Post op complications

[Rainbow]

My husband had an AVR on the 9th July. He was discharged and we came home a week later. He was pleased to be home but gradually became more breathless and unable to complete the planned light exercise routine. He had no appetite and to put it in his words at the time “felt like ****!” Last Friday I decided there must be something more than just post op tiredness going on. I rang the cardiac rehab nurse at our local hospital, told her what was happening and she told me to bring him straight to the hospital. When we got there they did an echo and everything got crazy. He had pericardial effusion fast approaching tamponade. Translated this is fluid build up around the heart with the pressure slowing and eventually stopping the heart from beating. They inserted a drain and got him into the emergency helicopter back to the city where he had the AVR done. They told me he wouldn’t be alive now if I hadn’t called the nurse and gone in. He came home today and is a lot better than he was since before the op. The message here is NEVER ignore anything that doesn’t seem right post op. They don’t mind if it’s a false alarm, rather that than have a tragedy. If you've been breathless before the op you may just accept it as the norm. Don’t! Go get it checked out.

 

[Seaton]

My husband had an AVR on the 9th July. He was discharged and we came home a week later. He was pleased to be home but gradually became more breathless and unable to complete the planned light exercise routine. He had no appetite and to put it in his words at the time “felt like ****!” Last Friday I decided there must be something more than just post op tiredness going on. I rang the cardiac rehab nurse at our local hospital, told her what was happening and she told me to bring him straight to the hospital. When we got there they did an echo and everything got crazy. He had pericardial effusion fast approaching tamponade. Translated this is fluid build up around the heart with the pressure slowing and eventually stopping the heart from beating. They inserted a drain and got him into the emergency helicopter back to the city where he had the AVR done. They told me he wouldn’t be alive now if I hadn’t called the nurse and gone in. He came home today and is a lot better than he was since before the op. The message here is NEVER ignore anything that doesn’t seem right post op. They don’t mind if it’s a false alarm, rather that than have a tragedy. If you've been breathless before the op you may just accept it as the norm. Don’t! Go get it checked out.

Great you made that call @Rainbow. Fantastic you got your husband to hospital in time for the medical team to act promptly.

And sound advice from you to never ignore anything that doesn’t seem right post op.

Wishing your husband a smooth and positive recovery from here on in. And all the best to you, too.

 

[user 16827]

Well Done Rainbow

Remind him constantly that he 'owes you '

 

[Duffey]

Your husband’s experience is why I suggest everyone weigh daily for 6-12 weeks post-op. Fluid build up in the lungs or around the hearti is a fairly frequent complication following valve replacement and the scales will show it early on. I’m glad you figured it out in time.

 

[Protimenow]

This is great advice. Like the others, I'm glad that you reacted in time, I'm glad that the nurse you spoke to knew what to say, and I'm really glad this resolved for you.

I hope he fully recovers --- quickly and easily.

 

[pellicle]

...
The message here is NEVER ignore anything that doesn’t seem right post op.

They emphasize this to you when you leave hospital here.

Glad it all worked out well.

Stay observant and pay attention for some time after. It's not like buying a new appliance, heaps can go wrong. (Even with the new appliance actually)

Which is why I always wish people an uneventful recovery.

 

[LonMel]

Congrats on his recovery! I was told that @10% of AVR get pericardial effusions as a complication. I fell in to that group! Fortunately I was not far from the hospital and @12 days after my surgery I was admitted for a "window" the next day. Walking, I felt like I was a 90 y/o man!
The night before was the worse of my life, felt like my heart would bounce out of my chest with no relief and no response to the call bell!
After the surgery I was a new man!

 

[Superman]

I don’t have data to back this up (sorry @pellicle), but it seems like fluid buildup post op is becoming more common. Based on my anecdotal experience between 1990 and 2009, it seems like they are way overdoing the IV fluids during and post up.

I don’t recall weighing any different pre and post op the first time. In 2009 I woke up after surgery 15-20 lbs heavier than my pre-op weigh in. I had fluid buildup post op as well just trying to get rid of it all. Fortunately I didn’t need to go in and be drained, but a friends husband did and he was relatively healthy going in otherwise. In his 30’s and athletic.

 

[pellicle]

I don’t have data to back this up (sorry @pellicle),

de nada ;-)
(and anecdotes dressed as anecdotes are perfectly acceptable, its when the attempt is made to dress them as predictable outcomes I ask for data)

 

[pellicle]

.... Fluid build up in the lungs or around the hearti is a fairly frequent complication following valve replacement and the scales will show it early on..

just out of interest would that show it up much?

 

[Rainbow]

Your husband’s experience is why I suggest everyone weigh daily for 6-12 weeks post-op. Fluid build up in the lungs or around the hearti is a fairly frequent complication following valve replacement and the scales will show it early on. I’m glad you figured it out in time.

He was weighing every second day and actually lost weight. They drained about 1500 mls of fluid off. I'm not sure how much that would weigh, maybe it's 1.5kg? It certainly didn't register on the scales but I suspect that's because he wasn't eating as he didn't feel well.

