Chris M
Well-known member
I've just read Ken Taylor's uplifting progress report and thought I would chime in with my good news story too...
Brief history, pre-surgery:
Rheumatic fever as a young child left my mitral valve scarred and damaged. Fast forward fifty-odd years and the symptoms begin to really impact on me, worryingly so: SOB, tiredness etc. All these valve/heart problems were news to me until I got these symptoms checked out in May 2010. With hindsight my heart issues explain a LOT about how pretty much all my life I have found exercise unpleasant and difficult. I thought I was just "different" to everyone else, or lazy, or because I smoked for a long while, or because I was getting older etc. etc. In other words I have never been the active type because I was oblivious to the fact that my deteriorating heart function was letting me down. I made excuses for how I felt and learned to avoid situations that made me feel bad or look inadequate.
Anyways... after all the investigations were concluded my diagnosis turned out to be severe mitral regurgitation, with some heart enlargement and a signifant degree of pulmonary hypertension. Without surgery my odds of living a further 3-5 years were a shocking zero percent. The odds of NOT surviving surgery were somewhere in the range of 2-4 percent. A repair was not an option (valve too far gone), a replacement was the only answer. All in all a no brainer, really.
I waited about nine months for actual surgery - not my choice, I guess I was not considered an urgent case and going through the British NHS system can be a leisurely affair sometimes but at least there is no stress about who is going to pay for the treatment & surgery. The waiting period was difficult for me mentally and emotionally, though... much anxiety and depression... I've never been ill before, never had surgery except for a routine tonsillectomy as a child. The only bonus of this miserable situation is that I feel I will be OK mentally now the deed is done as I've been through all that mental anguish already!
Brief account of surgery and recovery:
Tuesday, May 17th 2011: surgery day. The full sternum cut.
I have no memory of the first 24 hours, just briefly being woken up and asked to cough (Extubated? I don't remember). The next two days are a bit rough, I feel like I've been kicked in the chest by a mad horse, my head is fuzzy and I feel sick (oral morphine most likely to blame, plus a shed-load of meds both orally and intravenously). On day 4 my head clears and I feel much better!
I spent the first 18 hours in ICU then a further 24 hours in the high dependancy unit. On the Thursday my progress has been so good that I am moved to the regular ward. I'm lucky and have a side room and en-suite (toilet & shower) all to myself!
On day 5 or 6 (over the weekend) I start having rhythm issues, ranging from too slow to way too fast and irregular (and exhausting!). Having read this forum beforehand I know that such issues are not uncommon and am reassured by the doctors attending to me that this happens to about 1/3rd of patients. I'm put on Amiodarone and for several days I have to carry around a portable pacemaker (attached to the pacing wires in my chest and designed to kick in when the heart rate is too low) and a heart monitor (attached to sensors stuck to my chest, designed to alert the medics to any speed or fluttering issues). These boxes are a nuisance for several reasons and ultimately prove unnecessary but I put up with the situation. There is talk of sending me for cardioversion (I think? Where they give a small electric shock to the heart?) on the Monday if things don't calm down. However, my heart re-establishes it's own rhythm again relatively quickly and that procedure is not required after all.
On the Wednesday, day 9, I am able to go home. For the next six weeks I take it easy, doing some regular walks. I have good and bad days but mostly good. Small daily improvements are noted and it's only in the first few days that I need help with little personal things like washing my hair or my back. After a few days I had one short period of an elevated heart rate (110-ish at rest) for a few hours but I didn't panic and eventually it cleared up of it's own accord.
Things I found surprising or easier than expected:
Follow-up appointment
I had my post-op follow-up with my surgeon yesterday, @ seven weeks. I had an ECG which he said was "spot on where it should be" and an x-ray that showed all was well. I was so happy to hear him state that I now have a normal life expectancy!
He answered all of my questions including my request for his opinion on the question of prophylactic antibiotics before certain dental procedures... on this issue he was adamant that I should request antibiotics beforehand. This despite the official NICE* guidelines issued to the contrary here in the UK... the ONLY country in the world to say antibiotics are of questionable value. :rolleyes2: Interesting to get his take on this issue!
I also asked about the valve he fitted... a "whopping 33mm Carbomedics" one apparently (his words)... "the bigger the better!" :eek2: I didn't know they could BE so big but there you go... I now have this massive, freely flowing pipe inside me. My heart must be wondering what hit it. LOL!
So, all in all, a very positive meeting culminating in him discharging me back to the care of the cardiologist. Job done! I can now drive again, can stop wearing the surgical stockings and can come off the Amiodarone... I have gone from 10 tablets/drugs on discharge to just 4 now (one is for another medical issue)... in time I may get down to just 2. An excellent outcome!
