Re-operation.. should it be a deal breaker?

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Alerion

Alerion

Well-known member
Joined
Dec 28, 2008
Messages
100
Location
Dartmouth, MA.
Hey all

I had a meeting with a surgeon yesterday. It went great, we like the guy. We trust his motives, credentials, and stats and, although he doesn't use the On-x valve (my first choice for mech) he can hook me up with colleagues at B&W in Boston if I want to go that route.

So, I have come to the choice at last. I go next week for a tooth cleaning and final dental clearance and then schedule the operation. I need to make a decision and be comfortable with it. One of the major considerations we deal with in this process is whether or not a tissue valve and freedom from ACT is worth the second (or third) operation. My question is -

How bad is the operation?

I mean, I really want to know if I'm facing excruciating agony or debilitating, long-term physical hardship coupled with searing humiliation or whatever.

I know that to some extent, pain and suffering are relative. I look at my friends (and other women) who opt for natural childbirth and I think
"This woman is either clinically insane or far tougher than me or any guy I know of. Either way, I will not piss her off."

So pain is relative to your situation,upbringing, level of intoxication etc. but there are levels of discomfort we all seem to agree are unbearable. I don't know of anyone who's watched the "is it safe?" scene from the movie Marathon Man and said anything like "Huh. What's the big deal?"

So a BIG part of our decision in which kind of valve we choose has to do with the suffering we sign on for if the choice is tissue. And yet I don't see a lot of talk about it. Everyone seems very open and free with the other big decision-making factor i.e. the truth about ACT and it's impact on post-op life, but the misery of the operation itself is something we just assume?
I need more info than "Well, it really is unpleasant". I need to know that buying 15 or so years of ACT-free existence (in this case my 50s into my 60s)
with a tissue valve is worth it.

I mean all things being equal and assuming the best outcomes, am I crazy to prefer to avoid ACT, as opposed to the 2 or so months of discomfort and risk of re-op that mech valve patients get to avoid?

I understand that the unpleasantness of the operation and it's aftermath are difficult reading for some people, but I cannot fathom how one can make this decision without some understanding of what this operation really involves.

In short, is it so bad, so risky and so painful that you'll never, ever want to do it again ?

If I can answer that question, I think I can pretty easily decide on a valve.

So, if you're willing to recount it, please tell me the story of your operation, good or bad.

I hope you'll consider contacting me privately If you think it's just too gruesome to post here, but remember here is where everyone else is looking for answers, and the hard truth, even if it's really hard, can only help us make up our minds.

Thanks to you all
 
It's hard to say for sure.

We have Several Members with multiple surgeries.
Most got through OK. Mine was mixed.

Ross barely survived Both of his Surgeries. (LONG Stories about surviving a ruptured Aorta - few do)

Also ask the surgeons you talk to about their experience with re-do's.
 
From a clinically insane woman who birthed two babies the natural way, I don't know what to tell you. My bovine valve is in there doing its work. Yes I had some pain after the surgery. Am I prepared to have my chest split open again in say 20 or so years. I really don't worry about that. First I might get hit by a truck before then. But should I live to 76 I am betting that less invasive surgery will be the norm. If not "ah well, bring on the chest splitter" I spent most of my life not realizing anything was wrong with my heart. I was told I had mitral valve prolapse which did not require surgery, next thing I know I am advised after being hospitalized with bacterial meningities that I need a valve replacement. OK, but the kicker was that they needed to replace my aortic valve! Where did that come from???
Anyway....try not to over-think this cause there really are no clear cut answers, we only muddle on the best we can and thank God that there are surgeons out there who can fix our botched up hearts so that we can continue to spin around on this big blue marble we call earth.;)
 
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Why not just flip a coin !? You're still going around like a headless chicken, neither option is right or wrong and the fact remains either beats no option hands down ?

