Post Op Day 4

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Seastreet

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Jun 12, 2020
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Hi guys, just got out of a BAV replacement; surgeon recommend a mechanical valve. The pain in my chest has expanded to my back, shoulders and lungs. Been working on the spirometer and barely hitting 1500ml. When does the pain start to subside?
 

John K

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Jan 20, 2020
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Just had valve replacement surgery the end of January. I

The more you use the spirometer the quicker you will get better results. Try blowing out through it as well as breathing in, once I started doing that I made quicker progress.

As for pain, I was off narcotics within a week and all pain meds within a month.

Follow the restrictions that the doctors provide and get into Cardiac Rehab as quick as you can and you will be back to normal activities in a few months.

John K
 

Seastreet

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Thanks for the encouraging words. Yes, I’ve been whiling the hours on the spirometer and it does take abit of pain off.. what’s a good “inspired volume” to target?
 

John K

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Jan 20, 2020
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All I did was to keep trying to do better. The version I had came with a movable indicator on the side and I kept moving it to the highest I got and would then try to do better. Don't worry if you can't hit the goal every time as long as you keep trying you will get through this.
 

tom in MO

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During surgery they tie your arm to a board for stability due to all the things that go into it. This affected my neck and shoulders quite severely. I told the surgeon during rounds and he explained why it hurt. He ordered a physical therapist to come, assess me and prescribe some therapy. He also ordered a heating pad (real fancy with a water bath). She gave me some exercises and some good advice. She came in every day to see how I was doing and make sure the therapy was effective. I still hurt for a few months in the shoulder and neck, but the exercises really helped as did the heating pad.
 

LoveMyBraveHeart

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I second the heating pad! My husband has some pretty severe pain after his second surgery in his shoulders and neck and alternating heat and ice helped quite a bit. Also, I would put some Lidocaine cream (no menthol!) on his shoulders, or use one of the lidocaine patches for him. Those also seemed to help.

He has had many surgeries in his past, so is quite tolerant against standard pain medication. We instead asked for muscle relaxers and they helped significantly! Also, please be aware that if you are not getting any relief from pain medication, you may want to request some additional imaging. Things like pericardial and/or pleural effusion can cause building pain in your chest and back. Mathias had pain that would not subside and kept getting worse about 5 or 6 days after his last surgery and ended up with cardiac tamponade. He had to have another emergency sternotomy to evacuate the tamponade, but if we had been quicker to discuss the building pain and lack of relief with medications, we may have been able to avoid the extra surgery.

Hopefully soon, your surgery and hospital stay will be a memory and you can look forward to many happy, healthy years!
Be well,
Jill

p.s. as far as the spirometer goes, Mathias was told to shoot for 1500 at first, and an additional 250 every day or two. He was able to pull the full 4000 withing about 10 days. The more you use it, the better you get!
 

Protimenow

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Back in the ancient days (1991), there was no cardiac rehab, and I was expected to return to work six weeks after my aortic valve surgery.

I'm sorry that there wasn't cardio rehab back then -- it may have helped me.
 

Seastreet

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Jun 12, 2020
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i think they won’t be calling me back for cardiac rehab during the covid period. We’ll see if things get better. Are there any good exercises I can do at home in the interim? Going home tomorrow T+6
 

LondonAndy

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I remember doing a lot of two minute tasks during my rehab about 5 years ago: step ups, (two mins left leg first, 2 mins right leg first), stretching with resistance bands whilst seated, throwing a baseball.
 

Protimenow

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My cardiac rehab instructions were, if I recall correctly, to walk - a little more each day.

My longest outing was about a mile round trip to pick up chili burgers for my family and me. Yeah, I know, great cardiac rehab. (But the place made some really good chiliburgers. Gee, I can use one now.... but won't get one.)
 

