Anxiety about upcoming surgery.

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Justmadi

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I have had 2 OHS, each a year apart And both with full sternotomies. . The first was for an aneurysm repair. The second gave me my St Jude valve. My time in the hospital was minimal each time and more uncomfortable than painful. I would say the same for recuperation. Like many noted, I came off of narcotics quickly. Didn’t need them and didn’t like the way they made me feel.
There are things you can’t do at first, but you adjust. For example, my husband needed to put things in places easy for me to reach because one shouldn’t raise arms too high. I slept on the sofa because it was easier to get in and out of. My pillows had to be “just so”. You find you sleep when you can and it DOES get better.
I binge watched a lot of NEtflix shows!!
The most painful thing, for me, was getting my staples removed after surgery 2. I asked if would hurt and the nurse said no....she lied. :)

Take a deep breath and realize how lucky we are that this type of surgery is almost rote. Our grandparents didn’t have this option.
 

LoveMyBraveHeart

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Protimenow What is tachycardia and SVTS?
Tachycardia is higher than normal heartrate... usually about 95 or into the 100s which I lived with throughout my entire childhood and teen years without any issue. My heartrate was around 112 resting. SVT is supra ventricular tachycardia, where the chambers of you heart fall out of rhythm with each other. I get SVT episodes from time to time...your pulse can sky rocket into the 200s of you can believe that! Very uncomfortable in the sense that your brain knows your heart isnt functioning correctly, but usually the rhythm comes back on its own. Some people have to have a cardiac ablation to correct it as if they stay in SVT or have recurring more often than not, blood is not pumped through your body correctly. That can cause light headedness, fainting, jaw pain, temporary vision loss, shortness of breath.
 

Protimenow

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Protimenow What is tachycardia and SVTS?
Tachycardia is a rapid heartbeat. SVT is supraventricular tachycardia. It's a more specific statement about the type of tachycardia (and where it originates) that I was feeling. (FWIW - when I last had a holter monitor, the results showed that I was having SVTs at various times during the day, but only for a few heartbeats, so I didn't notice them).

When my tachycardia is most intense, my heart beats more than 150 beats per minute (according to my phone's app), and I can sometimes see it in the mirror when I look at the blood moving through the arteries in my neck. It's scary the first few times, still of concern whenever it happens, but you kind of learn to live through it (and it can sometimes be stopped by pushing down as if you were going to the bathroom - there's something about the internal pressure on the heart that stops them).
 

Protimenow

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I haven't been warned about Tylenol (acetaminophen). It has been prescribed (tylenol with codeine - which I hate) and recommended without codeine for general pain relief because it's not supposed to interact with warfarin. I don't think that it's ever helped me.

Too much acetaminophen can cause liver damage, so it must be avoided as a chronic analgesic. If you take too much for too long and it damages your liver, your INR could climb because of liver damage - but this isn't really related to warfarin.

A rheumatologist last year prescribed Ketoprophen for pain because, of all the NSAIDs, it has the least effect on the platelets. Unfortunately, this is still under patent and isn't on most drug formularies, so it's expensive. Rather than pay a few dollars a pill, I just chose to live with the pain.
 

ForeverThankful

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I remember my disappointment when my tachycardia returned. I was hoping that the surgery would keep it from happening again. I still get SVTs, and will probably continue getting for the rest of my life.
I remember the same disappointment. I had surgery in October and didn't have an SVT until March. I really thought that I was done with them. I've been getting them since I was 13 and I too will probably get them for the rest of my life.

Bearing down to cause pressure in order to stop them has never worked for me. What does usually work is to sit on a sofa or bed and then lay quickly onto my left side. It also has something to do with pressure on the vagus nerve. One time I had it and wasn't able to get it to stop for 5 hours. While they don't really freak me out much I must admit that at the 5 hour mark of having a 220 bpm heartbeat it gets very disturbing.
 

