Aortic valve replacement

[Starmouse]

Hello Everyone,

I am new to this forum, so any and all information is greatly appreciated.

In February 2001 my Mom had Flash Edema. In August 2001 she had a single by-pass and aortic valve replacement. She had more CHF complications, and finally made it out of the hospital in October 2001. The end of November, back into the hospital for CHF. In February of this year, back into the hospital for CHF. Finally, with a major change in diet, especially in the sodium department, she is doing ok.

However, after the heart surgery, her right leg was swollen. We thought it was due to the surgery and that the swelling would eventually subside. When she gets up in the morning the right leg is fine but after walking the swelling comes right back. The cardiologist says this will be a permanent thing and gave her a prescription for compression hose. These are not working either. He then told her to take two Triamterene a day, instead of one. They are not working either as she still has much pain and swelling in the leg.

So what do we do now? Is this a common thing after valve replacement surgery? Will it go away and if not, what can be done? Maybe we should trade in this cardiologist for one who can do something.

My Mom has been through so much, and we feel that there is something that could be done for her.

Does anyone have suggestions? Has anyone else experienced the same thing?

Thank you,
Patty

 

[Ross]

Welcome Patty

There are many people who have seen many things here. I'm not one of them when it comes to the symptoms that you describe, but I'm sure someone will be along that can answer some of your questions.

Where did your mother have her surgery performed?
Were there any other prior events that may have an affect on what your seeing?

Weekends are somewhat slow here, but someone will be along.

Again, Welcome to VR.

 

[sylviayasgur]

hi patty!
welcome to this site. it's a wonderful place and the people are just so supportive, caring and informative.
that was quite a year for your mother! wow! i'm sorry to hear that her leg, after all that , is still swollen.
my father, age 69, had a double bypass and a valve replacement 3 yrs ago (st. jude's). his ankles, to this day, are still swollen. not really really swollen, but noticeably swollen. his cardio thought it was vioxx back then, and took him off it_ no change. then he tried switching some of his meds_no change. i have been worried about this for the last 2 yrs, but my dad 's cardio is a personal friend of his and he refuses to go for a second opinion.
his ankles, incidentally, were just as swollen pre-surgery when his valve was starting to fail.
do you find that your nother's leg is less swollen first thing in the morning? his ankles are. by the end of the day, he has to elevate his legs. maybe it can be a post surgical avr thing?
i know one of the signs of chf is swollen ankles, so i worry about it all the time. his dr, however, doesn't seem concerned.
i'm sorry i couldn't help more. maybe it helps just to know you're not alone in this.
hopefully someone more knowledgeable will come along and reply to your post.
please let us know how things go, ok?
good luck and be well, sylvia

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello Ross and Sylvia,

Thank you so much for your reply.

I wasn't sure if I should be using the "Posting Reply" section, or the "New Thread" section, as this forum is set up a bit different then others. But I'm sure someone will get me headed in the right direction.

My Mom had the surgery performed at Riverside Community Hospital. Dr. Devin Mudge was the surgeon. Before her surgery, there was no leg swelling, of any type. This only occured after the surgery. Initially we were told that it was because of the vein stripping, but we have talked with other cardiac patients who went through the same thing she did and don't have this problem.

She has the Edwards Lifesciences Bovine Pericardial Heart Valve. Serial HH8307, Model 2800, Size 21mm.

This past week her cardiologist performed the TEE, to check for any other valve leakage, and found the new valve to be functioning quite well. A small leak was found in the mitral valve but he said that it was nothing for her to worry about.

Yes. When my Mom gets up in the early morning her right leg and ankle are less swollen. As the day progresses the swelling gets worse, and like your Dad, she has to put her feet up.

Again, thank you for writing and whatever information anyone can provide, is greatly appreciated.

My Mom is 74 going on 49, and we want to do whatever we can to try and help her.

