Severe Aortic Regurgitation Leading to Second Surgery

[skier]

Congrats! I'm 5 weeks tomorrow and started Cardiac Rehab this past Friday.

My 3 struggles at this point are

1) Musculoskeletal pain in the chest as my muscles, nerves, and whatnot are trying to come together.

2) Getting my lung capacity back. I can get my spirometer to 2500cc right now. But that's my current limit.

3) Pretty tired most of the time.

How are you doing with those 3 things?

My walking is good like yours. I'm doing 2.5+ miles a day.

First, it sounds like you are doing fantastic!. Everyone is different!

This is my second open heart surgery, and this time has been easier than five years ago for whatever reason. Don't worry too much about where you are. Just keep doing what you need to do, and you'll keep improving.

Where I'm currently at four weeks out:

1) Pain control is manageable with acetaminophen. I'm taking 3300-3600 daily on schedule, and it hurts pretty bad if I'm late. I've been off the narcotics during the day since week two and just took my last little pill at night. I'm not asking for more.

2) Spirometer is up to 3500. I was at 4000 before surgery, so I'm getting close. I need to do it more, as I've been slacking.

3) I'm also tired. I'm trying to get more sleep at night and take a nap every afternoon. I'm not always successful at those and pay the price.

For context, I went into my surgery in great shape. My docs attribute that to my quick recovery, even beginning in the OR. They extubated me and woke me up in the OR rather than the ICU because I was doing so well, something they rarely do. I was also sitting in the chair five hours after surgery, and it sounded like that was a record or close.

After my first surgery (also in great shape), I wasn't up in the chair until the second day, and it was a horrendous experience. Getting to the chair the first day was unthinkable. Moving to the chair the second day was so painful my heart actually stopped from bearing down! When I came to, there were like 30 people in the room and a crash cart open in front of me. A little epinephrine in my swanz ganz catheter and cranking up the external pacemaker got me going again. Good times!

 

[Timmay]

First, it sounds like you are doing fantastic!. Everyone is different!

This is my second open heart surgery, and this time has been easier than five years ago for whatever reason. Don't worry too much about where you are. Just keep doing what you need to do, and you'll keep improving.

Where I'm currently at four weeks out:

1) Pain control is manageable with acetaminophen. I'm taking 3300-3600 daily on schedule, and it hurts pretty bad if I'm late. I've been off the narcotics during the day since week two and just took my last little pill at night. I'm not asking for more.

2) Spirometer is up to 3500. I was at 4000 before surgery, so I'm getting close. I need to do it more, as I've been slacking.

3) I'm also tired. I'm trying to get more sleep at night and take a nap every afternoon. I'm not always successful at those and pay the price.

For context, I went into my surgery in great shape. My docs attribute that to my quick recovery, even beginning in the OR. They extubated me and woke me up in the OR rather than the ICU because I was doing so well, something they rarely do. I was also sitting in the chair five hours after surgery, and it sounded like that was a record or close.

After my first surgery (also in great shape), I wasn't up in the chair until the second day, and it was a horrendous experience. Getting to the chair the first day was unthinkable. Moving to the chair the second day was so painful my heart actually stopped from bearing down! When I came to, there were like 30 people in the room and a crash cart open in front of me. A little epinephrine in my swanz ganz catheter and cranking up the external pacemaker got me going again. Good times!

Thanks Skier! Like you, I went into surgery in good shape. So happy you replied because context is so darn important.

1) I haven't taken a single pain killer since I left the hospital. Nothing. So now I don't feel so bad if you say "it hurts pretty bad if I'm late".

2) WOW! Your spirometer is rocking it. I am extremely impressed. I don't know what I pulled prior to surgery. They didn't tell me. But, when I did the test the guy said that I scored at the top (whatever that means). This makes me think something else might be going on. I did have some weird issues on my final X-Rays before release and my cardiologist ordered some more to check in on those (small right pneumothorax). Hopefully it is nothing at this point.

3) I haven't napped in the middle of the day at all since I left the hospital. I feel like I want to but the body won't comply. I am getting OK sleep at night. My fitbit says almost 7h each night ... but it's not consistent time. More like 4-5h. Up for an hour. Then back to sleep for 2h or so.

So far the fastest walk I have done is at a 18min / mile pace. That's slow by previous standards of mine ... but I tell ya ... I really feel like I am moving when doing that!

Thanks again.

 

[skier]

1) I haven't taken a single pain killer since I left the hospital. Nothing. So now I don't feel so bad if you say "it hurts pretty bad if I'm late".

Given you mentioned pain as one of your primary concerns, is there a reason you haven't taken any pain killers?

I feel very normal as long as I stay on top of my acetaminophen. If I don't, I'm pretty miserable at four weeks out.

I get not wanting to be on narcotics. They make me feel like crap, and I got off them as soon as possible. I don't understand being uncomfortable when acetaminophen might make the pain go away?

I'll also add that I think pain killers are crucial for working the spirometer. That's been true since the first day using it in the hospital, and the same deal at home.

 

[Timmay]

Given you mentioned pain as one of your primary concerns, is there a reason you haven't taken any pain killers?

I feel very normal as long as I stay on top of my acetaminophen. If I don't, I'm pretty miserable at four weeks out.