ForeverThankful

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I just got my pre surgical physical yesterday and my anxiety is finally starting to hit me pretty hard. I talked to pharmacist, anesthesiologist, cardio nurse, and had an ekg, blood drawn and an X-ray. They gave me I think a 100 page handbook about the heart, and procedure, what to expect and going home to rehab. The whole thing is really starting to scare me . They say I’m going to have tubes and wires and be bloated and pale. What were some of your experiences after surgery, how long did it take to start feeling a little better? They talked about giving me insulin, and how I wouldn’t be allowed to have more than 8 ounces of liquid for first to days. How was going home. Hard to walk up a flight of stairs? Taking a shower, going to the bathroom? How about sleeping, getting out of bed? Thank you For all the advice you have given me so far. This is a great forum.
I had my bicuspid aortic valve replaced with a St Jude's Mechanical valve and I had a very large aneurysm rebuild.

I wasn't pale and I wasn't very bloated, just my fingers and hands a little. There will definitely be many tubes and wires. The only thing that bother me a bit were the drainage tubes which come out just sort of under your rib area in the front, they made me feel kind of full, it's hard to explain but it was a great relief when they were removed!

I didn't really have pain and wasn't given any painkillers. They did offer me Insulin on day two I think it was but I refused it. I don't remember them limiting liquids at any time. I do remember that everything tasted pretty bad on day two, kind of metallic, but by day three everything tasted good again!

As far as going home, I mostly remember being very tired for a few weeks. No pain or serious discomfort so much as just getting tired out quickly, feeling weak. . The first couple of days I took very short walks, down my driveway and maybe 200 feet down the sidewalk and back. That was all I could do before tiring out. We have stairs and they were no problem, you just have to go slowly at first and be careful not to hold on to the railing tight or pull yourself along or you'll experience the pain in your chest that we want to avoid. In the hospital they had me practice going up and down the stairs a few times before I went home.

I bought a recliner chair for my recovery and it worked out great. I rested in it when I needed to and I slept in it at night for a few weeks, maybe 4 weeks, I'm not sure now.

Showering, the first week showering really tired me out. I remember letting the water run only on my back to protect the chest area. The first shower when I got home felt so good!

I remember that at the 6 week mark I felt pretty good, mostly back to normal! I had the surgery on October 14th and was able to serve Thanksgiving dinner at the 6 week mark.

I didn't go to rehab because I was walking two miles a day on my own in a short period so there was no need. I wasn't having any weakness before surgery so I guess I didn;'t have much of a problem.

I was driving at 4 weeks.

I know it's natural to be anxious but try to relax the best you can. I actually found that I was less anxious as it got closer by days. I kept myself busy making lists and getting things ready.
 

Protimenow

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PVTs for FIVE HOURS? Wow. Even if it's not a big deal, having your heart pumping like that, for that long, would probably drive me to urgent care or somewhere.

No, the bearing down doesn't help much - sometimes standing up and grabbing my knees, then bearing down helped at least once.

Thanks for the tip about sitting in a sofa or bed and making a quick move to the left. (Of course, I'd probably just fall off the bed).
 

mecretired

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I had surgery for an aneurysm of my ascending aorta almost 10 years ago. I have a st Jude grafted valve (the ascending aorta and mechanical aortic valve in one piece) and artificial aortic root. My surgery was 6 hours with 3 hours on bypass. I had no symptoms before surgery. I spent less than 24 hrs in cut and 6 days total in hospital. I did get insulin. As I understand it—when you get put on bypass your organs are shut down and have to start up again? Anyway I was on insulin just 1 or 2 days. I was up walking as soon as enough of the tubes and wires were removed with no problems. I had afib for just a few days. But I’m still doing great. I had part of a lung removed 3 years ago and that was a much harder and more painful surgery. So just listen to your body and your doctors. Advice I was given back then——eat, breathe, sleep and walk—-repeat.
 

dick0236

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John did you have a mechanical valve? I’m not sure I can take Tylenol with me being on warfarin,
Tylenol(generic) is the only OTC pain reliever I can take. Currently, take two 500mg tabs daily for spinal pain. I have taken Tylenol(generic) periodically, over the years, as a pain reliever with the full approval of my docs.
 

Protimenow

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I've seen one list that probably erroneously lists acetaminophen as having an interaction with warfarin. Unless too much acetaminophen for too long a period damages your liver, I am unaware of any true interactions. My doctors have told me that it's the only thing that can be safely taken for pain. (Although Ketoprofen is supposedly the safest NSAID - it doesn't have as much effect on platelets as the other NSAIDs but is somewhat expensive, and not covered by most drug formularies).

