MANY Random Questions for AV'ers... Sorry :-/

[pgammo]

Hey all,

I am meeting with my surgeon this coming Thursday to talk about surgery and possibly set up an appointment. I had some random questions that I would love answers for, if possible. I'm 25, if that helps answering these questions. I have moderate-to-severe bicuspid aortic regurgitation with MILD LV dilation.

I was becoming extremely symptomatic, and for the last 5 days have been feeling GREAT. HR down, running and playing with my children, lifting, etc.


-Is it possible to become unsymptomatic after becoming symptomatic?
-After valve replacement (mechanical), if I get a sudden impact hit to my chest, can the valve be knocked loose? Will I die suddenly? For example, a car accident with deployed air bags to my chest.
-I have horrible teeth and probably need a lot of work done NOW. Should I do that before or after the surgery?
-What are the chances of endocarditis? Is it instantly fatal or can it be treated at home?
-Will I ever be able to DRINK beers or liquor? Will I ever be able to smoke (not that I want to)? [Being that I have an mechanical valve and am on coumadin]
-Is it normal to recommend surgery for a BAV with moderate-to-severe regurgitation and MILD LV dilation?
-Will I ever be able to work a labor'ish job?
-Is the scar really ugly? Like, not able to wear a V-neck status?
-After I get discharged from the hospital, will I be able to surf the web while recovering? Or will I be a vegetable?
-Have any of you ever needed a root canal(s) after your AVR? What did you have to do?
-How do they usually find endocarditis? Blood tests? And do they give you antibiotics during recovery?
-Will I ever be able to weight lift?
-What did YOU DO during recovery in the hospital to make the days go by faster?
-Will I ever be able to fully stretch my upper body? Or will I develop a stiff looking upper body?
-Are headaches a symptom of an aortic valve leak?

I know these are a bunch of weird and random questions, but they've been lingering in the back of my mind for a while now, so I figured I'd ask. Would suck not being able to have a beer here and there, or ever be able to work a semi-strenuous job. Sorry if I'm being a nuisance, and thank you for any help in advance!

Take care and God bless!

 

[JimL]

Fix your teeth before surgery. Yes, you can drink in moderation. Don't smoke. You may not have any physical limitations at all, although that varies from person to person. The scar is a badge of courage; wear it proudly. During recovery, I mostly looked forward to my next meal. I had a good book to read, which passed the time.

 

[queenie]

To answer your questions about endocarditis, you may never get it. If you do the vast majority of cases are cured with IV antibiotics, just be aware of the symptoms so you can rule that out as quickly as possible. You are young and healthy and will be able to return to your normal life or hopefully, better life within a few months. The surgery is a tremendous shock to your body so remember to give it time and don't rush recovery. I know it's easier said than done but I am about to have my 3rd aortic valve replacement in the last ten years so I have some experience here.

 

[Dgreenbee]

Oh my. There are many web sites that explain in full what to expect. Spend lots of time at your computer! There are also YouTube videos that at helpful. Your valve will be part of you and cannot be knocked out of place. You need to protect your sternum from impact during healing. Sure you can drink. You can exercise and work hard and do nearly anything after the healing period. When you are out of ICU and in your ward you will be very comfortable and alert. On my second day I was up walking, eating in my chair, reading, watching TV. Each day gets better. You start getting rid of all the tubes and wires and stuff. You will be able to stretch. Scars fade. My used silicone scar cream to help her knee scars.

 

[dick0236]

I'll take a shot at some of your questions:
-I was generally non-symptomatic before my surgery, but my docs convinced me that my situation was crtical, with or without symptoms.
-That used to bother me too. I was afraid my little ball would get struck in the cage. After healing there is little chance of the valve tearing loose. It would be a good idea to minimize the chances of blows to the chest for a few months.
-Good dental hygene is very important after OHS. Talk with your surgeon about the better time to have your teeth worked on....before, or after OHS.
-My surgery was 45 years ago and I've NEVER had endocarditis(sp?) so I don't think it is innevitable.
-You can drink socially(I was even prescribed a beer each nite while I was in the hospital post-op). If you don't smoke, why would you even consider starting....and it would be a bad idea.
- I've never had a laborish job, but I have built a cabin, done a lot of home remodeling and "honey-do" projects. I have a good friend who has had two valves and he was a building contractor prior to retirement....so, yes I think you can do a laborish job.
-I have always been a little self-conscus about my scar. Back then, the surgeons didn't pay a lot of attention to the cosmetic look of the surgery.
-We have some on this forum who have posted withing a day after surgery.
-I have had several root canals since my surgery. Only standar pre-visit anti-biotics were necessary.
-There are several weight lifters on this forum.
-The hospital gave me a little job of visiting with the new pre-op patients to assure them that people did live after the surgery.
-You can do whatever you like to do without undue concern. I am 76, still play golf, fish and work out at a gym....almost every other day. Normally, there are no limits.....so long as you use common sense.
-I very seldom get a headache.

