Can't sleep

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J

Jed

Hi All,
Thanks for all your help in the past. To be honest you guys have been more help than my cardiologist so that's why i am here again. I am 4 months removed from aortic and mitrol valve replacement. I have two mechanicals clicking away. I have been back to work for a month now and physically i am doing pretty good. I still have shortness of breath and my chest feels tight at times. My main problem is that i can't sleep. I get so tired but when i get in bed i can't fall asleep and get very antsy. I am not in any pain so thats not the reason. I am on 5mg of coumadin 5 days a week and none the other 2 days. Also i am on Metoprolol 50mg twice a day for a fast heartbeat and Protonix for my stomach. It seems like this has all started since i have gone back to work. I work a very physical job as i am a Meat Manager in a grocery store. My recovery and life in general would be so much better if i could just get some regular good sleep. If you have any ideas or suggestions i would greatly appreciate it. Thanks in advance for your help, Jed
 
Talk to your doctors first, but maybe it's worth asking about doing something that requires less physical effort on your part at work.

There's a risk there of course, they may choose to transfer you to another department entirely and/or dock your pay and or lay you off or or or...

In theory, this practice is illegal. Most states (and I believe federal law as well) forbid employers from moving employees to lower paying positions because of a newly developed medical condition or disability, or firing them outright.

How often are you getting post-surgery follow-ups with your doctor or surgeon?

Are you in cardiac rehab? If not, you really should be, and should have been before starting work again.

You feel OK otherwise correct, just having difficulty sleeping? Sometimes that comes up post-op and usually rectifies itself after a while, sometimes not. Ask why you're not sleeping, is it the meds? Work? Stress? Try some changes with your doctor's approval and see if they help.

Maybe you can arrange a shorter shift at work, or possible part time for a while until you're 100% again... Again, a doctor's supervision and advice (including a letter to your employer possibly) would help here.
 
Hi Jed,

I am sorry to hear about your sleeping difficulties.

When you say you're not sleeping, do you mean only a couple hours a day or no sleep at all?

I too had trouble sleeping after my AVR surgery. My cardio gave me Ambien. That put me right to sleep, but it is not good for the long term. I think I took it for about 3 weeks.

I would also recommend that you talk to your doctor about this sleep problem and try to find the real cause for it, whether is work, stress or some other physiological issue.

Good luck, let us know it turns out.

Jim
 
Hello Jed,

Sleep issues are not at all uncommon following OHS. I could only sleep for a few hours at a time for several weeks, maybe months.

Some people find that sleeping on an incline (raise the head of your bed), or use a wedge pillow, or try sleeping in a recliner.

WHO is managing your Coumadin?

I NEVER heard of anyone skipping two days a week.
CONSISTENCY is the KEY to SUCCESS with Coumadin.

5mg X5 Days = 25 mg / week

The BEST way to achieve that weekly dose is 3.5 mg 6 days and 4 mg 1 day. This will provide a MUCH smoother result. Yes, you will need two different dose tablets that way (2.5 mg and 1.0 mg) but it's a LOT safer.

MANY Coumadin patient's INR will Nose Dive if they skip a dose, especially if they skip two days in a row. THAT is NOT a good practice!

Have you read Al Lodwick's website www.warfarinfo.com?
That is the BEST source of information on Coumadin use. You may want to buy his book and dosing algorithm as well.

'AL Capshaw'
 
Hi Jed,

Its so frustrating not getting good sleep and so important for getting back to life. I had sleep problems for about 6 weeks before I gradualy got back to sleeping full nights more or less. It has to do with the long anesthesia and then probably the by pass. Then you get into a loop, not sleeping well putting you under stress which keeps the sleep away.

I would try some medical assistance to try and break the loop. If you take some sleep pill for a couple of weeks you might become more relaxed and less stressed about the lost sleep and then sleep better naturaly.

Do you think the ticking is bothering you? I can hear my st Jude but only rarely does it wake me or bother my sleep. My wife hears it and sometimes moves away from me cause it disturbes her (excuses...)

I think it is very important you get good sleep, don't just pass on this.
 
I had another thought about your Coumadin dosing Jed.

