Questions regarding AVR

[FredW]

Hi Folks,

Been reading and monitoring posts on this site for the past month and find it very helpful. I'm a 72 year old male and have been monitoring my Aortic Stenosis for the past two years. Just recently, it has progressed where surgery may be coming. Due to symptoms and my valve area going to .8, my cardiologist scheduled a catherterization test which I understand is one step toward surgery. In trying to get better prepared and my expectations set correctly I have been doing my own research on OHS and the recovery afterwards. This site has helped a lot. There are some questions however that I have both leading up to having the surgery and regarding recovery at home after the surgery.

The main question I have before surgery is what criteria is used to decide when to have it done. My cardiologist told me when the valve us .8 or lower, surgery should be planned. However, my echo tests show the mean gradient to be 31, which put the stenosis in the moderate category. My concern is that my symptoms (shortness of breath, chess pain, dizziness) have increased a lot in the past six months and I know that once one is in the serious category, the odds of life expectancy are not favorable. So, I'm in a mindset that, given the choice, I will rather have surgery sooner than later. Also, being I am much more active in the summer than winter, I figure I may recover soon enough to cut grass this summer.

As for after surgery, I understand that sleeping in a bed may be an issue and see many find it best to sleep in a recliner or Lazy-boy chair. Wonder what those of you who have gone thought this may advise as to what type of sleeping furniture is best. Also, how much personal care does one need the first few weeks after they get home? My wife can help, but she can not lift me, plow the driveway, shovel snow or mow grass. I have a son who is offering to come help and he is asking how long should he plan on staying. Is it true you can't drive for weeks?

If any of you want to share your feedback, I would appreciate it.

Wishing you all a happy new year and those of you who are having surgery soon, speedy recovery.

Thanks
Fred

 

[Paleowoman]

Hi Fred - welcome to the forum !

Yes it's true they like to do surgery before serious symptoms set in as that means there may be left ventricular hyprotrophy from which the heart may have a hard job recovering. My valve area size when I had surgery was 0.9 but the mean pressure gradient had reached 68 which put me in the severe category. I didn't have any symptoms at all though prior to surgery.

As for afterwards - I slept on our sofa with large pillows propping me sitting up. We have a very comfortable sofa which is very suitable for sleeping on, and it was nice being in the living room as, to be honest, you don't sleep so well the first few weeks so being able to potter around in the night without disturbing anyone else in the house was very nice. I would come online to the forum as I live in the UK and all the US folks here were up and about when we on this side of the pond were supposed to be asleep I had my mobile phone next to me and could contact my husband who had his mobile phone next to him in the bedroom in case I needed anything. After about five weeks I was able to lie down for an hour or two each night and progresed from there until I was able to sleep in a proper bed lying down all night. You will not need to be lifted by anyone or need any help that way - they won't let you out of hospital until they know you can get in or out of your bed or sofa or recliner by yourself, and until you can climb stairs fine. You're not meant to lift anything much heavy at the start. You'll also probably get very tired easily so need a nap in the daytime. Make sure your GP knows when you come out of hospital so that if you need anything he can help.

all the best !

 

[honeybunny]

Hello, Fred. I ditto what Anne said about sleeping and getting around after surgery. I bought a Lazboy power lift chair specifically for post surgery and it helped though it was hard to get truly comfortable anywhere. I didn't have any pain but your body has undergone trauma and that affects many things, including sleep.

I don't think your son will need to stay more than a couple of days to assess your situation unless you and your wife want him there for support (which is important). My daughter lives with me and she took a week off work to be around 24/7. After she returned to work as a flight attendant she was here 3-4 days a week. I was able to shower, make coffee and light meals, simple things when she was gone. I had a set back due to pleural effusion that took three weeks to clear up and I was still able to return to work by week 8. I was driving locally a week before that.

For your main question, I was stunned by my diagnosis in late May of this year. After all tests were done, stenosis was shown to be severe. My cardio said it wasn't an emergency, that it would need to be done within a year. I asked the surgeon to have it done as soon as possible for insurance purposes and I went in on September 30th. I would think you could have it done at any time as long as your insurance company approves it.

Try not to worry about chores. I know it will be difficult to be inactive when snow needs shoveling, but your concern is recovery, and anything "heavy" you do during that time will delay recovery. Maybe you can arrange for snow shoveling with a neighborhood teen.

Best us luck and keep us posted on how you are doing. We care.

Michele

 

[skeptic49]

Hi Fred,

Welcome to the forum.

It took a mild heart attack/stroke combination caused by my stenotic bicuspid aortic valve in my case to prompt the surgery, because my numbers were not quite in the severe range. Bottom line: have the surgery earlier if you can. You are symptomatic and that should be enough regardless of the numbers to get you a ticket to the OR.

Best thing I did was to rent a power lift recliner. In my case not so much because of pain or difficulty sleeping, but after 13 days in the hospital and two OHS I was extremely weak and barely made it home. The power lift chair is a life saver since it will enable you to get up and sit down by yourself in addition to providing a comfortable place to rest and sleep. Another thing to get: a toliet seat extension...once again...it will make it easier for you to get up and down from the potty. Make sure you have a shower/bath seat and a detachable shower head hand held spray so that you can shower with comfort.

I needed my husband to prepare meals for me and help me with some basic chores for a few weeks.

Hope this advice is useful.

Jim

 

[FredW]

Thanks for the iformation and tips

I will say waiting is not fun, especially when your heart constantly reminds you that it needs fixed.

However it has gotten me off the couch to get my will, advanced directive, and some projects done that I won't be able to do after surgery. Is this normal or am I overly concerned?

 

[honeybunny]

A few of us commented on the preparation topic here: http://www.valvereplacement.org/for...-could-literally-be-days-away-from-open-heart. I was in a much better place emotionally and mentally once I got my ducks in row so to speak. So to answer your question, you are very much normal. It's all about making things as easy as possible for those we leave behind. And we WILL leave them behind one day.

 

[cldlhd]

I think it's normal to want to get things in order even though the likelihood of not making it is low .I was 45 when I had my surgery and I still got some things straightened out just in case. It's a good idea even if you're not having surgery, it's not pleasant to think about but we're all going to go one day and having things in order makes a difficult time a little easier for loved ones. Just don't dwell on the possibility.
I second skeptics recommendation of renting a power lift . I slept in bed some the first week home but more often I slept in the recliner not just for my sake but for my wife as I wasn't always sleeping well.