Post Surgery tips

[BrownEyes]

I had less than great chest tube removal experience for surgery #2. So for my 3rd surgery, I was determined to ask for something to take the edge off before they were removed when the PA came in to do it. She said not to worry, that she was really good at it and I believed her.
It went smoothly, no pain at all. And I had 4 tubes for the 3rd surgery. (2 for #1, 3 for #2).

Do they have to add stitches after they pull them? Or just put a bandage on?

 

[Gail in Ca]

No, she didn’t add stitches after pulling the tubes. Only a bandage.

 

[dornole]

Tube removal no big deal for me, not painful and I felt a lot better after they came out. Easier breathing and way easier to move around.

 

[d333gs]

I had a full sternotomy, but I slept on my side the first night after my surgery. My chest never hurt from the sternotomy. I don't move around after I go to sleep, which allowed me to position myself so everything was comfortable enough to sleep on my side. When you want to sleep, position yourself in bed while someone is still in your room. Have them help arrange the various IV lines, IV trees with saline bags, drain tubes, nurse call button, etc. Then they can turn off the lights and CLOSE THE DOOR so you can sleep!


You may be able to reach up within a few days after surgery. I could. I was allowed to shower 6 days after surgery, and this included washing my hair. I just had to limit the weight I lifted when my arms were above my head or away from my body. This does vary for different people.


I started cardiac rehab 2 weeks after surgery. I think that is normal.

"My chest never hurt from the sternotomy" That is amazing.

 

[d333gs]

I had a mini-sternotomy. Instead of the full cut, they cut about 3.5 inches at the top of my sternum. Having said that, I would now say that I am probably more in the camp that a full sternotomy is better, in order for the surgeon to have better access and less time on the heart and lung machine. The less invasive procedures have shown to require longer operating times and more time on the heart and lung machine, which is not a good thing. The advantage of the mini was that my wound healed faster, but it really did not help me get back to sports any quicker. The limiting factor for that is the healing which needs to occur in the heart from being sliced and sutured. The mini procedures don't help with that. Not talking about TAVI, to be clear.

I should add that when I made that call, the anesthesia had worn off enough that I had some mental clarity, but not so much that I yet felt any pain. About 3 hours later, it had worn off to the point that some pain was kicking in and I would not have wanted to make any calls at that point.

Thanks Chuck,

 

[Colo Artist]

Do they have to add stitches after they pull them? Or just put a bandage on?

For me the surgeon did two sets of stitches for each tube. One to hold the tube in and the other a "purse" stitch. Once the first set was removed with the tube the second was pulled tight to close the incision.

 

[V__]

Do they have to add stitches after they pull them? Or just put a bandage on?

A PA placed stitches on my after the tube removal. They used surgical glue for all other incisions. I guess our mileage does vary

 

[Zoltania]

I didn't have stitches, but my chest tube incision spot was leaking clear fluid for nearly three weeks. I had to keep it covered using gauze and surgical tape.

 

[danielwoz]

Age seems to really matter here, so with the preface I'm 42,

1. I was a side sleeper too, there really is no chance of sleeping on your side for ~10 weeks. I didn't like it but its not the worst of it...

2. I got a sponge on a stick for like $3. It was great. Highly recommend. Its hard to shower but its not getting out of bed hard For the first week you should get use to the idea that a Nurse is likely neccesary to clean you in all regards.

3. Like most have said there are different levels. They will get you walking or standing up as soon as they possible can. A body at rest tends to stay at rest (Newton was a smart man)... The chest gym / strength rebuilding component is probably 10-12 weeks out. I didn't really get to *start* using my chest/pecks successfully until week 12. Your mileage may vary.

4. I'm a software engineer, started writing code on day 3, went a little too hard (1 hour) too early and had an anxiety / heart racing episode when I fell asleep sitting up. You'll be able to do it pretty early but don't over estimate your ability to situp straight in the first 2-3 weeks for too long at one time. I was coding 8 hours a day by week 4.

I highly recommend finding a psychologist for the first 12-16 weeks, it has weird (well documented) affects on your brain, more predominantly for people under 60. The severe depression and anxiety events went away (almost magically) after week 14ish, but my doctor gave me the advice to start early because its normal to happen but if it sticks around (rare) you've got the psychology sessions to help justify the necessary psychiatric help. Just having a stranger to talk to about the weird experience that OHS is, was really helpful, even if I was ultimately fine.

 

[LondonAndy]

Side sleeper here, too, and hate sleeping on my back! But I found an electric recliner really helped - you can make very small adjustments to the angle and get comfortable, which I found I had to do frequently at first.

My surgery was over 10 years ago now, and the first 10 days after I was stuck in hospital as I ended up needing a pacemaker too, owing to surgical complication. Once I got home I think it was 2 to 3 weeks before I started gently trying to sleep on my side. So that's at least 3 to 4 weeks after surgery. You will know if you can manage side sleeping by how much pain you get (or not) as you get into bed! Ideally, leave it for six weeks.

I had no trouble using a desktop computer sitting normally at a desk soon after I got home. I wonder if wanting to use a laptop if it is worth getting a Bluetooth keyboard you can use, so that the laptop can sit on a nearby table and you just have the keyboard on your lap if in the chair?

