B
Boo I need a valve
Hey all, I?m now at week 5 post AVR.
Below are some lessons learned over the 1st 5 weeks after a valve replacement. I put this together to be helpful to folks about to go through with this. I hope it will make their experience easier. For those who have already been through it, please feel free to post the lessons you learned?
Here is the summary, details are below
1) Rent a hospital bed? its cheaper then you think
2) If you have friends and relatives come to stay with you to ?help? ? talk with them about what ?help? means before they arrive or be ready for some un-needed stress.
3) If you must have goals - Have only one goal. The goal: do a little more then yesterday, unless your vitals get worse or it hurts, then scale it back to what worked in the past and ramp more slowly. This will help you avoid getting depressed.
4) Don?t over do it?
1) When you get home? Rent a hospital Bed? its cheaper then you think.
If you have a flat bed? read this section! I set my healing process back a week on the 2nd day home with the rolling in and out of bed shenanigans. I ended up re-cracking my sternum. Thank god I was still very early in the healing process.
They taught me a roll technique in the hospital? its great for hospital beds, but sucks for flat beds. In any case, every attempt to get in and out of a flat bed was a chore and a little nerve racking. Then my dad suggested ?why not rent a hospital bed?? the powered kind that with a touch of a button goes from flat to sitting and back?
Best idea ever ? in my area we found we could rent one for $250 for 6 weeks, with delivery and set up free of charge! One of these beds makes you completely independent. You can get in and out of bed on your own and more importantly, you can do it without any trouble. I will admit the bed is not the most comfortable? but it sure beats the alternative.
If you don?t want to do that, looking into it I found out one of my fellow patients used 2 additional people to help them get in and out of a flat bed. He would sit in bed, and have 2 people use a sheet wrapped around his back to lower him from a sitting to lying position. They would use this same sheet to raise him from a lying back to sitting position. Worked well, but made him dependent on others, even for 2AM bathroom runs.
2) If you have friends and relatives come to stay with you to ?help? ? talk with them about what ?help? means before they arrive or be ready for some un-needed stress.
I am fairly young, so I had my parents come in the second and third week to take care of me, so my wife could go back to work. Unfortunately it got tense, especially between them and my wife ? which ironically had never happened before.
My parents left frustrated and feeling unwanted: not because of anything anyone said, but mostly because a lot of the thoughtful niceties one does taking care of guests in normal conditions were missing. Meanwhile my wife felt frustrated because she was expecting a full relief crew but instead kept feeling pressure to watch out for and take care of my parents in addition to me.
We learned you need to be really clear with your visitors as to weather they are coming to ?visit and offer emotional support?, or coming in as ?full relief pitchers? (or somewhere in between). In any case, it was not until my folks left that we really figured out what had happened and why people were upset. Talking with friends, I hear this same issue is very common when you have your first baby.
3) If you must have goals - Have only one goal. The goal: do a little more then yesterday, unless your vitals get worse or it hurts, then scale it back to what worked in the past and ramp more slowly. This will help you avoid getting depressed.
I don?t know that this is the best goal for all, but so far its worked for me: at 4.5 weeks post Op I am now walking over 1 hour each walk in hill country on the order of 2 miles, my resting pulse rate is back down in the 50?s bpm (from 100 bpm post op), I have had no depression issues, and the doc tells me I am way ahead of the curve.
Before I went into this I heard a lot of talk about goal setting during the recovery. I also heard about a lot of people getting depressed during the recovery state. I don?t know what works for others, but I know what has been working for me.
Some things to think about as you think about goals for post surgery:
a) Any fixed goals (i.e. walking 1 mile by week 2) you set before the surgery are meaningless. You just don?t know how your body will react or what kind of complications you will end up with. Any fixed goal you set can just get blown out of the water and that can depress you.
b) If you push too hard, you will set yourself back ? no question. (See lesson 4)
c) What is very encouraging about this surgery is that if you can avoid complications, or over doing it, every day is better then the last. Sometimes it does not go as fast as you want and that can be frustrating, but on the other hand each day there is something to rejoice about, and you will get stronger.
d) Keep in mind; you are not training for a race. 6 or 7 weeks to your first mile is not the issue here.
That takes me to the goal that worked for me: do a little more then yesterday, unless your vitals get worse, then scale it back to what worked in the past and start again.
In doing this, I monitored my vitals closely every day? to see if I was overdoing it. The thing I paid most attention to is resting heart rate. I would measure each morning around the same time. If it shot up relative to the day before (i.e. 5 to 10 bpm for me), I figured I had pushed to hard and scaled back that day.
As far as ?doing a little more each day? That meant initially adding a minute to my daily walks each day and keeping my heart rate at a steady place. When adding a minute was no problem, the next day I added 2? and so forth. One day I added a hill to my walk, the next day my resting pulse shot up, I skipped the hill for a few days and then tried again, but only doing half a hill. When that worked, the next day I did the whole hill.
