What can I expect?

[dcat96]

I was just reading through some posts adn much of it seemed so foreign to me. I am going to be having aortic valve replacement in the next 4-6 weeks. I feel clueless after reading some of these posts. What can I expect for pre op testing? time away from work ( I am an elementary school counselor), what about the meds (blood thinners?) and follow up after? and finally while Are there questions that I should be asking my surgeon that I may not have thought of?

 

[Ross]

Chest xray, echocardiogram, stress testing, gamma imaging, transesophogeal echocardiography, cathererization, I think I hit them all. You should have already had most, if not all done, otherwise, how could they determine you need surgery?

You'll be out of work 4 to 6 weeks, perhaps longer. It just depends on how fast you recover.

You need to choose a valve be it tissue, mechanical, Ross procedure or Homograft. Mechanical would require anticoagulation for life. See the valve selection forum stickies at the top of the page.

You'll follow up with your Cardiologist at 6 weeks, 6 months and then 1 a year with repeat echo's to keep an eye on the valve and make sure things are doing ok.

Do a search for questions surgeon. That will give you advice on what to ask.

 

[ricks399]

My pre-op consisted of blood work, testing of urine, ekg, meeting with anesthesiologist, meeting with cardiac rehab nurse (she gave me my spirometer) and chest x-ray. My surgeon did the TEE at the same time as the sugery. My surgeon said I would be off 3 months but I'm afraid I may have to go back sooner.

Whether you take anticoagulant will depend on the type of valve you choose, preferences of your surgeon and maybe whether your heart stays in rhythm after the surgery. I went in and out of a fib so my surgeon put me on warfarin but I'm hoping to go off after my next visit on September 3.

Oh, and my surgery was on July 21 but I had my echo in late April. What have you asked your surgeon already? If you forget anything you can always call his/her office with questions.

Good luck and I hope everything goes smoothly for you.

 

[WayneGM]

After I was diagnosed that I needed OHS, I had a cardia catherization and just the usual heart monitoring tests until surgery (echo, EKG, stress, blood, etc). I was told I'd probably be off work 10 - 12 weeks. I took the full 12 as I had the insurance coverage to do so. However, I've noticed many in this forum were back to work much earlier than me. Best wishes and good luck.

 

[ponygirlmom]

I was just reading through some posts adn much of it seemed so foreign to me. I am going to be having aortic valve replacement in the next 4-6 weeks. I feel clueless after reading some of these posts. What can I expect for pre op testing? time away from work ( I am an elementary school counselor), what about the meds (blood thinners?) and follow up after? and finally while Are there questions that I should be asking my surgeon that I may not have thought of?

Some of the popular tests get repeated several times. You mayu have already experienced this. Your surgeon will want to get a really good idea of what is going on in your heart before surgery, so it's picture, picture, picture!

The test that will keep you from work for a few days (are you on vacation, or do you have year-round school?) is an angiogram. That's where they put a catheter into an artery in your groin (usually) and snake it up to your heart, squirt dye in there and look at it. Some people have their angiograms right before surgery, but it seems that most people have them in advance. You generally stay in the hospital for many hours because you have to lie flat, or nearly flat, afterwards to prevent bleeding. You also won't drive the next day at least, again to prevent bleeding. But don't let this test sound too scary, because you are very sedated for it. They like you to be awake -- why, I'm not sure -- but for me and for everyone whose stories I have read, there isn't any pain and you don't remember a lot of it.

Another test that will take up a whole day is a TEE -- "transesophogeal echocardiogram." This is where they put a camera down your throat to look at your heart. The reason you will miss a whole day of work is because of the sedation. I was nervous about this test beforehand, but I don't remember a thing about it. They have very good meds there at the hospital!

Early on I had an MRI with contrast dye. Even earlier I had a regular CAT scan. Have you had these already? My surgeon was going to order another MRI, but I have too many problems with contrast dyes so he decided not to. It was enough that they had to use dye for my angiogram.

And then there are chest x-rays, blood tests, ekgs (really fast tests where they stick wires all over you and seem to take them off the second they get them on) and echo-cardiograms (like a sonogram, only they look at your heart rather than a baby.) And I guess a stress test -- I had one, but I don't remember if everyone whose stories I've read here had one before surgery. The stress test is the infamous treadmill test.

I'm wondering if your surgeon will want to keep you away from the kids for a few weeks before surgery. You don't want to have to postpone surgery due to illness, and kids and germy! (I know -- I taught K-8 music and dance.)

A good thing about your job -- being a counselor -- is that you don't have to lift anything, like a classroom teacher might, but you also don't have a job that is done 100% at a desk. That means that you can physically perform your job, and be more comfortable about it. (That's from my personal experience -- I am almost six weeks from surgery. I run a business from my home. I have started to take care of some business again, but I am not able to sit at my computer for as long as normal. I would not be good in an office right now!)

