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Lynn

VR.org Supporter
Supporting Member
Joined
Mar 24, 2021
Messages
168
Location
British Columbia
Good morning all, I am new to the board but posted on my upcoming Valve replacement surgery in late March. I am home now and thought and update might be in order. Surgery was April 1st, and went well. I woke up in Intensive Care with the breathing tube still in as is common. The insertion of my Onyx valve went well and I was relieved to be through to the other side. The longest night was that first night in ICU, I was hyper alert and not dulled (unfortunately) by the pain meds. The strongest pain was in my shoulders.. the never ending Charlie horse that stayed with me for 36 hours. I know others have reported this, but I was surprised at how uncomfortable it was.

Most everything looked great post-op day one, oxygen, blood work ect. But I was told that i was being externally paced through the wires they insert. I had some heart block, that was initially hoped to be temporary. Not much to do at this point but wait it out and see if things improved as the swelling declined. I was sent up to the ward at the end of day 1, as I was doing really well in all aspects other than the heart block.

On the ward, I continued to do well, but nausea set in on day two in a big way and stayed until early day three when we decided to cut back to opioids and the naproxen and go just with Tylenol. Now I know Tylenol would not cover many peoples pain at this point, but it worked well for me and the nausea subsided. I have never tolerate pain meds well, and the very talented head of surgery that was covering that day (it was Easter weekend) said it was worth a try. After that everything improved, I felt pretty darn good and as cath and chest tubs came out I was able to be mobile and independent. The exception of course was my external pacer due to the heart block.

This was closely monitored with 12 leads daily, and experimentation with the pacer to see what rhythm I had on my own underneath. I had some, the block is 3rd degree. The problem is, my own rhythm was unreliable. It was becoming clear to everyone but me ( I was fighting it) that I would likely need a pace maker. It was a surprise to everyone, given my lack of co-morbidity other than BAV. This is an uncommon complication, and the nurses on the ward put it at around 5%. My very experienced surgeon has a much lower rate of this, so ya, a shock. Given the way it was dealt with by the nursing staff, I would say they see enough of it. They seemed to know what they were doing. By Monday and into Tuesday discussions began in earnest with me about the likely need for a pacemaker. I didn’t take it well. It was not something I had prepared myself for, at 58 and in otherwise good health I had really thought to dodge this one. Why it happened will likely never be know for sure, I received many different opinions on this, but I think my surgeon summed it up best by simply saying anatomy. He explained that sinus nodes that conduct electricity are unremarkable clumps on cells in otherwise normal looking heart tissue. Mine was located closer than most to the aortic valve. I do have a slightly miss shaped left ventricle so this is entirely possible.

Early on the morning of Wed the 7th, we tried another 12 lead at my surgeons request, and the pacer was turned off to get a look at my own rhythm. My ventricles did nothing for 8 seconds. In that 8 seconds 6 additional people burst into my room not realizing this was planned. They had a scare, but I will say I was impressed to see they really do watch those monitors and warning bells out there at the desk. This convinced everyone, including me that it was unsafe to go home with out the Pacer. They worked hard to get this swiftly taken care of, and the head of cardiac surgery who is in partnership with my surgeon, stayed late on Wed put in the pacer herself. They knew how badly I wanted to go home, and I appreciate their efforts. I also appreciate the support, the listening and the advising of all the doctors and nurses who came and talked to me to help me process this. They assured me a state of the art two lead pacemaker would allow me the best chance at a high quality, active life. It’s still tough to take, but as the pacer does make me feel noticeably better I am coming to terms with my additional hardware.

Doing well at home, but feeling a bit paranoid about every little change as I really don’t want another complication. Temperature spiked slightly to 37 plus last evening (around 98-99) for you non metric folks, and it worries me. It’s not high, but higher than I generally run. Hoping life gets better everyday and the rest of my recovery is uneventful.
 
Hello Lynn ... Good to see you back here post-surgery. Thank you for the detailed write-up.
Glad you’re home and healing, despite the bumps. Keep an eye on your temperature but hopefully things will settle down soon.
Wishing you a good and steady recovery as the days go forward. Very best to you.
 
My ventricles did nothing for 8 seconds. In that 8 seconds 6 additional people burst into my room not realizing this was planned. They had a scare, but I will say I was impressed to see they really do watch those monitors and warning bells out there at the desk.
This made me laugh, thank you, Lynn. I also had my doubts over whether they were really watching the monitor from the faraway nurse’s desk. : )
 

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