My operation wasn't too bad pain wise, infact on the "big" day I was laughing and joking (probably nerves!) with the doctors in the morning ... Next thing I was waking up in the early hours of the next morning. The mental head trouble is far more painfull than the physical pain. Although the early days/weeks really are not comfortable at all, however for about 4-5 days you'll have very strong, button fed pain relief and pretty much as many pain drugs as you like... So for the main part still no REAL pain. I just had a few really nasty episodes with so much pain, mostly from a tickly throat bringing on caughing fits a couple of days after surgery. On one occasion I actually fainted and can honestly say I've never been in that much pain ever ! Mentally I actually broke down in tears one morning at about 5am, I was absolutely exhausted, at my lowest ebb with a nurse stabbing my arm for a blood test, FOUR times she tried and failed. That dosn't sound too bad but you had to be there really, or in my head anyway, it was the very last straw !
But to put it in perspective, in the last 5 weeks and including the surgery I've probably suffered about 30-60 mins of real breathtaking, eye watering pain !?
Mentally, that's where the battle is. Adjusting to not being the agile, broard shouldered, unbreakable, do anything, go anywhere bloke I was 5 weeks ago ! That's the tough bit. I'm now weak and fragile ... But, hopefully on the mend and clawing back some of the lost ground ?
Be it Mechanical, Warfarin or tissue it matters not really. A tissue valve could clog up or go wrong, a mechanical valve might just drive you nuts with it's clicking and clog up too(although mine seems to be getting filtered out by my brain as time goes on). Neither are nearly as good as your old one (before it went wrong). The Warfarin is a drag if you drink loads and loads of alcohol and get tatooed regularly, live on brocolli or drink only cranberry by the juice by the gallon !? Otherwise it's really not a big deal. There are folk on here who have been on the stuff for decades !
If they have to open you up again there are more risks than the first time, that'll be on your mind for years to come, also you'll have the annual scans showing it deteriorating in the latter years and the associated damage to you heart ? The mechanical last for ever but it clicks, it damages your blood cells and makes you dependent on vit K antagonists too !
Cheery stuff, but you did ask ?

Here's the thing .... Yes, it hurts and you wouldn't want to do once, never mind twice ! But you'll probably survive ..... Flip a coin !?
 
I have not too much to say about a re-op except that I am resolved to outlive the usefulness of my Medtronic Freestyle Porcine Tissue Aortic Valve, thus a third valve replacement surgery sits somewhere in the foggy future.

I am anticoagulated for the rest of my life anyway but that's due to my natural tendency to form clots in my extremities and not because of cardiac concerns. The beauty of having the tissue valve in place even though I am on ACT is that if I must discontinue my warfarin for any reason, I don't need to bridge with Lovenox or heparin injections.

The redo came early in my first Freestyle's placement since I formed pannus which had reduced my valve opening to something even smaller than before I had the first surgery. I recovered quickly and this, I think anyway, was due to the fact that the second time around was performed on a far healthier me. You see, before the first valve replacement most of us are actually more ill than we know. Valve degradation is an incipient and pervasive disease that has lasted, for many of us, most of our adult lives although we remained unaware. So, for surgery two I was healthier and the recovery was faster.

Prior to AVR#1 my left ventricle had hypertrophied and the ventricular septum had thickened (due to muscle growth) so much that it was impeding my mitral function (which was also impaired due to the high left ventricle pressure because of the aortic valve stenosis). So, for surgery two I didn't have any serious heart remodelling and thus my mitral and pulmonary valves were both functioning as advertised.

The actual sternotomy pain and subsequent drainage tubes and pacer wires were all expected leftovers the second time around and easier to deal with.

If you have a mechanical valve any future percutaneous or even tissue valve replacements are not generally options you will have the opportunity of exploiting. There's a reason mechanical valves are one surgery valves, they will outlast your heart and for many people this is exactly what they want. Me, I like knowing that as technology and cardiac medicine changes and (hopefully) improves over time, I have the chance to experience the benefits.

I hope that helps.

Take Heart,
Pamela.
 
Well, I hope I never have to go through it again - that was my reason for choosing a mechanical valve. Plus I had a lot of faith in my surgeon who advised mechanical because in someone my age, and due to it being the mitral valve, tissue "would only last 10-12 years in all probability".
I know there are people on this board who wouldn't agree with that statement, but I trusted his judgment. He is a very highly regarded, experienced surgeon.

I think the discomfort (not so much actual pain) and being "out of action" was the worst thing for me - plus I had post op complications and had to be readmitted to have fluid surgically drained from the pericardial sac.

No way would I want to have a tissue valve and know that I would be facing another operation - that's just my personal view of course. There are people here who are okay with having a second surgery.

I have had a gutsful of hospitals and procedures (having been admitted to hospital many times prior to my surgery, due to A Fib) and want to try and avoid them in future, lol.

The thing is, we can tell you our stories but everyone's outcomes are different - some people still end up on ACT even with a tissue valve (because of AF) while some mechanical valves do need replacing for various reasons. Both these occurences are relatively uncommon but can happen.

Um....like Justin says...toss a coin??

