Surgery in a week! (Mechanical Bentall)

[Deidra]

Hey everyone! Hope you're all doing well.

My surgery is scheduled a week from today (May 3rd) I'm a bit anxious of course, but overall I'm feeling good about it. I'm looking forward to being on the other side and starting my recovery. My pre-op medical appointment went well—according to them "Patient is below average risk for this procedure," which is always nice to hear.

I feel like I've gotten a good sense of the common "tips and tricks," but if anyone has any more they want to share I'm all ears!

I know my cardiologist is supportive of INR self-testing and I have an appointment with her 3 weeks after my surgery which seems like a good time to go over that kind of thing.

 

[Chuck C]

Best of luck with your procedure Deidra!

Please keep us posted on how your recovery is coming along and we'll see you on the other side!

 

[Survived03]

Good luck Diedra. Regarding last minutes tips, you have probably done everything you can at this point so leave it to the surgery team now. All the best and see you on the other side. It will be over before you realize it.

 

[pellicle]

My surgery is scheduled a week from today (May 3rd) I'm a bit anxious of course,

naturally ...

just step up to the plate and it'll all just unfold before you

See ya on the other side

 

[3mm]

my cardiologist is supportive of INR self-testing

Wonderful! FYI: Medicare requires 3 months of lab tests before they will issue a Coaguchek meter. I don't know if other USA insurance companies have similar policies.

We all look forward to hearing from you after your successful surgery!

 

[V__]

My surgery is scheduled a week from today (May 3rd) ...

I feel like I've gotten a good sense of the common "tips and tricks," but if anyone has any more they want to share I'm all ears!

Great to hear the surgery is scheduled. AFAIK mechanical Bental should be quite safe and reliable.

A week of time should be enough for the last-minute preparations. I wrote about what worked (and didn't) for me HERE. And added a pointer to the thread with a lot more information. A couple of things I missed to mention:

• Getting a recliner chair was useful (as many other people found as well). It's just easier to get in and out of it than a bed. So it's a useful option to have. Maybe not essential, but certainly useful.
• You'll need to walk regularly when you are back home after the hospital. Thinking through where/how you will do that can help. (I got extra shoes ahead of time, which are easier to put on/off. But missed to get sunhats. And I have an easy option for walking, but it depends on where you live. Using a stationary bike is an alternative, but, according to the hospital PTs, people usually don't do that.)

Good luck!

 

[LondonAndy]

Good advice already, Deidra. I'd like to add a couple of points for the recovery period, afterwards:

1. When people say get a recliner, it should be an electric one. Fortunately I already had one, and slept in it a lot. It was great to be able to make small adjustments to the angle, as sleeping can be a bit of a challenge. You will struggle to use a manual chair because of the need to avoid stressing the chest wound.
2. The biggest risk we face after surgery is infection. Don't share towels, and wash yours no more than every 2 or 3 uses, in a hot wash.
3. Be careful with well-meaning visitors. You will be tired, and want to sleep a lot. When your body says sleep, do it! Concentration span will be limited to 20 minutes or so. Keep visits short, and avoid people wanting to touch the scar!
4. If you live alone, plan your kitchen carefully, so that you don't have to reach up for plates or food supplies. It may be a while before your taste returns properly too.
5. Once the six-weeks-ish physical healing has passed, you may want to rub bio-oil into the wound to help the skin recover. I did it daily for several months, and my scar is almost invisible.
6. Protect the scar from the sun for a year. Tanning the scar will mean it stays permanently dark!

Very best wishes for the whole period. It sounds like you have a great attitude to it, and that definitely helps.

 

[Deidra]

Thank you so much for the kind words and advice everyone, really can't tell you how much I appreciate it and how much it helps <3

About the recliner, I don't really have room in my apartment for one unfortunately. I got a set of memory foam wedge pillows so I can prop myself up in bed in a reclining position. Hopefully that works, but if it doesn't, I'll see if my partner can help me figure out a recliner situation.

 

[pellicle]

. Hopefully that works, but if it doesn't, I'll see if my partner can help me

maybe just helping you up will be sufficient (if they are present)

I'm pretty sure you'll be fine. I as 48yo on my last OHS and I never used a recliner ... I still never use a recliner.

I'd say you'll be fine

 

[NorthVanJosh]

Best of luck! I am having my mechanical bental done at the end of May. Wishing us both uneventful surgeries/recoveries!

 

[3mm]

set of memory foam wedge pillows so I can prop myself up in bed in a reclining position

I suggest you experiment with using the wedges and getting up from bed with your arms "in the tube" next to your body. Do you think you can do this after surgery? If your mattress is soft, you may want a solid board next to you on the bed so you have something to push against when you get up.

My recliner was not "necessary" after surgery, and it still is not necessary.... But it is a small piece of heaven in my very own home!

 

[V__]

I suggest you experiment with using the wedges and getting up from bed with your arms "in the tube" next to your body.

I think it's an excellent advice. A bit of practice now may help later, even in the hospital. The hospital beds have rails, and there should be nurses available at all times. But a bit more "self-maneuverability" will be helpful.

 

[LondonAndy]

I think it's an excellent advice. A bit of practice now may help later, even in the hospital. The hospital beds have rails, and there should be nurses available at all times. But a bit more "self-maneuverability" will be helpful.

Admittedly my hospital experiences have been in a capital city, but I think all hospital beds here now have motorised adjustments, at least in the high dependency levels. Perhaps some other Brits can correct me.