I don?t know that this is the fastest way to recover, but I am not in any short term race, I am in it for the long haul, and it?s been working great.
4) Don?t over do it?
I saw this on the forum, read it 10+ times, knew to watch out for it, and still did it: twice. As such I figure its worth giving you the story to learn from my mistakes.
The first time I overdid it was the day after coming home: Day 5 post op. On day 4 in the hospital I was doing about 4 walks a day, very, very slowly, between five and ten minutes each. Resting heart rate had dropped to 78. I got home, felt great to be in comfortable surroundings, immediately picked up the pace and locked in on 10 minute walks. It felt great that day. Next day though was not so good. My resting pulse rate was up to 90, and per the doc I was seeing fluid build up in my chest cavity. I slowed town to hospital speeds and within a day I was back to a 78 resting BPM. At that point I started to increase my walk time by a minute a day. (Unfortunately the fluid took a while to clear out)
2nd time I overdid it was after 3.5 weeks. I visited with my surgeon who was happy with my progress. I asked him what my walking heart rate should be at as at the time, I was keeping it around 90 bpm. He told me that at my age and current healing rate, he would be comfortable with 110 and in fact recommended I step it up. At the time I was walking two 45 minute walks per day and two 10 minute walks, all at 90bpm, with a resting heart rate of 57 (had been steadily declining by about 1 bpm each day). After meeting with the doc I stepped up my after noon 45 minute walk to 110bpm. Next morning, my resting bpm was up to 62. Talked to my cardiologist about it. He was not worried about me breaking anything, but immediately cautioned that if I want to jump from 90bpm walks to 110bpm walks (which he felt was reasonable), he recommended that I do it over a few days. I scaled back to walking at 90 ? 95 bpm with a few short exertions, and the next day my resting bpm was back to 57, then 54 the day after.
Anyway, minus the initial fluid filling incident, I have been fairly complication free, but from my experience, it?s clear you can overdo it without even noticing until the next day. And overdoing it can have some pretty nasty consequences early on (fluid build up is bad!) So take it easy and go gradually.
PS ? I really like focusing on BPM. I have found that each day, even though I stayed at 90 bpm, my walking got faster meaning my mileage was up. I picked 90 bpm originally because this felt like a very comfortable, non-winded pace, and getting up to 100 felt kind of tough. It was not until week 4.5 where clearing 100 did not feel even the slightest bit uncomfortable.
Below are some lessons learned over the 1st 5 weeks after a valve replacement. I put this together to be helpful to folks about to go through with this. I hope it will make their experience easier. For those who have already been through it, please feel free to post the lessons you learned?
Here is the summary, details are below
1) Rent a hospital bed? its cheaper then you think
2) If you have friends and relatives come to stay with you to ?help? ? talk with them about what ?help? means before they arrive or be ready for some un-needed stress.
3) If you must have goals - Have only one goal. The goal: do a little more then yesterday, unless your vitals get worse or it hurts, then scale it back to what worked in the past and ramp more slowly. This will help you avoid getting depressed.
4) Don?t over do it?
1) When you get home? Rent a hospital Bed? its cheaper then you think.
If you have a flat bed? read this section! I set my healing process back a week on the 2nd day home with the rolling in and out of bed shenanigans. I ended up re-cracking my sternum. Thank god I was still very early in the healing process.
They taught me a roll technique in the hospital? its great for hospital beds, but sucks for flat beds. In any case, every attempt to get in and out of a flat bed was a chore and a little nerve racking. Then my dad suggested ?why not rent a hospital bed?? the powered kind that with a touch of a button goes from flat to sitting and back?
Best idea ever ? in my area we found we could rent one for $250 for 6 weeks, with delivery and set up free of charge! One of these beds makes you completely independent. You can get in and out of bed on your own and more importantly, you can do it without any trouble. I will admit the bed is not the most comfortable? but it sure beats the alternative.
If you don?t want to do that, looking into it I found out one of my fellow patients used 2 additional people to help them get in and out of a flat bed. He would sit in bed, and have 2 people use a sheet wrapped around his back to lower him from a sitting to lying position. They would use this same sheet to raise him from a lying back to sitting position. Worked well, but made him dependent on others, even for 2AM bathroom runs.
2) If you have friends and relatives come to stay with you to ?help? ? talk with them about what ?help? means before they arrive or be ready for some un-needed stress.
I am fairly young, so I had my parents come in the second and third week to take care of me, so my wife could go back to work. Unfortunately it got tense, especially between them and my wife ? which ironically had never happened before.
My parents left frustrated and feeling unwanted: not because of anything anyone said, but mostly because a lot of the thoughtful niceties one does taking care of guests in normal conditions were missing. Meanwhile my wife felt frustrated because she was expecting a full relief crew but instead kept feeling pressure to watch out for and take care of my parents in addition to me.
