Wire Removal done, no walk in the park!

[Gail in Ca]

I am 3 days out since my sternal wire removal on Nov. 2. The procedure has changed since I had my wires out in '01, from my 2nd surgery. This time, I went off coumadin for 4 days, checking into the hospital on the 4th day to be put on heparin IV. When I arrived they did blood work and my INR was down to 1.2! About 4 hours later the nurse hooked me up to heparin. Since I was having my procedure at 7am, they had to disconnect the heparin at about 12am.
I was awakened at 5:20am and taken to the pre-op area after being wiped with antimicrobial cloths, and I got to brush my teeth, too. In pre-op I had to swish mouthwash and then just put on a cap.
I was wheeled into the same operating room they use for ohs. It sure doesn't seem like all that complicated stuff would happen there! I was told I was going to relax and I was out until I woke up in the post op area. I had a breathing tube put in, cause apparently some people have a problem with adhesion complications. It was all gone when I awoke about 9am. I felt a bit nauseated after a few minutes, and the nurse gave me something for that and I fell back asleep. The nurse woke me up about 10:30am, time to get dressed and get out! As the nurse wheeled me out to the waiting car, I mentioned that my mouth felt like I had bit my tongue in many places. She looked at it and said it was very bruised. When I got home, I looked at it, and it was VERY bruised! I was not expecting that. My tongue hurt and the right side is still numb. Anyway, I had to leave the dressing on the sternum for 48 hrs. After that, I took a shower and got to see what was done to me. It was not the tiny slits at each wire that I expected, but a couple of incisions, one at the top about 2" and one at the middle about 4". Lots of bruising, and it was more painful than I remembered from '01, and stiff as I had experienced before. I also had to start Lovenox shots 2X's a day until my INR got to 1.8, which it did, thankfully, this morning.
I do feel better today than yesterday, am moving better, and they don't give any weight lifting restrictions. The sternum stings still.
I'm glad it's done, but it wasn't the best experience to go through!

 

[Fundy]

Sounds like it was a bit rougher than before. I had this done last Monday and basically checked in at 11am, waited until surgeon finished his morning OHS at about 3pm and left hospital at abit after 5pm. With a 3.5 inch incision with 10 staples. I only had top 4 removed, not sure how many I started with.

Surgeon told me they usually like to see 2-3 weeks away from labour, but to take at least a week. Anethesiologist said I'd have a tube as well, but it was in and out when I was asleep. It was a bit sore but compared to the OHS it wasn't much at all.

So what possibly could have happened to your tongue?

 

[Jkm7]

Sounds like it was a bit rougher than before. I had this done last Monday and basically checked in at 11am, waited until surgeon finished his morning OHS at about 3pm and left hospital at abit after 5pm. With a 3.5 inch incision with 10 staples. I only had top 4 removed, not sure how many I started with.

Surgeon told me they usually like to see 2-3 weeks away from labour, but to take at least a week. Anethesiologist said I'd have a tube as well, but it was in and out when I was asleep. It was a bit sore but compared to the OHS it wasn't much at all.

So what possibly could have happened to your tongue?

Fundy,
Mind if I ask if you had staples close your incision from your OHS or did your surgeon close you by different method and used staples only for your wire removal?

Hope you both heal well and quickly and get the relief you are seeking.

 

[Fundy]

Staples both times.

 

[coffeelover]

Do you mind if I ask this question, but why did you have the sternal wires removed? I am curious because I had AVR several months ago so was wondering what are the reasons this is done?
Hope you have a speedy recovery.

 

[Gail in Ca]

I decided to have them removed because a couple of them were really poking into my skin, I could feel the wire, and it bothered me. I waited over 3 yrs before making this decision, as the one at the top was the worst. Surgeon suggested I might as well have all 8 wires removed since I was going off coumadin anyway. I am on the thin side, and the wires just seem to poke out more for me, I guess.
I am not sure about what caused the bruising to my tongue. I wonder if it was a student learning anethesia, but how in the world did he or she have such a problem inserting the tube? I am going to find out more about the cause of this, because I'm curious, and I think my surgeon should know what happened to me!

 

[coffeelover]

Gail,
Thank you for sharing!
Wishing you a speedy recovery!

 

[Fundy]

Gail, I'm wondering why you took three years to decide. From looking through posts at this site and others about sternum wire removal, it seems that a doctor often talks someone out of it.
My surgeon tells me I don't really need them anymore and the only real risk involved is that which accompanies all general anethesia. Considering anytime the wire spots were touched was like having someone push a tack into me, and at work this happened several times a week. Which would be more if I wasn't consciously trying to avoid such situations.

I'm kind of wondering what doctors would be saying that would talk someone out of the procedure if the wires were indeed bothering the person.

 

[Roberta]

Gail, I'm wondering why you took three years to decide. From looking through posts at this site and others about sternum wire removal, it seems that a doctor often talks someone out of it.
My surgeon tells me I don't really need them anymore and the only real risk involved is that which accompanies all general anethesia. Considering anytime the wire spots were touched was like having someone push a tack into me, and at work this happened several times a week. Which would be more if I wasn't consciously trying to avoid such situations.

I'm kind of wondering what doctors would be saying that would talk someone out of the procedure if the wires were indeed bothering the person.

Gail and Fundy,

Thank you both for sharing your experiences and wishing you both an uneventful and speedy recovery.Hopefully, you will both have relief now that the wires are removed.

Fundy, when I spoke to my surgeon about a few wires bothering me (6 months post op) he said that I should give it more time as he had seen in a number of patients the discomfort subside after a year or so. He said he didn't want to put me through an unnecessary procedure. I recall reading that if the wires are actually 'protruding out/breaking' of the skin this seems to warrant more urgent removal (perhaps to avoid infection).

