plsflgood
Member
How frequent are the complications like pneumonia, water around heart, bleeding, etc ? I mean, is it even possible to have this surgery with a smooth (though long) recovery, without being readmitted to emergency ?
Treatable complications - how frequent ?
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I'm sure it is possible, even probable, that many patients go through the surgery and recovery without serious complications. The fact that I did not is not statistically relevant. If you look through the Post Surgery section of the forums, I think you'll find that many of us just cruise through the whole thing and get back to our lives in short order. The few of us who have complications may be more communicative, giving the impression that a higher percentage of patients have problems. I don't have the statistics, but I would bet that the vast majority have either no complications, or minor things that can easily be dealt with.
wxman
Well-known member
I agree with Steve. I had a very rapid and uncomplicated recovery. I was home in 6 days...started rehab a week later. Started driving again at 3 weeks...and went back to work in 6 weeks. There was occasional pain and discomfort the first few weeks...but nothing requiring any special visits to the doctor or ER. Everyone is different...but I believe many people could tell you a similar story.
ABSOLUTELY. There is every reason to believe that this surgery is no different than any other major surgery. My docs told me, a long time ago, that this was an easier surgery than many others and I bought into it. Turned out they were right:biggrin2:. Educate yourself and I think a lot of your fears will subside.
I'm somewhat in between Steve and Jim. After my valve replacement, I felt really good with some discomfort in the back but almost none in the chest. On the third day after surgery, I walked five times which totaled a little over a mile. By the time I was released, the nursing staff told me that, perhaps due to the walking, my lungs were very clear. Five days after surgery, I was home where I slept in my own bed. The next morning, six days after surgery, I went walking (4 blocks out and back) in my neighborhood for the first time and felt really well. It is certainly true that one may have early issues but among those who had surgery within a few days of my own only one had an issue of congested lungs and she was a smoker.
Several weeks after surgery, I did develop a couple of irritating problems but they were merely uncomfortable not threatening in any way. The skin on my chest became hypersensitive for awhile and later costochondritis developed in the cartilage along the right side of my sternum even though my sternum had never been painful before due to the Talons used after the AVR.
No one can anticipate your experience but we can say that you should be more healthy after surgery than before and, possibly, much quicker than you can believe. You can aid your recovery by following the guidelines you will be given as you begin your recovery. Walking, using your inspirometer for lung exercise, eating thoughtfully, and giving your body the rest it needs while avoiding the motions that can trouble your sternum. I began driving in my 5th week and returned to work at the end of week 6 when I began Cardiac Rehab. I worked half time for a few days and then found I had no difficulty working a normal schedule.
I also began Cardiac Rehab at 6 weeks after surgery. The regular exercise, I think, is good for anyone, especially, if you are not used to exercising on a schedule. The greatest benefit, however, was being part of a group of people who are healing just as you. The nurse-physiologists who monitor one's exercise are a wealth of information and provide assurance that you can exercise without harming yourself. The end result of Cardiac Rehab was, for me, a return of confidence that my body was well.
Your early recovery is likely to be a surprise. I don't think most people have a long, slow, difficult recovery. Early on, you can feel a healthy difference in your body every day. The first three weeks are the time when the incisions both external and internal are healing. Your sternum takes about 12 weeks to really knit back together but three or four weeks after surgery you are likely to notice that you can use your arms more easily. Recovery for me was not marked by being sick. Recovery was a time of returning strength and health that was wonderful to feel.
Larry
Several weeks after surgery, I did develop a couple of irritating problems but they were merely uncomfortable not threatening in any way. The skin on my chest became hypersensitive for awhile and later costochondritis developed in the cartilage along the right side of my sternum even though my sternum had never been painful before due to the Talons used after the AVR.
No one can anticipate your experience but we can say that you should be more healthy after surgery than before and, possibly, much quicker than you can believe. You can aid your recovery by following the guidelines you will be given as you begin your recovery. Walking, using your inspirometer for lung exercise, eating thoughtfully, and giving your body the rest it needs while avoiding the motions that can trouble your sternum. I began driving in my 5th week and returned to work at the end of week 6 when I began Cardiac Rehab. I worked half time for a few days and then found I had no difficulty working a normal schedule.
I also began Cardiac Rehab at 6 weeks after surgery. The regular exercise, I think, is good for anyone, especially, if you are not used to exercising on a schedule. The greatest benefit, however, was being part of a group of people who are healing just as you. The nurse-physiologists who monitor one's exercise are a wealth of information and provide assurance that you can exercise without harming yourself. The end result of Cardiac Rehab was, for me, a return of confidence that my body was well.