charlottekaye

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During surgery they tie your arm to a board for stability due to all the things that go into it. This affected my neck and shoulders quite severely. I told the surgeon during rounds and he explained why it hurt. He ordered a physical therapist to come, assess me and prescribe some therapy. He also ordered a heating pad (real fancy with a water bath). She gave me some exercises and some good advice. She came in every day to see how I was doing and make sure the therapy was effective. I still hurt for a few months in the shoulder and neck, but the exercises really helped as did the heating pad.
Here's my experience in excruciating detail :) :
First, though - I believe surgeons need to figure out a way not to damage the shoulder area when they tie the arm to the board. I've had 2 valve replacement surgeries, and 2 shoulder injuries following those surgeries. The pain from the shoulder injuries was way worse than the discomfort of the heart surgery. After my 2nd surgery, I remember going to a physical therapist who'd gone through OHS after a rotator cuff repair. She told me she had worked with her thoracic surgical team to make sure they didn't damage her shoulder during surgery, and, because they followed her plan to properly brace her arm and shoulder, she had no post- surgical issues. Which suggests to me that there is a way all OHS could be improved when it comes to bracing patients' shoulders. As to my recovery, PT didn't do the trick on the 1st surgery; I suffered with a damaged left shoulder for about 5 years off and on. After my 2nd surgery, when they pulled the wires out of my left shoulder, I felt the wires go past the injury and reposition something in that space so that I felt, all of a sudden, complete relief. And I never had another second of pain there. After the 2nd surgery, my right shoulder was damaged. I came up with a series of upper body exercises that began with rotator cuff strengthening. As I started to feel better, I added wrist weights. One day, I lifted a piano bench ( a small, heavy one with the knobs for adjustments on either side,) by bending at the waist and lifting it from my back. I heard a ripping sound from my shoulder area, and felt the injury in my right shoulder a little more intensely, then - immediate relief from the pain. I've never had another second of pain in my right shoulder. I believe what happened was something akin to traction. And, it seems to me the cause of the injuries was the interference with and subsequent lessening of the space for nerves and blood supply in the Thoracic Outlet.
 

LondonAndy

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I hadn't heard of the arm being tied during surgery before, and whilst I don't know if they did that during my surgery in London over 5 years ago I haven't had any of the issues people have been through here. Hope it is not a common thing.

On the point about walking once discharged from hospital, which is obviously a good thing to do, they warned me not to stand and chat whilst out walking. This is because the process of walking helps pump the blood around the body, and when you stop that benefit stops, putting more strain on the heart, and can lead to dizziness.
 

Paleowoman

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Just seen this thread and issues with left shoulder.

I have a "shoulder injury" as a result of my AVR surgery, but the fact that it was caused by surgery was not discovered until last year, five years after surgery. I had a lot of left shoulder pain which got worse over time following surgery. Things were blamed on a tendon tear and on poor posture but nothing helped and it got worse, especially got worse with phsyiotherapy. I then started to get a tingling feeling and pain all down my left arm. I had also been having sternum pain on and off following surgery so last year I had an MRI of my sternum. That showed that I had an effusion and degenerative changes in the left sternoclavicular joint. The right sternoclavicular joint was fine. Degenerative changes in the sternoclavicular joints don’t happen until very old age, older than I was. And problems with the sternoclavicular joint cause referred pain to the shoulder ! A referral to a pain specialist and my rheumatologist confirmed that this problem with the sternoclavicular joint would have resulted from forcing apart the sternum during surgery. There isn’t any treatment - I was advised not to carry or left heavy weights - something I enjoy doing which is a bummer. I’m very careful now not to aggravate the joint and so manage the shoulder pain.
 

almost_hectic

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Just seen this thread and issues with left shoulder.

I have a "shoulder injury" as a result of my AVR surgery, but the fact that it was caused by surgery was not discovered until last year, five years after surgery. I had a lot of left shoulder pain which got worse over time following surgery. Things were blamed on a tendon tear and on poor posture but nothing helped and it got worse, especially got worse with phsyiotherapy. I then started to get a tingling feeling and pain all down my left arm. I had also been having sternum pain on and off following surgery so last year I had an MRI of my sternum. That showed that I had an effusion and degenerative changes in the left sternoclavicular joint. The right sternoclavicular joint was fine. Degenerative changes in the sternoclavicular joints don’t happen until very old age, older than I was. And problems with the sternoclavicular joint cause referred pain to the shoulder ! A referral to a pain specialist and my rheumatologist confirmed that this problem with the sternoclavicular joint would have resulted from forcing apart the sternum during surgery. There isn’t any treatment - I was advised not to carry or left heavy weights - something I enjoy doing which is a bummer. I’m very careful now not to aggravate the joint and so manage the shoulder pain.
Oh man, that’s bad news. Sorry to hear there’s nothing they can do
 

Seastreet

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Jun 12, 2020
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there is a gauze over the wound where they took out the drainers from. I’m having the stitches from the drainers removed this Thursday. Can I remove the gauze in the interim? It’s been on for 4 days now and it’s starting to itch
 

Paleowoman

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Oh man, that’s bad news. Sorry to hear there’s nothing they can do
Well they could do surgery on the joint but it has a high failure rate for success, or they could give a steroid injection in the joint but that only gives temporary relief - I can't imagine a joint injection in the sternoclavicular joint, it's a tight joint with very little space, it's where the clavicle joins the sternum. The best thing is to avoid aggravating the joint by avoiding lifting or carrying heavy weights....and I used to enjoy lifting heavy weights.
 

Paleowoman

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there is a gauze over the wound where they took out the drainers from. I’m having the stitches from the drainers removed this Thursday. Can I remove the gauze in the interim? It’s been on for 4 days now and it’s starting to itch
Ask the nurse, I wouldn't mess with anything so close to having had surgery.
 
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