Small Setback- Pericardial Window

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dwhist

Well-known member
Joined
Dec 30, 2011
Messages
169
Location
Elmhurst, IL
I have been more of a watcher on the list, but thought I would post my last weeks experience and get more involved. Post op stress test and echo at 7 weeks showed me to be doing great. I was working out an hour each night with no problem. I had started rehab and they saw no issues with the workout.

During the holidays I only had rehab once a week and noticed I was slowing down. In week 9, I noticed the hour workout now became 1/2 hour and I was tired all of the time. At work I have choice between elevator and stairs and for the 2 floors I always take stairs. I started noticing I was out of breath at the top of the stairs. Something that did no happen before the valve replacement. In week eleven I called and got in to see cardiologist. I told him I felt like I was going backwards in recovery. He looked at tests and said everything looked ok and sounded ok. He had me go for blood test and ekg. Weekend came and went and I got a call at work on Tuesday from nurse who put me on with doc. He said he wanted me to leave work and go straight to hospital for ct scan and not to leave till results come in. Got there at noon and they took me right in. Told me to wait in waiting room and not to eat anything. Around 2 another hospital tech came in and said she was there to take me for echo. That was completed and I was told to stay in waiting room and doctors nurse would be over to see me. They were in same building. And I was not to leave the building. I called my wife and parents to let them know something was up. As I was sitting there I suddenly noticed the beds of my finger nails were blue.

The nurse came over and said doctor wanted to admit me. I asked what was up and she said he wanted to keep an eye on me as there was some fluid around the heart. So, she took me to admitting. I was put in a room and 3 nurses came in and 1 started asking questions and the other 2 tried putting inan iv. They tried 7 times without success. My parents showed up first as they live nearby. Another nurse then stuck her head in the door and said to the other nurses surgery had called down and asked why they did not have me up there. Then the surgeon who did valve came in and told me that they had found some fluid around the heart and he was going to go in and take it out and was going to put in a Pericardial Window. I was taken up to surgery and the anesthesiologist was able to get some iv's going. Although it took him 3 tries to get picc line in left wrist.

Surgery went well and I was put in a room and kept in hospital with a drain for 3 nights. Doctor said they took out a litre of fluid and it looked to be mostly old blood. I am wondering how long it has been there and if it was missed in 7 week echo. He explained that the fluid had built up and was squeezing the heart so it was not pumping at full volume. It looks from web search that this happens about 20% of the time after heart surgery, but is usually caught earlier and they can use needle to remove fluid.

I got up this morning and do feel better than I have in last few weeks. They told me I could go back to normal activities and just take it easy for a bit.

I needed to get this off my chest and appreciate any responses from people who may have had this happen and how the recovery went after this procedure. They are telling me it would be very rare for any new occurance.

Thanks
 
Good to hear you followed thru with your feelings, got the medical team to investigate and discovered the problem.
Did you have any wheezing with this.


now I'm looking at my finger nails and probably will for weeks :eek2:
 
I'm glad to hear they found it before you had really bad problems, but sorry it took so long to find it and help you. Its good you called and they listened to you. Altho is doesnt sound like they did that good a job talking to you explaining what was going on that day, and I'm not sure why it took so long between your blood work and EKG for the cardiologisit to check things out and call you to be admitted.
Justin had problems with pericardial effusions after a couple of his surgeries the worst was after his 2nd, but they were able to drain it altho it did come back a few times that was 20 years ago and they are much better at treating pericardial effusions at least from our experience. Did they say were the fluid was? My guess is maybe most of the your fluid was in a pocket behind your heart which is harder to see (and drain) with an echo, which could explain why your 7 week echo looked good. But that is just a guess.
Do they have you on any meds or even something OTC like motrin?
 
So sorry you had that trouble, and quite happy to hear they got it sorted for you, even if it took some pushing on your part. With this sort of stuff, outcomes count more than anything else.

Also, glad to see you haven't lost your sense of humour! ("I needed to get this off my chest"). That's important too!

Paul
 
Thanks for replies.

My wife and I feel the docs had missed this and are lucky we followed up and pushed. Doctor told me he was looking for blood clot in lungs and was surprised by fluid. We think they were not saying much because they were trying to rush me into surgery. And I was in a daze, so maybe do not remember everything they were telling me. Not sure why the 7 week echo did not show it but surgeon told my wife most of the fluid was old blood. So, I am guessing it had been there awhile. I did do a stress test about the same time and did great on it. Noticed the slow down in activity and work out in maybe week 9. This was week 11.

I did not have any wheezing, but had been coughing alot. Had been tired and going to bed early and having a hard time staying awake all day.

They did put me on prednizone for a few days as test showed some inflamation in the body and they thought it would help. Also gave me some Tylenol 3's but have not really needed them.
 
I always worry when someone post surgery is doing great, then they suddenly start getting a little short of breath, or complain of pains when taking a deep breath. Seven weeks is farther out than most, but we have had a substantial number of valvers encounter difficulties with fluid build up either in the lungs or around the heart post-op.
I'm so glad yours was caught in time, but I do think they did an awful job of explaining what you were experiencing and what they intended to do to fix it.
Best wishes for no more bumps in your recovery.
 
You explained it well. Feeling great then down hill. Doctor did say it was rare to happen this late after surgery. The issue had built up over time and not just over night. I was getting out of breath a little more each day. I think communitcation was bad because cardioligist was in his office sending messages through nurse who did not want to tell me that I had to have surgery right away. I am happy he was able to communicate to surgeon who did prior surgery so he could be right there to make the fix. I am being carful not to complain too much, because they did make it all right in the end and I feel better than I have in many weeks.
 
Glad they caught it before it caused even more problems!!!
Here's to a smooth recovery from now :)
Love Sarah xxxx
 
Hi Debbie,

They told me it was rare at 11 weeks, so I quess we were in same boat. I read your notes and the part about feeling like a rubber ball in chest was the same thing I had and I tried to explain to doctor. Mine was at the top of the sternum. The other thing my wife mentioned after the surgery was she noticed my stomache looked puffed out the night before, but she did not want to say anything. I quess the fluid was pushing everything out.

We were surprised they kept me in hosptial for 3 nights as I was in for only 4 with the valve replacement. On last day they came in and pulled the tube and told me I could go home. A week out now and except for some discomfort in belly a from surgery, no other issues. They did line the new drain hole up so with the other two, I have a smiley face.
 
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