7 Weeks Post-Op

[Arne]

So I'm now 7 weeks post-op. My feelings are mixed and I'm not sure how I should be physically at this point.

I am 30 years old and had my BAV replaced with a mechanical valve and my ascending aorta + root replaced (Bentall) at the end of October.

I haven't been able to exercise much since it's cold out and long walks aren't very fun. Monday morning I did a 3.5 km walk up and down a few hills. I felt pretty good about it but when I got home I started getting what I think were PVCs (skipped beats). I've gotten them intermittently since. I'm hooked up to an event monitor for 2 weeks so it's good that I can capture them.

Should I be in better shape by now? I'm also getting a bit of shortness of breath after walking up hills. I used to bike 10 or so kms to work everyday before the surgery so I was definitely active before the surgery.

My heart was also pretty enlarged prior to the surgery. Does anyone know how long it takes to remodel and get back to normal? I can definitely feel it pounding in my chest, which probably doesn't help my anxiety/stress from the PVCs.

I'm also having issues sleeping. I tend to wake up in the middle of the night and wake up tired.

Don't get me wrong, I'm so happy that I'm here with the 'upgraded' heart. I'd just like some advice/thoughts about some of my concerns.

TheGymGuy was back at the gym 4 weeks post op!!! He must be super human.

 

[Paleowoman]

Hi Ame - 7 weeks is still early post op. My cardiologist put it like this: it's like you've been hit by a car in the chest. Do what exercise you can and ask for cardiac rehab as that will help and give you more confidence. See your cardiologist whenever there are these blips too with PVCs or anything.

I was getting shortness of breath until ten months post op, but it turned out not to be heart related after everyone thought it was ! It was respiratory related and now that is improving. I'm 11 months post op now, still not back to where I was before surgery and I was very fit before, even doing weight lifting and a six mile walk the day before surgery (note, I know you are 30 and I was 60 when I had the op, but I was fitter when I was 60 than when I was 30 - really !). I restarted doing weight lifting, though low weights at first, when I started cardiac rehab at about 8 weeks post op, under supervision of cardiac nurse and with heart rate monitor to watch things.

Sleeping issues may be related to the trauma of surgery or lack of exercise or hearing your heart more easily ? Give it time. All the best.

 

[epstns]

It sounds like you're pretty much on track, Arne. I wasn't able to start cardio rehab until I was 12 weeks post-op, although I went back to work full-time (office job) at 8 weeks. I, too, had my surgery during Chicago's cold winter, so long outdoor walks weren't in my plan either. I was able to use the indoor track at a park district fitness center during the day when it wasn't busy. I just walked a couple of miles there, and could measure time and distance well. I think that this got me "more" ready for rehab.

As Anne mentioned, rehab was incredibly valuable for me. I had a rough time in surgery, ended up with a pacemaker, and then complications in recovery. By the time I was a couple of weeks into rehab, I was back at my own gym on the days when I didn't have rehab. In other words, the rehab gave me the confidence to get back to vigorous physical activity 5 days a week - just as I did prior to surgery and as I still do now (almost 4 years later).

As for the sleep disturbances, I had similar issues. I would fall asleep normally, then wake up at 1 or 2 AM and have real trouble getting back to sleep. I would wander the house, wrapped in a blanket. I would read, surf the web, snack, all sorts of things to keep my mind from being anxious about not sleeping. At some point, probably around 4 AM, I would go back to bed and sleep a few more hours. I even got a prescription for Ambien, but once I read the side effects of the drug, I never opened the bottle. Over time, the sleep disturbances diminished and my sleep patterns became more normal. I think the cause was a combination of the trauma of surgery, the medications given in hospital, and the new meds given as I was sent home and maybe all the irregularly-timed naps I took once I got home. Once my body became accustomed to the meds, the issues diminished. Give it time. The most important thing to me was to be sure I was not obsessed with my crazy sleep patterns. I just made sure I had enough chances to nap so that my body could continue to heal. Also, I think that as my activity level rose to a more normal level, my sleep patterns normalized as well.