For myself, I've never (or not in recent memory) gotten any pain relief from acetaminophen. I suspect that others on warfarin just get used to living with minor pain.
 

pellicle

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I've seen one list that probably erroneously lists acetaminophen as having an interaction with warfarin
what makes you doubt it as having an interaction. Its been discussed here before and its well known

https://www.ncbi.nlm.nih.gov/pubmed/21923443

The use of moderate-to-high doses of acetaminophen while receiving warfarin results in supra-therapeutic INRs in some patients. The characteristics that may predispose a patient to this interaction are unclear, yet the widespread use of acetaminophen calls for enhanced clinician awareness and reinforcement of patient education about this interaction.

Myself I'm one of the people for whom Panadol (acetaminophen) is pretty much the only effective pain relief. Ibuprofen for instance does nothing for me (which is probably a good thing)

You may find this thread interesting:
https://www.valvereplacement.org/threads/inr-and-paracetamol-todays-reading.43679/

I sure do wish I'd kept the citation for what I quoted there ... can't find it.

This one still works though
https://www.ncbi.nlm.nih.gov/pubmed/17145598
 
Last edited:

Protimenow

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Well, gee, after 28 years of ACT, and hearing from countless doctors that acetaminophen is the only analgesic that I can safely take -- and having NO physicians warn about its use, I kind of assumed that, based on 28 years of 'advice,' it was relatively safe.

The study that you quote is a single study - and may be the most current, and most relevant.

However, if you search a bit further, you should find a LOT of reports and research that contradict the report that you quote.

THAT's what made me think that acetaminophen - as needed, and not chronically - is okay for people on ACT.
 

epstns

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Buckeye - I'm late to the party, but thought I would join in just the same. Your profile doesn't mention your age or any pertinent info, so I can only guess. . .

I was 63 when I had my bicuspid aortic valve replaced with an Edwards bovine pericardial tissue valve. I also had a single bypass "while we were in there" rather than a stent. I, too, had no symptoms prior to surgery - I was a runner/jogger, actually running about 3 miles/day right up until the week of surgery. I had a "traditional" full sternotomy, but in spite of that, my incision scar is only 4 inches or less. My surgeon even made the incision on a slight angle, so that I can wear an open-collar shirt without my scar showing. He also used "surgical Krazy Glue" for external closure, so I have no staple marks or needle holes from sutures. Of course, with all of his care, I am also (fortunately) one of those people whose scars blend into skin tone quickly, so I even have to hunt for mine.

I was also the "poster boy" for post-op complications. I won't scare you with all of the stuff I went through, but I will mention a couple to try to help you understand that these things feel monumental to the patient, but to the docs, they see them often and just deal with them. Here's a couple of my experiences:

1. My native valve was so heavily calcified that the surgeon had to "cut wide" to get it out. This resulted in his "nicking" the nerve bundle that connects the top of the heart (the atria) to the lower part (the ventricles). Immediately after surgery, my heart would go fast, slow, it would skip beats. . . and it would even just plain stop for up to 20-30 seconds. Believe me, it is scary to be in the hospital and see your own monitor screen go "flat line." I would black out, then wake up to see all these very concerned faces looking down at me as the docs and nurses adjusted my meds. Finally, the doc said to me, "We can either keep trying to control this with medication, which could take a week or longer, or we can implant a pacemaker." I immediately asked him "Do you have a pacemaker in stock? What are we waiting for?" My mom had a pacemaker for a number of years, and it was a big NON-issue, so I just went for it. That almost immediately settled my heart rhythm issues. After a bit of tweaking the settings, I was back to all of my pre-surgery activities. Today, almost 9 years later, I am still a gym rat 5 days a week, doing much more than most all of the gents my age (72) at the local fitness center. I often tell people that the only way I am reminded that I have the pacemaker is when I look in the mirror with my shirt off.

