My AVR OHS Experience

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pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
10,278
Location
Queensland, OzTrayLeeYa
Insane guidance. No logical or reason behind it. It is as if they often use a Magic 8 Ball to come up with their warfarin plan.

Making decisions with Magic 8 Ball:

"It says, 10mg for 3 days then 7.5mg the rest of the week. Let's go with that."


thanks for that very educational. I always wondered how clinics made branching decisions on dose changes

:)
 

Timmay

Well-known member
Joined
Apr 22, 2022
Messages
71
Location
Frederick, MD
Update: About 5-1/2 weeks past surgery.

I'm walking 2-3 miles a day. Walking is super easy and my speed is getting better. Example: This AM I did a 1.8 mile walk at a 21 min/mile pace. I often do shorter walks targeted specifically at a faster pace and have hit a 18 min/mile pace without issue.

My chest scar is healing really well. I still have the little scab at the top and I am protecting that to allow my body time to fill in with skin. Preventing any chance of an infection here is paramount. It's now finally become a little bit itchy ... a good thing in the healing process.

I'm completely off metoprolol. I did this on my own while watching my FitBit's daily Resting Heart Rate. As the heart rate started coming down, I started reducing my metoprolol. I was originally prescribed 25mg twice a day. Then I went to 12.5mg three times a day. Then 12.5mg twice a day. Then 6.25mg twice a day. Then 6.25mg once a day. Then nothing. It's important to wean yourself off of metoprolol and not go cold turkey.

A lot of the weird little things that have popped up as challenges from week to week seem to have gone away. Woohoo! I still have challenges for sure - but new challenges are few and far between. My challenges at this point are ...

1) Musculoskeletal chest pain from the muscles and nerves all trying to come back together and be normal. No pain just sitting around or walking around. Just pain from time to time doing bigger things like getting in and out of bed, doing deep breathing exercises, etc. The "pain" is only like a 3 on a scale of 1-10. This is getting less as time goes on.

2) So sleepy! I'm just so tired in the AM and I feel relatively exhausted once I finish up work (desk job, working from home, software developer). FWIW, I do not nap during the day and I get plenty of sleep at night (according to my fitbit). I'd probably feel better if I took a nap in the middle of the day ... but "I ain't got no time for that" (ROFL). FWIW, I went back to work at 2-1/2 weeks post surgery. I started with 4hr for a couple days. Then I went to 6hrs. I am now up to 7hrs. I anticipate being back to 8hrs in a week or so.

3) Trying to get my lung capacity back. I'm up to ~2600cc on the spirometer, but I just feel like this should be more at this point. The doctors say I'm doing great - but my pre-surgery volume was 3800cc so I have a ways to go for sure.

I started Cardiac Rehab 1 week ago (at 4-1/2 weeks)! Definitely cool because I was actually able to work up a sweat ... AND feel confident that everything was ok because I was hooked up to monitors with someone looking at what was going on. I'm currently doing 15 minutes on some sort of seated pedal pusher (lol). Then 10 minutes on the bike. Then 16 minutes on the treadmill. My heart rate is getting up to 130-ish at times. That feels good (and comforting knowing that all is ok).

My appointment with my surgeon at 4 weeks went great. My appointment with my cardiologist at 4 weeks went great too. My surgeon gave me approval to drive. My cardiologist told me that it's in my best interests to hold off until 8 weeks. I agree with my cardiologist so no driving for me for another 2-1/2 weeks. Cardiologist gave me orders for an X-Ray and for an echo before meeting with him again at the 2 month point.

If you're following along, I'm anaging my own INR (with significant assistance from pellicle). So - finger puncturing every day. I can't wait to move over to every other day ... and eventually once a week. Let's do the math together. 32 days. $6 per strip. Probably 8 extra strips used due to mistakes in the beginning (it happens). 40 x 6 = $240 in strips. Plus, it just gets annoying puncturing fingers every day (yes, I'm rotating fingers and sides of fingers). lol. My sensei said I could definitely move to every other day but I have a need for data right now :). We've reached a stable dose of 11mg that seems to put me pretty squarely around 2.5. That said, I'm currently experimenting with 11.5mg :D

As part of my daily routine, after my morning walk I do Weight, Temperature, O2, Blood Pressure, INR, Blood Glucose (finger is already punctured so why not). I then also record my warfarin dose, total steps for the day, max spirometer reading, my average resting pulse rate (also supplied by my FitBit) ... and some comments for the day. This sheet now really shows my progression and helps me track what is going on.
 

