Sternal Pain 5 Weeks Post-Op.?

[Homeskillet]

As several on here know, I am now 5 weeks post-op. w. an ON-X mitral valve.

Still having a fair amount of pain in the lower right sternum area, as well as the top of the incision (still bruised & a bit swollen).

I am only taking 5mg of Oxycodone daily now (no worries about addiction - I absolutely despise taking the stuff). 2 quick questions:

(1) Is a significant amount of pain at this point in post-op. normal? Nothing debilitating, just definitely still there, but thought I would be further along by now.

(2) I have read about disunion (i.e., that the sternum bones are not growing back right). Just wondering if this is a possible cause of the on-going pain (?).

Walking about 2-3 miles per day w. ease (I usually just stop out of boredom).

Thank you in advance.

 

[harrietW]

Homeskillet
Although my incision healed very quickly like within days l had alot of lower right sternum pain for months literally but was off pain killers into my second 3rd week. Although readmitted do to other complications and back on pain meds within week 4 and for several mths afterwards.
Also at a 3 mth follow up the top incision area was still bruised and swollen. I wondered about the bone not healing as well but it did. Took along time .. hope that gives you perspective.

 

[Homeskillet]

Homeskillet
Although my incision healed very quickly like within days l had alot of lower right sternum pain for months literally but was off pain killers into my second 3rd week. Although readmitted do to other complications and back on pain meds within week 4 and for several mths afterwards.
Also at a 3 mth follow up the top incision area was still bruised and swollen. I wondered about the bone not healing as well but it did. Took along time .. hope that gives you perspective.

Yes, very helpful.


My surgeon told me I could begin doing "girl-pushups" after 10 weeks, but, at this point, the idea of any kind of "push-up" makes me shiver :Face-Crying:!


It's looking like it's going to be a lot longer recovery than I anticipated.

Thanks again.

 

[pellicle]

hey ho

remember that the sternum is a critical but thin bone. Give it time to heal and don't rush things. Take small steps fwd and none backwards. You don't want to hurt or damage the sternum while its healing (and to be honest the rest of the valve needs time to bed in too. The process of the cells growing around it to weld it in place (epithelization) takes time but eventually like ivy latches onto a wall it will be welded in place.

I know that ticks by when you're in a waiting room (looking at a clock) but soon enough it will be in the rear vision mirror and you'll stop even thinking about how it held you up.

 

[Paleowoman]

(1) Is a significant amount of pain at this point in post-op. normal? Nothing debilitating, just definitely still there, but thought I would be further along by now..

Certainly sternal pain five weeks post op is quite normal. Have you started cardiac rehab ? My cardiologist referred me for rehab around that time as he felt that might help with the pain I was still getting.

 

[Homeskillet]

hey ho

remember that the sternum is a critical but thin bone. Give it time to heal and don't rush things. Take small steps fwd and none backwards. You don't want to hurt or damage the sternum while its healing (and to be honest the rest of the valve needs time to bed in too. The process of the cells growing around it to weld it in place (epithelization) takes time but eventually like ivy latches onto a wall it will be welded in place.

I know that ticks by when you're in a waiting room (looking at a clock) but soon enough it will be in the rear vision mirror and you'll stop even thinking about how it held you up.

Okay - got it. Sure hope you're right on this one.

Getting rather annoyed w. the waiting process....but sure beats risking disunion.

 

[Homeskillet]

Certainly sternal pain five weeks post op is quite normal. Have you started cardiac rehab ? My cardiologist referred me for rehab around that time as he felt that might help with the pain I was still getting.

Thanks!

I begin physical therapy (I assume that's the same as rehab?) @ around the 7 week mark. I wanted to give the bones plenty of time to heal first.

Walking about 3 miles/day & doing extremely light toning-up work (e.g., 5 lb. curls, air squats, etc.).

Not looking forward to rehab though. I imagine it can be pretty painful (?).

 

[Paleowoman]

Not looking forward to rehab though. I imagine it can be pretty painful (?).

Not at all painful - the whole point of rehab is that you are helped to recover and helped to become confident in yourself and your healing. If you get any pain during rehab please tell the rehab nurse. Rehab isn't with regular gym trainers, it's with either a cardiac nurse or at least someone trained in cardiac sutff so they can work with people who have had cardiac surgery. If you find you're just in with a lot of heart attack survivors check that the person in charge is fully aware you have had heart surgery.