2. Somebody else mentioned that the meds they give you during surgery, combined with inactivity, can lead to constipation. YES, it can, in a BIG way. All that "stuff" backed me up so bad that about 4 weeks post-op I had to be readmitted to the hospital to get my digestive system back into operation. A couple of doses of some industrial-strength laxatives fixed me up, but they told me to take Miralax for a month anyway. I started with the full dose per label instructions, then after 2 weeks went to half, then after 3 weeks to a quarter. The docs that time told me that usually the nurses and docs tell heart surgery patients to take Miralax after surgery, and they didn't know how nobody told me.

3. For the few weeks right after surgery, I was always cold. I mean, shivering cold. The docs told me that it was because I was borderline anemic. Not bad enough for medication, just cold. I walked around the house like a ghost, dragging my blanket everywhere. Eventually, it just subsided.

4. For the first couple of months after surgery, NOTHING tasted right. I had no dietary restrictions, but the food just tasted like industrial chemicals. That was a side effect of the anesthesia and other IV meds. Just find the things you can tolerate and eat them. Eventually, this just goes away, but I probably ate 5 pounds of vanilla wafers by then. . .

5. If you are in decent shape before surgery, you will do fine. Our house is on three separate floors, so stairs were an everyday thing for me from the start. I actually think this was helpful in my recovery. With all of my complications after surgery, I was not cleared for cardiac rehab until 3 months after surgery, but I was doing well anyway.

6. Speaking of rehab, if they offer it to you, jump for it. I did a rehab program that was 12 weeks long, 3 days a week. On the other 2 week days, I went to my own fitness center and did the same routine I had done that week in rehab. I came out of rehab able to do everything I had been doing before surgery - except push-ups. I waited about 6 months before I was comfortable doing them. Doc said I could do them, just didn't feel right.

7. Oh, and I also received insulin for a day or two right after surgery. My docs said that they had found that after surgeries like open-heart procedures, the body often goes out of whack and can't deal properly with sugars, so they give insulin temporarily. I think mine was even administered through my IV port, so this was a non-issue, too.

I could go on and on, but my point is really to say that no matter what happens, you WILL get through this. Your docs have seen it all before, and they can help you deal with it. After recovery, life is like a "do-over." You will once again be "just like everyone else."
 

Buckeye

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Dec 2, 2019
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Buckeye - I'm late to the party, but thought I would join in just the same. Your profile doesn't mention your age or any pertinent info, so I can only guess. . .

I was 63 when I had my bicuspid aortic valve replaced with an Edwards bovine pericardial tissue valve. I also had a single bypass "while we were in there" rather than a stent. I, too, had no symptoms prior to surgery - I was a runner/jogger, actually running about 3 miles/day right up until the week of surgery. I had a "traditional" full sternotomy, but in spite of that, my incision scar is only 4 inches or less. My surgeon even made the incision on a slight angle, so that I can wear an open-collar shirt without my scar showing. He also used "surgical Krazy Glue" for external closure, so I have no staple marks or needle holes from sutures. Of course, with all of his care, I am also (fortunately) one of those people whose scars blend into skin tone quickly, so I even have to hunt for mine.

I was also the "poster boy" for post-op complications. I won't scare you with all of the stuff I went through, but I will mention a couple to try to help you understand that these things feel monumental to the patient, but to the docs, they see them often and just deal with them. Here's a couple of my experiences:

1. My native valve was so heavily calcified that the surgeon had to "cut wide" to get it out. This resulted in his "nicking" the nerve bundle that connects the top of the heart (the atria) to the lower part (the ventricles). Immediately after surgery, my heart would go fast, slow, it would skip beats. . . and it would even just plain stop for up to 20-30 seconds. Believe me, it is scary to be in the hospital and see your own monitor screen go "flat line." I would black out, then wake up to see all these very concerned faces looking down at me as the docs and nurses adjusted my meds. Finally, the doc said to me, "We can either keep trying to control this with medication, which could take a week or longer, or we can implant a pacemaker." I immediately asked him "Do you have a pacemaker in stock? What are we waiting for?" My mom had a pacemaker for a number of years, and it was a big NON-issue, so I just went for it. That almost immediately settled my heart rhythm issues. After a bit of tweaking the settings, I was back to all of my pre-surgery activities. Today, almost 9 years later, I am still a gym rat 5 days a week, doing much more than most all of the gents my age (72) at the local fitness center. I often tell people that the only way I am reminded that I have the pacemaker is when I look in the mirror with my shirt off.