Hang in there. You're on the mend and doing fine.

 

[river-wear]

If you want to try something to help you sleep, try Tylenol PM. I used that on the odd occasion after surgery (and it was approved by doctors).

It does sound like you're on track. Just keep walking and it will keep getting better. A little shortness of breath isn't unusual. Do you monitor your heart rate? That might help calm your nerves, but keep in mind it will be higher than it used to be because you're still healing. I've seen on here that it can take six months or more for your heart to remodel and get back to a normal size.

I had PVCs too. It's good you have a monitor to make sure they don't indicate anything serious. They will diminish and go away over the next month or two. Sometimes they would be bad when I first laid down for bed, and I found that if I sat back up for few minutes, relaxing, they would mostly go away.

 

[tom in MO]

I guess I will be a little counter point. Each person is different, but per my experience and what my Rehab team advised you may want to exercise more. I had an AVR-only at 55 and started cardio rehab at the 4th week and did it three times a week for the next 10 weeks. On rehab days, I skipped a walk. I never exercised before surgery, other than walking the dog, so this was a big change for me. As soon as I was released from the hospital, I also walked at least three times a day, once in the morning, once in the afternoon and once in the evening. Due to the walking, I also took at least one nap a day : ) By week 8, I was less winded going up the big hill I live on than I was presurgery.

My heart would occasionally pound and also an occasional skipped beat, but it all went away with time. I only wore a monitor at Rehab and that was only three times. If you don't walk much and then did 3.5 km, that may have been the cause. I used to live in Vermont, w/o a car and now I live in MO and walk/bus to work at 57. The cold and snow are not good reasons to stay inside. Now rain... : )

When it comes to sleeping, I would nap in the afternoon until I went back to work at week 8. This helped my overall energy. You may want to make sure that you control your caffeine intake (none after dinner) and use your bed for sleeping not watching TV or reading. Those are usually the top two tips for anyone with sleep problems. A light snack about 1 hour before bread (protein and carbs like peanut butter crackers) is a "natural" sleep aid that we used at a mental hospital where I used to volunteer.

Per your enlarged heart, I don't know much, except I was told by my cardio that mine was not too enlarged and should go back to normal with time. I was also warned by my surgeon, during the pre-surgery consultation, that if you go too long w/o surgery, the heart will get enlarged but may not return to normal with time.

 

[Arne]

Thanks for the replies! They're definitely making me feel more at ease. I guess I thought I'd be blasting through recovery, but unfortunately it's something that takes time. I will try to keep up with my walks in order to keep pushing myself further but obviously not overdoing it.

 

[AZ Don]

If you are on Metoprolol, I found that it can cause insomnia. I slept much better when my dosage was cut and when I didn't take it in the evening.

Everyone recovers differently. You have to go at your own pace and as long as your are following any restrictions advised by your Dr., keep pushing forward. My surgery was at the beginning of summer in Phoenix where it can be too hot to walk outside. Until I could drive to the gym or a mall, I did laps inside the house. Quite boring but an ipod can help with that.

 

[Paleowoman]

I did inside laps too, backwards and forwards in my living room, plus climbing stairs many times a day, as it was winter when I had my surgery last January and absolutley no good for walking outside !

 

[Cooker]

This has been said a thousand times and still bares repeating. This ain't no hangnail. Hang in there. It takes TIME. I pushed my recovery and at times paid the price. Just continue to rest, exercise at a comfortable level and eat healthy and you will get there!!

 

[MrsBray]

Do you have a shopping mall nearby? That's a great place to walk! I'm 9 months post op and am just starting to get back into normal (for me) sleeping habits.

A little acetaminophen takes the edge off enough for me to go to sleep.

Every time I mention soreness or tiredness to one of my doctors, they say, "It's not even been a year! What are you expecting, a miracle?"