized that deconditioning may lead to symptoms of depression. The second link below (Leddy et al) "Concussion is associated with metabolic and physiological changes in the brain and in other organ systems (for example, autonomic function of the heart and altered cerebral autoregulation, sleep, and circadian rhythms). We propose that PCS results from ongoing central and systemic physiologic regulatory dysfunction after traumatic brain injury (TBI) and we further propose that this physiologic dysfunction may be reduced or alleviated by individualized controlled sub-symptom threshold aerobic exercise rehabilitation"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784364/
http://www.ncbi.nlm.nih.gov/pubmed/17917170

Michael Ellis wrote a good summary article in Brain Injury "Physiological, vesticulo-ocular and cervicogenic post-concussion disorders: An evidence-based classification system with directions for treatment" 2015. It emphasizes the importance of sub-threshold aerobic exercise treatment to improve cerebral blood flow. The article discusses associated vision problems, but Brainline has an easier to read article:
http://www.brainline.org/content/2011/03/vision-and-rehabilitation-after-brain-trauma-part-1-.html
or at the Neuro-Optometric Rehabilitation Assoc (NORA): https://nora.cc/
(under Patients)

Support of brain injured:
TBI Consumer Report: Coping with Post-TBI Emotional Distress
http://www.brainline.org/content/20...ping-post-tbi-emotional-distress_pageall.html
Cognitive rehabilitation article at the Brain Injury Resource Center
http://www.headinjury.com/rehabcognitive.html
Traumatic Brain Injury Survival Guide
http://www.tbiguide.com/
Mild cognitive impairment: Tips for living well with memory/cognitive impairment
http://alzonline.phhp.ufl.edu/en/reading/mciarticle.pdf
Spiritual Care handbook on PTSD/TBI, US Navy. The stages through which patients move as they heal are articulated in the handbook
http://www.militaryconnection.com/assets/pdf/Spiritual Care PTSD Handbook.pdf

I know you posted this years ago, but tonight, sitting in ICU with my husband recovering from his heart surgery I am enriched. I just had a long interesting discussion with his nurse on cognitive issues post surgery and some of the things I just read and I'm trying to figure out if I can feel my heart beat.

Something I found interesting. My husband was ALWAYS aware of his heart. I asked if he could hear the ticking from his new valve. He said no. I put my head onto his chest and heard a tiny, almost not there, tick tick. Such a small noise. While before it was loud and powerful, sort of a whoosh. I guess that was his murmur, his heart having to work harder to do the same thing another heart did. I had told him his heart was the strongest heartbeat I had ever felt or heard and now it's basically gone. I wonder if once the fluid drains away and the different areas of swelling in his body go down if he will still feel his heartbeat? And after I read this I wonder what it will mean if he doesn't... I guess we will find out.

 

[dick0236]

Take his recovery "slow and easy" and do not try to "eat the entire elephant in one sitting". It seems that his recovery is going along smoothly and for that be grateful. If he is like the majority of us, he will be up and living a normal life for many, many years. The issues he might experience shortly after surgery will fade away.......but it may a little time, but maybe not. After 57 years since my surgery I'm still sharp, even tho my wife might argue that point sometimes.

Ps: I haven't heard my heart beat for 5 decades.......at least!