16 days post op with some venting and ?'s

[Oscar61]

For those of you out there who happen to read this and arent familiar with me......AVR replacement, mechanical valve 2/26. Out of the hospital on 3/2, 4 days later. Wasnt an emergency surgery, Cards had been watching me now for about 2 1/2 years, was pretty much asymptimatic, but they thought it was just about time to have the surgery so no more damage was done to my heart.

Just a little update on my progress (or lack their of possibly). I actually ended up in the ER a few nights ago (Monday 3/12). I called the Card. on call and explained that my heart was beating about a 135 beats a minute and the rythym seemed to be all over the place to me. He had said that "I had been in the office earlier in the week, they hadnt seen any signs since surgery that I had A-Fib. I had called the on call service once or twice.....that my tests seemed to be ok seeing that I was just under two weeks post op and there wasnt much they were going to be able to do for me in the hospital anyway. Unless I felt extremely short of breath, dizzy, had chest pains, etc. that I should be fine until my next check up scheduled a few days later"

In any event, 10 minutes after getting off the phone I just didnt feel comfortable. went to the ER, was checked out. After having a chest x-ray the ER doctor said they were going to admit me "to keep an eye on me" for the night. Said their was some fluid around my heart (which I had already indicated I was told earlier in the week when I had an echo at my Cards. office) and that my heart was "enlarged". I was given no dimesions, but again I had been told this before but instead of the term "enlarged" being used, I was told that my heart was "inflamed", which I took to mean from the trauma of the surgery and much more of a normal circumstance. They gave me an echo the following morning, cardiologist reviewed it, came in to see me and basically said that not much had changed from the echo earlier in the week and that they were going to release me with no new instructions.

I'm exactly 16 days post op AVR right now. I do feel a little better than the day I came home. Not experiencing a lot of pain at all...more just discomfort. I just feel as though I'm not ready to really do anything. I am tired all the time, I feel weak, and although I know it has been a short period, I dont feel as though I have made any progress or feel any better since my second or third day home (about 9 days now). I'm eating and drinking as recomended. I live on the third floor of a three floor walkup and the only time I have left the house for is my appointments (about 4 times) and each time I havent felt great when I get to the top of the stairs. My pulse still seems to be wacky......sometimes its between 95-100, sometimes its at 125...all at rest (on metoporolol 50mg/2x day). And I as I stated before, I seem to have a "wacky" rythym.....thump,thump,thump.......thump.......thump.....thump,thump,thump....thump....etc. All of this I am being told by my docs that this is "pretty normal post op...that my heart may go back to its regular rythym after time, maybe it wont..but wither way it is completely safe." Same is said about my pulse. Just dont feel like I'm getting any realy answers here.....maybe their arent any?

Maybe I have some unreal expectations, but just thought day by day I would feel incrimentally better, and dont really notice that at all right now. I know everyones recovery is different but I'm only 32, and from my surgeon describing how the surgery "couldnt of gone better" I just thought I'd be feeling better than this right now. Additionaly I have to admit I'm somewhat depressed (knowing that this comes with the territory sometines after these surgeries). I guess I just dont see a light at the end of the tunnel right now. Like I said, if I felt like I was even a tiny bit better every day, or even after an additional week, maybe that would be different. But thats just not how I feel right now.

As I said before, I really appreciate everyone responses on their own expierences, and additionally if anyone has ANYTHING to weigh in about anything I've said here please do.

Thank you again, and as always I'm saying prayers and thinking of all of you out there!

Jay

 

[gijanet]

Sorry to hear that you are having ..........

Sorry to hear that you are having ..........

such a rough time of it............and the fact that no one seems to really be listening. I'm not of much help with all of your questions, but I can tell you that my daughter's heart rate was all over the place post-op. Her heart was JETting and would stay up around 200 for hours on end. They would eventually get it under control with meds for a while and then it would shoot through the roof again. External pacing and subcutaneous pacing were to no avail. She finally went back into sinus rhythm after about three weeks (we were still in the hospital all this time, though), and we have had no further problems, thank God. For what it is worth, her surgeon was adamant that we give her heart sufficient time to heal and go back into sinus rhythm before we even considered a pacemaker. He was right, of course, and that is why we pay him the big bucks that we do.