Final thoughts
I think that, on the whole, I have had a fairly normal and relatively uneventful surgery and recovery. The early days and weeks were somewhat uncomfortable but with basic painkillers it is surprisingly manageable and bearable - here in the UK we use Paracetamol, an over-the-counter pill commonly used for headaches etc.
Many of the fears and worries that I had beforehand never came to pass. I'm glad I did my reading and had some idea of what problems might crop up but I also think I may have worried about these things a little too much for my own good, if I'm honest.
Being at the slightly "younger" end of the spectrum (I'm 56), and otherwise in good health is, I feel, an advantage when going into this type of surgery.
For those of you still in the waiting room I can only echo what others have said about the waiting being the worst part. I was miserable for months beforehand, scared witless about what was to come. Eventually I worked through my demons and came to a sense of peace in the couple of weeks before my surgery. It really is a case of do it or die!... so I did it and my story just goes to show that whilst the experience is not exactly a walk in the park it doesn't necessaily have to be fraught with difficulties or problems! There are probably many people like me who had a rather uneventful time of it. I feel incredibly lucky not to have experienced some of the "bumps" that can happen post operatively.
Finally I just want to say how I have had days recently when I have felt on top of the world... striding out at a steady and brisk pace for half an hour at a time... unlike many of you sporty, active types here I have never, EVER, done this sort of thing in my adult life before... it has been a revelation to me! I don't feel like this every day (yet!) as my recovery still has a long way to go, but I am hopeful of having a new life from this surgery and perhaps to do a few things that have always been denied to me. I'm excited to find out how far this will go and what it will feel like to be "normal". What an amazing journey this has been and it's not over yet!
Thanks for reading this far and sorry for the length of this post but I hope it will serve as an example of a relatively straight forward heart surgery and recovery. Good luck to those of you about to go in... chances are you will be fine too!!
*National Institute for Clinical Excellence
Brief history, pre-surgery:
Rheumatic fever as a young child left my mitral valve scarred and damaged. Fast forward fifty-odd years and the symptoms begin to really impact on me, worryingly so: SOB, tiredness etc. All these valve/heart problems were news to me until I got these symptoms checked out in May 2010. With hindsight my heart issues explain a LOT about how pretty much all my life I have found exercise unpleasant and difficult. I thought I was just "different" to everyone else, or lazy, or because I smoked for a long while, or because I was getting older etc. etc. In other words I have never been the active type because I was oblivious to the fact that my deteriorating heart function was letting me down. I made excuses for how I felt and learned to avoid situations that made me feel bad or look inadequate.
Anyways... after all the investigations were concluded my diagnosis turned out to be severe mitral regurgitation, with some heart enlargement and a signifant degree of pulmonary hypertension. Without surgery my odds of living a further 3-5 years were a shocking zero percent. The odds of NOT surviving surgery were somewhere in the range of 2-4 percent. A repair was not an option (valve too far gone), a replacement was the only answer. All in all a no brainer, really.
I waited about nine months for actual surgery - not my choice, I guess I was not considered an urgent case and going through the British NHS system can be a leisurely affair sometimes but at least there is no stress about who is going to pay for the treatment & surgery. The waiting period was difficult for me mentally and emotionally, though... much anxiety and depression... I've never been ill before, never had surgery except for a routine tonsillectomy as a child. The only bonus of this miserable situation is that I feel I will be OK mentally now the deed is done as I've been through all that mental anguish already!
Brief account of surgery and recovery:
Tuesday, May 17th 2011: surgery day. The full sternum cut.
I have no memory of the first 24 hours, just briefly being woken up and asked to cough (Extubated? I don't remember). The next two days are a bit rough, I feel like I've been kicked in the chest by a mad horse, my head is fuzzy and I feel sick (oral morphine most likely to blame, plus a shed-load of meds both orally and intravenously). On day 4 my head clears and I feel much better!
I spent the first 18 hours in ICU then a further 24 hours in the high dependancy unit. On the Thursday my progress has been so good that I am moved to the regular ward. I'm lucky and have a side room and en-suite (toilet & shower) all to myself!
On day 5 or 6 (over the weekend) I start having rhythm issues, ranging from too slow to way too fast and irregular (and exhausting!). Having read this forum beforehand I know that such issues are not uncommon and am reassured by the doctors attending to me that this happens to about 1/3rd of patients. I'm put on Amiodarone and for several days I have to carry around a portable pacemaker (attached to the pacing wires in my chest and designed to kick in when the heart rate is too low) and a heart monitor (attached to sensors stuck to my chest, designed to alert the medics to any speed or fluttering issues). These boxes are a nuisance for several reasons and ultimately prove unnecessary but I put up with the situation. There is talk of sending me for cardioversion (I think? Where they give a small electric shock to the heart?) on the Monday if things don't calm down. However, my heart re-establishes it's own rhythm again relatively quickly and that procedure is not required after all.