Bridgette
 
Assuming you get the pain medicine you need, there is very little or no excruciating pain. You will be uncomfortable. You will be sore. Sneezing and coughing may hurt, but compared to natural childbirth, open heart surgery is a breeze! The risk of reop for tissue valves or any other valve, is that scar tissue forms and each surgery is a little more risky.

Now, if, like me, morphine makes you throw up, and the nurse thinks the surgeon's phone order is discontinue morphine and give phenergan instead (as opposed to keep giving morphine and add phenergan for the nausea), your pain will be truly horrendous.
 
Thanks Pamela, that does help a lot. I'm really happy to hear you're 3rd OHS won't scare you as much as my first is freaking me out!

"The actual sternotomy pain and subsequent drainage tubes and pacer wires were all expected leftovers the second time around and easier to deal with."

That's kinda what i figured. Does the prospect bother you much?
Thanks for the lucid insight.


Hey Woodbutcher - You have pretty much nailed it. I actually have a coin I intend to flip if I get down to the wire without some brilliant insight popping up to inform me.

I think the most important thing I've learned in the past month is that nobody, not the patients who've been through it, not the doctors who perform the operations or the manufacturers who make the valves or the researchers and tech writers who bring the data to the masses... NOBODY has the answer. In fact, unless you have some other compelling disease, condition, restriction or medical history, there is no answer.

If you're not particularly put off by ACT or thoracic surgery, you might as well go ahead and flip the damn coin because IT DOESN'T MATTER!
The balance between the two is too close to call so I just decided to weigh the respective down-sides.

Thoracic surgery sux. I get that. But it lasts a short while.
ACT is no big deal. I get that. It has it's risks, though, and it's a life-long therapy.

SOooo, since I tend to avoid the intrusion of Doctors, Pharmaceutical companies and the rest of the machine into my life, I want to know if I'm bad-ass enough to face TWO operations and the difficulties they impose on one's life.

Sounds like you had a tough go of it. I'm grateful you put it out here for us to read. Not sure I would face it so calmly but I guess you never know 'til you've been there. Congrats on the on-x. No doubt you'll be back to kicking ass and taking names in no time.
 
Or, if you're like me and unable to tolerate morphine and morphine derivitives you'll go through a full gamut of pain killers until you find the best. Mine is codiene and of course the dietician provides a verrrrrry healthy fibre supplement in prunes and prune juices :blech:.
 
"The thing is, we can tell you our stories but everyone's outcomes are different - some people still end up on ACT even with a tissue valve (because of AF) while some mechanical valves do need replacing for various reasons. Both these occurences are relatively uncommon but can happen."

Bridgette - Understood.
I just wonder if the thing I'm supposed to be avoiding, the main reason people give for avoiding a tissue valve, i.e. the actual operation, is really a deal breaker. Is going through it twice worse than going through it once and being on ACT? That's not a question anyone can answer for me but I can try to make up my own mind if I get a good enough idea of how bad the actual operation is.

Lisa - Holy Crap!!! Oh man, that's a horror story. I am considering hiring, at whatever the expense, a large, well-muscled, surly but well trained Armed Forces combat hardened medic as a bedside "consultant" who would monitor my meds and dressing changes with a short length of lead pipe in his hand.

Yikes, I hope you didn't suffer too long ?
 
Now, don't get me wrong about the worry and stress of anticipating another surgery. It's there, it's simply taken a distant seat on a different train platform than the one I'm standing on right now. I can live with it, though. For me, my decision was based on the fact that I was still a fertile and (relatively) young woman and I'd had a bleeding experience in the early eighties (granted ACT managers then didn't have the tools of today to make my INR # as well tuned as it could have been) that predisposed me to avoiding Coumadin therapy. Valve #3 could very well be a mechanical instead of tissue.
 
Alerion said:
"The thing is, we can tell you our stories but everyone's outcomes are different - some people still end up on ACT even with a tissue valve (because of AF) while some mechanical valves do need replacing for various reasons. Both these occurences are relatively uncommon but can happen."

Bridgette - Understood.
I just wonder if the thing I'm supposed to be avoiding, the main reason people give for avoiding a tissue valve, i.e. the actual operation, is really a deal breaker. Is going through it twice worse than going through it once and being on ACT? That's not a question anyone can answer for me but I can try to make up my own mind if I get a good enough idea of how bad the actual operation is.

Lisa - Holy Crap!!! Oh man, that's a horror story. I am considering hiring, at whatever the expense, a large, well-muscled, surly but well trained Armed Forces combat hardened medic as a bedside "consultant" who would monitor my meds and dressing changes with a short length of lead pipe in his hand.

