Surgeons letter

[tex]

I have just received the letter my surgeon has wrote to the Occupational Advisor re-my job.I am or was a Nursery Nurse working in a special school for 26 years, i work with students who have challenging behaviours. I have been on long turn sick since Oct 2007, i was just finding the job too hard and went on long term sick. I had my operation Oct 2008 AVR and Mitral Valve repair, i am still on sick leave, i have had meeting with the school etc and there is no way i can go back to this job, they cannot write Risk assesments etc needed to do this job safely. I have now been refered to Occupational Health and its looks like i will be offered early retirement. Its just the report i have received a copy of that was sent by surgeon to Occupational health, thats has upset me, It states when surgery took place was heart was very enlarged and that there is now damage to the heart i did wonder why i was still breathless and tired, the report has said and finishes with this paragraph
I am not sure if Jane would ever be able to return to a full time job, which might impose considerable strain on her heart which has already shown itself to be in a precarious state.
Can anybody help as to what they might mean by that, also if my heart was enlarged at time of surgery now i have had the valves replaced and repaired has my heart gone smaller, i will be asking my surgeon this but dont see him for another 2 weeks.
Thanks for you help
Jane

 

[Ross]

Without a Catscan or Echo, we couldn't say. Mine never did return to normal. I now have Cardiomegaly or an enlarged heart, congestive heart failure and seems like everything else related to it. My Doctors have told me that I'm in a race to see what fails first, heart, lungs or kidneys.

 

[netmiff]

well, Ross, that was a nice cheerful response!

Jane, I think your best bet is to talk to the surgeon, I know that they are expecting my heart to "remodel" (that is the medical term, I believe) itself, but there is a possibility that they may never go back to what they should be. It may also depend on your age etc.

As far as work goes, is there anything you could get in the same line that would be less strenuous? Maybe working with older kids or kids with less behavioural problems?

 

[ALCapshaw2]

Jane,

Can you obtain copies of ALL of your previous EchoCardiogram Reports? In the USA, Medical Providers are required by Law to give copies of reports to patients (although there may be a copying fee).

Your Echo Reports should contain information on the dimensions of your heart which will show if it has 'remodeled' or remained enlarged.

'AL Capshaw'

 

[ChouDoufu]

Can anybody help as to what they might mean by that,.... i will be asking my surgeon this but dont see him for another 2 weeks.

if you're concerned, why wait? call the office tomorrow.

 

[Bina]

Jane, it does sound like an early retirement will end up being your best route.
I used to look after little children all the time and loved it, but now I really don't trust myself to be able to keep up with them .
Of course, you are only 6 months out from surgery and many of us do take longer to have a decent recovery, even if it's not as good as we hoped for.
Keep us posted.

 

[Bridgette]

Hi Jane,

I am a kindergarten teacher, so I know what it is like working with young children all day. While rewarding it can be physically and mentally draining especially when dealing with very behaviourally challenged kids day in and day out.
If you still want to work in the area maybe you could do admin where you still have a bit of contact with the kids but your main role is in the office?

I think from reading your post though that your main worry is what the surgeon said - so as Chou said, why not get in touch with him now instead of waiting for your scheduled appointment?

 

[sue943]

Your surgeon and cardiologist will have written to your GP regarding your condition so why not visit your GP and ask him/her?

 

[Lisa in Katy]

My heart was enlarged for 22 years and did go back to normal size after surgery. You won't know until you have an echo/x-ray/etc.

As far as working, I'm all for finding a job that isn't too hard on you. I personally think that getting back in a "normal" routine helps with recovery. I taught school for 7 years after my surgery, 1st grade for 4 years, 5th for 2 and 6th for 1. Some of the kids were extremely challenging, but I felt that my physical condition was fine for handling them. It just depends on you.

 

[lilteach3234]

Wow, how scary this must be.

I taught special needs for several years and feel I could still do it once I've healed, but last year I took a position teaching special ed teachers. There is alot you can do out there, especially in this field so don't give up.

 

[terodac]

Good Luck! I have been fight my long term disability from work (a benefit) for six months! They decided I was just fine back in June of 08. I just had to take memory test to prove to them I am just not right. Waiting to hear back from them any day now. I had to get a attorney to help me. It is just ridiculous what we have to go through! I was a accountant all my life, there is NO way I could return to my high stress job, multi tasking three companies. I can't even remember what meds I have taken, or what I just said! I try and find humor in it most days! It is really sad! We pay for benefits and we don't get them!! Corp. America!