Patty

 

[hensylee]

Hey Patty - Sorry for late post to you, but I have had out-of-towners visiting -

Anyway, I had quad bypass. They took the saphenous vein from my right leg to use for the bypasses. I have four separate scars, one for each bypass. The swelling in my right leg was a surprise to me, after surgery. I, too, asked about it and my cardio told me that it would subside, but always be there to some degree. Mine is not much, and nobody else would notice except me. So maybe that is the answer, though there should not be that much swelling. They did say the blood that goes through that vein has to find a new way of traveling and it would take time, but to expect some swelling always. Hope this helps. God bless

 

[Mara]

Starmouse-

Did the docs ever talk to your mom about wearing a compression stocking? I know that those are supposed to help with edema. Maybe she should ask about that. Don't they send by-pass patients home with TED hose to keep the swelling down. This might give your mom some relief.
Your poor mom. Get her a personal massage therapist for Mother's Day, she could probably use it!
Hope she's feeling better.
-Mara

 

[MarkU]

Fortunately I didn't have any swelling problems after my AVR, however my father had a quad bypass about five months later (same surgeon that did my AVR, but that's another story...) and he experienced quite a bit of swelling in one leg. As others have reported, he was told that some swelling might be permanent. He wore compression hose for several months and saw significant improvement once he got into his rehabilitation program and was able to exerise.
Mark

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello Everyone,

Yes. Last month I bought my Mom compression hose, and she does wear them. However, after she takes them off the leg swells up again.

She does quite a bit of walking, but she says her leg feels like it weighs a ton. And the skin looks like it is so tight.

I have read that after some surgeries, people can develop Lymphedema. Any opinions on this?

Take care,
Patty

 

[Mara]

Patty-
I hope you don't think that I seem like a know-it-all, but my dad is a rep for Jobst, they make compression hose. Has your mom been professionally fitted for compression hose. I know the companies that make them have different compression strengths. Maybe she needs a different compression. I also know from my dad that some people wear their hose pretty much all the time. There is that young golfer Casey Martin, he wears his all the time, in fact I think he wears two sets all the time to get the right compression.

I think lymphedema can be pretty serious. Maybe your mom can get a referal to one of those docs who does vein surgery. It might be worth a shot to see what someone who does leg veins says.

Good luck to you and your mom! I hope she gets some relief.

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello Mara,

I truly appreciate the information that everyone is giving me, so keep on with the insights.

Yes, as a matter of fact, the pair I bought my Mom is the JOBST. I do notice a difference when she wears them, but after she takes them off the swelling comes right back. How long does it take before an appreciable difference is realized?

Take care,
Patty

 

[Mara]

Patty-
Supposedly, it depends on how long they are worn. My dad deals with the physicians who prescribe Jobst hose to patients with severe vein problems and or edema. From what he's told me a lot of patients need to wear the hose all the time except when bathing. Others only wear them if they are doing an activity or working.
I would bet your mom might get a more complete answer from seeing one of those docs that specializes in veins. Around here we have a lot of "vein clinics" that have opened. People go to them for varicose and spider veins, but those docs really know what is happening with edema, too. Your mom probably needs to be seen by a doc who specializes in vein treatment.

I am sure it is very uncomfortable for her. Tell her to wear the hose when her legs hurt and even when she is just working around the house.
-Mara

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello Mara,

I am going to visit my Mom tomorrow, so I will bring up what you have mentioned.

Did you have any permanent leg swelling after your operation? If so, are you wearing the compression hose and are they working for you?

After my sister had surgery she developed Lymphedema and went to one of those vein clinics, that you are referring to. They prescribed the compression hose and told her to buy Venastat. I will talk to my Mom about going to see them.

Thank you so much for writing.

Take care,
Patty

 

[John Cochran]

Patty,
Welcome to the group! Sodium does play a large role in swelling (went through this with my mother), and even though she thought she was watching her sodium, there were all sorts of things she was missing. One has to read food labels SO carefully. Things like canned soup are notorious for extra sodium. Processed meats are bad too. Maybe you've already screened the diet carefully, but if not, do take a second look.

Mara,
I've often heard people refer to a "real hose job"--sounds like your dad actually has one!!!

