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johnmarkos

Cyborg in training
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I had my first cardiac rehab appointment on Friday. They let me use the elliptical for five minutes, which felt great at the time, but when I got home, my forearms were a little sore. I'm going back tomorrow (Monday), which will also be my first day back at work.
 

epstns

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I found rehab to be really helpful -- especially the way I chose to do it. I had rehab classes three days each week. On the two off-days, I went to my won fitness club and did whatever activities they had me do the day before, so I actually did rehab five days a week. By the end of my 12-week rehab program, I was back to probably 90% of the exercise activity I did prior to surgery. That excluded push-ups and bench presses, though. Those just didn't feel right until about six months out.
 

johnmarkos

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I found rehab to be really helpful -- especially the way I chose to do it.
I switched to two days a week, Tuesday/Thursday, due to conflict with some work meetings. Nevertheless, I'm really enjoying it so far. Given my arrhythmias early on in my recovery, I don't want to take it too hard, too fast. The level of activity in cardiac rehab is just about perfect for me right now.

I'm not repeating the rehab exercises yet, but I am getting a whole lot of walking in, basically every day. Nevertheless, there's a little gym in my office, so I could theoretically get some workouts in on my own.
 

johnmarkos

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I saw my cardiologist today, a little more than two months after my surgery. I'm stopping Amiodarone, Furosemide (diuretic), and Potassium. He also gave me a seven day heart monitor to check for recurrence of atrial flutter.

Because my arrhythmias were over a month ago, he's having me go back to the INR target range for the valve (1.8-2.5), rather than that for arrhythmia (2-3). So my last INR measurement of 1.8 was OK, as was the previous measurement of 1.9.

I was cleared to ride a bicycle, do bodyweight exercises, and do aerobic exercise at the exertion level I was doing in cardiac rehab before they paused for COVID-19.
 

Protimenow

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Regardless of what your cardiologist said, I know that there are many on this site who believe that, even with an On-X, you're safer maintaining a target range between 2.5 and 3.5. Your lifestyle won't change, you won't really notice any differences from living with an INR of 2.5, rather than 1.8.

There have been horror stories from people who kept their INRs around 1.8 or so. If it was me, I wouldn't take the risk - I'd want to keep it at 3.0 +/- .5.
 

johnmarkos

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Regardless of what your cardiologist said, I know that there are many on this site who believe that, even with an On-X, you're safer maintaining a target range between 2.5 and 3.5. Your lifestyle won't change, you won't really notice any differences from living with an INR of 2.5, rather than 1.8.
After my 1.8 result a week ago, my Warfarin dosage was increased, so I might not get to 2.5, but I'll probably be above 2 with today's measurement.
 

Freebird

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After my 1.8 result a week ago, my Warfarin dosage was increased, so I might not get to 2.5, but I'll probably be above 2 with today's measurement.
Glad to hear your update.

I'm curious about your trip to the INR clinic. Did you really have to walk 6 miles to get there? How did they handle any lines or crowding once you arrived?
 

johnmarkos

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I'm curious about your trip to the INR clinic. Did you really have to walk 6 miles to get there? How did they handle any lines or crowding once you arrived?
My wife didn't go to work today: she runs a preschool, and they closed because of the SF Bay Area COVID-19 shelter in place. So the car was available -- we were worried about parking near the lab, so she drove me this time. Next time, if I have access to the car, I'll drive myself, or I could bicycle, because I got cleared to ride today.

The lab wasn't crowded at 10:30am today: they aren't offering COVID-19 tests at that location, and there were multiple signs telling people to stay away if they had symptoms. It was possible to walk in and stand 6 feet away from people in the waiting room.
 
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I had this same thing happen about four weeks out. They call it spitting a stitch. My insurance company had cut off my at home nurses (of course), so I was relying on a doctor friend for advice. That and the internet. It cleared up on its own within a couple days. Curious how yours fared.
 

johnmarkos

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After I stopped taking Amiodarone on March 17, I got a seven-day heart monitor. I'm happy to report that the results came back showing me in normal sinus rhythm with an average heart rate of 71. No AFlutter.

I'm feeling good physically, despite being stuck at home most of the time and pretty anxious about COVID-19. My work is quite busy these days and can be done entirely from home. I went for a brisk walk around the neighborhood this morning, being careful to keep physical distance from my neighbors. Later, I did a video bodyweight workout at home, and that felt pretty good -- I feel as though my energy level is back to where it was before surgery.

I have to go get my INR checked next Tuesday, and already I'm planning how I'm going to bike there and get in and out of the lab without touching anything. I'm hoping to get started with home testing right away on April 6th, which will be 90 days after my surgery. It will be nice to stop going to the lab, particularly in the time of COVID-19.
 
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johnmarkos

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It's been 90 days plus a week since my surgery -- my home INR monitoring kit has shipped, and it should arrive Thursday.

Still feeling good, knock on wood. First thing in the morning, when there aren't too many people out, I've been going for very brisk walks, like under 15 minute miles (9 minute km). Heart rate up around 100-110 at that pace. My cardiologist didn't exactly clear me to run yet -- he said I should exercise at the level I was doing at cardiac rehab before they shut it down for COVID-19. I'd really like to get back to running, so I'll probably call him soon to see if I'm allowed.

And then maybe in the summer I can have that beer.
 
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Freebird

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It's been 90 days plus a week since my surgery -- my home INR monitoring kit has shipped, and it should arrive Thursday.

Still feeling good, knock on wood. First thing in the morning, when there aren't too many people out, I've been going for very brisk walks, like under 15 minute miles (9 minute km). Heart rate up around 100-110 at that pace. My cardiologist didn't exactly clear me to run yet -- he said I should exercise at the level I was doing at cardiac rehab before they shut it down for COVID-19. I'd really like to get back to running, so I'll probably call him soon to see if I'm allowed.

And then maybe in the summer I can have that beer.
Thanks for the update! Glad to hear things are going well!
 

Protimenow

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I was taking Amiodarone at the hospital, then at home, and all it did was turn my intestinal contents to concrete. It did nothing about my heart rhythm.

An electrocardiologist changed me to Verapamil. A hospitalist prescribed another Calcium Channel blocker (Sotolol), and my Cardiologist wanted me to continue with Benazapril. The combination dropped my heart rate into the 30s, and I felt weak and, basically, like I was dying. I went back to the hospital, feeling extremely weak, and after a day off of most medications, started to feel much better.

I went home, with instructions to only take Verapamil if my pulse was over 50. I didn't take it for three days, because my resting pulse was under 50. At the end of the third day, my pulse varied from 40 to 70 in a few seconds. I skipped the benaxzepril, took Verapamil, and put up with a heart beat of around 132 BPM. After an hour or so, the Verapamil settled things down.

I think I may have figured it out -- the Benazapril dropped my heart rate below 50 - so I couldn't take Verapamil (which improves my heart rhythm). I'm taking a half dose of Benazapril and, so far, the resting heart rate is around 53. I may discontinue Benazapril altogether and see if my heart rate goes a bit higher. It would be nice if the cardiologist and the electrophysiologist communicate better with each other.

I'll update this if things change again.
 

Suckyvalvegurl

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Jan 26, 2019
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Tx
It would Protime, but seems like your monkeying around with it like you are is going to provide the best outcome.
 
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