This is a very good forum for the "newbie". Stick around and ask your questions.....I guarntee that someone has "been there, dont that" and can help take the fear out of this surgery.

 

[Bill B]

-Is it possible to become unsymptomatic after becoming symptomatic? - Although there are some reports of stenosis and regurgitation improving, it's very, very unlikely.
-After valve replacement (mechanical), if I get a sudden impact hit to my chest, can the valve be knocked loose? Will I die suddenly? For example, a car accident with deployed air bags to my chest. - these things are sewn in with almost 100 stitches - very secure. I'm just going to say if you had an impact that could fatally damage the valve, you'd probably have died even if it wasn't there.
-I have horrible teeth and probably need a lot of work done NOW. Should I do that before or after the surgery? - I would.
-What are the chances of endocarditis? Is it instantly fatal or can it be treated at home? - The incidence is quoted as 2-4% with artificial valves. It is usually slowly progressive and CAN be treated at home with IV antibiotics via special catheter.
-Will I ever be able to DRINK beers or liquor? Will I ever be able to smoke (not that I want to)? [Being that I have an mechanical valve and am on coumadin] - The recommendations regarding booze are pretty liberal (just don't binge). Bottoms up!
-Is it normal to recommend surgery for a BAV with moderate-to-severe regurgitation and MILD LV dilation? - Well, normally things are toward the severe side, but symptoms, and other things like aortic dilation or rate of change in test results would change that. Most of the time cardiologists and surgeons are on the conservative side in terms of recommending surgery and are VERY unlikely to recommend it when it's not needed.
-Will I ever be able to work a labor'ish job? - Absolutely. After the FULL recovery period wherein ALL restrictions are usually lifted (about 6 months), you can tote that barge and lift that bale. Prior to that you will have some lifting limitations.
-Is the scar really ugly? Like, not able to wear a V-neck status? - I guess most people end up with a pretty thin line that is not ugly. I developed a keloid only on the bottom 1/2 of my scar. The top half is pretty nice, but the bottom half is raised, reddish and, well, ugly.
-After I get discharged from the hospital, will I be able to surf the web while recovering? Or will I be a vegetable? - Hah, hah, you're pretty funny! Several people here have logged in the day after surgery. It took me 5 days before I had the energy to work the laptop. There is a lot of talk about "pumphead" that screws some people up post-op, but I think it's rather uncommon.
-Have any of you ever needed a root canal(s) after your AVR? What did you have to do? - Not me, but I think that would not be any more than some antibiotics before and after.
-How do they usually find endocarditis? Blood tests? And do they give you antibiotics during recovery? - Yes, blood cultures are definitive, combined with symptoms that point to a vegetation on the valve, which can be seen with an echocardiogram. Any prolonged fever with some weakness and signs of cardiac impairment would trip an investigation for endocarditis. Almost always a specific bug is identified and antibiotics are tailored based on that with a minimum treatment of 6 weeks or so.
-Will I ever be able to weight lift? - Yes! Weight is initially very restricted, but the restriction is gradually lifted, and by 6 months it is usually unrestricted.
-What did YOU DO during recovery in the hospital to make the days go by faster? - There is the biggest problem. I couldn't sleep at all in the hospital. I ended up walking the halls a lot more than required. I had a lot of visitors.
-Will I ever be able to fully stretch my upper body? Or will I develop a stiff looking upper body? - Most people have no movement restrictions after the initial healing. My scar has a bit of tension in it and is still tender in spots, so I do tend to crouch a bit when I get up after sitting, as it can feel a bit tight, but I can walk perfectly straight up and most of the time I have no sense of any restriction in reaching or stretching. I do heavy repair work on cars, mostly as a hobby, and I can spend 8-10 hours out in the garage wrenching, swapping motors and transmissions, and I do perfectly fine. I started doing this about 2 months after surgery.
-Are headaches a symptom of an aortic valve leak? - Not for me. I really don't know.