Best,
--John

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello John,

Thank you for taking the time to reply.

Yes, my Mom has completely changed her eating habits. I go up to her place at least once a week, and also take the time to peek in the refrigerator.

She eats no bacon, processed meats, soups, etc. When I go shopping with her, she automatically checks the labels, and that is good.

Sometimes she says that my sister and I harp too much about the necessity for a low sodium diet, but it's only because we don't want her to end up, again, in the hospital.

Take care,
Patty

 

[Mara]

Patty-
I did not have any leg swelling except right after the surgery while in the hospital, but I am a lot younget than your mom (34).
I have worn the Jobst hose though. I have a pair of hose and a pair of knee-hi's. used to wear them to work when I knew I'd be standing all day in court, and when flying to see my husband's family overseas. They were a pretty light compression. Made my legs not feet tired by the end of the day.

Tell your mom to put the hose on while she is still in bed in the morning and not to take them off until she goes to bathe/sleep at night.
More info I got from my dad was that some people never lose the edema totally, and the trick to the hose is to keep going to a smaller size once you have it. down. He explained it like this. If you squeeze something to make it smaller and then let go, it goes back to the normal size, but the hose give some temporary reduction, so then you can go to the next smaller size. He really thinks she needs to be professionally fitted. There are a lot of shops that help in this. You probably need to look in the Yellow pages, or ask your mom's doc.
I hope it helps.
She'll know the right size by measuring her ankle and then the fattest part of her calf first thing in the morning before getting out of bed, when the swelling is lowest. That is how the hose are sized, by those two measurements. By putting on the hose first ting in the morning, they stop the edema from swelling a lot during the day.
Good luck to your mom!
-Mara

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello Mara,

So what exactly causes some people to have the swelling, permanently, and others only have it temporarily? The cardiologist doesn't seem to have an answer for that question.

Yes. My Mom also says that the hose make her legs tired. Is it because of they have the compression fibers?

My Mom did have the measurements done and that is how I knew what kind of hose to get her. I didn't understand what you meant about going to a smaller size.

Her compression is 15-20, ankle 10 1/2, thigh 23 1/2. Size is large. I did get her the thigh highs but she said the toes were too tight so she cut that part off. So now I will have to get her the
open toe hose. I don't know if Jobst has those, but I will have to check.

Thank you for taking the time to write.

Take care,
Patty

 

[Ross]

Patty, Jobst does make open toes. I have a pair around here somewhere, but they are medium.

Check out there site at:
http://www.jobst-usa.com/medical_legwear.html

 

[Mara]

Patty-
Jobst makes a "million" different kinds and styles of hose. thigh highs, toe-less, knee-hi's, they even make compression sleeves for arms.

I don't think anyone knows why some people have problems with edema.

If your mom has been measured for the right size then she should do okay. According to the Jobst stuff, edema is a chronic condition and the hose will not "cure" it. They just provide relief. But, you have to wear the hose everyday, and most people with severe edema have to wear them all day long. Only a doctor can figure out what the cause of the edema is. Is your mom on Lasix or anything like that?

I think I am confused, the Jobst hose should not make your mom's legs feel tired. The should give her good support and help her. If they are making her legs tired maybe she's got some other things going on.

I hope she can get it worked out. I am certain it's very painful, not to mention annoying.
-Mara

 

[sylviayasgur]

hi patty!
as i mentioned before, my dad lives life with swollen ankles (legs from the knee down). he seems perfectly fine and the cardios are not concerned_ thank God.
i wore jobst hose for varicose vein treatments and i agree with mara, the hose should be making your mom's leg(s) feel better, not worse or tired. maybe this needs to be looked into further?
hope this all gets resolved soon.
all the best, sylvia

 

[Starmouse]

Aortic Valve Replacement

Aortic Valve Replacement

Hello Ross,

Thank you so much for the information. My Mom said that the closed stocking just squeezed her toes too much. She ended up cutting the toe portion. I don't know how that affects the compression but I will definitely check out the web site you mentioned.

Have a great day.
Patty