 

[pellicle]

... They drained about 1500 mls of fluid off. I'm not sure how much that would weigh, maybe it's 1.5kg?

yes, it would be about that. 1L of water = 1kg (near enough without going full ISO temperature and stuff)

 

[JAMES W]

I too experienced a plural effusion post AVR. Was discharged feeling worse than ever. It went downhill from there. Returned to my surgeon for followup. He admitted me to ER immediately, where an echo showed near tamponade. They drained 1800 ml of bloody fluid from around my heart. Here I was at home unable to breath, remembering my discharge nurse telling me to use the “spirometer faithly” or I would not heal well. Well ****, damn near killed me. I didn’t know how I would feel post op, so waited too long.
Be your own advocate. You should feel better very soon after. This is probably the most major surgery of our lives. Don’t take it lightly.
This was 16.5 years ago for me. Thankfully I knew something was amiss. Peace and heal well my friends...!

 

[Duffey]

just out of interest would that show it up much?

I’m not sure why Rainbow’s husband appears to have lost weight. Perhaps he was measuring his weight by the hospital scale and there was a difference in what the scale at home measured? In any case, weight gain of more than two pounds over 24 hours would be enough to cause me concern. I seem to remember having gained around three pounds when I started experiencing a sharp pain when I breathed deeply. I think I had been home about ten days. I went in to the cardiologist and the pain was from a pleural effusion. Diuretics and steroids fixed it.

 

[Penny2003]

I too had complication of tamponade after AVR in 2003, my aortic Valve was replaced by a Medtronic Mosiac Porcine. Valve. I went home from the hospital on blood thinners which would be discontinued within a month or so. I started feeling short of breath and having swollen ankles a couple of weeks later. To make the long story short I had a pericardial window and spent another 5 days in the hospital. My doctor said I had 12 ounces of blood that had to be drained out. My heart was under a lot of stress. Mine was because of my body’s response to the warfarin. It was a setback, but it’s now been 16 years and I’m beating the odds for longevity of my valve!

 

[Duffey]

I too had complication of tamponade after AVR in 2003, my aortic Valve was replaced by a Medtronic Mosiac Porcine. Valve. I went home from the hospital on blood thinners which would be discontinued within a month or so. I started feeling short of breath and having swollen ankles a couple of weeks later. To make the long story short I had a pericardial window and spent another 5 days in the hospital. My doctor said I had 12 ounces of blood that had to be drained out. My heart was under a lot of stress. Mine was because of my body’s response to the warfarin. It was a setback, but it’s now been 16 years and I’m beating the odds for longevity of my valve!

Way to go on #16!

 

[gerrychuck]

I’m not sure why Rainbow’s husband appears to have lost weight.

Weight change post-op can be very dramatic and could easily hide the relatively small change in weight from the effusion. When I went into the hospital ER I weighed 195 lb. 4 days later when they managed to get me upright for my first post-op weigh-in, I was 220, or 100 kg. After that I lost 1 kg/day on Lasix, and at discharge less than 2 weeks later I was 169. I had a pleural effusion that had to be tapped and drained for a week, but the weight if that fluid was insignificant compared to the massive amount of fluid my body had taken on and was in the process of eliminating, as well as the significant drop in actual body mass. I remember at 220 I basically couldn't bend my knees due to my elephant like swollen legs. It wasn't a good look. Anyway, that would be my theory!

 

[Rainbow]

I’m not sure why Rainbow’s husband appears to have lost weight. Perhaps he was measuring his weight by the hospital scale and there was a difference in what the scale at home measured? In any case, weight gain of more than two pounds over 24 hours would be enough to cause me concern. I seem to remember having gained around three pounds when I started experiencing a sharp pain when I breathed deeply. I think I had been home about ten days. I went in to the cardiologist and the pain was from a pleural effusion. Diuretics and steroids fixed it.

He lost weight because he wasn’t eating! He just felt unwell and everything tasted bad. He kept saying he would feel better soon, that it was just what you have to go through. I wasn’t convinced so that’s why I rang the hospital. It was the breathlessness that concerned me rather than any fluctuations in weight. I guess we need to be conscious of all of these signs that something is amiss.

 

[Duffey]

He lost weight because he wasn’t eating! He just felt unwell and everything tasted bad. He kept saying he would feel better soon, that it was just what you have to go through. I wasn’t convinced so that’s why I rang the hospital. It was the breathlessness that concerned me rather than any fluctuations in weight. I guess we need to be conscious of all of these signs that something is amiss.

I think most of us went through that stage of not eating, food didn’t taste appetizing and naturally we lost weight as a result. What I found puzzling in your husband’s case was that his weight loss was so much that it prevented anyone noticing the weight gain from the fluid buildup. Sudden shortness of breath is something that should always be reported following surgery since it can also indicate a pulmonary embolism. I’m glad it all worked well for your husband and you.

 

[carolinemc]

@Rainbow thank goodness you were with him. I was one week out myself when the visit nurse went over my INR and notices too low in my numbers and had me go back to the hospital for vitamin k shots. Hated going back, but was glad it was a short visit. Ain't had to go back since.