On the Wednesday, day 9, I am able to go home. For the next six weeks I take it easy, doing some regular walks. I have good and bad days but mostly good. Small daily improvements are noted and it's only in the first few days that I need help with little personal things like washing my hair or my back. After a few days I had one short period of an elevated heart rate (110-ish at rest) for a few hours but I didn't panic and eventually it cleared up of it's own accord.
Things I found surprising or easier than expected:
- I was able to sleep on my sides straight away.
- I was able to raise my arms up in the air, making it easier to get dressed etc.
- I had no coughing to speak of and my first sneeze was at 3 weeks or so - no problem, no pain.
- 99% of the time I cannot hear my mechanical valve! Just in bed sometimes when the room is super quiet. I'm delighted!! I'm also left wondering if the relative quietness is to do with the fact that the mitral valve is deeper inside the heart, and therefore more "soundproofed" than the more common aortic valve is. ???
- I am amazed at the body's power to heal! My chest has gone from something you might see in a butcher's shop to a rather tidier and much less offensive scar in just a few weeks. I'm not even bothered if the top of my scar shows now, it's still a little pink in colour but I doubt anybody would really notice!
- Taking Warfarin has been very easy - my dose has been well controlled and I am now steady and in range.
Follow-up appointment
I had my post-op follow-up with my surgeon yesterday, @ seven weeks. I had an ECG which he said was "spot on where it should be" and an x-ray that showed all was well. I was so happy to hear him state that I now have a normal life expectancy!
He answered all of my questions including my request for his opinion on the question of prophylactic antibiotics before certain dental procedures... on this issue he was adamant that I should request antibiotics beforehand. This despite the official NICE* guidelines issued to the contrary here in the UK... the ONLY country in the world to say antibiotics are of questionable value. :rolleyes2: Interesting to get his take on this issue!
I also asked about the valve he fitted... a "whopping 33mm Carbomedics" one apparently (his words)... "the bigger the better!" :eek2: I didn't know they could BE so big but there you go... I now have this massive, freely flowing pipe inside me. My heart must be wondering what hit it. LOL!
So, all in all, a very positive meeting culminating in him discharging me back to the care of the cardiologist. Job done! I can now drive again, can stop wearing the surgical stockings and can come off the Amiodarone... I have gone from 10 tablets/drugs on discharge to just 4 now (one is for another medical issue)... in time I may get down to just 2. An excellent outcome!
Final thoughts
I think that, on the whole, I have had a fairly normal and relatively uneventful surgery and recovery. The early days and weeks were somewhat uncomfortable but with basic painkillers it is surprisingly manageable and bearable - here in the UK we use Paracetamol, an over-the-counter pill commonly used for headaches etc.
Many of the fears and worries that I had beforehand never came to pass. I'm glad I did my reading and had some idea of what problems might crop up but I also think I may have worried about these things a little too much for my own good, if I'm honest.
Being at the slightly "younger" end of the spectrum (I'm 56), and otherwise in good health is, I feel, an advantage when going into this type of surgery.
For those of you still in the waiting room I can only echo what others have said about the waiting being the worst part. I was miserable for months beforehand, scared witless about what was to come. Eventually I worked through my demons and came to a sense of peace in the couple of weeks before my surgery. It really is a case of do it or die!... so I did it and my story just goes to show that whilst the experience is not exactly a walk in the park it doesn't necessaily have to be fraught with difficulties or problems! There are probably many people like me who had a rather uneventful time of it. I feel incredibly lucky not to have experienced some of the "bumps" that can happen post operatively.
Finally I just want to say how I have had days recently when I have felt on top of the world... striding out at a steady and brisk pace for half an hour at a time... unlike many of you sporty, active types here I have never, EVER, done this sort of thing in my adult life before... it has been a revelation to me! I don't feel like this every day (yet!) as my recovery still has a long way to go, but I am hopeful of having a new life from this surgery and perhaps to do a few things that have always been denied to me. I'm excited to find out how far this will go and what it will feel like to be "normal". What an amazing journey this has been and it's not over yet!
Thanks for reading this far and sorry for the length of this post but I hope it will serve as an example of a relatively straight forward heart surgery and recovery. Good luck to those of you about to go in... chances are you will be fine too!!
*National Institute for Clinical Excellence