I get not wanting to be on narcotics. They make me feel like crap, and I got off them as soon as possible. I don't understand being uncomfortable when acetaminophen might make the pain go away?

I'll also add that I think pain killers are crucial for working the spirometer. That's been true since the first day using it in the hospital, and the same deal at home.

Cool questions! First, I am not in pain for any significant amount of time. And when I do feel pain it's a 3-ish. Example, my half hour walk this AM I maybe felt some 'pain' for about a total of 20s (couple seconds here, couple seconds there)? Maybe . I feel pain when laying down for bed and getting up out of bed. I feel pain when standing up after sitting down for a long period of time. I feel pain when taking deliberate HUGE breaths that expand my chest. I feel pain when doing a movement that is somewhat out of the range of what I should be doing. HOWEVER, the "pain" is fleeting lasting only seconds and is only at a level of 3-ish. Nothing that really matters so much to cause me to take pain killers.

The significant, overwhelming majority of the time I have no pain. So why did I ask? Because I've never been through OHS w/ full sternotomy before and I don't really know what is normal and what is not. I literally know someone who had a full sternotomy from the same hospital and same surgeon ... and hasn't felt any pain whatsoever during their recovery. Like Wow. All in all, I am happy, doing well, and super thankful

As to why I shy away from pain killers: I had an episode about 4 years ago that put me in the ER. I had taken Advil ALL of my life. Never any issues. Came home from work with a really bad headache, took Advil, and napped. Woke up from my nap with a ballooned face. Had a friend rush me to the ER for fear of the ballooning causing my airway to close. So, never again.

 

[skier]

Happy New Year!

I'm bumping my original thread as I've been skiing the last three days and felt great with my new St. Jude mechanical valve. Seven months out from surgery, I'm not quite 100% yet, but getting close. I'll share a few pics.

From the top of Copper Mountain, Colorado:

My son and I skied steeps:

And deep:

Thank you to everyone for all the fantastic advice I've received here.

We are off to a fantastic ski season in Colorado. If anyone is skiing Copper or A-basin this season, shoot me a pm!

 

[Beach77]

Beautiful pictures! I know the feeling you had, I had the same when I did a huge hike in the Sierra's 5 months after my surgery! It was beyond words I was feeling! So happy for you!

 

[Chuck C]

Happy New Year!

I'm bumping my original thread as I've been skiing the last three days and felt great with my new St. Jude mechanical valve. Seven months out from surgery, I'm not quite 100% yet, but getting close. I'll share a few pics.

From the top of Copper Mountain, Colorado:

View attachment 888971

My son and I skied steeps:

View attachment 888973

And deep:

View attachment 888972

Thank you to everyone for all the fantastic advice I've received here.

We are off to a fantastic ski season in Colorado. If anyone is skiing Copper or A-basin this season, shoot me a pm!

Excellent! Glad to hear that your St Jude is holding up to the skiing! So much for the myth that those with a mechanical valve can't be active, lol.

 

[pellicle]

that those with a mechanical valve can't be active

or tolerate the cold...

 

[skier]

What? Nobody told me!

 

[skier]

What about altitude, say 12,400 feet?

That's my heart rate and elevation skiing today!

 

[skier]

I should add that I'm doing this with the approval of my cardiologists. I don't want anyone to think I'm crazy or to do the same without the blessing from your doc.

I was in pretty good condition going into my surgery and have worked my butt off since surgery. I completed thirty sessions of cardiac rehabilitation and have continued to exercise since.

I'm also fortunate that my sports cardiologist is the lead author on the guidelines for exercise at altitude for people with heart disease:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649141/pdf/JAH3-10-e023225.pdf
He's being cautious and wants me to keep my heart rate below 140 until I do a VO2 max test in a couple of weeks.

 

[d333gs]

BRAVO! Skier!

 

[treichert0312]

It’s a different story in Ohio…. I need to make it to CO! Replacement to On-X in June for Father’s Day, been running a fair amount after the rehab bit. Got the green light from the doc to go for it, so back on ski patrol and hustling the toboggan down the hill. Headed to Killington end of the month for the steeps & bumps as part of “Patroller School!”

 

[treichert0312]

Oh and I ALWAYS ski with my helmet. There’s tons of beginners that have no clue how to stop willing to take you out - sort of like taking warfarin - really good idea.

 

[d333gs]

Treichert, ". I need to make it to CO! Replacement to On-X in June" 2023? or was it 22?

 

[BillDaThrill]

View attachment 888976
It’s a different story in Ohio…. I need to make it to CO! Replacement to On-X in June for Father’s Day, been running a fair amount after the rehab bit. Got the green light from the doc to go for it, so back on ski patrol and hustling the toboggan down the hill. Headed to Killington end of the month for the steeps & bumps as part of “Patroller School!”

Hey fellow patroller - and On-X valv'er!!! How cool to hear of you doing well. I got my On-X about 18 months ago. We're still waiting for snow at my mountain (skipajarito.com) but I did patrol last year with it and did many toboggan trips. Wishing you a great season - enjoy Killington, that's where I learned to ski 40 years ago. I got a trip to UT in a few weeks for 6 days of skiing at Alta, Snowbird, and Snowbasin.