Seeing Surgeion Tomorrow - 6 month follow - up

[ALLBETTERNOW!]

I see my surgeon tomorrow for my 6 month follow up, not sure what to expect. I saw my cardiologist at 3 months and had an echo, the results of which she was very pleased with. My Ejection fraction was 55-60% and valve function and new dacron sleeve Aorta looked normal. My BP and cholesterol numbers are OK ans I just finished phase II cardio rehab. Not sure what to ask or what will happen? Maybe just a carry on and see you in 6 months or a year? I do have a few lingering issues which I understand are somewhat common. Problems sleeping, achy shoulders and being tired from those 2. I am back to work (desk job) and participating in life and family events. I do plan to ask him about the tissue valve we chose and TAVR and a game plan. He is a well respected Surgeon with outcomes equal to or better than the large Boston centers like Mass General and Beth Isreal, but its not CC or Yale....

 

[epstns]

I'm surprised you even have a 6-month follow-up with your surgeon. My last visit with my surgeon was at about 5 weeks post-op, at which time he released me to go back to my life (driving, work, etc.). I then transitioned my care to my primary cardio. I wasn't ready for cardiac rehab until about 3 months out due to complications and slow initial progress. Once I got into rehab, things got right back on track, and the rest is history.

I do remember dealing with sore shoulders for the better part of a year, and sleep disturbances for just a couple of months post-op. We all heal differently, but it sounds like you're pretty much on track. Life is good. Just remember that life is not a spectator sport. Enjoy!

 

[ALLBETTERNOW!]

I'm surprised you even have a 6-month follow-up with your surgeon. My last visit with my surgeon was at about 5 weeks post-op, at which time he released me to go back to my life (driving, work, etc.). I then transitioned my care to my primary cardio. I wasn't ready for cardiac rehab until about 3 months out due to complications and slow initial progress. Once I got into rehab, things got right back on track, and the rest is history.

I do remember dealing with sore shoulders for the better part of a year, and sleep disturbances for just a couple of months post-op. We all heal differently, but it sounds like you're pretty much on track. Life is good. Just remember that life is not a spectator sport. Enjoy!

I saw his Nurse Prac about 6 weeks and then they scheduled this. I have not laid eyes on him since the morning of surgery and will be happy to see and thank him. Ive go a 27mm 3300 TFX valve as well!

 

[almost_hectic]

I would welcome the chance to do a six month follow up with my surgeon if it were possible. My guess is Id just be distracting him from more important work he could be doing. I had my follow up appointment 2 weeks after I went home from the hospital. Unfortunately I didnt get to see my surgeon as he was called out of town for something so I had to see a PA instead. Wasnt pleased but I wasnt going to make a stink about it and be "that guy". My surgeon is in demand so I recognize whatever he was doing was probably more important, because I was basically fine any way. From there they released me to the care of my cardiologist who sent me to the surgeon in the first place. My cardiologist is really good, but hes not big on personality...

Actually the American heart Association has a local Heart Walk event coming in December and my surgeon is a Heart Walk team captain for his surgical unit of the hospital so I was thinking Id join his team for the walk and try to collect donations on behalf of his team.

This forum is great for asking questions and finding support, but it is just a website. Its no substitute for having access and direct personal interaction with medical professionals (if they even had time to answer questions) or even others going through the same experience you are with surgery. Where Im doing rehab just about everyone there is there as a result of heart attacks or blockages. I did meet one girl who is actually there like me recovering from surgery. She didnt have a valve job, something even more complicated. But its great to see and talk to someone in person who know what youve gone through; the surgery, the chest pain, caring for your incision or drain tube holes, even how hard it can be to sleep or how wiped out you can feel in the middle of the day. I just find it so fascinating and comforting to meet another OHS patient in person.

 

[ALLBETTERNOW!]

We will see how it goes. My cardiologist is at a local hospital but the surgeon is at another. I can get echos and CT scans here and he can see them online which is neat. Hopefully I See him tomorrow, but if he has emergency surgery, I will understand and his NP is really excellent, she seems very used to standing in and running the office part of the practice. I think/hope it is a non event since I feel generally good, finished the cardio rehab and my cardiologist already told me the echo results were good. Last time I was at his office to book the surgery he hopped online and read my CT scan of my aneurysm while I was there and he disagreed with the size in the report (4.8 v 5.0) as he measured it differently. His experience was evident and reassuring. Mr cardiologist is much harder to talk to and understand then the surgeon.

