My New Valve! (The TAVR Journey - More Complex Than I Imagined!)

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Jul 1, 2018
Siesta Key, Florida
My TAVR (Transcatheter aortic valve replacement) experience was much more involved than I imagined. Now (2 days later), I want to share some important details so if any of you will be taking this journey, maybe this will help you through what I found to be the “most scary” part, and how I got through it.

My journey started 5 weeks ago with initial testing. I had a “double header”, (a TEE (transesophageal echocardiogram) and a cardiac catheterization). Not nearly as bad as it sounds, as you’re mostly sleeping through them. 2 weeks later I had a CT scan (Cake Walk), and 1 week later met with my (Interventional Cardiology) doctor, and set up my appointment. (All this scheduling is handled thru the excellent “Valve Clinic” in Sarasota Memorial Hospital, which is a “high Volume” Center for “TAVR”.

Unfortunately, my hospital experience was difficult, as many emergencies that day caused my “TAVR Procedure” time to slip from 12 noon until 4:30. While I tried to handle it, my “stress level” was rising. I was relieved as they wheeled me into the OR, knowing that I’d soon be in “La-La Land”. About 2 hours later I awoke with no pain and only pleasant memories of my dreams. (The actual procedure only takes about a half-hour, I’m told). My stress level was gone! (Little did I know that the next 12 hours would be “prue misery” for me. (I do realize that not everyone has the same issues when they’re confronted with sleepless nights as I do!).

A necessary part of their “Post TAVR Protocol” to help assure nothing “bad” is happening, are endless “vital’s checks”, starting at every 15 minutes, then finally working up to hourly (all night). Adding these hourly checks to the endless hospital noises, pretty much eliminates any chance of sleep. (I totally understand why all this is necessary, but the end result for me was suffering from “sleep deprivation”).

Anyway, I was released by 9am or so, meaning my whole “TAVR Procedure” lasted less than 24 hours. But the rest of that “day-after TAVR” was the “BAD PART”, for ME! (Probably not for you). As it is “impossible” for me to sleep during daytime, I was loaded with stress. I know myself well enough to understand that I was pretty much having an “anxiety attack”. Throughout the day, this often made me “short-breathed” as I struggled to get some rest. The worst part for me was I was beginning to think maybe TAVR didn’t work, or maybe something was wrong. I pretty much felt that I was now more “short-breathed” than I had been prior to the procedure, and of course those thoughts just made things worse.

Through all this, I tried to reason with myself. I knew I was stressed and having anxiety. I kept telling myself that I needed to have a full night's sleep before trying to figure out if anything was wrong. I reviewed my “Discharge Instructions” and was surprised to learn that I had “Breathing Exercises” I was supposed to be doing. They wanted me to use an “Incentive Spirometer” 10 times PER HOUR, ALL DAY! Turns out because I had had a Quad Bypass 8 years ago, I actually still had one of those meters.So I got going on my breathing exercises. I was somewhat relieved to learn that my “recovery process” would be much like the 2 months I went through after the By-Pass.

(TODAY - 2nd day after TAVR). I got a great night's sleep (9 hours). I'm breathing “normally”. (To me, “normal” means I am unaware of my breathing, it just happens, no short-breath feeling). I am still really “tired” and taking it very easy, but no pain at all. So I’m feeling relieved that my TAVR may turn out OK for me. I’ll keep up my “Post-Op” exercises and give you an update in a few weeks. Thanks!
Hi Jimmy,
I'm happy to hear you got a good night's sleep after this stressful time and you feel very good about your TAVR-Thank Goodness. It really is great to be unaware of one's breathing-I love that feeling too. I was in the hospital recently for a cardio version for which I needed to wait an extra 24 hours (of hell) until a time slot opened up. It was the most glorious feeling when I came out of the Cardio version and my chest was calm again. I think I heard the angels singing!
I wish you continued success with your TAVR. Keep us posted.
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Being in the medical world for 50 years I have frequently wondered on how much we put patients through that is unnecessary. For example not eating before surgery and scheduling surgery at 6pm. Having surgery and being awoken at 4 am for blood work. There are usually reasons for these things but they never are for the patient’s comfort. Somewhere this concept doesn’t get discussed in medical training. Even when I had mitral clips placed and was ready to go home the following day at 9am I had to sit in the bed waiting for one more test that wasn’t available until late in the afternoon. I had to be a squeaky wheel (complain) to even get that done. Hospitals have a way to go to make the surgical experience as efficient and pleasant as it can be.
not eating before surgery
I was told by an anesthesiologist that my stomach needed to be empty to ensure that food in the stomach did not get vomited and go into the lungs. Is this not true?

Hospitals have a way to go to make the surgical experience as efficient and pleasant as it can be.
Mayo Clinic was very efficient and comfortable for my open heart surgery Sep 14, 2023. They scheduled all of my pre-operation tests for the day before surgery, so I only had to arrive in Rochester 2 days before surgery. Day of surgery was an assembly line. The anesthesiologist was talking with me before the nurse's aide finished shaving my chest and groin. I barely had time to urinate before I was going to sleep in the operating room. They also were good about efficiently handling my post operation procedures (blood draws, EKGs, removing tubes, etc). I had a single person room that was a comfortable size and was quiet.
Nil by mouth isn't necessary?
Nothing by mouth is necessary to avoid aspiration from stomach contents when starting and finishing anesthesia, but scheduling surgery at 6PM and forcing the patient to starve for the entire day is not ideal . This may also include no liquids. So elective surgeries should be done earlier if possible. In my field frequently surgeries are set for the evenings since the physicians are not available earlier.