I did have some concerns this past fall, so we did a holter test for 24 hours, which showed some low rates at night but nothing alarming. WE also have a Raytel event monitor which allows us to record Katie's heart rate in the event that she complains that someone is "spanking her heart." 'Course since we have had this monitor, she has not complained or had any episodes that we know of.

For peace of mind purposes, why don't you ask your card for a 48 hour holter. I would think that he would be more than willing to comply with your wishes. Either you will get some peace of mind that nothing unusual is going on, or you will have some evidence that something is going on and needs to be addressed.

As for the enlargement of the heart, well, just my two cents, but I think you are expecting too much too soon. Same with the fatigue. You have just had a very major surgery. Your body and heart have been violated and you need to give them both time to recover. Everyone recovers at a different rate, even you young uns. And yes, the depression is almost a given. Don't be ashamed to seek counseling if you need to.

Hope some AVR folks come along soon with some more insight for you, but it will probably be morning, since there aren't too many of us hoot owls. Keep us posted. Hugs. J.

 

[marky]

Oscar.. I am sorry that things seem so discouraging.. I understand that feeling and spent the first 2 months of recovery like that

I wouldnt' discard the fluid around your heart.. that can make you feel very tired..and can mess with the rhythms a bit.. Do isist that they watch that closely.

Recovery is a tricky thing.. It just takes Time..and everyone resonds a bit differently to the process..

the ER treated me great..and I didn't hesitate to return to them when I want 'right'. My cardiologist is so so.. and missed some important issues with my recovery.

I enourage you to cont. with the ER if you need to, or push the issues with your cardio.. until you get the answers you need.
Hang in there.. you are still pretty new in the recovery stage.. it really does take time.

 

[Phyllis]

Jay, Janet's suggestion to ask for a holter is good advice if only to allay your concerns. Sixteen days post op is early and not unusual to not feel a lot of progress at this time. Lots of people have experienced the depression and that may be worth mentioning to the docs for some help with a prescription. I'm willing to bet that in another week you will start to see real progress. Three flights of stairs is a big thing to conquer at this time. Dick was mainly walking around the house for the first two weeks and ventured out for walks at around 3 weeks, starting with a mile and then working up to 3 by the time of his 6 week surgeon appt. Wishing you the best for a slow but steady improvement.

 

[EireCara]

Hi Jay, sorry to see that you are having a rough time. I know exactly what its like when you feel ''chronically'' unwell. Please dont hesitate to seek out the help you need, nobody knows your body like you do !! I'll be the first to admit I dont follow this advice as much as I should, but I think we all know, it is the right thing to do.
I will pray for you to turn the corner in your recovery. Very Best Wishes..Jacqui.

 

[ruth]

Jay -

Your experiences are pretty much in line with mine EXCEPT I was in a-fib that was directly causing my high pulse. Since the cardioversion Tuesday, my resting pulse is now in the 70's not the 110's. It goes to 80 if I climb stairs, not 135 like it was. My rhythm is now fine but it wasn't early on. It was what my PCP called irregularly irregular. In other words no pattern to its irregularity at all.

I know you're not in a-fib according to the ER but without a Holter they don't know that you're not going in & out of rhythm. I know that when my heartrate was that high it beat the daylights out of me and I had NO energy and felt like my recovery was just absolutely going nowhere. I had this vision of recovery with me sitting in my recliner watching reruns of Turner Classic Movies, doing breathing exercises and 2 walks every day each longer than the day before. My recovery could not have been farther from that vision. There were good days, there were bad days, I caught the flu, then bronchitis all while in a-fib, and I'm only 9 weeks from surgery!! I think a 3'rd floor walk up would have put me 6 feet under.

The 3'rd week was the worst for me, I was ready to feel better and my body just wasn't. I felt like I was making no progress. I convinced myself everyone on this board was having a faster and better recovery. I didn't start feeling incrementally better until just recently, actually I may have been I just couldn't see in myself the improvements.

Stay after those Dr.'s and give your body time. I worried a lot about fluid around the heart but for me it was not an issue. Something has your pulse awful high and until it comes down you may well not feel very good. Maybe your cardio needs to adjust your meds to try to drop that rate? Mine did and it helped some.