We learned you need to be really clear with your visitors as to weather they are coming to ?visit and offer emotional support?, or coming in as ?full relief pitchers? (or somewhere in between). In any case, it was not until my folks left that we really figured out what had happened and why people were upset. Talking with friends, I hear this same issue is very common when you have your first baby.
3) If you must have goals - Have only one goal. The goal: do a little more then yesterday, unless your vitals get worse or it hurts, then scale it back to what worked in the past and ramp more slowly. This will help you avoid getting depressed.
I don?t know that this is the best goal for all, but so far its worked for me: at 4.5 weeks post Op I am now walking over 1 hour each walk in hill country on the order of 2 miles, my resting pulse rate is back down in the 50?s bpm (from 100 bpm post op), I have had no depression issues, and the doc tells me I am way ahead of the curve.
Before I went into this I heard a lot of talk about goal setting during the recovery. I also heard about a lot of people getting depressed during the recovery state. I don?t know what works for others, but I know what has been working for me.
Some things to think about as you think about goals for post surgery:
a) Any fixed goals (i.e. walking 1 mile by week 2) you set before the surgery are meaningless. You just don?t know how your body will react or what kind of complications you will end up with. Any fixed goal you set can just get blown out of the water and that can depress you.
b) If you push too hard, you will set yourself back ? no question. (See lesson 4)
c) What is very encouraging about this surgery is that if you can avoid complications, or over doing it, every day is better then the last. Sometimes it does not go as fast as you want and that can be frustrating, but on the other hand each day there is something to rejoice about, and you will get stronger.
d) Keep in mind; you are not training for a race. 6 or 7 weeks to your first mile is not the issue here.
That takes me to the goal that worked for me: do a little more then yesterday, unless your vitals get worse, then scale it back to what worked in the past and start again.
In doing this, I monitored my vitals closely every day? to see if I was overdoing it. The thing I paid most attention to is resting heart rate. I would measure each morning around the same time. If it shot up relative to the day before (i.e. 5 to 10 bpm for me), I figured I had pushed to hard and scaled back that day.
As far as ?doing a little more each day? That meant initially adding a minute to my daily walks each day and keeping my heart rate at a steady place. When adding a minute was no problem, the next day I added 2? and so forth. One day I added a hill to my walk, the next day my resting pulse shot up, I skipped the hill for a few days and then tried again, but only doing half a hill. When that worked, the next day I did the whole hill.
I don?t know that this is the fastest way to recover, but I am not in any short term race, I am in it for the long haul, and it?s been working great.
4) Don?t over do it?
I saw this on the forum, read it 10+ times, knew to watch out for it, and still did it: twice. As such I figure its worth giving you the story to learn from my mistakes.
The first time I overdid it was the day after coming home: Day 5 post op. On day 4 in the hospital I was doing about 4 walks a day, very, very slowly, between five and ten minutes each. Resting heart rate had dropped to 78. I got home, felt great to be in comfortable surroundings, immediately picked up the pace and locked in on 10 minute walks. It felt great that day. Next day though was not so good. My resting pulse rate was up to 90, and per the doc I was seeing fluid build up in my chest cavity. I slowed town to hospital speeds and within a day I was back to a 78 resting BPM. At that point I started to increase my walk time by a minute a day. (Unfortunately the fluid took a while to clear out)
2nd time I overdid it was after 3.5 weeks. I visited with my surgeon who was happy with my progress. I asked him what my walking heart rate should be at as at the time, I was keeping it around 90 bpm. He told me that at my age and current healing rate, he would be comfortable with 110 and in fact recommended I step it up. At the time I was walking two 45 minute walks per day and two 10 minute walks, all at 90bpm, with a resting heart rate of 57 (had been steadily declining by about 1 bpm each day). After meeting with the doc I stepped up my after noon 45 minute walk to 110bpm. Next morning, my resting bpm was up to 62. Talked to my cardiologist about it. He was not worried about me breaking anything, but immediately cautioned that if I want to jump from 90bpm walks to 110bpm walks (which he felt was reasonable), he recommended that I do it over a few days. I scaled back to walking at 90 ? 95 bpm with a few short exertions, and the next day my resting bpm was back to 57, then 54 the day after.
Anyway, minus the initial fluid filling incident, I have been fairly complication free, but from my experience, it?s clear you can overdo it without even noticing until the next day. And overdoing it can have some pretty nasty consequences early on (fluid build up is bad!) So take it easy and go gradually.
PS ? I really like focusing on BPM. I have found that each day, even though I stayed at 90 bpm, my walking got faster meaning my mileage was up. I picked 90 bpm originally because this felt like a very comfortable, non-winded pace, and getting up to 100 felt kind of tough. It was not until week 4.5 where clearing 100 did not feel even the slightest bit uncomfortable.