 

[Fundy]

You might want to ask about your medications, you have two listed in your profile maybe one of them could be slowing the healing process of your aching shoulders. I looked at the medications you listed and not knowing what they actually were I looked them up. I guess the xarelto is for a-fib but the site I looked the drug up mentioned it shouldn't be taken if you have an artificial valve. http://www.drugs.com/xarelto.html

So if it were me, I would be asking about that for sure. As well as asking if beta-blocker was needed to be continued or if maybe another could be subbed that might improve your sleep.

Also, maybe ask if he encountered anything that might indicate a more risky reop than he would usually expect.

 

[ALLBETTERNOW!]

You might want to ask about your medications, you have two listed in your profile maybe one of them could be slowing the healing process of your aching shoulders. I looked at the medications you listed and not knowing what they actually were I looked them up. I guess the xarelto is for a-fib but the site I looked the drug up mentioned it shouldn't be taken if you have an artificial valve. http://www.drugs.com/xarelto.html

So if it were me, I would be asking about that for sure. As well as asking if beta-blocker was needed to be continued or if maybe another could be subbed that might improve your sleep.

Also, maybe ask if he encountered anything that might indicate a more risky reop than he would usually expect.

Yes damm a fib . They also did a maze procedure while they were in there and so far, so good but nobody wants to risk taking me off of it and throwing a clot again. They did close off my left appendagevthough

 

[ALLBETTERNOW!]

Saw the NP and Surgeon. Of interest, we reviewed the surgery note. There was some debate as to whether I had a bi or tri cuspid valve heading in and it turns out it was actually a unicuspid valve some leaflets had fused together and calcified. No wonder I had an aneurysm!! Good news, the recent echo shows EF at 55-65% and a peak gradient of 11. He is happy with those numbers and my scar healing and todays EKG which showed normal sinus rythym.

We did discuss tissue valves and exercise and essentially he is less worried about valves in the Aortic v pulmonary positions with exercise. Aortic valves "only" have to go from 80 to 120 each beat but I guess the pulmonary goes from 0 to 120 each beat. He also mentioned that he thinks they re on to a reversal agent for one of the newer anti platelet drugs (perhasp elliquis).Very superficial discussion of both issues

Most interesting, while I was waiting I got to play with and handle the samples he has of a St Jude mech valve and new sapien edwrds TAVR valve. Both are truly works of art and engineering with incredible workmanship

 

[almost_hectic]

Great news!

 

[ALLBETTERNOW!]

Great news!

. thanks. Now comes the next battle - the surgeon would like me off the Xarelto. He did a maze procedure and left appendage closure during surgery so feels my stroke risk is very low, not zero. But I know my cardiologist doesn't wasn't to take risk. It's another interesting choice with no obvious answer. I think they will have me wear a monitor for a while to confirm I stay in sinus rhythm and no A fib but we will see

 

[pellicle]

Hi

. thanks. Now comes the next battle - the surgeon would like me off the Xarelto.

Ross (God rest his soul) from here was always very against Xarelto, in fact it has a worse record than warfarin as an anticoagulant and its suggested that the tests that allowed it to pass were "doctored". Its also difficult if you hurt yourself. Anecdotally my mate who is a pharmacist has an elderly patient who was on dialysis for 2 days after he fell down the stairs and broke his nose. They just couldn't get it to stop bleeding, so he was on blood transfusion and dialysis to remove the anticoagulant.

Warfarin is just a Vitamin K injection in the ER and you're done.

Let me know if you want me to fish out some of the digging I think I've stored (god help me) away on that compound and its tests.

 

[ALLBETTERNOW!]

Hi



Ross (God rest his soul) from here was always very against Xarelto, in fact it has a worse record than warfarin as an anticoagulant and its suggested that the tests that allowed it to pass were "doctored". Its also difficult if you hurt yourself. Anecdotally my mate who is a pharmacist has an elderly patient who was on dialysis for 2 days after he fell down the stairs and broke his nose. They just couldn't get it to stop bleeding, so he was on blood transfusion and dialysis to remove the anticoagulant.

Warfarin is just a Vitamin K injection in the ER and you're done.

Let me know if you want me to fish out some of the digging I think I've stored (god help me) away on that compound and its tests.

Thanks, they closed my left appendage and I have been in normal sinus rythym since May and also take a baby aspirin, I think the Xarelto is going to go... May have to wear a holter or event monitor for a few weeks to make everybody happy. Fewer drugs are better for my body and wallet.