 

[Homeskillet]

Not at all painful - the whole point of rehab is that you are helped to recover and helped to become confident in yourself and your healing. If you get any pain during rehab please tell the rehab nurse. Rehab isn't with regular gym trainers, it's with either a cardiac nurse or at least someone trained in cardiac sutff so they can work with people who have had cardiac surgery. If you find you're just in with a lot of heart attack survivors check that the person in charge is fully aware you have had heart surgery.

Got it. The thing that I guess troubles me a bit is that the surgeons indicated I should be back to working out doing "girl push-ups" in 8-10 weeks.

Well, an outright miracle will need to take place for that to happen at this point! I still have to move around very carefully or the sternum screams in protest!

This seems to indicate to me a much slower recovery than anticipated.

Probably varies individually.

 

[pellicle]

... the surgeons indicated I should be back to working out doing "girl push-ups" in 8-10 weeks.

Well, an outright miracle will need to take place for that to happen at this point! I still have to move around very carefully or the sternum screams in protest!

This seems to indicate to me a much slower recovery than anticipated.

Probably varies individually.

it is totally dependent on the individual ... however some things (like bones, like the sternum {which is a bone}) normally (note word normally) follow patterns. So all things being equal your surgeon is correct.

That does not preclude pain in the mean time.

And if you ask me you've already got your miracle ... that is why you're still here not dead or dying ... :-D

PS: how many weeks are you post op now? 5? I think that you should take it as a sign that you're feeling this good that you can actually muster the energy to do stuff and muscle up to the keyboard and type.

I've read of folks here who after 5 weeks were still suffering post surgical complications.

 

[Paleowoman]

Got it. The thing that I guess troubles me a bit is that the surgeons indicated I should be back to working out doing "girl push-ups" in 8-10 weeks.

Well, an outright miracle will need to take place for that to happen at this point! I still have to move around very carefully or the sternum screams in protest!

First of all, was your surgeon a gym goer who knows all about various exercises ? My experience is that many doctors know very little about weight lifting and such like, though my rheumatologist is an ex champion power lifter, but my cardiac surgeon and my cardiologist know zero about real weight lifting. Secondly, don’'t do press ups now, you must know that push ups put a big strain on the muscles near your sternum. I’'ve read posts on here from people who’'ve not been able to do push ups for a very long time after heart surgery. There are other exercises you can do WHEN the time is appropriate - dumbbell flys are very good for exercising the chest muscles but only when you no longer have sternal pain and only with low weights at first, and not fast reps. Be really careful if you want to get back to exercising like you did pre surgery !

PS Actually your surgeons saying you could do “girl push-ups” shows they know absolutely zilch about working out - there’s no such thing as girl push-ups or man push-ups, push-ups are lifting your own body weight with your own arms - you can'’t make yourself weigh as little as a girl LOL

 

[Homeskillet]

it is totally dependent on the individual ... however some things (like bones, like the sternum {which is a bone}) normally (note word normally) follow patterns. So all things being equal your surgeon is correct.

That does not preclude pain in the mean time.

And if you ask me you've already got your miracle ... that is why you're still here not dead or dying ... :-D

PS: how many weeks are you post op now? 5? I think that you should take it as a sign that you're feeling this good that you can actually muster the energy to do stuff and muscle up to the keyboard and type.

I've read of folks here who after 5 weeks were still suffering post surgical complications.

True. Was feeling aggravated about all of this @ only 49 yrs. old a couple of nights ago - when I saw a post by a young man who just had his 7th OHS. Ummm, kinda' humbled me a bit.

Yea, 5 weeks post-op.

 

[Homeskillet]

First of all, was your surgeon a gym goer who knows all about various exercises ? My experience is that many doctors know very little about weight lifting and such like, though my rheumatologist is an ex champion power lifter, but my cardiac surgeon and my cardiologist know zero about real weight lifting. Secondly, don’'t do press ups now, you must know that push ups put a big strain on the muscles near your sternum. I’'ve read posts on here from people who’'ve not been able to do push ups for a very long time after heart surgery. There are other exercises you can do WHEN the time is appropriate - dumbbell flys are very good for exercising the chest muscles but only when you no longer have sternal pain and only with low weights at first, and not fast reps. Be really careful if you want to get back to exercising like you did pre surgery !

PS Actually your surgeons saying you could do “girl push-ups” shows they know absolutely zilch about working out - there’s no such thing as girl push-ups or man push-ups, push-ups are lifting your own body weight with your own arms - you can'’t make yourself weigh as little as a girl LOL

I know. That's why I put "girl push-ups" in quotes. No such thing, but I knew what he was referring to.

