Activity restrictions after valve repair

[Zoltania]

I saw my surgeon today (19 days post-surgery) and he says I'm healing very well and my heart sounds great. BUT: I can't play clarinet or tuba for three more months, can't do any exercise except walking for three or four months and can't lift anything more than "a few" pounds for three or four months either. At least I'll be able to drive in a couple of weeks, though I'll need my groceries to be packed in multiple lightweight bags. I will probably never be able to go back to lifting heavy weights in the gym either.

Of course I will follow his advice and do the right things for my healing, but this seems really conservative to me. Have other valve repair patients been given similar restrictions?

Thanks,
Claudia Z.

 

[AZ Don]

My restrictions were dropped before 3 months and that includes being given clearance to swim. I was advised to avoid heavy weightlifting and competitive sports, but exercise was encouraged.

Your drs advise seems more restrictive then most but all drs are different and my issue is with my aortic valve and an aneurysm (repaired). I would expect similar restrictions for mitral valve but don't really know.

 

[harrietW]

Eeeek that does sound like pretty tight restrictions Claudia golly. My biggest this is not being able to drive l don't know what l would ever do without a licence Good thing they lift the restrictions in a reasonable time.
Hopefully some of those other ones will be lifted earlier as well like Don made reference to.
Amazing where 19 days out takes you .. l am truly amazed at what modern medicine is able to repair. The sheer fact that a person even thinks about doing any of those things after OHS is amazing to me.
Xx

 

[pellicle]

Hey there.

The driving restriction is normal as your sternum is kind of the keystone to your rib cage.

What do you mean by heavy weights? Can you give numbers?

I regularly tried to find my own limits and took the surgeons advice as a starting point. Does playing tuba cause strain on your vascular system? Do you feel veins popping out on your forehead?

PS: I just rang my Tuba playing mate (the one who was kidding around in that concert video) and he agrees that playing tuba shouldn't put much more stress on your heart / circulatory system than blowing up balloons. He said that while he's not a surgeon he thinks your surgeon may not know much about playing tuba.

To my mind if the repair is so fragile why the hell didn't they replace the valve with a mechanical? I know surgeons are risk averse but my view is that life is to be lived and that if you carefully listen to your body it will tell you.

Why not get your blood pressure taken when playing a note and see what it is? Of course wait till after convalescence period.

 

[Paleowoman]

Hi Claudia - I had similar restrictions regarding weights for the first three months. Then I had cardiac rehab and another month or so later cardiologist said no restrictions. I lift heavy weights (heavy for a woman my age, 62, e.g. 48 pounds chest press, 40 pounds shoulder press, 20 pounds per arm biceps curl), took me about a year to get back to pre surgery weights. I would wear heart rate monitor while working out just to check things were okay. Your cardiologist might know not much about lifting weights !

 

[Paleowoman]

Just wondering whether your cardiologist fears you may do the equivalent of valsalva maneuver when blowing into a clarinet or tuba ? If you did it would increase pressures in your heart which I suspect he may be concerned about.

 

[cldlhd]

It seems conservative but 3 months goes by pretty quick and if pushing it causes a problem its not worth it. If these restrictions were lifelong then I'd push the surgeon for their reasoning.

 

[W. Carter]

I saw my surgeon today (19 days post-surgery) and he says I'm healing very well and my heart sounds great. BUT: I can't play clarinet or tuba for three more months, can't do any exercise except walking for three or four months and can't lift anything more than "a few" pounds for three or four months either. At least I'll be able to drive in a couple of weeks, though I'll need my groceries to be packed in multiple lightweight bags. I will probably never be able to go back to lifting heavy weights in the gym either.

Of course I will follow his advice and do the right things for my healing, but this seems really conservative to me. Have other valve repair patients been given similar restrictions?

Thanks,
Claudia Z.

I'm 8 mo. post op and every time I see a cardiologist or go to pro time clinic they ask me if i'm lifting anything heavy. They all are against it and 1 yr. prior to surgery I had worked construction all my life. I reassure them the heaviest thing I lift is a fork, they laugh and are happy. But its all cool, I am retired now and besides walking my dog for exercise thats all I care about doing anymore anyways.

