Recently just had a bentall procedure on Thursday with a mechanical valve and graft to replace the aortic root. Was discharged yesterday from the hospital (which in my mind was crazy how quick the turn around in hospital is). Anyone have tips for recovering after post-op.
ahh, well now that I see this I see my above is superfluous ...
recovery: just follow the directions, don't lift things (as per directions to not do so). Steps and walking ... do it.
after about 5 weeks of course you can act more normally but still no lifting things more than a couple of Kg
longer term your most important step for long term health will be proper INR management. Proper compliance can not be understated and its actually simple. I'm presently writing an eBook on this subject but for now here's a bit from that related to the above
Then there is this study: The influence of patient adherence on anticoagulation control with warfarin: results from the International Normalized Ratio Adherence and Genetics (IN-RANGE) Study
We performed a prospective cohort study at 3 anticoagulation clinics to determine the effect of adherence on anticoagulation control. Patients treated with warfarin with a target international normalized ratio of 2.0 to 3.0 were monitored with electronic Medication Event Monitoring System (MEMS) medication bottle caps. Detailed information was collected on other factors that might alter warfarin response…
Among 136 participants observed for a mean of 32 weeks,
- 92% had at least 1 missed or extra bottle opening;
- 36% missed more than 20% of their bottle openings;
- and 4% had more than 10% extra bottle openings.
In multivariable analyses, there was a significant association between underadherence and under-anticoagulation.
For each 10% increase in missed pill bottle openings, there was a 14% increase in the odds of under-anticoagulation (P<.001);
participants with more than 20% missed bottle openings (1-2 missed days each week) had more than a 2-fold increase in the odds of under-anticoagulation (adjusted odds ratio, 2.10; 95% confidence interval, 1.48-2.96).
Participants who had extra pill bottle openings on more than 10% of days had a statistically significant increase in overanticoagulation (adjusted odds ratio, 1.73; 95% confidence interval, 1.09-2.74).
Conclusion: Patients have substantial difficulties maintaining adequate adherence with warfarin regimens, and this poor adherence has a significant effect on anticoagulation control.
(re-formated for emphasis)
So even when a clinic was involved we see this is no magic solution for proper patient adherence (commonly called compliance) with taking your warfarin and taking the right amount.
Taking your dose
To make sure that you take your dose you need a number of (let's call them rules) which work in synergy in order to remind you. I like to have three, but you can have more or less. I’ve found that three ensures a very low likelihood of failing to take my dose. Oh, and yes, despite doing this for over 12 years (perhaps because it's part of my life) I find that I still need all three now and then. Some suggestions:
- Put your pills in a day marked pill box
- Put the pill box in a place where you will notice it (kitchen bench where you often do something)
- When you’ve taken a dose, leave the lid up (as a flag)
- Pick a time of day to take them which fits your routine (for some that’s morning, for others that’s evening).
- Have an alarm set on your phone to remind you (actively try to take the dose at that time, don’t just cancel the alarm. If the alarm is at an inconvenient time then think about that and change the time to a convenient one.