Three Weeks Out - Too Early to go to Work?

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MarcoPolo

Member
Joined
Dec 26, 2013
Messages
9
Location
CA, USA
It's been a little over three weeks since I had my bicuspid aortic valve replaced. The surgery was on Thursday January 9th and went extremely well. By Friday mid-day I was out of ICU and was reading email and even having a few phone calls on Saturday and Sunday. I had little pain and probably could have been released on Monday morning, but was finally let out of the hospital on Tuesday Jan 14th. I felt great. By Wednesday and Thursday, I was taking walks around the block (relatively slow walks). All this time, I kept thinking how easy this was going.

On Friday (Jan 17 - 8 days post surgery), I had to go get my first INR blood test post-hospital. I decided to go the On-X mechanical valve route so that I wouldn't go through the surgery again, but given how easy this was, I was starting to question that decision. The lab is just five minutes away and I was back to the house within 30 minutes. However, when I got home, I started to go downhill fast. Just walking up a small flight of steps was exhausting. I collapsed onto our couch and rested for an hour. Then I attempted to go up to the bedroom with the same response. All the symptoms of were back - shortness of breath, extremely exhaustion, angina. I again collapsed into my easy chair and rested an hour. Then I called the surgeon.

The surgeon tried to get a hold of my cardiologist so I could avoid the emergency room, but in the end, I was advised to go directly to the emergency room. There, they did an echo-cardiogram where I was diagnosed with pericardial effusion. They put me on Colcrys (a gout medicine) and admitted me to the hospital for observation. BTW - my INR that day was 3.0 - when I had left the hospital the previous Tuesday it had been 1.7.

Everything was going well until Sunday around noon, when I started to again be very short of breath and then starting shivering. The doctors said I was going into tamponade, took me to the cardiac lab where they drained 1/2 liter of fluid from my pericardial sac. Almost immediately, I felt great. I was back in my hospital room within a football half. How do I know? I was wheeled out of the room when the 49ers recovered a fumble in the first minute of the game against the Seahawks and was back in the room for the last minute of the 2nd quarter. I felt great - shame the 49ers didn't play better.

In any event, they kept me under observation for another four days and I was finally released from the hospital on Jan 23rd (the two week anniversary of the surgery) and have been home for another week. I feel great and have no pain. The only issue I have right now is that my INR is not yet in therapeutic range. When I left the hospital on the 23rd, my INR was 1.6. By Saturday, it had dropped to 1.1 and has slowly risen back to 1.8 (on Friday Jan 31) with the doctors changing my warfarin dosage practically every day. The only inconvenience has been needing to go to the lab every morning to get blood drawn.

Which leads me to my question - is it too soon to go back to work? I'm bored to death hanging around the house and frankly can't concentrate working from home. At work, I spend my days in meetings, on phone calls, reading and writing emails. I don't do any heavy lifting. It's a typical office job. Therefore, I'm thinking about going back to work tomorrow (25 days post surgery)

Am I crazy? Are there other factors I'm not thinking about that should keep me home resting longer?
 
Everyone is different and what kind of jobs make a difference too, since you have to follow the weight lifting guidelines, but since you dont do lifting for your job, as long as you feel well, it probably wouldnt be a problem going back to work as long as you get clearance from your doctors. I know some jobs you need a written note you are cleared to return to work. I probably would plan and tell them (job) you might not be full time the first few weeks, so if you get more tired than expect or even have the pericardial fluid return or run into another possible complication this far out. it isnt unexpected if you dont work every day or 8 hours a day or whatever you normally work. The main thing right now is not to over do. It can be amazing, just how draining meeting and desk work can be, so if you get tired, don't push yourself go home.

It stinks you got pericardial effusion, it isnt that rare, but it seems more people here tend to get plueral effusions (fluid in the space around the lungs) than pericardial. My son has a tendency to get pericardial post OHS, but "luckily" he/we know symptoms he tends to get w/ it, so usually catch it early enough the past few surgeries, he doesnt get bad enough to need it tapped. I'm glad you called and that they had you go in to get an echo that Friday, I was surprised they admitted you to keep an eye on it, so was wondering if you know approx how much fluid there was that Friday and maybe they kept you since there was more than they felt comfortable sending you home w/ out draining it. But it was VERY good you were in the hospital when you were getting worse, since tamponade can be very dangerous, so being some where they could drain it quickly instead of at home when you felt so bad, probably helped alot. I'm curious did they discuss the chances they might need to drain it? Were they maybe trying to drop your INR a little before they drained it? and hoped in that time the meds worked well enough to avoid draining it if possible. Also I hate to say it, but since you were admitted later on a Friday, I wonder if it was a weekend they were watching you instead of doing an intervention play some part in it?