And I do understand not to put any stress on the eternal area. My goodness, I can still barely move my torso...No way I could engage my pectorals.

I am actually going to the gym now, but hide upstairs & do air squats (very carefully) & very slow lunges. Just to tone the legs.

Doing 5lb. curls & shoulder raises - again, all extremely carefully. Just cannot do much more than extremely light extremity work (nothing over 5-10 lbs). Sternum definitely let's me know if I get too carried away.

Have been a gym rat for years & years now. Lost 20 lbs. in the surgery. Going to be starting all over again.

 

[pellicle]

... Was feeling aggravated about all of this @ only 49 yrs. old a couple of nights ago - when I saw a post by a young man who just had his 7th OHS. Ummm,

indeed ... its one of the benefits of mixing with peers (like in this case those of us who've been there and done that with OHS).

If you haven't seen it this is a post of mine soon after I joined:
http://www.valvereplacement.org/foru...ges-disturbing

I think its fair to say that 5 months of "**** and scrape" surgeries, every second day getting a waterproof bandage ripped off your chest (and the attendant skin irritations), having the wound stuffed with foam (to be pulled out 2 days later), carying around a VAC pump and a pump for a PICC line filling me with Vancomyicin led me though the entire range from despair to seriously looking at my shotgun as my best remaining friend. The compounding of my other personal life problems (the deaths in the family) only exacerbated it.

debridement "surgical wound"

Vac pac

an off cut of the "foam" they pack in the wound:

quite interesting stuff actually. Its so porous that it allows the VAC to suck out the pus from deep down, and tough enough that the "cells" which grow to it (and the bacteria if they have found a "new home") can get ripped off each time they take it out (leaving it fresh and clean ... the old way was brushing).

So yeah ... perspective is always good

Be Happy

 

[Paleowoman]

Have been a gym rat for years & years now. Lost 20 lbs. in the surgery. Going to be starting all over again.

I was doing weight lifting (not girlie/Hollywood actress weight lifting) for ten years prior to surgery at a gym (a serious body building gym, no swimming pool or sauna, just weights, both free weights, machine weights with stacks and hammer strength machines which I used the latter a lot), using a high intensity technique. In a very short period after surgery all my muscles were catabolised - it was awful. I lost 4 kg (9 pounds) in a week, and bear in mind my starting weight was 48 kg (105 pounds) and I’m 5ft 4ins tall so I am not petite but just lean. I then started cardiac rehab and one of the exercises wrecked an old injury in my ankle - fast reps step down. I could barely walk for a month due to the ankle so the rehab nurse, who also hapened to be ironman enthusiast, had to give me only upper body exercises which, of course, was weight lifting and exactly what I wanted to get back to ! At first only light weights with fast reps, but when I'd finished re-hab I got back to gradually higher weights and high intensity technique. (I never got back to my pre-surgery fitness though, but that's becasue there's an issue with my new valve and, since last week I have been prohibited from doing any weight lifting for the moment). Be patient, you will get back your strength eventually but even cardiac surgeons will say that full recovery can take 6 to 12 months !

 

[epstns]

Homeskillet - I just "stumbled" onto this thread. Prior to my valve surgery, I was also a gym rat. I ran 7 days a week, lifted weights (bench pressing my own weight in multiple sets), did isometrics and floor exercises including push-ups. (Our great Uncle Sam got me started on all this in army basic training many years ago, and I never stopped.) At one time I was doing 3 sets of 60 push-ups every morning before going to work. Not bragging at all - just trying to set the stage. I was in good shape for a geezer going in to my surgery at age 63. After surgery, with all my complications, I was not cleared to even start cardiac rehab until 12 weeks after surgery. I did really well in rehab, but I couldn't even THINK about a push-up until I was nearly a full YEAR out from surgery. It was just too uncomfortable.

I'm now 6 years out from surgery (and 6 years older), and I never did get back to the 180 push-ups daily. I'm stuck at about 35 (one set) now, and use 15 lb. handweights for curls, etc., and do planks and all to stay defined. I also have given up running (knees won't have it) and have moved to an elliptical machine instead.

I guess my points are several:
1. Don't ever give up. It may take a while and you may not get back to where you were, but it will get better.
2. You're younger than I, so you have a better chance to regain fitness.
3. Don't over-do it. It may take time, but you have time to stay with it.

The worst is behind you. You have fitness wired into your mind and body. Work at things only as hard as your comfort allows. There is time. You will regain your strength. (If you want to read of some real extremes, look for old posts by gymguy. He really pushed the envelope.)