About follow up care: this is totally my own experience. I saw my surgeon once a week for three weeks in a row, each time getting a blood test, ekg and chest xray. I also had one emergency visit due to complications, at which I had those tests plus an echocardiogram. I'm seeing him again today to follow up because of more complications. I have an appointment with my cardiologist, too, which is standard, and one with my GP to discuss my wretched anemia problem. (Not something you are likely to have.)

Other member will be able to tell you what kinds of after-care you get if you have a mechanical valve and are on blood thinners. I have a bovine valve. (Technical name -- Moo Cow.)

Oh, and they will be recommending that you go to cardiac rehab exercise classes, which seem to be held in many locations. In other words, you can go close to your home or school, and not have to travel to the hospital at which you had surgery.

As for questions to ask your surgeon, I don't know what you've already asked! Some basic ones are:

* What are my valve choices?
* Do I HAVE a choice, in your opinion?

Okay, I'm fresh out of surgeon questions. All the questions I had were for the hospital!

Here's some unsolicited advice:

* Buy a recliner

* Buy a pedometer with a heart-rate monitor and figure out how to use it before surgery. You'll want it afterwards.

* Find an errand service, even if you have a husband, parents, in-laws and the entire church choir swearing they will help. They aren't thinking about eight weeks after surgery, when you're back at work but easily exhausted.

 

[Jkm7]

It seems to vary as to which tests we have. I never had an MRI or CT scan but many did. Most have echo, TEE and angiogram. TEE's are done again during surgery while the surgeon still has the chest open.

I had periodic echo which was scheduled as part of regular Cardio visit. It showed the regurgitation had worsened. I then had chest x-ray, blood and urine just prior to a TEE. I found the TEE very easy, no pain, no side effects and I was permitted to drive the next day.

I then had angiogram and like the others have said the anticipation was worse than the realization. (I had an angio 4 years ago but have no memory of it as it was emergent and I was very ill.) This angio was painless for me, much of it I don't remember. My doctor used the plug to close the artery so I only had to lay for about 3-4 hours after. I had no bruise, no pain, no swelling, no after effects and again was permitted to drive the next day.

I then saw my surgeon who reviewed all these CD's while I was with him.
We agreed on surgery date.

His office set up my pre op testing at Mass General for the day before my surgery. I was not admitted until the morning of my surgery....the next morning. DH and I stayed overnight in a hotel in the city so we would not have to worry about weather or traffic in the morning as we had to be at the hospital about 5:30 or so.

The pre op testing was blood, urine, chest x-ray, physical exam and loads of questions with surgeon's PA. We met with anethesiologist and again lots of questions. This was my second OHS at Mass General so the nurses knew I was familiar with what would happen after the surgery. (I was in CICU prior to the first surgery.) I imagine there would have been more orientation etc if I were not a repeater.

You're going to one of the finest heart hospitals and will be well taken care of.

 

[dcat96]

Thank you!

Thank you!

Wow you guys are great. Thanks for the insight into the next few weeks for me. and your advice and behind the scenes info will prove very helpful. I am becoming more at peace with this each day (and it has only been 3 days since I found out) I am starting the mind set " ok let's get on with it so I can get back to life!

 

[Susan BAV]

I was just reading through some posts adn much of it seemed so foreign to me. I am going to be having aortic valve replacement in the next 4-6 weeks. I feel clueless after reading some of these posts. What can I expect for pre op testing? time away from work ( I am an elementary school counselor), what about the meds (blood thinners?) and follow up after? and finally while Are there questions that I should be asking my surgeon that I may not have thought of?

Can you stand one more reply? And a welcome .

Pre-op testing: Common echos, and I had an MRI w/contrast, and an angiogram (or heart catheter). Some are given stress tests or stress echos; I don't like them and now refuse them.

You may want to start a personal medical file at your home and keep copies of all of your test results in that file. These can come in very handy and in many ways.

Time away from work: I think I've frequently read twelve weeks; but several members feel much better than that much sooner, and others, not.

You likely will not be allowed to drive for at least six weeks post-op. My surgeon told me eight weeks.

Meds: I had to temporarily take a whole bunch of meds post-op but don't have to take much now. For anticoagulation therapy (ACT -- commonly known as blood thinners) I take one baby aspirin each day which is common with a tissue valve. Coumadin or Warfarin is common for a mechanical valve.

Lots of questions for your (experienced and highly recommended) surgeon: I think you would want to ask what complications he/she may (or may not expect) and how often that occurs with their surgeries. Ask them what kind of valve they would recommend for you and why and also ask them what kind of valve they would choose for themselves and why. Also ask him/her what post-op complications they have dealt with, etc. It seems to me from what I've read here that it is not uncommon for a patient to endure at least one significant post-op complication, sometimes prolonging hospitalization and sometimes necessitation of re-hospitalization.

Also, I researched pre-op recommendations here on this site and my surgeon's office gave me a very informative packet of pre- and post-op information.

Take care and post again. Best wishes .