Post Op..what to expect?

[Mitral-Man]

My first post! Quick history: 45 year old male. While pre testing for surgery last summer, my ekg came back showing a problem. Surgery would be canceled unless doctor cleared me. He did and I had two vertabrae in the neck fused. While in the hospital I asked for a cardiologist to step in. He did and ordered me a non-tread mill type stress test. Had that several weeks after discharge. I then was ordered an echo. Had that. Then a chest x-ray. Then the last test, the TEE. Results of that came back in mid Dec. Cardio said I need an operation. He sent me to a surgeon and he looked at the tapes and other info. He said, I need to have this fixed asap. Seems I have a significant mitral valve problems. He descibed the leaflets as bumpy and at least partial tears in the chordes. When I seen him in early Jan 2007 he said this should be done fairly soon and he suggested sometime before Valentines day. So we settled on Jan 30. Yes, I know, it is fast approaching. Went to the hospital for a pre-op interview last week to get everything finalized. I am sure I am like everyone else who is or has faced Open Heart Surgery. I have my concerns and worries. But I look at it this way. There is not a dang thing I can do during the repair/replacement procedure. My job comes afterwards in the ICU/Critical Care unit and later in the hospital room. I thought the ICU experience would go off without a hitch. It still may but during the pre-op interview and reading the info packet I was given by the nurse, I cringe on what to expect in there. First off, the air tube will still most likely be installed for several hours after. Me, I am an easy gagger. The nurse prewarned me of this tube and all other hookups I will be on. She also said my arms and hands will be tied down to prevent me from disturbing the tubes and wires. One question I have is it possible to breath easily, while awake, with that tube down your throat? I can almost see me in a panic. I know that must sound like the dumbest worry I can possibly have at this point but that is what I am wondering. I wish I would be in a deep grogginess long enough as to where I would wake up without having any tubes down the throat. What can I really expect in the ICU? Other than that, I think I am ready enough. My job is to basically lay there til the operation is over then recover the best I can. Thanks, Gary

 

[Ross]

Honestly, it's not as bad as your imagining. You'll be so sedated for the first 24 hours that even if you should wake up with the tube in, your not going to be awake long enough to panic. My best advice to you is to try to get your mind together (very hard to do when coming out of anesthesia) and breath with the cycling of the ventilator. Don't try to breath against it. Some people have it removed while they are still out. Hopefully yours will be too.

You'll have pacer wires, drain tubes, the breathing tube, most likely a swaz/gans catheter in just below your collar bone area, bladder catheter. You'll be kept pain free as possible, but slowly weened off the heavy duty pain killers in favor of Tylenol or something of that nature. The first couple days are the roughest for most people, but after that, each day gets better and better. Your sternum, if you go full incision, will be very sore for about 2 months, so you'll want to be holding on to pillows for dear life when you have to cough or sneeze. Pray that you don't have to sneeze!!! Lord you feel like your coming apart. You'll have a breathing device to excercise your lungs and keep you free from pneumonia. Everyone hates it, but it's a must. Just think of it as something that must be done and when your done with it, your method of destruction is up to you, shoot it if you'd like too.

Day number 2 they'll probably get you up and walking. You most likely won't have all the tubes removed, so go slow and easy. Usually the drains and such are removed between 24 and 48 hours after surgery, depending on how things go. Your only job from here on out is to breath, walk, sleep and eat.

Really it sounds terrible, and to a point it is, but it's nothing at all what your imagining. There is a thread going on now where one of our members had a Ross procedure and had the whole thing photographed. You may want to see it to get an idea. I'll post the link.

Welcome aboard.


