48 year-old newbie - Lots of questions to come

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I'm still planning on having plenty of fun, I'll just have to make some adjustments... 3 drinks when out with the boys instead of 6 or 8. Adjust my coumadin when on salad diets. Not sure how to "work around" the beta blocker yet as far as sexual performance (on 100 mg, hoping I can get weaned off that eventually) but will figure something out. So I apologize for insinuating those on coumadin can't have fun! I was just naive!

Wow, 1.8 to 2.2 range huh? That's too small and nearly impossible to maintain. 2 to 3 would be more appropriate and expectable.

So I have to stop drinking more then 3 drinks? :D Umm don't know if I can do that. hehe, but in all seriousness, be moderate in your consumption. Last thing you want is to eat a hole in your stomach.

About these salads, if you normally eat one a day, continue eating them and your dose will eventually be adjusted around your diet, then you don't have to worry anymore.

The beta blocker.....If you find a work around, cut me in please!!!!
 
1.8 - 2.2

1.8 - 2.2

See pic of my Warafin bottle below. Kinda blurry, but it confirms what I remembered the surgeon saying in the hospital - 1.8 - 2.2. I remember him giving me an explanation of why it was lower than 'normal' - I just can't remember it exactly. I'm pretty sure it's because the St. Jude Regent (like the On-X) requires less anti-coags than other mechanical valves. Not sure why the range would be tighter than normal though... But I'll confirm when I meet with him again in a couple wks.

I got tested for the second time today and it was still 2.5 - exactly what it was last Thurs (my first post-hospital test). So he's going to let me go a week now w/o getting tested again, and is keeping me on 5 mg Warafin per day. The thinking is, as I get back to my normal diet (basically a salad each day) my INR should drop down a little - hopefullly putting it right in the target range.

If I find a work-around for that beta blocker issue, I'll let ya know. Although, it does make for a convenient excuse! It's easy to say "these damn beta blockers I'm on block more than beta..." But we all know, the truth is, it's probably just cause I'm old... But shhhhhh!

Still waiting for my cookies, but at least I have my heart pillow.
 

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Don't get me wrong, many surgeons are now recommending lower INR windows, it's just that that particular window is too small. Your INR can be off as much as .5 in a test, so you can see where the problem lies with a tight window like that. 2.5 is perfect and I wouldn't monkey around trying to bring it any lower in all honesty, because if you do, you'll get started on a yo yo and it will be near impossible to stay in range. Just eat your salads as normally done and it'll all work out. Don't fall into the trap of thinking eating more Vit k is going to regulate INR. Diet plays a very small roll in INR.

Age? I'd like to think so, but nope, damned Atenolol anyhow! Nothing worse then being a horny little critter and nothing you can do about it.
 
Andy,
I just your post where you asked about minimally invasive surgery or I would have posted back then. When I saw you scar photo earlier, had to wonder why there are not more people getting minimally invasive AVR surgeries. I did not need any bypasses, or anything else, and CT said he was about 90% certain he could do it that way depending on how the aorta sat in my chest which was confirmed by a CAT scan. The only difference I can see between the two of us is I was not a BAV, so I'm wondering if they wanted the more roomy approach for you because of that? Maybe some doctors are just more comfortable not doing them. I don't know, but it does surprise me as I can think of only about 4 people here who've had it (at least that I know of) and doesn't seem like anyone with upcoming surgery is having it either.
 
I talked with my surgeon about it, and he said while it's possible I could have had minimally invasive, he really discouraged it. He said using that approach means you're on the heart/lung machine longer because it takes longer to do the surgery. He said it's like working on an engine through the glove box instead of under the hood, so it takes a lot longer. I concurred, telling him, you go ahead and open me up then - I want YOU to feel comfortable!!! And I'm glad I did it this way. You may notice my scar is a little smaller than most others (not quite as long - starts lower). It's kind of a compromise he does on his patients - somewhere between traditional and minimally invasive. I'm totally happy w/ my scar. If it were 3 - 4 inches shorter - wouldn't make enough difference to me to offset the additional worry of the guy working on my heart having to fight with less than ideal visibility/mobility!!!
 
Andy,
Sorry, when I said less invasive I meant no sternotomy. My incision was between 2 ribs on the right side of my chest about 3 or 4 inches down from the collar bone. Surgeon said it was no problem for him. I agree that if he needed more room, certainly sternotomy would have been the thing to do, but I'm glad as a female I don't have that big scar down the center of my chest and I had hardly any pain after surgery. Sometimes, though, when I get a glance of it I'll think, how the heck did he have enough room to do what needed to be done?
 
Yep, I know about the "Between the ribs" approach. And that was what I was wondering if I'd be a candidate for (and asked him about) in addition to the smaller (like 4 inch or so I think) sternotomy approach. He's on some committee or something that is continually looking at those options. And he said if I really, really wanted it, he'd talk to me more about it. But as he described the pros and cons (most importantly, more time on heart/lung machine), I just felt - ah, what the heck - at least for a guy, the sternotomy scar isn't THAT bad, and if it makes it easier on the surgeon - I'm all for him being comfortable while he's working! And in my case, it might have been good he had extra room - he said he had a heck of a time getting my old valve out cause it was so calcified. I suspect it's still just a little too "experimental" for some of the old-timer surgeons. Although mine seems pretty progressive, he still preferred his modified traditional approach (slightly less long scar than 'normal' and glue instead of stiches / staples). But glad yours worked out for ya! That's awsome - you got the best of both worlds - a successful surgery, and a smaller scar! Maybe you should advertise that a little more (I didn't know you'd had minimally invasive) just in case others aren't aware it's a possibility.
 
Andy,

keep it up, posts are humorous, informative and fun, member responses not so bad either (smile)....stay with it guy, whilst you can, it'll get tougher todo, when you get better and life gets in the way.
 
I hear ya Gil. I'll find out tomorrow what my recommended return date is for going back to work. Hope it's out a ways yet - enjoying the time off ;) And of course I'll have to cut back on my time in here once I start back to work. But honestly, I'm pretty sure I'll always find some time to come check things out. This has just had WAY too big an impact on my life to totally drop out of sight. Hope you feel the same, and here's to many, many years of OHS friendships!
 

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