My AVR surgery story

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palmaceae

Well-known member
Joined
Feb 25, 2009
Messages
280
Location
Eastern TN
Here is my story of my AVR surgery.
I wanted to write all this down before I forget it, even though there are certain parts I would like to forget ;). I had my aortic valve replaced on Tuesday March 10th, 2009 at Alexian Bros Hospital in Elk Grove Village IL. I am 46 years old. My surgeon was Dr. Henry Sullivan (excellent surgeon BTW). He has been practicing for 43+ years and has excellent qualifications.
My aortic valve was replaced with a Carpentier-Edwards PERIMOUNT Magna pericardial aortic bioprosthesis with ThermaFix process, Model # 3000TFX. It?s a bovine tissue valve. (MOO!) The surgeon later told us how bad the valve was leaking when he got in there, he said I was very lucky to have this done because within a year I would have had serious issues. God blessed me so much to lead me to this surgeon before it got too serious!
I arrived at the hospital 5:30am, took me in at 6:30am, I remember being wheeled into the operating room but before that when they were prepping me and started wheeling me into the operating room where I said my "love you" to my wife, I got a bit choked up, I was a bit emotional at that point (yes I am an emotional guy :D) but I was not really feeling scared. Of course instead of coming up with something really memorable to say, I said "lets get her done" :D.
I then remember having the wrist catheter put in. Actually I felt like Jesus Christ with His arms outreached being ready to be crucified. Of course His pain was much worse but that is what I thought of while laying there. I was in a fog but I do remember the warm lights and people talking. I sort of remember the neck swan catheter being inserted, (just a short note on needles, I hate needles and was more worried about the catheters then I was with the actual surgery) then I remember just everything fading away.

Started surgery around 9:30am (I heard the surgeon had an emergency procedure to go to so I had to wait a little while but I was pretty well sedated at that point).
Surgery was finished up around 12:45pm.

2:30pm my wife and daughter saw me for the first time. They tell me it was a freighting sight seeing me attached to so many things. Let me stop right here and just tell you how wonderful my wife is, I am very blessed to have her as my best friend, she was with me every second that was possible, and I could not have gone through this at all without the Lord and without her. She was my private nurse for the entire time!

She said when she first saw me awake it was traumatic to her, my hands and arms were swollen and I was very pale. She said my eyes were open and I squeezed her hand, but I had tears in my eyes and looked like I was in pain. The breathing tube has just been removed I choked trying to speak I said, ?It hurts.? They were trying to regulate the pain medication and the morphine was not working. Even though we were warned what I would look like, there is no way you can really expect what your love one will look like after this major surgery.

My next memory is being in the CICU looking at my red socks, kind of like tunnel vision, and moving my feet and feeling like there is something wrong, just a bunch of weird feelings, but I don?t remember anyone talking, even though my wife said she was talking to me. I do remember the incredible pain and the worst feeling I have ever felt in my life. Now before we say that may have been poor pain management, you need to understand me, I can not take codeine or vicodine, and do not react well with most medications. I can not really describe the true feelings I had but it was not pleasant. They told my wife I was in pain and was trying to regulate the morphine for it to help me, took a while to do that. The feeling I had was indescribable, awful and terrible. I know some people here said their pain was not too bad but for me it was quite different. I guess medications work differently for different people. It was not just the pain, but the all around terrible "sick" feeling, that is what I could not get my mind around.

The surgeon likes to remove the breathing tube before his patients wake up, thank God but I had to be breathing on my own. So they keep me asleep until 5:30am Wednesday morning when they took the breathing tube out, so I have no memory of that at all. It was a very strange feeling trying to breathe after this, amazing how hard that really was, seems I could not get my lungs to open all the way, but it got steadily better everyday. But I had my trusty spirometer with me.

8:00am Wednesday is when I started to really remember things.

I remained in CICU until Wednesday around 4:30pm, so about 16 hours there.

I was moved to the cardiac floor where I was rewarded with a private room!

I was there from Wednesday to Monday March 16th at 3:00pm, a total of 6 days and 9 1/2 hours in the hospital.

During my time in CICU, I do not remember much except that I did have my heart pillow, and after the pain management kicked in I started taking things in and remembering a bit more. One of my first memories was wow, this was A LOT harder then I thought this would be.
During my time there I had a couple complications; the first was Post-Pericardiotomy Syndrome (PPS). They told me it is not that uncommon for that to happen. The way they explained it is it is an inflammation of the pericardium (the sack that surrounds the heart). They gave me prednisone for that and still taking it for a while. The 2nd complication was fluid in my lungs, they were afraid of pneumonia. I am taking antibiotics for a week.