Please don't get discouraged, your body has been through a lot. You are young and that should help. Recovery isn't a linear line up, it felt more like a stock chart looks (a positive one) with jagged ups & downs but a general upward trend. Don't let the bad days get you down. There were plenty of days 3 weeks out where I said to myself that I didn't feel a bit better than the day I was released from the hospital. I think I probably did, but it sure didn't seem that way to me at the time.

Venting here helps, cutting yourself some slack helps too. Stay after the Docs if things really seem wrong.

I wish you all the best,
Ruth

 

[Mary]

Jay,
I agree that 16 days post-op you might not be feeling nearly as well as what you thought you would be, but I would keep an eye on the fluid around your heart. Are you weighing yourself every day? Are you having shortness of breath or sharp pains in your back? Those type symptoms could be indicative of trouble along with the heart beat irregularities.
Don't forget, that you still are under the care of your surgeon. If you feel the cardio is dismissing your concerns, contact the surgeon's office.

 

[WayneGM]

Don't be discouraged. Pre-op I didn't know what to expect and thought I'd feel better much quicker than I did. What I learned is that recovery was the hardest part of the OHS. I even found myself back in the hospital in week 3 due to fluid build up (resulting in conjestive heart failure) so definitely keep an eye on that.

From the stories I've read here, everyone is different when it comes to pace of recovery.

As for my story, during recovery, I learned the true meaning of patience. I discovered that recovery isn't linear and went in spurts. It also had ups and downs as I'd feel great a few days only to feel worse a few others. For the first few months, improvement wasn't day by day, it was more like week by week. Later, it even felt like month by month. However, it does get better. Now, just over a year out I think I'm about 90 - 95% my "old" self (I was asymtompatic), and I still have the odd "down" day.

Stay positive and good luck.

 

[MaryC]

Jay,
I had my mitral valve repair on 02/21 and, like you, I was pretty much asymptomatic prior to the surgery. Prior to the surgery, I was used to doing my cardio exercise 5 days a week. Now that I am post surgery, I have times that I experience some dizziness when I get up too fast, I was having rapid heart beats periodically last week, general tiredness. I have to keep reminding myself that my recovery is not going to be overnight and there will be some bumps in the road - just as there was with my brother, who had a mitral valve replacement back Sept '06. Today he says he feels better than ever and is able to do his very manual-intensive job.

I will tell you what I keep telling myself - hang in there and it will get better.

 

[Mike C]

From my experience, recovery has many peaks and valleys and as time goes by you will have less valleys. 16 days is not alot of time, be patient with your recovery.

also, this is obviously only a guess but it sounds like you might be going into afib periodically, if it continues you may want to be on a rate controlled drug. In majority of cases it will go away, at least for the most part.

Also,keep an eye on the effusion. If the effuson is getting larger, itsquezzes the heart, which may be causing afib, large effusions can make it feel like you are in congestive heart failure. Not only does the heart not like surgery, it also does not like beign surround by blood, it is coarse and irritates it.

Keep an eye on those two areas but also be patient, a few more weeks you should feel much better

 

[Marguerite53]

Great remarks from everyone so far...so I'll probably be repeating.

This is the BEST place to vent and ask questions so keep them coming!

You are probably experiencing more tiredness from the irregular heartbeats. They are exhausting!!! Chances are, they are PVC's or PAC's (premature ventricular or atrial contractions) which are benign. If 2 cards sent you on your way....then they are probably not concerned with afib. You could easily request to be put on an event monitor. It's very simple to use and you just plug yourself in, call a number when you feel your heartbeat doing its thing. After a week of that, they call and let you know exactly what was going on. Then, they can correct, tame, whatever, those feelings with some meds. I am on betablockers (Toprol XL and Atenolol are 2 examples) to curb the nuisance of my PVC's. Trust me. THose irregular heartbeats can make you really tired.

So many of us feel those unsettling heartbeats post surgery. You have to remember that they were in there handling your heart. It's abit of a shock to the system...even a 32 year old system. Your heart may just be adjusting. Think of it this way (well, it helped me). It's like your heart just won the lottery. It's dancing with joy!!! It's so excited with itself that it just can't calm down! So maybe you need some beta blockers to help things along. Be patient. A lot of these things just resolve themselves with time and patience. It's very wise to be all over the doctors about it though. Don't worry about being diligent and advocating for yourself....keep at it. But do understand that a lot of recovery is about patience. We've all learned new lessons from our experience.....you shall too!