2. Somebody else mentioned that the meds they give you during surgery, combined with inactivity, can lead to constipation. YES, it can, in a BIG way. All that "stuff" backed me up so bad that about 4 weeks post-op I had to be readmitted to the hospital to get my digestive system back into operation. A couple of doses of some industrial-strength laxatives fixed me up, but they told me to take Miralax for a month anyway. I started with the full dose per label instructions, then after 2 weeks went to half, then after 3 weeks to a quarter. The docs that time told me that usually the nurses and docs tell heart surgery patients to take Miralax after surgery, and they didn't know how nobody told me.

3. For the few weeks right after surgery, I was always cold. I mean, shivering cold. The docs told me that it was because I was borderline anemic. Not bad enough for medication, just cold. I walked around the house like a ghost, dragging my blanket everywhere. Eventually, it just subsided.

4. For the first couple of months after surgery, NOTHING tasted right. I had no dietary restrictions, but the food just tasted like industrial chemicals. That was a side effect of the anesthesia and other IV meds. Just find the things you can tolerate and eat them. Eventually, this just goes away, but I probably ate 5 pounds of vanilla wafers by then. . .

5. If you are in decent shape before surgery, you will do fine. Our house is on three separate floors, so stairs were an everyday thing for me from the start. I actually think this was helpful in my recovery. With all of my complications after surgery, I was not cleared for cardiac rehab until 3 months after surgery, but I was doing well anyway.

6. Speaking of rehab, if they offer it to you, jump for it. I did a rehab program that was 12 weeks long, 3 days a week. On the other 2 week days, I went to my own fitness center and did the same routine I had done that week in rehab. I came out of rehab able to do everything I had been doing before surgery - except push-ups. I waited about 6 months before I was comfortable doing them. Doc said I could do them, just didn't feel right.

7. Oh, and I also received insulin for a day or two right after surgery. My docs said that they had found that after surgeries like open-heart procedures, the body often goes out of whack and can't deal properly with sugars, so they give insulin temporarily. I think mine was even administered through my IV port, so this was a non-issue, too.

I could go on and on, but my point is really to say that no matter what happens, you WILL get through this. Your docs have seen it all before, and they can help you deal with it. After recovery, life is like a "do-over." You will once again be "just like everyone else."
Thank you for the insight! I’m 51 years old and have been cancer free from colon cancer for almost 5 years. The constipation worries me a little bit since I have a very small rectum and they took a foot and a half of my colon out as well. I take Imodium every day just to slow down my bowels. maybe the narcotics will do the same as the Imodium and I’ll have minimal problems . I guess I’ll find out! 😬
 

Astro

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I hope this is of some help to you. I felt that the process of having an OHS was like a train. You can't micro control it, you have to go with the flow. Before you know it, it will be done. The unpleasant stuff passes quickly. I started having periods of feeling 'normal' after 3-4 days. After two weeks, I had long periods of feeling 'normal'. Now at 6 weeks, I feel 'normal' all the time.

Best wishes
 

pellicle

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The constipation worries me a little bit ... I guess I’ll find out! 😬
I always recommend KimChi as soon as back in the ward.


 

Bryan B

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Not sure if you're on the "other side" of surgery yet but it's quite normal to have the reality of the surgery "hit you hard" when you go in for your pre-op screening. I've done it twice, and while the anxiety was a bit less for the 2nd one it was still there. I could tell you all the details on how it was for me, but to be honest it will be different for everyone. Generally though it sucked the first day or 2 and then got a bit better every day. One piece of advice I can give is that the sooner you can start getting up and walking the better. I found that walking (a little at first and then a bit more each day) was very beneficial in my overall recovery. So much so that I'm still walking 9 years after my last surgery.
 

LondonAndy

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Yes, stool softeners were given to me after surgery. The initial pain medication you are on when discharged is quite strong and can cause constipation so it seemed to be automatic to be given them here in UK
 
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