Yikes, I hope you didn't suffer too long ?
Click to expand...


I guess some more members might chime in eventually, specifically those who have had two or more surgeries, with their perspectives - then you might get more of an idea.
If you did decide to get a mechanical valve you could get a home tester for your INR and then you are in control of your ACT - there can be minimal contact with doctors/clinics. I can tell you that my doctor knows that I home test and control my dosing (with the help of Al Lodwick's chart) and he is fine with that.
I don't think that being on Warfarin is really that bad - again, just my opinion.

If you really, really can't make up your mind, why not just go with what your surgeon advises?
 
If pain was the only consideration, we'd be a nation of only children!

If pain was the only consideration, we'd be a nation of only children!

The mind can both drive us to the brink with worry and concern and then just as easily help us to overcome the worst memories and circumstances. If pain were the only consideration, we would have long ago turned into a nation of "only children" as woman after woman rejected the idea of a second childbirth!

The truth is that most of us have been blessed with the ability to quickly "forget" or at the very least, be left with cloudy or faded memories of the most awful experiences we have endured during our life. Measuring pain is very difficult and I don't think it can be used as the determining factor in making the valve decision. There are excellent arguments on both sides of the issue and we all have to finally go with whatever seems the best fit for our own lives--and then don't look back.

My surgery is still several weeks away, but I've decided on a tissue valve for my own reasons and now I feel like I can move on to the other things that I need to take care of before the surgery. We are all different in the way that we deal with this problem, and I'm sure that you'll soon come to your own resolution. Once you've decided, toast to your choice and relax...worrying at this stage won't help. Those of us who are good candidates for this surgery are the lucky ones--a generation ago our problems may have gone undetected, with a very bad outcome. I'll drink to the next generation and hopes that soon our fellow valvers won't have this issue as transcatheter valve replacement becomes the norm. Good luck and best wishes for soon finding peace in a decision that works for you.

Jane
 
Alerion,

It is important to trust your surgeon and feel at peace to put your heart in his hands.

As to how bad is the operation? the answer will differ from one person to another, depending on the person's age, psychological state, and health. But in general, and my personal opinion, time is a real healer and one forgets how bad it was within weeks. So pain is relative and there will (my exerience) great discomfort the first couple of days, and then it improves slowly.

It will be hard ot advise you which valve, but I will share with you why I avoided tissue valve. At age 57, I did not want to go through this again neither in 5 nor in 20 years. I lived most of my life worrying of the anticipation of when I shall need the surgery, and I do not wish to do it again when I am older. If I were in my 20s or 30s and with the energy I had then and as strong mentally and emotionally as i was then, and knowing that in the near future valves will be replaced precutaneously, I may have gone tissue then!

ACT is unpleasant until you learn how to handle it, if one needs surgery, you have to go through 'bridging' procedure...but all are livable like many other things in life. .

The story of my operation in brief: I said goodbye to my hubby and soon later after a restful sleep I woke up with my hubby and sister and step son around me. Luckily for me, the breathing tube was removed while I was unconscius. I was in much discomfort that first night, add to it the nurse's tapping on my back to get my lungs working better again.

Next morning, I was feeling great...mentally alert, emotionally storng, and pain free. I did not believe I was operated on. I was joking with everyone around.. The following day, I felt like I was hit by a train, yet it was acceptable knowing that I survived the surgery and will have a healthier me! my HR went up to 106, I developed slight fever and was given anitbiotics only that day and it was gone, my sugar level was high (I am not diabetic) but it was the trauma of the surgery on the body and I was given insulin shots for seven days. The worst part was I could not sleep and rest, mainly at night,with all the x-rays, blood drawings, and BP monitoring. But one nurse told me that I was in a hospital not in a hotel and being in a hospital is to make me feel better more than to sleep! All nurses were wonderful and in general and overall I can say somehow 'pleasant' instead of not a bad experience. I stayed in ICU for 8 days as there were no rooms in the down level. My total stay was ten days because of my inr was way below range. Ninth day, a nurse caught me with a tear on my cheek...I do not remember now why, but definitely I was reflecting on what I was going through. So, in brief, it was not that bad, and again, time flies quickly and once you start recovering your energy, you start feeling better, you forget what went behind.