Here are some highlights of the days I was there.
Wednesday,
Was in a lot of pain, very out of it, had an xray. Had an xray done everyday because fluid build up in my lungs. Ate for the first time, had the 2 drain tubes taken out and the foley tube out. The 2 drain tubes was NOT fun, to me it felt like someone trying to vacuum out your insides! The foley was not too bad, as I had kidney stones last year with some complications and had a foley in for a week, so no surprise there. Had a Heparin shot everyday in the belly, ouch! I was also getting daily blood sugar test and insulin shots, seems this is normal for post op of major surgery. Also everyday the respiratory therapist would give me 3 breathing treatments which included pounding me in the back to break up the fluid, that was not much fun either. Took my first walk later in the day when I was in the new room. The cardiac therapist would come 3 days in a row to get me walking. I also took Darvocet everyday for pain and these pain patches (can't remember what they were called).

Thursday,
Was in new room, still out of it, noticed my groin was sore on one side, they must have inserted 2 catheters in both femoral arteries during the surgery, xrays. Ate again, but not much of an appetite.

Friday,
Was feeling a little more alert, xray, had the smaller drain tube removed, thought this tube would be easier then the larger 2, to me, it still felt bad! Started giving me cortisone for the PPS.

Saturday,
Was feeling a bit more normal, was actually feeling human again, xray again, had the pacer wires removed, now I thought the pacer wires would be the easiest to take out, boy was I wrong. Don?t know how many people know how it is attached to your heart but the wire has a curly queue end that is physically in the tissue of your heart. They have to pull it very slowly, with each heart beat, I held my wife's hand and they pulled gently and slowly, it felt as my heart was coming out with it, it was one of the worse experiences I had in the hospital. When the nurse pulled it out, she showed me the wire and how the wire had a curly queue end and that it had no heart tissue on it, I thought that was probably a good thing! Had an echo because of the PPS.

Sunday,
Was wondering when I could get out of the hospital, xray, taken off oxygen.

Monday
Released from the hospital, before I left they take a echo of the spot in my groin, was still sore and they found out it was a 4 cm hematoma, I thought I told the nurses about it before Monday but I did not really notice it unless I washed there, very tender and sore.

Alexian Bros Cardiac unit is wonderful! I know a lot of people talk about the other good hospitals in the area like Northwestern and Loyola but Alexian Bros. is one of the best cardiac units in the Chicagoland area.

I hope this helps in some way on my open heart surgery went, everyone's experiences differ and I am just glad I am on this side of the mountain! I still have a ways to go but I am headed in the right direction! I thank God my family and I made it through this, the Lord was my strength and my refuge.
God Bless,
 
I am glad to read that you're home, and I hope you have no more issues with recovery.:)
 
Welcome to this side of the mountain. I'm sorry to hear you had such issues with pain in the beginning... but it sounds like they finally got that under control for you.
Relax and heal, you've been through a lot. But each day will be brighter for you now.

jen
 
Sounds like a real ordeal, P., but you sound like trooper. Thanks for sharing the saga; it really does help, I think, for those of us who're still pre-op to get a solid picture of what can and does go on. Much of what you describe (tubes & stuff, especially) is familiar from my previous OHS, but it's really good to get a picture of what a different procedure can look like.

Good luck, and continued progress on the recovery!
 
Great job remeberring everything. I'm sorry you were in so much pain.
I'm curious do you know why you got the heparin shots in your belly? Justin never had them for any of his heart surgeries (he also have a perimount valve) If they were given you hep I wonder why they didn't just run in in your IV.
 
Great job remeberring everything. I'm sorry you were in so much pain.
I'm curious do you know why you got the heparin shots in your belly? Justin never had them for any of his heart surgeries (he also have a perimount valve) If they were given you hep I wonder why they didn't just run in in your IV.

That is a good question, I just thought it was normal? Come to think of it they did not give me much of anything in the IV tube, the insulin and heparin was a stick in the arm or belly. I would have much preferred it in the IV!
 
Thanks for sharing your story with us. We all have a different experience with the surgery. I don't remember being without pain the whole stay at the hospital. The nurses were always late with the meds, they had a lot of people on the ward, so I was told.
Anyway, you made it! We made it! Have a good recovery.
 
Hi Palmaceae, it's fascinating to me how people can have such dramatically different experiences getting the same surgery. Just one example I wanted to comment on was the removal of the chest tubes, wires, and foley. My nurse in ICU took these out on the second day after surgery and it took all of about 3 minutes (it seemed). She had me stand up, and one by one she pulled them out. The wires, in particular, were taken out differently than you. They came out fast (it did feel like there was a ton of wire), but not timed to my heart (that I noticed, anyway). Overall there was no pain, just some discomfort and weird feelings. Of course, I was on percosets at the time! Anyway, Godspeed in your recovery and may you heal quickly!

Dave
 
Hi Palmaceae, it's fascinating to me how people can have such dramatically different experiences getting the same surgery. Just one example I wanted to comment on was the removal of the chest tubes, wires, and foley. My nurse in ICU took these out on the second day after surgery and it took all of about 3 minutes (it seemed). She had me stand up, and one by one she pulled them out. The wires, in particular, were taken out differently than you. They came out fast (it did feel like there was a ton of wire), but not timed to my heart (that I noticed, anyway). Overall there was no pain, just some discomfort and weird feelings. Of course, I was on percosets at the time! Anyway, Godspeed in your recovery and may you heal quickly!