 

[tom in MO]

I do not know your age, but that sounds more restrictive than what I was told. I could drive a car as soon as I was off my narcotic pain medications. I was told to take cardiac rehab and did. They told me what exercises I could do or not. I did not lift weights, because it was not part of the rehab routine, not because I was told it would be bad. The biggest restriction was to make sure I breathed during exercise.

 

[DachsieMom]

I was told Dont lift more than 10 lbs first month, 20 lbs second month, 30 lbs third month. And I only weigh 99 lbs. I started rehab at week 5, running by week 6. Running almost back at regular pace 3 months out. At 4 months out (just 2 weeks ago) I keep forgetting I even had surgery! Except can't keep my INR on track.

 

[DachsieMom]

I should also say that I couldn't walk for the first 3 weeks after surgery....had a walker too. Amazing the difference a few weeks makes!

 

[Zoltania]

The driving restriction is normal as your sternum is kind of the keystone to your rib cage.

What do you mean by heavy weights? Can you give numbers?

I didn't have a sternotomy, I had a right-sided incision between the ribs. Even so, I wasn't allowed to ride in the front seat of a car until yesterday because of the risk of injury from airbag deployment.

As for lifting weights, in May I was bench-pressing 70 lbs. (pair of 35-lb. dumbbells), doing biceps curls and shoulder presses with 25-lb. dumbbells, and doing unassisted triceps dips.

Just wondering whether your cardiologist fears you may do the equivalent of valsalva maneuver when blowing into a clarinet or tuba ? If you did it would increase pressures in your heart which I suspect he may be concerned about.

That's exactly what he said he was concerned about.

Tuba requires a high volume of air but low pressure (not to mention having to pick up 20 or 30 lbs.). Clarinet, which is my main instrument, requires less volume but much higher pressure.

Next week I'll see my cardiologist and will ask him about all this too, though I know he works very closely with the surgeons and I wouldn't expect him to contradict them.

Thanks,
Claudia Z.

 

[pellicle]

Hi

I didn't have a sternotomy, I had a right-sided incision between the ribs.

Ahh, well that changes things, but still I recommend prudence in the first few months. Ease back into things and don't be afraid to be cautious. Better than to rush in and cause backward steps.

As for lifting weights, in May I was bench-pressing 70 lbs. (pair of 35-lb. dumbbells), doing biceps curls and shoulder presses with 25-lb. dumbbells, and doing unassisted triceps dips.

To me those are mid range weights and not in the power lifting range. I would still dial it back to half that for the first few months. Perhaps up your reps in the sets and make sure you breath properly

Naturally take anything I say with a grain of salt, but thems my feelings.

PS a useful table
http://www.exrx.net/Testing/WeightLifting/BenchStandards.html

 

[Paleowoman]

Yes, if you up your reps by lifting and lowering more quickly that is much easier. The cardiac nurse told me to lift fast, but as soon as I could I was back to SuperSlow which puts greater pressues on the heart, but works the muscles more plus is safer on the joints. It's a matter of adjusting your lifting.

You would be wise to follow your surgeon's advice re the valsalva maneuvre as that puts tremendous pressures on the heart. Perhaps find out when he considers it will be safe to play the tuba and clarinet again.

 

[Zoltania]

I just saw my cardiologist for the first time since my surgery four weeks ago, and he had a completely different viewpoint than my surgeon does on recommended activity levels. He thinks I can gradually start more vigorous activities, including lifting more than five pounds, and just pay attention to my fatigue levels in deciding how much to do. I will still be careful, probably won't touch a wind instrument for a while yet, and won't go nuts doing too much too soon, but I like this advice much better!

 

[carolinemc]

The thing is, did you have bypass and have a long scare on the center of the chest? That is tthe sternum and when the muscles are cut during surgery, afterward, it takes the sternum to heal from the surgical trama. The muscles have to have time to heal, which it can take to a year. The restriction is usually up to three months and must slowly build the weight. Good luck, take care, keep listening to the cardio and build yourself back up slowly, healing takes time.

 

[Zoltania]

No, my sternum wasn't cut. I had a right mini-thoracotomy, where they go in between the ribs. Some muscles were certainly disrupted near the incision, but it's not as bad as having the full sternotomy which requires bone healing. What my surgeon is concerned about is the healing of the repaired valve itself. He doesn't want too much pressure exerted on it while the repair heals and the new components (annuloplasty ring and Gore-Tex chords) become covered with my own tissue.