DJ-Rae09

Active member
Joined
Apr 26, 2022
Messages
40
Nice update Tim! .....When's that IPA going to be consumed? :)

How is the clicking/thumping sensation going? Has that gotten better or you're now just used to it?
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
10,278
Location
Queensland, OzTrayLeeYa
So - finger puncturing every day.
amen Sista
1656813212974.png
 

Timmay

Well-known member
Joined
Apr 22, 2022
Messages
71
Location
Frederick, MD
Nice update Tim! .....When's that IPA going to be consumed? :)

How is the clicking/thumping sensation going? Has that gotten better or you're now just used to it?

Hi Tim,

I’m thinking of having a Michelob organic lite beer at 8 weeks. Yea, weak-sauce but I need to feel comfortable with it :) For the good, potent, IPA I’ll probably wait until I can do a full workout in my home gym. That’ll be a nice little reward.

I would say that I’ve just gotten more used to it … the thumping and clicking. Oddly enough, the thumping is almost soothing at this point. Almost. The clicking is another story. First - It is important for me to say that it is not a big deal at all for me and it rarely bothers me. But, that’s possibly because I’m a white noise kinda person. There aren’t many dead quiet rooms in our house. That said, the bathrooms are sorta quiet and there have been times that I’m using the bathroom for several minutes (lol) and I’m like “whoa! That’s some clicking!” … and then I turn on the vent fan and all is well.

Sidenote: Today was an awesome day. I walked 2.04 miles in about 34 minutes. The second mile was at a 16 min/mile pace and my overall average heart rate was close to 120bpm. Definitely making good progress.
 

Timmay

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Joined
Apr 22, 2022
Messages
71
Location
Frederick, MD
Another milestone today. Less than 6 weeks and I walked a self-imposed 5K this morning without stopping (actually a tiny bit more at 3.3 miles). I cranked the speed down and focused on distance. But, I still kept it a brisk walk. My pace was under 20min/mile for each mile :D. Woohoo! Big thanks to the man upstairs (and my wife for her support, and pellicle for all his help, and so many people to list!).
 

ValveAdmin

Administrator
Staff member
Admin
Joined
Apr 9, 2019
Messages
196
Location
SE USA
Another milestone today. Less than 6 weeks and I walked a self-imposed 5K this morning without stopping (actually a tiny bit more at 3.3 miles). I cranked the speed down and focused on distance. But, I still kept it a brisk walk. My pace was under 20min/mile for each mile :D. Woohoo! Big thanks to the man upstairs (and my wife for her support, and pellicle for all his help, and so many people to list!).
Amazing, nice work.
 

Superman

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Joined
Oct 2, 2009
Messages
1,589
Location
Grand Rapids, MI, USA
Nice to read the progress updates. Keep up the good work. Before you know it, you’ll look back and wonder when exactly it was that you started feeling normal again. 👍
 

AZATADINE

VR.org Supporter
Supporting Member
Joined
Aug 30, 2021
Messages
96
Just on coming off Metoprolol, probably not advisable to be coming off it or any other medication unsupervised? I was on Bisoprolol for about three months post op (9 months ago) but I waited until my cardiologist ok'd me coming off it. My BP was perfect and no arrhythmia plus my heart rate was steady at around 65 bpm. Still, I waited until given the approval to do so.
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
10,278
Location
Queensland, OzTrayLeeYa
Just on coming off Metoprolol, probably not advisable to be coming off it or any other medication unsupervised?
if you don't have regular visits to your primary care I would monitor HR and BP and be ready to resume and titrate down if things go whacky. Frankly I'd wean off (titrate dose down) if you were on a dose larger than 50mg per day.
Best Wishes
 

Timmay

Well-known member
Joined
Apr 22, 2022
Messages
71
Location
Frederick, MD
I'm almost at 10 weeks post surgery and wanted to provide an update. It's a long update - so buckle up if you're interested?

Things are going great (fingers crossed). I feel human again
🙂
. This morning I did a 3.4 mile walk with my neighbor ... with plenty of gas left in the tank. "Rehab" (which is really just cardio exercise for 45 minutes) is going awesome. Yesterday I held an average 125bpm for 45 minutes with spikes to 150 as I pushed myself (which I tend to do). I never get out of breath and I think I am the only one in rehab sweating and going for gold (lol). I've started weights again and it will be a slow crawl back to where I was, but I am on that path for sure. Feels phenomenal to hold and use dumbbells again. Can't wait to do benchpress and pullups one day!

Latest appointment with my cardiologist went great too. My previous stenotic aortic valve was so small that it was shooting blood out at 4.2 m/s with a pressure differential of 70 mmHg. My heart was working hard to get blood out that tiny opening. The new valve is flowing the same volume but at 1.7 m/s with only a 12 mmHg pressure differential. What an improvement. I don't feel a difference yet, but I probably will after full recovery and getting back to some running (I've already started some small jogs during my walks). X-Rays are showing that my lungs are good to go and my aorta is happy. Sweet!