I am around the same time frame as Gail and have to admit that a few of them have settled down the past few years. I now only have one that is poking into the skin that still bothers me regularly. My surgeon said that because it is one wire, he could probably do it under local with IV sedation in the day unit. It sounds like both your procedures were more involved.

 

[Gail in Ca]

Gotta love my surgeon. The anesthesiologist has already e-mailed me to explain how my tongue was traumatized. It seems the resident anesthesiologist tried to place my tube, but had difficulty, and so the supervisor anesthesiologist had to take over and place the breathing tube. He apologized and said he has spoken to the resident about this. Mystery solved.
I guess I waited so long to have this done because I just wasn't ready to have my sternum cut and bruised until now. Also, I was having irregular heart beats for quite awhile and went thru some months with a-fib/a-flutter, and cardioversion. I am feeling quite good today. Just a bit of pain, and some stinging when I do things like play fetch with my fox terrier and move the recycle bins from the street!
Thanks for all the kind words. It does help one feel better.

 

[Roberta]

Gotta love my surgeon. The anesthesiologist has already e-mailed me to explain how my tongue was traumatized. It seems the resident anesthesiologist tried to place my tube, but had difficulty, and so the supervisor anesthesiologist had to take over and place the breathing tube. He apologized and said he has spoken to the resident about this. Mystery solved.
I guess I waited so long to have this done because I just wasn't ready to have my sternum cut and bruised until now. Also, I was having irregular heart beats for quite awhile and went thru some months with a-fib/a-flutter, and cardioversion. I am feeling quite good today. Just a bit of pain, and some stinging when I do things like play fetch with my fox terrier and move the recycle bins from the street!
Thanks for all the kind words. It does help one feel better.

Gail,
I am glad that you received a prompt reply re: the tongue trauma and the mystery was solved. Gee...I hope that resident gets some more training to prevent another patient having to go through that.

Thanks for the 'other' reasons one waits for sternal wire removal.

Glad that you are feeling a little better today!

Thinking of you...

 

[TomAlbers]

Gail, I guess congrats on being wire free. Godspeed on a very fast recovery. I guess I'll have to request them not be any resident docs trying to learn how to put breathing tubes in on ohs patients. Thanks for the information. I don't mean to gross you out but my doctor said he had a patient have one of his wires poke out. The guy, Kansas farmer, took some pliers and pulled the wire out himself. One tough man if you ask me.

 

[Fundy]

Gail, that was certainly a fast reply concerning your tongue. I guess once you think about its kind of strange it doesn't happen more often with others. First time I remember even hearing about such a thing.
How long is the pain or discomfort from the tongue bruising expected to last. Or is it mostly better already?

 

[DanielB]

I went through wire removal in July after experiencing sternum pain since my OHS Oct. 2011. It was an 'in the hospital in the morning, home in the afternoon' affair for me as well. In my case, I was left on coumadin after I asked about bridging with the surgeon, he said he was fine doing it without stopping it all together. No other isses, though my sternum still causes me some pain four months out. I've decided to just work though it and see what it feels like as I try to get back into shape again.

Good luck on a speedy recovery for you!

 

[Fundy]

DanielB, if your surgeon has run out of possibilities you could talk with a chiropractor and have him/her look at your chest xrays and see if they see anything out of alignment that they may be able to help with.

 

[TheGymGuy]

DanielB, if your surgeon has run out of possibilities you could talk with a chiropractor and have him/her look at your chest xrays and see if they see anything out of alignment that they may be able to help with.

I second this advice. Find a good chiro or sport medicine doctors and have them check for possible misalignments or muscle tightness, you would be surprised how many times I see people with knee issues only to find out that their tight quads, IT Band, etc., are the cause and getting those soft tissues worked on and stretched takes care of knees which people in all honesty just gave up on.

 

[Bina]

Great thread, thanks to all of you for sharing.
My wires are so annoying, really wish I had the guts to get them all out.

 

[Fundy]

Bina, I found it to be a quite simple and easy process. I took two tylenol that evening on their suggestion, but not sure I even needed it really.
I had no effects from anethesia afterwards as I did for valve surgery. At that time I was awfully ill for two days and was probably more the result of morphine induced ileus. This surgery I don't believe any painkillers other than the anethesia were given. Just two tylenol shortly after I woke up.

 

[Bina]

Bina, I found it to be a quite simple and easy process. I took two tylenol that evening on their suggestion, but not sure I even needed it really.
I had no effects from anethesia afterwards as I did for valve surgery. At that time I was awfully ill for two days and was probably more the result of morphine induced ileus. This surgery I don't believe any painkillers other than the anethesia were given. Just two tylenol shortly after I woke up.

Pain doesn't concern me, I can deal with that, but I react very badly to any anesthesia; fainting--low BP etc.
For my pre-surgery cath I was even kept overnight because of this issue.

 

[Gail in Ca]

I feel pretty good today, went grocery shopping and just a bit of stinging at my sternum. It's still quite bruised, but they are turning yellow, green, so they'll be gone soon. I am getting scabs on the incisions.
My tongue bruises are gone. The only residual problem from that trauma is that my tongue is still numb on the right side. It feels like I burned my tongue in boiling liquid. I pretty sure at Stanford, when go you there for procedures, you give them permission to use students (residents). There's always a "real" Dr supervising. I was surprised they used a resident for me, because I've been thru alot with 3 surgeries and bacterial endocarditis. I made a deal with my surgeon, not to have any more surgeries!