 

[Lisa in Katy]

OK Guys...I'm going to get on my soapbox for a bit. I don't know about everyone else, but one of the reasons that I had valve replacement is so I could begin to live a normal life. Sure some people have complications that prevent this, but the majority of people can and should go back to work, unless they can afford and want to stay home. I was "sick" for 22 years before my surgery. I had severe regurgitation and CHF for 22 years. My nail beds and tongue were blue for 22 years. I had an enlarged heart for 22 years. I worried about when my heart would completely fail for 22 years. My valve replacement fixed all that. I went back to work in a high stress job after 8 weeks. Three years later I began a 7 year teaching career, a physically demanding and very high stress job. After 7 years, I returned to my previous career in healthcare. I've also raised two children (almost!), exercised, been involved in church, etc. If you are like the majority of people who have this surgery, there is no reason that you cannot go back to work. Disability is for the truly handicapped, and luckily, I don't, and have never, included myself in that category.

Unless you had a complication, don't fall into the "I have a heart condition and I'm disabled" trap. In my opinion, that attitude leads to depression, which can then lead to mental and physical disability. Get up, tell yourself that you are well, and get out in the world!

 

[Bryan B]

Here's a view from the "glass half full" side. Maybe your surgeon knows the system and wanted to make sure that there would be no doubt that you were able to get your early retirement without anyone disputing it.

I personally would get to the bottom of it by going straight to the surgeon since he is the one who wrote the letter. The good news is that he is backing you for an early medical retirement. But if the reasons he gave are ones you didn't know existed I would push him for some explanations.

 

[Bryan B]

OK Guys...I'm going to get on my soapbox for a bit. I don't know about everyone else, but one of the reasons that I had valve replacement is so I could begin to live a normal life. Sure some people have complications that prevent this, but the majority of people can and should go back to work, unless they can afford and want to stay home. I was "sick" for 22 years before my surgery. I had severe regurgitation and CHF for 22 years. My nail beds and tongue were blue for 22 years. I had an enlarged heart for 22 years. I worried about when my heart would completely fail for 22 years. My valve replacement fixed all that. I went back to work in a high stress job after 8 weeks. Three years later I began a 7 year teaching career, a physically demanding and very high stress job. After 7 years, I returned to my previous career in healthcare. I've also raised two children (almost!), exercised, been involved in church, etc. If you are like the majority of people who have this surgery, there is no reason that you cannot go back to work. Disability is for the truly handicapped, and luckily, I don't, and have never, included myself in that category.

Unless you had a complication, don't fall into the "I have a heart condition and I'm disabled" trap. In my opinion, that attitude leads to depression, which can then lead to mental and physical disability. Get up, tell yourself that you are well, and get out in the world!

Lisa,

That's what you need to remember...that you are NOT everyone else. Some people see drastic improvement after surgery. Some people might see minor improvement but they are no longer at risk of an aortic aneurysm dissecting. Some people have complications that cause problems for awhile after surgery that were worse than their pre-op symptoms, but after some time end up feeling better than before surgery (I would fall into that category). And some people have complications from surgery that cause permanent post-op problems. You simply can't compare your experience and judge everyone else by what you experienced. And this might sound harsh...but I think you know better than that and you need to quietly step off of your soapbox.

But while I disagree with you I don't have a problem with you stating your opinion. My opinion just happens to disagree with you. I think a lot of people get jaded by the few people who try to take advantage of the medical disability system. And because of them that is why people like Ross have to jump through hoops, go to court, and go through the stress of fighting for their right to collect SS disability even when it's obvious that his medical condition will not allow him to work. It makes me sad that the minority of people who have abused the system make all of the people who really need financial help have to go through hell to get what they deserve. And yes...they deserve it because everyone pays taxes to have SS disability to fall back on if/when their health fails to the point that they are no longer able to work.

 

[debster913]

I have to agree with Lisa on this one.

I have been a (gasp!) high school teacher for going on ten years now. I just got back from Open House tonight after having met with dozens of parents and having taught a full day's worth of classes. I love my job, I love my students, and I can't imagine doing anything else. And by the way, I was wearing my event monitor. Most parents didn't bat an eye; many of them know about my heart history through my students, and others were curious. None of them felt sorry for me, and I'm glad.

I've also had to deal with co-workers who (still) ask me if I'm OK. As if heart surgery made my heart weaker, not stronger. This is especially when I've had several Holter monitors after the fact, or have had to miss staff meetings because I had to run to my cardio's office. I try to be nice about their concern, but it does tick me off that my heart issues make me fragile or something.

What really gets me (guess I'm joining you on this soapbox, Lisa) are people who a) feel sorry for us "heart patients," or b) define themselves negatively through thir heart disease. I never once thought, "Oh, gee, I'm not going to be able to teach again after my surgery--there's no way I'm going to be able to keep up with 150 crazy teenagers all day!" I actually looked forward to going back to work! It's sad that too many people assume that teaching high school is dangerous, overly challenging, etc. Yes, it can be challenging, and yes, there are days when I question my sanity for choosing this career, and yes, there have even been days when I've been tired and haven't been on my "A" game. But: I have taught tired from 150 milligrams of my beta-blocker. I've taught when I've had a gazillion PVCs. I taught through all my three years of heart adventures post-op, except, of course, when my cardio put me on medical leave from my job pre-surgery. There was obviously no way I could teach severely tired and short of breath all the time.