This was the hardest part for me...choice of a valve. Wish you luck. :)
 
not much pain

not much pain

I chose a tissue valve, so obviously the re-op issue was one I weighted lower. But now that I've been through it once, I won't dread the next one nearly as much. I was one of the fortunate ones, not I think unique, in the fact that I had little pain from the surgery. I stopped taking the pain-killers at the hospital after the first day post-op. My worst discomfort was actually horrible reflux the second day after surgery. They dosed me with their whole arsenal for it until it subsided by the end of the day. And the third day I went home. I never filled the take-home prescriptions for pain-killers. I'm a wimp, too.

Before surgery, I was consoled by reading in this book, "Your Heart/An Owner's Guide," by John A. Elefteriades, M.D., professor of cardiothoracic surgery & professor of surgery @ Yale University School of Medicine, and Lawrence S. Cohen, M.D., Ebenezer K. Hunt professor of Medicine at Yale, that sternotomy is one of the least painful surgeries because most of the nerve supply to the chest does not reach that far (p. 224).

Many comment on back pain during recovery. Mine got better when I stopped clenching my pillow so tightly. It was also worse at night, and I've wondered whether that was because I did my prescribed walks during the day and ended up sitting several hours in the evening.

Three months later I developed pericardial effusion and and pleural effusion and ended up with thoracotomy (between the ribs). THAT was painful, and the drain line between the ribs was painful, not excruciating, but not controlled the 3 days I had it.

Hope this helps--glad I don't have to decide for you!:D
 
It just wasn't that bad for me. I wasn't in a lot of pain (I requested Fentanyl instead of morphine) in the hospital. I had a short period of time when the chest tube rubbed inside in a bad way.

There wasn't much pain when I got home (three days after surgery). I was up the steps the minute I got home, and never had trouble with them. I was out and smelling the flowers pretty quickly. I was walking unhurriedly to town and back (about five miles) daily, less than a week after the surgery.

I will have another surgery, maybe two (I will likely have to have a resurgery long before my current tissue valve wears out, due to a hyperactive ventricle that thinks a 25mm valve - a good, average size - is too small). While I can't say I'm looking forward to it, I'm really not horrified about it at all. I'm not just content with my choice, I'm very happy with it, and will be choosing it again (unless the On-X is cleared for no-ACT usage).

Indications are from most women that childbirth is more painful. I have been blessed with an inabilty to test that theory.

Some people have trouble and some sail through. Attitude has something to do with it in many cases, but there are certainly complications that can override a good attitude pretty rapidly and thoroughly. That is the flip a coin part. However, most seem to come through it pretty well.

Best wishes,
 
Speaking from my experience(2 Mitral ops in 3 years) I never want to go through it again. Having my finger pricked and taking a few more pills a day isn't much of an obstacle. Besides my heart rate after Mitral replacement was all over the place. 150's for 24 hours 60s for 8 hours 0 for 8 seconds 40 36 hours. The scar tissue and were they cut your heart open is right on the electrical center for your heart. So now I have my new pacemaker(see iBeat add in small talk) My surgeon told me that after the first surgery the chance for a pacemaker goes up 30% after every next surgery. But on the other hand if I need another one I will have it. But I don't want it just to have a part replaced.
 
Alerion said:
I mean all things being equal and assuming the best outcomes, am I crazy to prefer to avoid ACT, as opposed to the 2 or so months of discomfort and risk of re-op that mech valve patients get to avoid?

...... but remember here is where everyone else is looking for answers, and the hard truth, even if it's really hard, can only help us make up our minds.

Thanks to you all
Click to expand...

There is no guarantee that someone who gets a mechanical valve will not need a re-op. There is no guarantee that someone who signs up for a tissue will not end up with a mechanical (either when first opened up, or in subsequent weeks, months, years)

So much of this seems to be luck. Can you create your own luck? No. Perhaps the lucky ones who sail right through surgery and recovery with the tissue, will have the valves that last the longest! Perhaps those who have horrid pain and post-op complications with tissue will be those for whom the darn valve doesn't last very long and have to go in for a new one sooner than the currently proposed 20+ years. Or, perhaps, vice versa.