There are four pages, so be sure you use the navigation arrows at the top to see them all:

http://stretchphotography.com/avr/images

You may want to check this online book out. It explains all:

http://cardiacsurgery.ctsnetbooks.org/

 

[Chrish]

Mitral-man,

Your concerns are not without merit. I think we all focus on some aspect of what we "know" is going to happen and let that aspect grab hold in our mind. Mine was the thought of being 36 years old with with a giant scar on my chest and never being able to get back to being me. Since the surgery, I've come to realize everything will be fine. As for the tubes and bells and whistles, I can tell you that you will be so well medicated that you won't even know what is going on. I have a very vague memory of being in ICU post op. I knew my hands were tied down and I knew I had a tube in my throught but I couldn't really feel anything and I didn't have much engery (or I was just really drugged up) to care all that much about it. My wife tells me that I asked to have the tube removed and the nurses said it wasn't time yet. My response was, "ok, whatever, no big deal."

All that said, the best advise is go in with a smile, make some jokes, and let your family know you'll be ok. I found it made everyone's anxiety level so much lower. When your an ICU.. look out for the hickups. Those are far worse than any tube or constriction.

Best of luck.

Chris

 

[CathyK.]

Gary - I am so glad you asked that question. That is the one thing that has been bothering me also. I have surgery scheduled for Feb. 9th and am okay with everything else, but waking up on the vent worries me. I want to wish you luck and thank you for easing my worry also. Godspeed!

 

[michellep]

hi Gary,
I just had an avr on January 12. Everything is very fresh in my mind. Ross decribed the first fews days very accurately. You will be so drugged up that the tube will not be a problem. Mention it just before you go into surgery to the nurses and your short gag reflex. I awoke to mine still being in my throat. I began to gag and they removed it instantly. It was a moment of panic, then it was over. I don't really remember much else of that day.
There is a wonderful presurgery thread started about 3 weeks ago by Ruth on how to prepare your home and pack for the hospital. The members of this forum gave Ruth and I really good advice on how to prepare our homes for our return. I did everything they suggested including buying a large, ugly recliner. Let me tell you, I am glad that I did.
Ross, maybe you can give him a link to that thread? Ask questions, those of us on the other side of the mountain are willing and anxious to continue the good work started on this website long ago.

 

[jeffp]

The vent tube is not the worst but it's still no fun. Some folks wake up while it's still in, others it's out before they're up. I remember it being in there and signaling to the nurse that I wanted to write. I was too goofed-up to hold anything but did manage to use my finger to write in the air "wet lips" because they were so dry. The best advice I can give you is to resist the temptation to fight it and try to gauge your breathing to the machine. Try to relax and go back to sleep if you wake up with it still in. In my case, after I woke up the second time, the next shift nurse was not as accommodating as the last one. I gave her a nasty look and a "less than polite hand gesture" and she took the tube out. (I did apologize to her the next time I saw her )

 

[WayneGM]

Welcome aboard. While not a walk in the park, OHS was not nearly as bad as I pictured in my mind. In fact, I was pleasantly surprised about how "not bad" the experience was.

In my case, I don't remember the tube down the throat myself, but my wife saw me with it. She said while it certainly looked uncomfortable, she knew I had no idea as I was so "out". What's been said above is pretty accurate. The pain meds work wonderfully.

All the best.

 

[hensylee]

The only thing I remember when the tube was still in was the sight of my son's tearful eyes staring into mine. He was so upset about all the tubes and paraphernalia attached to his mother. I recall nearly nothing else. When I woke up the tube was gone. Even if you wake up during this period, you may not remember it later. Those drugs are forgetterers.

 

[Mitral-Man]

re: Post Op...what to expect?

re: Post Op...what to expect?

Thanks for all the posts. I had a chance to read them all. I hope I experience nothing with the tube like the majority of you had. When I say I gag easy, I gag just looking at a tooth brush! No, not that bad, but I do have a light refex. 3+ days to go. I'll be sure to post again when I am back on my feet. Thanks again.....Gary

 

[perkicar]

Waking up!

Waking up!

Hey Gary,

Countdown to surgery! I can hardly believe it's been nearly two years for me!