The bottom line for me is this: My valve is fixed. I'm fine. I've had a few unfortunate bumps in the road and most all of you here have read my vents about them. But I'm OK. I'm still alive. My cardio thinks that my job stresses me out too much and that "there are other jobs out there" that I can do. Even before my surgery, I begged him to let me go back to work (even though I knew it probably wasn't in my best interest). I don't care. It is stressful, but I love what I do. Simple as that.

So my advice to you, Tex, and anyone else is this: Don't let your surgery define you. If you are well and healthy enough to go back to your job, do it. Don't let yourself be weakened by your own fears or by those who think you aren't strong enough. And while I acknowledge that there are people who have had to go on disability after surgery for various reasons, much of the time, heart surgery has positive outcomes. It's up to your health care team and you to decide how much you can handle after surgery. We all recover differently. It took me a full year before I felt like myself again.
Best,
Debi (debster913)

 

[Lisa in Katy]

Wow, Bryan, that was quite a slam and completely uncalled for. I think I was pretty clear that I am aware that there are those who have complications. My point was to not let your attitude be a complicating factor.

 

[Bryan B]

Wow, Bryan, that was quite a slam and completely uncalled for. I think I was pretty clear that I am aware that there are those who have complications. My point was to not let your attitude be a complicating factor.

Lisa,

I apologize for the "slam". I'm guessing the "slam" was saying that you need to "quietly step off of your soapbox. That was a pretty vicious statement (that was followed that I still respect your opinion but disagree with it).

Given the context of the first post, it appeared to me that you were almost (but not quite) insinuating that Jane was using her heart condition as an excuse for being disabled. I think it was completely "called for" to state my opinion that while some people may use this as an excuse, the vast majority of VR patients do not unless they are truly disabled after surgery. I just don't think it is right to judge other people based on your own personal experience. I lost the best paying job I've ever had because of sternum complications after surgery. I WANTED to go back to work, but because my surgeon insisted on having lifting restrictions (which traveling nationwide with luggage and computer/supplies/paperwork bag would exceed that limit) my company wouldn't let me come back to work until they were lifted. By the time my surgeon lifted the restrictions my FMLA had run out, my job had been filled, and I was out of work. IMO it's too complicated to get on a soapbox and preach that once you have VR, if you can't just "jump back on the horse" that you are using the surgery as an excuse. Maybe I read your post in the wrong context...if so I do apologize. But given the topic of the thread and the person's post that started it I found it difficult not to read it as judgemental towards those who seek disability after having post-op problems. I'm sure some people use this as an excuse, but I'm willing to bet that most post VR patients that need to go on permanent disability have valid reasons. And it's not a "teacher" thing...it's a person thing. I don't think the occupation has anything to do with it...it's a matter if your ability to perform whatever type of career you are in is affected to the point that you are not able to perform it satisfactorily.

Again...I apologize if my post came across as a "slam", but that was not my intention. Maybe we BOTH read too much into each others posts.

 

[Bryan B]

BTW Lisa...I just read your post for the 3rd time, and I am still struggling with this comment in the context of this particular thread.

Sure some people have complications that prevent this, but the majority of people can and should go back to work, unless they can afford and want to stay home.

This statement makes perfect sense...but IMO not in a thread where the original poster is asking for advice on what the comments in the surgeon's letter as to why she couldn't go back to work meant, not a "soapbox response" that may very well leave her feeling guilty about having to go on permanent disability.

I am now done and will not respond again. I wouldn't want to hurt anyone's feelings any more than I have.

 

[Marguerite53]

Yes, please... Bryan and Lisa. Points made! Let's not parse each other's words. I suspect that most of us would see that you have each made valid remarks; and remarks which came from your 2 very different hearts (personalities). Let's please not de-rail this very troubled poster's post. (and BTW, Bryan's second post above came "in" while I was writing this one so I'm not trying to over-emphasize one of you or the other!!)

Jane, I too was wondering if the strength of the surgeon's words weren't guided by the notion that he wanted to help you gain your early retirement. I don't see any reason why you have to wait 2 weeks to call him, unless you need some time to decompress from the emotions which his words welled up in you.

I understand that some hearts will remodel themselves back to normal, and some may not. Either way, at 5 months post-surgery it may be too early to tell, completely.

You've been given some great suggestions from caring teachers, here. Perhaps while you are still recovering (remember, we all have decided that there is a new-normal....not quite the same as the old normal... and that can take over a year to really find) and need to pursue some of those alternative ideas in your profession.

At any rate. It's good that you came here to ask. I hope that some of these answers have helped you. Please keep talking with us.

Best wishes.

Marguerite

 

[Ross]

Hi Jane,

While rewarding it can be physically and mentally draining especially when dealing with very behavioral challenged kids day in and day out.

....but you deal with me everyday!

Wow, reading through here. No wonder so many of you tolerate me. You've all catered to special needs/behavioral problem kids. I'd like to introduce myself, my name is Little Johnny.