Since you already have 5 mg tablets, you could split 2 and use the following schedule:

MWF 5 mg
TTSS 2.5 mg

That still comes to 25 mg / week and has NO skipped days which will keep your INR from CRASHING as so often happens with skipped doses.

'AL'
 
Still Can't Sleep

Still Can't Sleep

Hi All,
Thanks for your help and words of wisdom. Glad to see that i am not alone with this problem. Hopefully i will "grow" out of it, and soon. Al to your comments/concern my coumadin dosage is 5mg s,m,w,f,s and nothing on tu,th. I do like your comment on splitting a few tablets so i will not go without on any day. Still new at this coumadin thing. My Dr. seems to make light of just about everything. To me if i have to do something i might as well do it the right way, not the good enough way especially when it comes to my health. My body has been through alot in my 41 years on earth. Cancer 3 times, Scoliosis, major heart issues, now i learn that i have Barrets Disease/Syndrom. Always something. Today is my birthday and i am pleased to be having it. When i was nine i was diagnosed with Hodgkins Disease. Very rare in children back then. They didn't expect me to make it to my 10th birthday. I fooled them and plan on doing it for a long time. Anyway thanks again for your help. Have a great holiday and stay away from the greens, lol, Jed
 
We have a LOT in common Jed!

I was treated for Hodgkins Disease 30 some years ago at one of the first Radical Radiation Centers. I strongly suspect the 'just in case' radiation to my chest is a major contributing factor in my REFLUX problems, Coronary Artery Disease (2 angioplasties, 3X Bypass surgery) and Valve Disease (Aortic Stenosis / AVR and Mitral Valve calcification).

Jed, I STRONGLY recommend that you look for a REAL Coumadin Clinic. Skipping doses is DANGEROUS. IF you stick with the 5 day routine, it would be better to have 2 and 3 days between 'skips'. IMHO, your Doc does NOT know what he is doing when it comes to your Coumadin dosing. With your 5 mg tablets, I think alternating the 2.5 mg 4 days and 5 mg 3 days is the best compromise.

Hang in there, you've got a lot on your plate!

'AL'
 
My card. prescribed Ambien for me. I'll have nights where I just psych myself out and can't sleep. It usually occurs before I have a big day the next day and I worry about the energy I'll have if I can't sleep. I'm finding the Ambien to be very helpful. Usually 5 mg does it, but I have taken 10. Benedryl or Tylenol PM does nothing for me, so I was not sure Ambien would be strong enough. However, it is. It doesn't knock me out, but allows me to drift off to sleep nicely. Now when I have those big days I tend to not psych myself out nearly as much because I know all I need to do is take the Ambien if I can't sleep.
 
You may want to think of another line of work. One miss whack with a meat cleaver could spell disaster.
 
Jed,

I've had problems sleeping as well since my surgery 8 months ago. It is S L O W L Y getting better. When it was at its worse I used Ambien for awhile and it works well. I decided to go off of it so I wouldn't become dependent on it.

Other things that have helped are:

Taking walks on a regular basis

A warm bath or shower before bed

No caffeinated beverages in the evening

Rub some Icy Hot on my legs (I tend to have restless leg syndrome at times that keep me up)

Background noise (I usually like to sleep with a fan running)

Benadryl (although this makes some people feel "hungover" the next morning)

Hope this helps and your sleeping pattern returns to normal soon.
 
Sleep and drug splitting

Sleep and drug splitting

Hello Jed

I read an article in a mens health magazine yesterday saying that if you split drugs you may only end up an 80/20 effective dose on each side of the pill - not 50/50 as you might expect. I can give you the stats/research if you want.

Sleep is a problem for me at times - my surgery was only a bit over two weeks ago. I have been told it is due to;
1. Psychology
2. Bypass
3. Anaesthetic

and this seems to agree with what others are saying. You are in a new sleep pattern and you may need help to break it. In my case it is the awareness of my heart thumping away inside me (apparently due also to the above three factors). I will be happy to take sleepers on a diminishing dose for a while yet.
 
Happy Birthday, Jed. With all that you've been through, you sure as heck have fooled them, and done a darn good job of it.

A lot of us have had trouble sleeping after the surgery, many for months.