My sternum has healed up pretty good. I have a nice, 8" long story on my chest now. Was just out in the garage sawing up some wood this weekend shirtless. Speaking of house work, I felt good enough to be up on a ladder taking my broken garage door opener apart to replace a broken sprocket in a 100d garage ... and pulling the lights off the front of the house for a repaint. Woohoo!

I have my Warfarin in check and and I've moved from testing every day to 3 times a week. Currently taking 11mg a day and have been steady the past two weeks and averaging 2.8 with all of my readings being between 2.6 and 3. Sweet. Next up will be moving to twice a week and then eventually once a week. Looking forward to that ... but I'm not in a rush either. HUMONGOUS thanks to @pellicle for managing me, educating me on many levels, and being patient with me.

I was 170lbs prior to surgery. I am only 160lbs now. Lost a lot of muscle, but have no doubt that I'll eventually gain it back. The good news is that I have managed to keep my eating habits in check so that I don't gain much weight in the wrong places while allowing the healing process to progress.

I did have some small concerns about the level of clickity-clackety that this valve would make. It didn't disappoint me, but It is still totally not an issue. Luckily, we are white noise people. It's rare to find me without music. We have air cleaners running and the sounds of crickets on the phone at night. I never really hear it. That said, get me into a completely quiet room and I sound like a loud watch, lol. I went into work the other day and my teammate said "That's you?!?". "Why yes, yes it is. Would you like to know the time?"

I still have healing to do (obviously) and that will take several months or more. But, I am super happy with how things are going and super thankful for my amazing blessings. Huge special thanks to the Lord (Amen!) and to my amazing wife. Without either of them, I wouldn't be where I am (mentally, emotionally, spiritually, physically, etc.).
 

Chuck C

Well-known member
Joined
Dec 5, 2020
Messages
1,648
Great update Timmay! It is really good to hear how well you are recovering!
 

KLS39

VR.org Supporter
Supporting Member
Joined
Dec 21, 2021
Messages
76
I'm almost at 10 weeks post surgery and wanted to provide an update. It's a long update - so buckle up if you're interested?

Things are going great (fingers crossed). I feel human again
🙂
. This morning I did a 3.4 mile walk with my neighbor ... with plenty of gas left in the tank. "Rehab" (which is really just cardio exercise for 45 minutes) is going awesome. Yesterday I held an average 125bpm for 45 minutes with spikes to 150 as I pushed myself (which I tend to do). I never get out of breath and I think I am the only one in rehab sweating and going for gold (lol). I've started weights again and it will be a slow crawl back to where I was, but I am on that path for sure. Feels phenomenal to hold and use dumbbells again. Can't wait to do benchpress and pullups one day!

Latest appointment with my cardiologist went great too. My previous stenotic aortic valve was so small that it was shooting blood out at 4.2 m/s with a pressure differential of 70 mmHg. My heart was working hard to get blood out that tiny opening. The new valve is flowing the same volume but at 1.7 m/s with only a 12 mmHg pressure differential. What an improvement. I don't feel a difference yet, but I probably will after full recovery and getting back to some running (I've already started some small jogs during my walks). X-Rays are showing that my lungs are good to go and my aorta is happy. Sweet!

My sternum has healed up pretty good. I have a nice, 8" long story on my chest now. Was just out in the garage sawing up some wood this weekend shirtless. Speaking of house work, I felt good enough to be up on a ladder taking my broken garage door opener apart to replace a broken sprocket in a 100d garage ... and pulling the lights off the front of the house for a repaint. Woohoo!

I have my Warfarin in check and and I've moved from testing every day to 3 times a week. Currently taking 11mg a day and have been steady the past two weeks and averaging 2.8 with all of my readings being between 2.6 and 3. Sweet. Next up will be moving to twice a week and then eventually once a week. Looking forward to that ... but I'm not in a rush either. HUMONGOUS thanks to @pellicle for managing me, educating me on many levels, and being patient with me.

I was 170lbs prior to surgery. I am only 160lbs now. Lost a lot of muscle, but have no doubt that I'll eventually gain it back. The good news is that I have managed to keep my eating habits in check so that I don't gain much weight in the wrong places while allowing the healing process to progress.

I did have some small concerns about the level of clickity-clackety that this valve would make. It didn't disappoint me, but It is still totally not an issue. Luckily, we are white noise people. It's rare to find me without music. We have air cleaners running and the sounds of crickets on the phone at night. I never really hear it. That said, get me into a completely quiet room and I sound like a loud watch, lol. I went into work the other day and my teammate said "That's you?!?". "Why yes, yes it is. Would you like to know the time?"

I still have healing to do (obviously) and that will take several months or more. But, I am super happy with how things are going and super thankful for my amazing blessings. Huge special thanks to the Lord (Amen!) and to my amazing wife. Without either of them, I wouldn't be where I am (mentally, emotionally, spiritually, physically, etc.).
This is great news.
 
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