Dave

Yes I agree, it is amazing how each person reacts differently to things like this. I guess I could have been thinking about it way too much and thinking what was really going on inside while pulling out the wires! I was really trying to think of something else.:D
 
Back in '77 they had my pacer (jumper cables) wires going into me just about an inch above my naval. When my surgon pulled mine out he was very quick about it after they let go. Needless to say I did a situp, and was ready to inflict bodily harm unto him. :eek:

All in all it seems to me that things have gone well for you, and I hope they continue to do so. Best of luck to you & God Bless :)
 
Had a rough night last night. Every since I have been sent home Monday I had a hard time sleeping in my bed. I have a wedge pillow but I continue to slide down off of it, and have to wake my wife up every hour just to get back high on the pillow again. Last night after my shower I had some uncontrollable shakes, felt really cold. This has happened every night since I got home, but last night I went to bed and had uncontrollable shakes for a good 15 minutes. I also have night sweats, so then I get cold. My temperature is OK. My blood pressure was a bit high yesterday 126/78, but better today.
Has anyone every experience this in their recovery?
So last night I tried something new, I slept on my recliner that I sit in all day and that gave me a good nights sleep for the first time since being home. Still had the night sweats but felt a little better. I told my nurse this morning after she came over and she said I was over doing it. I live in a raised ranch so I have 15 steps to go up to get to my shower and my bedroom. My recliner is downstairs so I will stay down here for a while, since I have a bathroom and just about everything I need down here.
I just pray I get more strength back soon! I have been taking a 6 minute walk about twice a day, but no steps involved because I go out my garage.
 
Had a rough night last night. Every since I have been sent home Monday I had a hard time sleeping in my bed. I have a wedge pillow but I continue to slide down off of it, and have to wake my wife up every hour just to get back high on the pillow again. Last night after my shower I had some uncontrollable shakes, felt really cold. This has happened every time since I got home, but last night I went to bed and had uncontrollable shakes for a good 15 minutes. I also have night sweats, so then I get cold. My temperature is OK. My blood pressure was a bit high yesterday, but better today.
Has anyone every experience this in their recovery?
So last night I tried something new, I slept on my recliner that I sit in all day and that gave me a good nights sleep for the first time since being home. Still had the night sweats but felt a little better. I told my nurse this morning after she came over and she said I was over doing it. I live in a raised ranch so I have 15 steps to go up to get to my shower and my bedroom. My recliner is downstairs so I will stay down here for a while, since I have a bathroom and just about everything I need down here.
I just pray I get more strength back soon! I have been taking a 6 minute walk about twice a day, but no steps involved because I go out my garage.

Many people sleep better in their recliners..Night sweats are VERY common. What were you doing that the nurse said you were over doing it? Sometimes the home nurses have more experience with post CABG patients and not valvers. Steps a couple times a day shouldn't be over doing it, unless you were pretty out of shapee before surgery or had major complications
 
Many people sleep better in their recliners..Night sweats are VERY common. What were you doing that the nurse said you were over doing it? Sometimes the home nurses have more experience with post CABG patients and not valvers. Steps a couple times a day shouldn't be over doing it, unless you were pretty out of shapee before surgery or had complications

I am glad to hear that night sweats is common. I was in good shape before the surgery, just the shortness of breath thing. I did go up and down those steps a couple times yesterday, that is what she thought I was over doing. I did have complications with the surgery and that could still be affecting me, such Postpericardiotomy syndrome (PPS).
 
I am glad to hear that night sweats is common. I was in good shape before the surgery, just the shortness of breath thing. I did go up and down those steps a couple times yesterday, that is what she thought I was over doing. I did have complications with the surgery and that could still be affecting me, such Postpericardiotomy syndrome (PPS).

What you describe seems pretty common things to do when you first get home. If not a few more walks in. Are you still using your spig doing your breathing?
 
What you describe seems pretty common things to do when you first get home. If not a few more walks in. Are you still using your spig doing your breathing?

Yep, I do it every 30 minutes or so, I also have this other breathing thing, you blow into it and it vibrates, so in theory it is supposed to break up the liquid in your lungs, seems to work good. I do have fluid build up in my lungs, I do cough up clear liquid, I am on antibiotics because they were worried about pneumonia.
 
This is the first week I've woken up dry... the night sweats were horrible! And it took me quite a while to feel comfortable sleeping lying down also.
I also get chills easily, but constantly took my temperature just to be sure.. and spend a lot of time in front of a little heater..
time will take care of all this... and other things.

jen
 
MANY patients find that sleeping in a Recliner is more comfortable for the first few weeks. For some reason, I've not seen much mention of recliners, but there have been LOTS of posts/threads with reference to recliners in the past. Some Hospitals / Docs / Nurses even recommend sleeping in a recliner for a few weeks until the sternum begins to heal.

YEP, night sweats are fairly common. You can always call your Surgeon's Office and ask to speak to his Nurse or PA about any new symptoms / developments. They should be familiar with them all and give you reassurance and maybe even better ways to cope / treat your reactions.

'AL Capshaw'
 

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