I remember waking up with the tube in and being pleasantly surprised at it not bothering me. The worst part was having a really dry mouth and not being able to get them to give me a swab so I could moisten it! I was on for maybe two hours, I remember hearing them talking about CPAP then a NIF test (to see if you can breathe deeply enough and blow out enough), then they suctioned me and pulled out the tube. The hard part for me was being a nurse and knowing what was going on, so I kept listening for the words that told me they were going to extubate me! After the tube came out it was just lying around watching TV and enjoying the ice chips. They got me out of bed the next morning, and moved me to the floor that afternoon. I got up and walked as soon as I could.

You'll do fine--we'll all be waiting for you on this side of the mountain! Don't forget to have some to post for you so we know how you're doing!

 

[marciemarine]

I went in to my surgery in November and the thing that most worried me was that ventillator tube. I decided that worrying about it wouldn't change anything, except maybe my anxiety level, so I said a prayer about it and left it to God. Anyway, when I came to in the ICU, my tube was already out! I was excited to be awake, alive and no ventillator tube! I hope it's as easy for you. The meds they had me on made me feel no pain too, so I was a happy camper.

 

[Phyllis]

Welcome and I put you on the calendar for the 30th. Wishing you the best and hope you will have someone post and let us know how you are doing. Best wishes,
Phyllis

 

[aussigal]

Welcome Gary...
I am also one who has a very good gag-reflex...and yes I did wake-up distressed...so I thought I would post of my memories but I dont have any , I didnt even know I woke up distressed . I asked my family what happened and this is what I was told ...apparently my ICU nurse just pushed the button that instantly drugged me off to sleep again...so I actually dont remember any of the yucky bits...pretty good I reckon!

All the very best for the 30th.

 

[Magic8Ball]

Well i guess everyone is different and i too was worried about the breathing tube when i came around like yourself.

When i did come around it was still in and i swallowed a little hard but didn't gag...

You really are drugged up so well that the time just passes by and nothing really bothers you...i had all manner of tubes pulled out including the breathing tube and it was no biggie....i certainly didn't experience any mental distress over the whole thing...

Its not the pulling of a small tube out of a big hole you should be worried about but the pulling of a big tube out of your nether regions just kidding, the catheter caused me more worry but again was no biggie to have removed.

You'll be sweet.

Best of luck buddy.

 

[davidfortune]

Another thread discussing waking up and post-op...
http://www.valvereplacement.com/forums/showthread.php?t=19403

Best of luck,

David

 

[Susan BAV]

Hi Gary -

Welcome to the site! I'm wondering if you will even see this; your surgery is so soon! Everyone is different but this past heart surgery, the ventilator was extremely traumatic for me. I won't go into detail but if and when there is a next OHS for me, I will ask for Versed (verced?) which will disallow a patient to remember the possibly unpleasant experience.

I read here and remembered to ask for pain medication before they pulled the drain tubes out so that didn't hurt. I don't know about pacer wires; some here said it was icky but I don't even know if I had them or if/when they may have been removed if I did.

My kidneys didn't work real well for the first few days and/or my blood pressure was too low then and I didn't get on a regular floor until the fourth day, surgery day being the first day. The fourth was also the first day that they got me up at all. A lot of people here were gotten up the same day as OHS though.

Your first few hours post op, after the vent is removed, you will be begging for ice chips. They know how much you can have and if they give you too much, you might vomit. That would be highly unpleasant.

Just a few high/low lights! Take care!

 

[Adrienne]

I have to say honestly that it was not that bad - not that I would like a repeat experience - but I was mentally prepared for the breathing tube, and besides I was only awake a few minutes with it, and the next thing I remember they were removing it. As long as I didn't move, cough, take a deep breath or sneeze, it didn't really hurt. It was just sore. I would say that the worst part for me was that the first couple of days I kept vomiting, even when there was nothing to vomit. Also, just the fact that the first couple of nights, I didn't dare try to turn on my side to sleep, I basically stared at the ceiling all night. I really can't sleep on my back. In general, though, I was just so happy with the results of the operation that I just said to myself "O.K. I'll just put up with this".