 

[V__]

I think all hospital beds here now have motorised adjustments,

Yes, of course. I'm not saying they don't. But being able to move around can be helpful even when there are other appointments.

 

[Deidra]

Best of luck! I am having my mechanical bental done at the end of May. Wishing us both uneventful surgeries/recoveries!

Hey, good luck to you as well! <3

 

[tommyboy14]

I am sure that you will be 100% fine. I will just add something on bio oil. I used bio oil and silcon on my sternal scar the second time around.

I then got an infection on the outside of the scar. I totally freaked out and needed to have antibiotic cream on the outside, which took care of it.

So I suppose you can use these things on your scar, but need to be careful in the beginning.

I would also say the following: Moving after surgery is really important. You will get exhausted at the beginning, but the more you move the faster you will actually get better. There is also a lot of good research that says that cardiac rehag + continuing to do exercie afterwards is associated with better long-term prognosis.

Fingers crossed.

 

[Timmay]

I highly recommend going to a place like WalMart and getting 5-7 white bath towels and a couple packages of oversized white shirts.

I used one towel per shower. So, each towel only got used once and then dried and then into the hamper. All towels were washed with a little bleach to ensure they were as free from bacteria as possible.

I also did the same with my oversized white T-shirts. Granted - a lot of people will say only use button down shirts. That said - I had no issues slowly, carefully putting on or removing oversized t-shirts.

It was nice to know - for me - that everything touching my chest incision was super clean.

Definitely have slip on shoes.

If you’re walking outside then make sure you have a good big hat.

I ended up doing a lot of walking around the first floor of my house. It’s a huge oval so I would get a lot of steps in that way. I would correlate 1 lap with X amount of steps … and then X amount of steps with a distance.

I have other advice but let me say one final thing so that this isn’t too long …

** DON’T leave the hospital until your INR is in range OR there is a solid plan to stay on heparin while IMMEDIATELY (same day or at latest next day) working with someone on getting your INR in range.

My hospital (MedStar in Washington DC) released me with an INR of 1.1. With no plan. Nada. And it was a holiday weekend. I was so out of it (as most of us are but don’t realize we are) that I didn’t even really “get it”. They could have killed me. Thank God I had additional assistance from people who were concerned about my welfare and understood INR in relation to mechanical valves.

 

[3mm]

DON’T leave the hospital until your INR is in range OR there is a solid plan

Also, please validate your "plan for care after leaving the hospital" before you even enter the hospital. Before surgery, check that your post hospitalization appointments are with people who truly understand INR management. These appointments should also include the labs that will measure your INR unless you are able to perform that task immediately after leaving the hospital.

I was sent home with an appointment with my primary care physician. But she was unavailable, so my appointment was switched to a nurse practician, who did not know me, did not know my situation. and was visibly uncomfortable with INR management. We barely got me into a lab for an INR check before closing time on a Friday. Fortunately, my INR was stable and within range. But it was 10 days later before I was seen at the Coagulation Clinic where they actually understand INR management and set up my long term plan. I now measure my own INR, report it to the clinic, and they adjust my Warfarin dose.

 

[Chuck C]

Also, please validate your "plan for care after leaving the hospital" before you even enter the hospital. Before surgery, check that your post hospitalization appointments are with people who truly understand INR management. These appointments should also include the labs that will measure your INR unless you are able to perform that task immediately after leaving the hospital.

I was sent home with an appointment with my primary care physician. But she was unavailable, so my appointment was switched to a nurse practician, who did not know me, did not know my situation. and was visibly uncomfortable with INR management. We barely got me into a lab for an INR check before closing time on a Friday. Fortunately, my INR was stable and within range. But it was 10 days later before I was seen at the Coagulation Clinic where they actually understand INR management and set up my long term plan. I now measure my own INR, report it to the clinic, and they adjust my Warfarin dose.

Good suggestions.

We barely got me into a lab for an INR check before closing time on a Friday. Fortunately, my INR was stable and within range. But it was 10 days later before I was seen at the Coagulation Clinic where they actually understand INR management and set up my long term plan.

One option is that some insurance will allow for an in-home visit by a phlebotomist for a blood draw a few times after being released from the hospital. This was the policy for UCLA- that upon release they scheduled for in home lab draws, so that my INR could be checked after 2 days out of hospital and then again a few days later. Hospitals generally have a person assigned to coordinating these things and other details for your release. IIRC this person is called your Case Worker. Mine was great, and was able to find a company in my insurance network which did the at home blood draws. In theory this would have saved a lot of time and travel to the lab.

In my situation, however, the person who they sent ended up being incompetent and messed up twice, both times not drawing enough blood to allow for an INR test. He was brand new. Knowing what I know now, if I had to do it again, I would schedule with the in home testing myself and do my best to make sure the company had a good reputation. I think I just got unlucky and had a person visit me who was just hired and did not know what he was doing. Perhaps I would use the same company, but would ask for a visit by an experienced phlebotomist next time, not a newbie.

 

[LondonAndy]

This thread has reminded me of another thought that might be worth passing on: I don't know how well connected American health service sites are, but in the UK they aren't always great! I was told that an appointment had been made for me to attend my local anticoagulation clinic, but when I turned up at the appointed time they didn't know anything about it! I found it useful to always take a copy of my hospital discharge notes with me whenever seeing someone new, just to make sure they could see them if they hadn't prior to the appointment.