 

[Bryan B]

I'll give it a go as well but remember I am not an expert, just sharing my experince.

Hey all,

I am meeting with my surgeon this coming Thursday to talk about surgery and possibly set up an appointment. I had some random questions that I would love answers for, if possible. I'm 25, if that helps answering these questions. I have moderate-to-severe bicuspid aortic regurgitation with MILD LV dilation.

I was becoming extremely symptomatic, and for the last 5 days have been feeling GREAT. HR down, running and playing with my children, lifting, etc.


-Is it possible to become unsymptomatic after becoming symptomatic?
I guess it's possible but I wouldn't know how or why.
-After valve replacement (mechanical), if I get a sudden impact hit to my chest, can the valve be knocked loose? Will I die suddenly? For example, a car accident with deployed air bags to my chest.
After healing the valve will be just as "secure" as your own valve. Your sternum will not be as strong for a couple of months until it completely heals and most surgeons don't allow you to drive for around 6 weeks because of that.
-I have horrible teeth and probably need a lot of work done NOW. Should I do that before or after the surgery?
I had a lot of work needed on my teeth and my surgeon "strongly suggested" that I have it done prior to the surgery.
-What are the chances of endocarditis? Is it instantly fatal or can it be treated at home?
Chances are higher than someone without valve disease but still low. Generally it is not instantly fatal and it usually requires a short stay in the hospital and then it can be treated at home. I had endocarditis prior to my first surgery...3 days in hospital and then 7 weeks of IV antibiotics from home...went back to work during this time.
-Will I ever be able to DRINK beers or liquor? Will I ever be able to smoke (not that I want to)? [Being that I have an mechanical valve and am on coumadin]
Yes you will be able to drink in moderation but you will also need to be consistent with it (no binging). I would advise not smoking...not so much because of the coumadin but because nicotine is bad for the heart (not to mention the possibility of cancer).
-Is it normal to recommend surgery for a BAV with moderate-to-severe regurgitation and MILD LV dilation?
My non expert opinion is yes. Usually when you reach moderate to severe range and your LV starts to become dilated it is time.
-Will I ever be able to work a labor'ish job?
Yesish lol. Some of that will depend on whether or not your surgeon puts lifting restrictions on you and how much.
-Is the scar really ugly? Like, not able to wear a V-neck status?
Most people's scars fade over time and are not that noticable. I don't have to worry as I have "natural camouflage". As was stated many of us wear our scars as a badge of courage. We even had a thread where members would post pictures of themselves showing their scar.
-After I get discharged from the hospital, will I be able to surf the web while recovering? Or will I be a vegetable?
You will be able to surf the web. Just look at the post-op forum for proof.
-Have any of you ever needed a root canal(s) after your AVR? What did you have to do?
My surgeon said no dental work for 6 months after surgery unless it was an emergency. I had a bunch of dental work done (including an extraction) 6 months after my last surgery and took oral antibiotics before the appointment.
-How do they usually find endocarditis? Blood tests? And do they give you antibiotics during recovery?
Usually by blood tests (blood cultures) and/or echo. Yes generally you are on IV antibiotics for approximately 6 weeks.
-Will I ever be able to weight lift?
That will be up to your surgeon. Chances are that you will be able to but not heavy weights...you will have to go for more reps.
-What did YOU DO during recovery in the hospital to make the days go by faster?
Actually I was only in the hospital for 4-5 days and I slept a lot, watched TV, did a bit of web surfing, and walked the halls...it went by quick.
-Will I ever be able to fully stretch my upper body? Or will I develop a stiff looking upper body?
You will be pretty stiff after surgery but eventually you should be able to stretch you upper body just fine.
-Are headaches a symptom of an aortic valve leak?
Not sure on this one maybe someone else can chime in here.

I know these are a bunch of weird and random questions, but they've been lingering in the back of my mind for a while now, so I figured I'd ask. Would suck not being able to have a beer here and there, or ever be able to work a semi-strenuous job. Sorry if I'm being a nuisance, and thank you for any help in advance!

Take care and God bless!

 

[Bryan B]

You beat me to it Bill. At least we used different colors.