For me, I decided that even though I was abit young, 52, I would go tissue. I understood that I was being given a true gift of life with either choice. So, having been handed this gift of technology -- of medical mastery, how should I best honor that gift? For me, it was to choose to live the life I am now living which is already so blessed and wonderful. Not to change anything. Not to have any new worries or new habits. I'm not that good with change. A scar I can live with. A few pills for blood pressure, etc, I can live with. But pills that require so much (in my mind) management, visits to coagulation clinics, regulating diet, going on and off for the myriad of future little procedures that I am likely to have (very fair skinned with several bad sunburns... already had a little no-no cut off my nose; just had a little benign lump taken out of my breast, gum disease runs in our family, Alzheimer's now runs in my family, I have really bad knees and would like to replace them someday, the list goes on and on). What I worry most about is not how my life may be affected, but how the lives of my children or my husband might be affected. I mean, you can bet that if they find a test for early Alzheimer's detection and I take it and I'm looking to have it, I will find a lawyer who will write me up some kind of document that makes any future elective surgery for valve replacement a not going to ever happen kind of thing. I do not want to prolong my life through something as grueling as that (been there, done that with my own father). I know several people who have lost their loved ones to stroke because of mishandling of anticoagulants. Or worse, had them grossly debilitated due to that kind of stroke. That world just did not appeal to me. For some, those sentences will sound like nonsense. And quite possibly, my words are nonsense. But they were my making of the sense for me. Just for me. You asked us to let it all out. I haven't, really, before.... but you did challenge us to, even though you have only made 30+ posts here. I hope that you have read as much as you can on this forum. There is wonderful advice about anticoagulants and how to manage them.

And you wondered about our feelings about surgeries down the road. Is the re-op going to be as easy? No. They will have to go through scar tissue. It will mean more time on the table, more time on the heart lung machine. At least I believe these comments are true. I will be older and less resilient, perhaps, so recovery could be awful, even.

Was the first op any fun? No. But I would have a hard time ever fabricating a horror story around it. I was very, very lucky. I had pain, loved the pain killers and used them. No problem. Mostly just that feeling of having been in a train wreck, than pain. Just stiff, apprehensive about moving through the pain kind of stuff. Did it take much away from my life? No, recovery was almost lovely for me.... a springtime, family-and-friends-waiting-on-me, kind of event. I'm a homemaker, mother of 3. I was not absent from a career, or worried about little ones running about, or needing me. My timing was good. Physically and emotionally it was tentative, sure.. (what is that feeling? is that okay?) and frought with the usual anxiety of a serious event.

I do not look forward to going through all the testing and pin-pricking again. I do not look forward to being tired, to the palpitations, to the weakness that precedes the surgery as my valve goes down. I do not look forward to "looking fine" but actually being very sick, to not having anyone really understand what I am feeling except people who have gone through it. But, like a teenager, right now I feel immortal. I don't worry about it. I'll "cross that bridge when I get to it".

I have no regrets. Most people here, have no regrets. We all choose (those of us who were lucky enough to have time to choose) what we think works the best for our own lifestyle, our own set of values.

This is a tough choice, but ultimately, as has been said so many times, you are choosing to live! And you will wake up still a member of this wondrous planet no matter which way you go. So smile at the warmth of the sun and the cool light of the moon because you get to stay in their light!! :D

Marguerite
 
My tissue valve surgery last February was my second OHS (in four years). When I chose that valve, I knew there was the possibility of a third OHS :eek: but made that choice. I am so so so happy now with my decision and know it was the right one for me. Though I was on warfarin for 2 1/2 months post op and didn't have a signficant problem but never reached therapeutic range, I was relieved and grateful when my surgeon told me I could stop. That's just me and I can't speak for anyone's thoughts or experiences but my own.

Were I to be told I needed a third OHS, I don't pretend I wouldn't go in a tail spin but I really do know the anticipation and wait is worse than the realization.....at least for me. Mass General Nurses made it very clear to us heart patients that pain control is as important to them as temperature and blood pressure. I was never in excrutiating pain this second surgery and with my first, the only horrid pain I suffered was removal of my three chest tubes. I knew to ask for additional pain meds prior to removal this time and it was day to night experience.

I chose a tissue valve and without question would do so again.
I also want to add that my re-op For Me was easier on me than my first OHS. I was in CICU under 24 hours post op, I walked the day after my surgery with four chest tubes in place when my nurse put the four containers on a wheel chair which I held onto. She walked on one side and my DH on the other. I felt good. My surgeon said the scar tissue was no problem for him and my surgery was about 7 1/2 hours as he tried hard for a repair before he knew it would not be a good one and went to 'plan B' and implanted the replacement bovine. I generally went through the second surgery consderably easier than my first four years prior.

I got so tired my first round hearing 'everyone is different' as the response to almost all my questions. By the second OHS, I accepted and understood that is true. We all experience this event differently and the same person often (usually ?) experiences it differently if re-op is performed.

The wait really is the worse part. Truly, it is.
 
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