Good luck and hang in there!

Marguerite

 

[savysmommy]

I am not recomending you exercise, but I also wonder if that is part of the problem. You mention that you havent left the house other than to see your doc. Are you able to do your daily walks? My surgeon and card made it very clear that those were imperative. My surgeon told me he didnt care if I walked in circles around the kitchen table, but that I need to do it. I also remember my heart rate jumping really high with very minimal exhertion. I would get up and walk to the kitchen and my heart would be racing!

I thinkt he holter would be a good idea, but also talk to your doc about the walking and excercise, to see if he thinks they could be related at all.

Good luck with everything. I hope you start feeling better soon!

 

[linda d.]

Jay,
I had aortic root replacement and aortic valve repair 1/10. I can tell you that the fourth to sixth weeks were pretty awful. Aside from an a-fib problem that put me back in the hospital, I developed bilateral pleural effusions. They finally tapped my lung, and I have been feeling an amazing improvement daily.
I too, felt that I should feel a little better each day after surgery...it just didn't happen. I became very discouraging. I am 48, was asymptomatic before surgery and all I heard was how well I would do with this surgery.
My best advice for you is to just relax and wait , wait, wait. It will get better but only in your own heart's time. Nothing will make it heal faster than it is willing to. It's a difficult thing for someone always on the go, but when it started to get better, you know it, and there's no looking back!
All of a sudden my heart rate dropped from 128 to 80. It just took it's own good time.
My prayers are with you. I won't say keep your chin up because that is sometimes the hardest thing to do. Be as patient as you can...it WILL get better.
LInda

 

[Oscar61]

Thank you all for your replies. It has been a few days since I started this thread. I ike to let a little time go by abd take in some advice/ suggestions, and see if I have anything new to repost at the same time before I re-post.

The last 3 or 4 days I have felt somewhat better. My pulse has definitely become more regular and "rythmic" and has now dropped down from the 11--125 range at rest to seemingly 70-85. In addition not sure if I had mentioned here but I originally came out of surgery with a new "bundle branch block", and that now too after 2 new echos has gone away. I'm being told from the usual healing, reduction of inflamation of the heart. I do have a little bit of fluid around my heart, as I am told more than 50% of ppl experience after surgery, but also have been told that it isnt affecting my heart function at all and I have since been put on lasax for the last 4 days to see if this may help with my body absorbing and getting rid of it. Follow up this Thursday 3/22 with cardio.

All in all I have been feeling better the last few days. Still have some of the depression hit me at random times. Sitting around all day, not doing much. Have just begun my walking regiment on my treadmill here at the house, but still bored and couped up.

Just going to take some time. Again thanks for the responses, and if anyone has anything to add please do.

Jay

 

[WayneGM]

Originally Posted by Oscar61
Still have some of the depression hit me at random times. Sitting around all day, not doing much. Have just begun my walking regiment on my treadmill here at the house, but still bored and couped up.

Jay, I know what you mean. I was recovering around this time last year and it was too cold to walk outside. I didn't even have a treadmill so walked the hallways from room to room. How boring is that!

I went from being asymptomatic to feeling like a crippled old man trapped in the house. Too much time to think was leading to feeling sorry for myself, and ultimately feelings of depression.

However, to counteract this, I found keeping my mind busy, if not my body, helped. I had a hard time concentrating on reading anything "heavy", but loaded up on DVDs which helped pass the time....I got my fill of all those movies my wife hates but I love. Also, somebody gave me one of those puzzle books that people use to pass the time when travelling which I really got into. I even rediscovered computer chess. Finally, I bought myself a new toy...a digital camera (one like an SLR but not an SLR)...and passed the time trying to figure out how it works...I'm still trying to figure out how it works! It's good thing with digital cameras you don't have to pay get films developed.

Anyway, try to keep your mind occupied until the spring weather emerges and you can get out into more comfortable weather. Hang in there, and good luck.