 

[davidfortune]

No disrespect Adam - I am sorry that you have had alot of pain. But I do want to present the other side. I had virtually no pain. Soreness yes but not significant pain. The pain from my knee surgery was much worse (I would wake up crying for codeine every 4 hours after knee surgery).

After my Ross procedure, I took one morphine shot in ICU (given to me by the nurse before I was coherent enough to object). The rest of my pain management (or soreness management really) was vicoprofen at four hour intervals for the first day, six hour intervals the second day, ten hour intervals the third day, 12 hour intervals days 4 - 7. Days 8 - 14 I took them before bed just to get great sleep.

I had a pericardial effusion diagnosed on day 14 which sent me back to the hospital for 25 hours. That wasn't fun but not really painful either (mostly feeling very bloated, SOB, and muscle weakness with fever). After the pericardiocentesis (draining the fluid from the pericardium), I felt great. That procedure wasn't a blast but I did get to argue with the cardiologist while on the surgical table (that's another story for another time) since he didn't give me enough versed (bad for him). Even that extra day was really just frustrating and inconvenient. As soon as the catheter was removed - I felt awesome. I walked 2 miles when I got home that day.

Was OHS fun? Nope. Would I like to do it again? Nope. Do I hope my valve choice precludes the need for another OHS? Yes most definitely! Was it my worst surgical experience? Nope not by a long shot. My knee surgery was much more painful and debilitating than my OHS has been. Please know I'm not trying to minimize the significance of OHS - I'm just relating my experience. Everybody is different. It isn't a surgeon thing either. Adam had the same surgery I did - by the same surgeon and has had MUCH more pain than I have.

I guess I'm blessed (lots of people praying) or lucky but my experience hasn't been near as bad as I imagined. I don't want to do it again but it wasn't the worst thing I've ever been through.

By week three I was walking 3 miles. I wasn't limited physically - I just only had enough time to walk three miles each day. I was working pretty much full time from home (minus my walking time and maybe a short nap). By week four I was ready to drive, quit my naps, and was definitely putting in more than 40 hours a week working from the house (really enjoying the light work week). Week 5 - I finally got my post-surgical followup appointment and got to drive. I was working full time for me (i.e. about 60 hours a week).

Good luck to all,
David

 

[Mitral-Man]

reost Op...what to expect

reost Op...what to expect

Whew! I am back! Was released from the hospital this afternoon, day 6. Will make a quick post now at this computer location (my sisters) until I go back home in a few days. Well, my Gag fear came into play but just barely. I remember being yelled at not to chew on the tubes! I wish I could see the photo my brother was about to take of me while laying there with my tounge hanging out and all the tubes still in but he said the nurse insisted no photos were allowed Like many of you, I was in and out of it most of th day but I remember hearing the rythym of the ventilater alarms were better if I breathed better on my own. I made them sing as fast I could. Only then was I instructed to cough so the ventilation tubes could be removed. Thank goodness for ice too. Couldn't get enough. Almost had too much as I remember a quick dry heave and the comment of a med going in to prevent any more. Was taken out of Critical Care the next afternoon. Day 3 is when I had my wires yanked out. I wish I was more prepared for that. Then again, maybe not. I think I actually felt them being ripped from the heart surface when she told me to take a deep breath and let it out......deeply. Day 3 was my best day until today. I had to deal with bloating, water retention etc. The actual pain of the surgery has been fairly light. The hicupps and sudden coughs still get me and I dread the day a sneeze sneaks up. All the hospital staff at the Medical Center, Beaver Pa. pulled me right along.

The final outcome of the 5 plus hour surgery is still to be known. A 1 1/2 hour repair attempt was made but the final solution to all the damage was a St Jude mitral replacement. And due to the enlargement of the heart, the largest one available was able to be sewn in, barely.

So it is a little scarey still and I will try to reach that 2 week, 3 week, few month and year goals like everyone else. ....Later, Gary

 

[Phyllis]

So glad to see you posting, Gary. Welcome home- well almost home. You know the mantra- sleep, walk and breathe and we look forward to hearing that you are having a speedy and uneventful recovery.