You have a physical job, which I think is a good thing, and you're doing well in other aspects of your recovery.

It is often pointed out that depression is a common after-effect of OHS. My personal belief is that many of us suffer from something more like post-traumatic stress syndrome from this surgery, at least for a while. It's a wonderful thing that they can fix the heart's valves, but it's a huge psychological burden to undergo it. No one brushes shoulders with the Reaper without being changed in some way.

So it's not surprising that we can't just walk back into our lives and jobs as if nothing happened. It's not simply a case of saying it's over with and moving on. There's a lot of readjustment we have to go through. It takes a long time to start to feel confident in yourself and "safe" again.

If it is affecting you badly, and you don't feel it is going away, consider whether you might want to look into consulting with a doctor for something to relax you or elevate your mood. I don't know how that would work with your job, though. Missing sleep is definitely preferable to missing fingers.

Best wishes,
 
Also have sleep problem

Also have sleep problem

I finally located this website while websurfing for an answer to my insomnia following a Bentall procedure last August. It is my CarboMedic aortic valve which is noisy. My daughter calls me Thumper ( I guess that makes her Bambi). I also have used Ambien on occasion, but I am wary of dependency. It is reassuring to hear that others have had the same problem, which apparently subsides with time.
 
Same here

Same here

I too had trouble sleeping about 3 or so months post op and I was given ambien and paxil but I was also having severe depression. I would cry or shot you within 2 mins. I was so crazy for awhile. Could not remember things I was a true pump head... :D ask your doctor about ambien it worked for me I only took it for a few weeks.
 
Thanks

Thanks

Hi Guys and Gals,
Thanks for your help and wisdon and especially your concern. Kinda glad that i am not alone with this thing, makes me feel like i am NOT going crazy, lol. Bryan B i looked into what you mentioned, Restless Leg Syndrome and i think i have that. Maybe not serious but i do have symptoms. Can't keep my legs still at night and when i am driving home from work and watching TV and i get antsy, can't keep still. My researsh said it was sometimes treated with oxycodene and fortunately i have some of that left over from my surgery and tried it and it seemed to help. I am sleeping better since trying that. Are there any tests for that syndrome? I am going to mention it to my Cardio and my GP and see what they feel. Anyway thanks again. You Guys and a gold mine of information and advice. Thanks, Jed
 
Jed,

I think there are several causes of restless leg syndrome, one of which is if you've been on pain meds for awhile (which most of us have been after surgery). Once you go off of the pain meds it's not uncommon to get RLS. I think it's just temporary, and the Icy Hot seemed to distract my legs with the warming sensation long enough to get to sleep. If you have never had the problem before, I think the culprit might be stopping the pain meds. I found that once I was off the pain meds for a week or so the RLS got better on its own.
 
I have had trouble sleeping before and after surgery. I take Xanex, 1 mg tabs on nights that I cant sleep. Usually about every 2 to 3 days. Be ready for 9 hard hours of sleep. Be careful though, It is addicting.
 
Ah sleep...elusive sleep for many. It's normal, I guess. Restoril, Xanax, Ambien, all work to some degree. Benadryl will raise your blood pressure some I think.

Probably best to meditate. Do the relaxation exercises.

I use 15 mg of restoril. And have been for a long time.

Xanax is HIGHLY addictive and if you're not on it, don't go near it.

On the other hand, the statin drugs and lipitor and metoprolol etc. all can interfere with sleep -- so what the hell, take a pill.

The goal is, of course, to have that head hit the pillow and dream of wonderful things for hours and wake up refreshed, wiithout alcholol or drugs.

Lunesta works. But...try to imagine simple pleasures...relax...relax...relax...

Good luck. I'm a month post op and struggling a bit with sleep, too. I nap in the afternoon due to lack of energy.

hope this helps some:)
 
I take the 15 mg of restoril (temazepam) also. Works for me. I've tried going to sleep without it and my mind just races til I wind up taking one in the middle of the night. So I've just resigned myself to taking it at bedtime for now. When the doc says I can no longer have them, will have to try something else. But warm baths, milk and cookies, all that, haven't worked for me since surgery.
 
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