Anyway i'm glad you are feeling better, I always took it as a good sign when Justin was well enough he was getting bored. I cant help w/ the INR, but wonderred what meds you are on for the fluid, Justin usually was on something like Motrin and steroids, and wonder if meds have an effect on the INR. Did they stop your Coumadin or try to lower it at all when you were in the hospital, if so it could take a litle while to get back in range, since it was up to 1.8 last test hopefully your back in range now.

Good luck with every thing
 
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.........with the doctors changing my warfarin dosage practically every day. The only inconvenience has been needing to go to the lab every morning to get blood drawn.

Which leads me to my question - is it too soon to go back to work? I'm bored to death hanging around the house and frankly can't concentrate working from home. At work, I spend my days in meetings, on phone calls, reading and writing emails. I don't do any heavy lifting. It's a typical office job. Therefore, I'm thinking about going back to work tomorrow (25 days post surgery)

Am I crazy? Are there other factors I'm not thinking about that should keep me home resting longer?

Why not, if your docs approve.

BTW, what's with changing warfarin dose daily and testing so often. Your body can't metabolize the dosing changes that fast. For me, testing more frequently than 3-4 days has been a waste of time and money.....and only makes INR management seem very mysterious.
 
Do you have to drive?
Have you been cleared for driving by your doctors?
How long a commute?

I agree with the comments about daily change of warfarin dose making it way too hard for you to get into your range. It takes 3 days for a dose change to be reflected in INR test. Changing daily will have you chasing your tail. I would suggest a conversation with a knowledgle coumadin manager....... most MD's do not fit that description.
 
I went back to work at three weeks. For me, getting control of my life back and not being 'sick' was critical to my healing! The only issue might be how you get there, I could take the bus from basically outside my door.
 
I went to work just after two weeks but only for three days a week and three hours each day. The company paid for a taxi and made sure I left after the three hours. The reason I wanted to go to work was that I was bored and I did not want to get used to being off work for any length of time. I found it mentally good for me even though I was not doing a lot of work.
 
My surgeon said I could go back to work immediately provided that I had a recliner in my office so I could rest and sleep when tired. It worked great I had surgery on Friday and returned work on Thursday. I shut my door and slept and my secretary kept people away. And I didn't go stir crazy but I mostly slept the first week or so.
 
We're all different. I say, if you feel up to it and if your doctors allow you all the necessary activities (driving?), then go for it. Just be prepared for some unpredictability of your energy levels. You might be better off planning on working part-time for a while.

I had a lot of complications in my recovery. (To put the severity of complications in perspective, I wasn't able to start cardiac rehab until 12 weeks.) I was allowed to work from home after week 2, but didn't really feel up to it until week 3 or 4. By week 5 I was allowed to drive. I went back to work part-time (doctor would only allow 4 hours/day) in weeks 6 and 7, then full-time for week 8. Since my regular "full-time" is 10 to 12 hours a day, I kept it down to 8 hour days for a few weeks. By week 12, when I started cardiac rehab, I was back to my usual 10+ hour days with little problem.

It sounds like you're recovering at a great pace, so just adjust to your abilities. Don't over-do it. If you do, you will pay for it for days.
 
Three weeks is too soon. I went back after 9 and found I was very tired at the end of the day. I got over this in a week or so. I can't imagine going back after three weeks. Can you work remotely for a few weeks?
 
Thanks all for the advice. I did go back to work this week. Spent about 5 hours on Monday, 2 hours on Tuesday, 6 hours on Wednesday and Friday and 8 hours on Thursday. As long as I felt great, I stayed, but when I got tired, I went home.

For those that were concerned about my driving, I haven't done that yet. I either was driven to/from work by family or friends and one day I took an Uber. My doctor told me that I could probably start doing local driving next week. My office is only 2 miles from my home.

I also finally got my INR to 2.0 after three weeks. I can't wait until I get my home monitoring equipment this week.

Thanks to you all.
 
What good news.
By next week, you should be able to walk to and from work. :)
Keep up the good work. Sounds like you are doing very well.
 
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