Looks like we were pretty much on the same page. As far as the lifting restrictions I guess that depends on what type of surgery. Since I had my aortic root / ascending aorta replaced I have permanent lifting restrictions although they are not severe. I believe 1/3 of my body weight so about 55lbs.

 

[Boston Tiger]

I wear V neck shirts all the time, and no one notices my scar. But that I had a mini-sternotomy for my mitral valve repair, and my scar is on the lower half of my sternum. If I recall correctly, the mini-stern for an AV operation is higher and the scar probably could be seen in a V neck. My chest hair also makes it a bit more difficult to see my scar when I am shirtless.

I have full range of motion in my upper body. I can feel things when I really stretch out, but the main thing that bothers me is when I sit in the same position for some time, such as in an airplane seat or when driving my car for several hours at a time. I find that stretching is something I like to do more now.

Before surgery, I had to have my dentist send the hospital a letter verifying that I didn't have any oral infections, so I would imagine that you would need to get your dental work done ahead of time. I had to premedicate for my visits before surgery, and have to continue that after. It's simply better to do that than to risk developing endocarditis.

It's going to take some time for your body to heal from the surgery, but you should be back to your new normal in a fairly short amount of time. I know that I can enjoy a drink here and there, and my body will tell me if I'm pushing things too far with yard work. One thing about the forums here is that a lot of people disappear a few months after their surgery, and that's because they have simply gone back to living their normal lives. That's a good thing, since there is a real fear before surgery that OHS will change your life for the worse, while in fact it will simply give you a new life-span.

 

[LiMbTwIsTeR]

-Is it possible to become unsymptomatic after becoming symptomatic? IDK
-After valve replacement (mechanical), if I get a sudden impact hit to my chest, can the valve be knocked loose? Will I die suddenly? For example, a car accident with deployed air bags to my chest.I re-broke my sternum 3 weeks after my last surgery having sex, so I'm guessing yes
-I have horrible teeth and probably need a lot of work done NOW. Should I do that before or after the surgery?do it now, don't risk infection, take antibiotics
-What are the chances of endocarditis? Is it instantly fatal or can it be treated at home?IDK
-Will I ever be able to DRINK beers or liquor? Will I ever be able to smoke (not that I want to)? [Being that I have an mechanical valve and am on coumadin]you can drink, but seriously consider a different valve type if its an option
-Is it normal to recommend surgery for a BAV with moderate-to-severe regurgitation and MILD LV dilation?sure, but always get a second opinion. Surgeons only get paid when they cut you
-Will I ever be able to work a labor'ish job?no doubt, even better with biological replacement valve
-Is the scar really ugly? Like, not able to wear a V-neck status?who are you Danial Tosh?
-After I get discharged from the hospital, will I be able to surf the web while recovering? Or will I be a vegetable?You'll be walking around the next day. I walked a half mile to the pub and had two pints of DogFish 60 minute IPA two days after getting home from surgery
-Have any of you ever needed a root canal(s) after your AVR? What did you have to do?anitbiotics
-How do they usually find endocarditis? Blood tests? And do they give you antibiotics during recovery?IDK
-Will I ever be able to weight lift?Absolutely, in fact you need to. Your'e only fragile if you allow yourself to be. Use it or lose it
-What did YOU DO during recovery in the hospital to make the days go by faster?recovery starts at home, you won't get much rest in the hospital. they will keep you up with tests constantly. Each day they yank a different tube out of you, so that feels better. You won't have a ton of time to kill so get the rest you can.
-Will I ever be able to fully stretch my upper body? Or will I develop a stiff looking upper body?you should have a full range of motion
-Are headaches a symptom of an aortic valve leak?IDK

 

[TheGymGuy]

You asked a lot of great questions. Some of the folks here, including yours truly, wrote up their post-op experiences in the Post-Surgery forum. Main thing that you should know is that recovery will be, for the most part, what you want it to be. As far as some other questions, even if you had very little prep, which looks like you will have plenty, always listen to your Dr. and nursing staff. Ask to be very mobile and ask for help and things will be fine. There is a TAWDRY t-shirt forum here and it has plenty pictures of scars from folks that wanted to share. You can look in there to see all sorts of nicely healing chest scars during different times of healing. Most look pretty nicely healed as early as 3-4 weeks out.

Hope this helps.

 

[pgammo]

Thanks so much for all your answers guys and gals!!! You have given me some comfort and ease of mind!

God bless!