Second surgery versus first surgery questions...

[6 for Sarah]

I'm having my 2nd OHS in 3 weeks to replace a human tissue aortic valve (2004) with a mechanical. How is the recovery/pain compared to the first operation? Similar? I was 30 first time and now 42. I will also have my aorta grafted as the previous repair failed.

 

[pellicle]

Hey

Recovery at 48 felt tougher than for me at 28. Pain wasn't any issue, but it seemed that things were a bit slower to recover (like fitness). Like yourself I had a mechanical this time from a homograft last time.

My constant irritation of my sternum wires proved to be an infection, and that may explain the general light level of weariness I felt ...

Best Wishes for the surgery and hope your landing is smooth.

 

[jwinter]

Surgery itself was very similar for me.

Recovery has been slower but probably to be expected as age becomes a factor.

Had a few snags getting my INR in line but all is good now. I had an ON-X put in at Mayo in Rochester MN and no problems with tubes or wires.

I was very surprised and pleased to tell you I am down to monitoring INR once a month at coumadin clinic and surgeon said a few weeks ago I will eventually be able to monitor just a few times a year! This surgery has come a long way!

I had tissue valve at 55 and was 60 for mechanical so just something to keep in mind.

Good luck to you and let us know how it goes.

 

[dick0236]

........ and surgeon said a few weeks ago I will eventually be able to monitor just a few times a year! This surgery has come a long way!
.

I would make sure your cardiologist is OK with monitoring INR that infrequently.

 

[pellicle]

I would make sure your cardiologist is OK with monitoring INR that infrequently.

I had exactly the same reaction, but as I grow tired of being accused of bullying people I didn't want to comment.

To me weekly testing is the standard. Monthly testing is like texting while driving, you kid yourself you can get away with it until there is an accident. Less frequently than monthly is just delusion.

Only recently there was a post here where the poster was stable INR for years, then suddenly they weren't. There is no letter to warn you of the change.

I noted that in the on-x trial they were weekly testing too.

Every accident assessment will show that a series of events caused the accident. If any one of those (often safety procedures) were were not neglected then the accident would not have happened.

Self test weekly, it's cheap convenient and may just elevate you away from the old time stats which have warfarin the risk levels once thought normal.

 

[jwinter]

Well I knew there would be comments on my post and think everyone here deserves to post their thoughts and experiences. After all there are no doctors on this forum that I know of. Delusional, lol

 

[pellicle]

Well I knew there would be comments on my post and think everyone here deserves to post their thoughts and experiences.

agreed ... even me perhaps?

I wish you every success with your strategy. I understand its based on many years experience and wide reading. I did not correct you or caution you or tell you you could not have that opinion, heck I didn't even reply to you. I just replied to Dick and I hope that between us we can help others from coming to harm.

I love the way that people bitch about my view then rather than say what is wrong with what I've said, and supply ANY examples or evidence then just say "they have a right to their opinion".

Of course you do ... just as equally as I have a right to assert mine. Then the reader can decided which opinions they wish to accept. Some people come here to get advice ... perhaps even good advice.

 

[Tojomiami]

Hi Sarah, I had a homograft in 1999 and just had my second AVR in January, a mechanical valve (On-X) at Mayo Clinic. My recovery from my second surgery was harder for me initially. I had 4 chest tubes the second time, and two the first. However, now I am doing great. I entered a cardiac rehab program, and have found it is a huge help in the recovery process. I highly recommend doing that. My INR has been jumping around a bit, but I just have to be more careful with my diet. I wish you the best of luck!
TJ

 

[Lisa2]

Hi Sarah,

I just want to wish you good luck and best wished for a smooth and speedy recovery.

I'm also curious to know if you are returning to UAB for your valve replacement? I hope you don't mind me asking. We are about the same age (I'm 44) and I also had surgery at UAB with Dr. McGiffin in March 2004. So 13 years this month for me. Homograft, same as you.

 

[Marko2011]

Hello Sarah,

Best of wishes for your upcoming surgery. Every person is different, in how they respond to and recover from a second OHS.

I'll be 30 days post op on Monday after redo AVR with an On-X Valve, (which is temporarily transforming my bed into a night club at the moment)
I think the most important thing, just my opinion though, is to see this is a fresh surgery altogether, it's going to be different. Some of my friends told me that well, at least you know what to expect this time round, No and no. Similarities, but no. I went in the night before with a list of demands for the anaesthetist to agree to, before I consented.

1. 100% management of post operative pain and nausea management. IV Ondansetron is very good, regardless of cost.
2. Up in chair as soon as is safely possible post op. Very important to start your breathing exercises as soon as possible, adequate analgesia will allow you to hoof and bark quite happily.
3. Industrial strength laxatives, and a seat belt for the loo, Day 3-4 post op in the bowel department, can be very interesting, I almost needed a Midwife.

I think these for me were the most important things, going by last time.

I was expecting to be cartwheeling again at 30 days post op, just like last time, not really cartwheeling, mind you. It's just a bit tougher, tiring, and emotionally draining the second time round, don't push yourself too hard, your nurses will be very aware and ready to care for you as a redo OHS surgery patient, mine kept me in check on a few occasions, when I was basically pushing my luck, in wanting to do more than I was ready too. Get loads of fruit in as well, Satsumas, oh my god, I must have scarfed a bag of them a day !!!


Good luck with everything, and look forward to reading your post op post, when you are ready to. Baby steps.
Mark.

 

[6 for Sarah]

Hi Sarah,

I just want to wish you good luck and best wished for a smooth and speedy recovery.

I'm also curious to know if you are returning to UAB for your valve replacement? I hope you don't mind me asking. We are about the same age (I'm 44) and I also had surgery at UAB with Dr. McGiffin in March 2004. So 13 years this month for me. Homograft, same as you.

No. I no longer live in Alabama. We live up in the NE. I will be going to Brigham and Women's in Boston this time.

 

[6 for Sarah]

Hi Sarah,

I just want to wish you good luck and best wished for a smooth and speedy recovery.

I'm also curious to know if you are returning to UAB for your valve replacement? I hope you don't mind me asking. We are about the same age (I'm 44) and I also had surgery at UAB with Dr. McGiffin in March 2004. So 13 years this month for me. Homograft, same as you.

No. I no longer live in Alabama. We live up in the NE. I will be going to Brigham and Women's in Boston this time.

 

[Lisa2]

Thanks for the reply, Sarah. I wasn't just curious because I am facing my redo sometime this year.