 

[Homeskillet]

Homeskillet - I just "stumbled" onto this thread. Prior to my valve surgery, I was also a gym rat. I ran 7 days a week, lifted weights (bench pressing my own weight in multiple sets), did isometrics and floor exercises including push-ups. (Our great Uncle Sam got me started on all this in army basic training many years ago, and I never stopped.) At one time I was doing 3 sets of 60 push-ups every morning before going to work. Not bragging at all - just trying to set the stage. I was in good shape for a geezer going in to my surgery at age 63. After surgery, with all my complications, I was not cleared to even start cardiac rehab until 12 weeks after surgery. I did really well in rehab, but I couldn't even THINK about a push-up until I was nearly a full YEAR out from surgery. It was just too uncomfortable.

I'm now 6 years out from surgery (and 6 years older), and I never did get back to the 180 push-ups daily. I'm stuck at about 35 (one set) now, and use 15 lb. handweights for curls, etc., and do planks and all to stay defined. I also have given up running (knees won't have it) and have moved to an elliptical machine instead.

I guess my points are several:
1. Don't ever give up. It may take a while and you may not get back to where you were, but it will get better.
2. You're younger than I, so you have a better chance to regain fitness.
3. Don't over-do it. It may take time, but you have time to stay with it.

The worst is behind you. You have fitness wired into your mind and body. Work at things only as hard as your comfort allows. There is time. You will regain your strength. (If you want to read of some real extremes, look for old posts by gymguy. He really pushed the envelope.)

Ok - will look into this.

But, as already mentioned, I can tell that it will be a lot longer than 8-10 weeks to start doing push-ups or any torso engagement.

Like you indicated about yourself, I can't even think of it right now w.out grimacing :confused2:!

 

[Protimenow]

When I had my valve surgery, nearly 26 years ago, the subject of cardiac rehab never came up. Either they didn't have it, or they didnt offer it, or I just didn't know about it. The suggestion to walk was ablout all the cardiac rehab that I got.

There's a book called 'You are your own Gym.' It's not the best writnig (or editing) in the world, but there are a lot of exercises that might be useful post-op without the risk of ripping stitches, or overstressing the sternum, or doing other bad things to you. It's probably downloadable.

Healing from OHS takes time. You'll get there.

 

[Homeskillet]

I was doing weight lifting (not girlie/Hollywood actress weight lifting) for ten years prior to surgery at a gym (a serious body building gym, no swimming pool or sauna, just weights, both free weights, machine weights with stacks and hammer strength machines which I used the latter a lot), using a high intensity technique. In a very short period after surgery all my muscles were catabolised - it was awful. I lost 4 kg (9 pounds) in a week, and bear in mind my starting weight was 48 kg (105 pounds) and I’m 5ft 4ins tall so I am not petite but just lean. I then started cardiac rehab and one of the exercises wrecked an old injury in my ankle - fast reps step down. I could barely walk for a month due to the ankle so the rehab nurse, who also hapened to be ironman enthusiast, had to give me only upper body exercises which, of course, was weight lifting and exactly what I wanted to get back to ! At first only light weights with fast reps, but when I'd finished re-hab I got back to gradually higher weights and high intensity technique. (I never got back to my pre-surgery fitness though, but that's becasue there's an issue with my new valve and, since last week I have been prohibited from doing any weight lifting for the moment). Be patient, you will get back your strength eventually but even cardiac surgeons will say that full recovery can take 6 to 12 months !

Yes, I am seeing that this is going to take a lot longer than I anticipated. Was back to bench pressing after 5 weeks of the minimally invasive OHS (my first surgery)....not gonna' happen this time.

Know what you mean about the muscles catabolizing. In 10 short days the diff. was absolutely night & day.

 

[Homeskillet]

When I had my valve surgery, nearly 26 years ago, the subject of cardiac rehab never came up. Either they didn't have it, or they didnt offer it, or I just didn't know about it. The suggestion to walk was ablout all the cardiac rehab that I got.

There's a book called 'You are your own Gym.' It's not the best writnig (or editing) in the world, but there are a lot of exercises that might be useful post-op without the risk of ripping stitches, or overstressing the sternum, or doing other bad things to you. It's probably downloadable.

Healing from OHS takes time. You'll get there.

Ok - book sounds just like what I've looking for. Beginning physical therapy next week, but don't think that's the same thing as cardiac rehab.

Thanks for tips.