Though don't forget that you will not be able to concentrate for long during recovery. They did a cardiac nurse lead briefing for patients just before surgery, and the way they described it is that the body is very clever, and redirects energy to the wound to effect repairs. But as the brain is the biggest user of energy in the body, that is deprived of energy the most. So don't expect to work more than about 20 minutes at first, before wanting a break. They also advised not to take any big decisions in the first six months after surgery, as you won't completely think right!

If interested in UK hospitals, I now come under "Barts", or St Bartholomew's Hospital, in the City of London, which is categorised as a "centre of excellence" for all things cardiac, and has amazing facilities.

 

[newarrior]

Well it is surprising, in most cases, it is the incision that takes all the recovery time. If it is a simple AVR your heart is pretty well fine right out of the box although it takes it some time to adjust to its new free-flowing valve.

What adjustments regarding the valve? Thanks

 

[newarrior]

Age seems to really matter here, so with the preface I'm 42,

1. I was a side sleeper too, there really is no chance of sleeping on your side for ~10 weeks. I didn't like it but its not the worst of it...

2. I got a sponge on a stick for like $3. It was great. Highly recommend. Its hard to shower but its not getting out of bed hard For the first week you should get use to the idea that a Nurse is likely neccesary to clean you in all regards.

3. Like most have said there are different levels. They will get you walking or standing up as soon as they possible can. A body at rest tends to stay at rest (Newton was a smart man)... The chest gym / strength rebuilding component is probably 10-12 weeks out. I didn't really get to *start* using my chest/pecks successfully until week 12. Your mileage may vary.

4. I'm a software engineer, started writing code on day 3, went a little too hard (1 hour) too early and had an anxiety / heart racing episode when I fell asleep sitting up. You'll be able to do it pretty early but don't over estimate your ability to situp straight in the first 2-3 weeks for too long at one time. I was coding 8 hours a day by week 4.

I highly recommend finding a psychologist for the first 12-16 weeks, it has weird (well documented) affects on your brain, more predominantly for people under 60. The severe depression and anxiety events went away (almost magically) after week 14ish, but my doctor gave me the advice to start early because its normal to happen but if it sticks around (rare) you've got the psychology sessions to help justify the necessary psychiatric help. Just having a stranger to talk to about the weird experience that OHS is, was really helpful, even if I was ultimately fine.

Thanks helpful

 

[d333gs]

Thanks helpful

What adjustments regarding the valve? Thanks

Chances are your heart became muscle-bound from forcefully pumping blood through a size restricted valve opening. All of a sudden your heart has a new and much bigger valve opening to pump blood through. The bigger valve offers much less resistance to your pumping heart. Think about what the resistance of bicycle pump feels like when you are filling a tire and then , all of a sudden the hose pops off the valve: no resistance. That is what the heart has to adjust to. I had afib the first week although I did not notice it. Also at about 8pm each evening, my heart would start to pump slower and harder until it would get down to 38 beats per minute. That lasted about two weeks. It was a bit scary at first.

I was very lucky to have been in a rehab facility with about 20 other OHS people .
There was always someone to compare notes with, which relieved a lot of the stress.

 

[JoeWanderer]

Chances are your heart became muscle-bound from forcefully pumping blood through a size restricted valve opening. All of a sudden your heart has a new and much bigger valve opening to pump blood through. The bigger valve offers much less resistance to your pumping heart. Think about what the resistance of bicycle pump feels like when you are filling a tire and then , all of a sudden the hose pops off the valve: no resistance. That is what the heart has to adjust to. I had afib the first week although I did not notice it. Also at about 8pm each evening, my heart would start to pump slower and harder until it would get down to 38 beats per minute. That lasted about two weeks. It was a bit scary at first.

That's a perfect description for aortic valve stenosis. Some people like me, though, have severe regurgitation without any blockage (at least so far). After surgery the heart will have to adapt somewhat since it won't need to do this "slingshot" movement to deal with the blood leaking from the valve. However, it seems (from what I read) that it's a less complicated healing process when compared to stenosis cases. I'll find out soon enough ...

 

[d333gs]

That's a perfect description for aortic valve stenosis. Some people like me, though, have severe regurgitation without any blockage (at least so far). After surgery the heart will have to adapt somewhat since it won't need to do this "slingshot" movement to deal with the blood leaking from the valve. However, it seems (from what I read) that it's a less complicated healing process when compared to stenosis cases. I'll find out soon enough ...

You are absolutely right! I would love to hear from people who had severe regurgitation.
Thanks for pointing that out!!!
When is your surgery?

 

[Chuck C]

Think about what the resistance of bicycle pump feels like when you are filling a tire and then , all of a sudden the hose pops off the valve: no resistance. That is what the heart has to adjust to.

That's a good analogy.

 

[JoeWanderer]

You are absolutely right! I would love to hear from people who had severe regurgitation.
Thanks for pointing that out!!!
When is your surgery?

Next month, probably. Health insurance approval still pending. It's not being considered urgent so I'm not too worried - the major annoyance is not being able to plan for the rest of the year (vacation travel, for example), since recovery can vary, and we never know if there will be any complication from the surgery.

It's a bit of a "twilight zone" feeling for me since I've been very physically active in the last few months, and some of the symptoms that I'd previously felt that were pointing to a symptomatic case of regurgitation have (mostly) subsided - however the echo numbers are clearly in the "severe" category and, as my surgeon pointed out, they're not getting any better - while surgery risks tend to increase with age.

I'll certainly report on my experience after surgery, it's the minimum I can do since this forum has been so helpful!