Your early recovery is likely to be a surprise. I don't think most people have a long, slow, difficult recovery. Early on, you can feel a healthy difference in your body every day. The first three weeks are the time when the incisions both external and internal are healing. Your sternum takes about 12 weeks to really knit back together but three or four weeks after surgery you are likely to notice that you can use your arms more easily. Recovery for me was not marked by being sick. Recovery was a time of returning strength and health that was wonderful to feel.
Larry
The vast majority of people who have OHS or valve surgery these days ( the last decade or so), have pretty smooth recoveries and dont end up with complications either while still inpatient or going to the ER once they get home, Even patients who are having REDOs or multiple REDOS usually are home in less than a week and only see doctors for their schdualled appts post op. Especially patients who are in pretty good shape or younger going INto the surgery.
Somethings of course the patients doesn't have any control over, like rythym problems, post op bleed, pericardial or plueral fluid (around the heart or lung), infections. But alot of the complications you ask about like pnuemonia for the most part if you do your "job" like breathing exercises, walking several times a day..even very short walks the first day or so post op and don't do things you are told not to the chances of having some of the complications are lowered even furthur. Choosing surgeons and centers with alot of experience in what you need done, also really helps lessen the odds of having some of the worse complications.
But even problems like pericardial or plueral fluid, can be pretty easy to take care of IF you catch it before it gets too bad. So another 'job" is to pay attention to your body and if anything seems different or worse, or you get any of the symptons they tell you to watch for call right away and ge checked. It is much better to call for something that turns out to be part of the normal healing than NOT call and it turns out to be something big that would have been easier to take care of if you called earlier.The saying its better to be safe than sorry is really true when it comes to heart surgery. Also what is a tough, recovery or "complication also can be different for different patients, some people who have pretty bad problems, can think they had a pretty good smooth recovery while others who have some of the more "minor" complications might thinnk they had a bad recovery/experience.. some just depends on the perception I guess. BUT the best part is remeberring that even people who have very bad complications might have a tougher time in the beginning, but for the most part end up having a full recovery and feel better after the recovery than they did for a while before surgery
Somethings of course the patients doesn't have any control over, like rythym problems, post op bleed, pericardial or plueral fluid (around the heart or lung), infections. But alot of the complications you ask about like pnuemonia for the most part if you do your "job" like breathing exercises, walking several times a day..even very short walks the first day or so post op and don't do things you are told not to the chances of having some of the complications are lowered even furthur. Choosing surgeons and centers with alot of experience in what you need done, also really helps lessen the odds of having some of the worse complications.
But even problems like pericardial or plueral fluid, can be pretty easy to take care of IF you catch it before it gets too bad. So another 'job" is to pay attention to your body and if anything seems different or worse, or you get any of the symptons they tell you to watch for call right away and ge checked. It is much better to call for something that turns out to be part of the normal healing than NOT call and it turns out to be something big that would have been easier to take care of if you called earlier.The saying its better to be safe than sorry is really true when it comes to heart surgery. Also what is a tough, recovery or "complication also can be different for different patients, some people who have pretty bad problems, can think they had a pretty good smooth recovery while others who have some of the more "minor" complications might thinnk they had a bad recovery/experience.. some just depends on the perception I guess. BUT the best part is remeberring that even people who have very bad complications might have a tougher time in the beginning, but for the most part end up having a full recovery and feel better after the recovery than they did for a while before surgery
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Jkm7
Well-known member
YES. It is VERY possible to have this surgery and a bump free recovery.
I had two OHS in four years and was blessed to have absolutely no problems post op either time. My recovery was slower the first time but I was out and walking, out for dinner with DH, serving dinner (not doing heavy cooking) and washing the dishes (no scrubbing of pots and pans) from my first day home. I showered independently, washed and blew my short hair dry and dressed with no difficulty. I needed lots of rest and had good days and some bad days but nothing that required anything more than regularly scheduled check up appointments with cardio and surgeon.
My second surgery, I was out of CICU in under 24 hours, was walking the hall the next day with my nurse and husband and had permission to drive within 2 1/2 weeks post op...... just local, short errands. Certainly I was very tired and needed lots of rest etc but absolutely no complications.
ElectLive
Well-known member
Many complication rates depend on individual circumstances: pre-surgery patient characteristics, type of procedure, and skill of the surgeon. As was posted, none of our individual stories is statiscally relevant. However, with that said, for most, complication rates overall are low.
For reference, I was quoted the following pre-surgery, as a 35 year old diabetic undergoing ascending aneurysm graft and aortic valve replacement with one of the leading surgeons and hospitals in the Southeast:
25% risk of temporary A-fib
15% risk of any complication that would slow recovery
2% risk of pacemaker
1.5% risk of stroke (surgical)
1.5% risk of infection
My infection and stroke risk were slightly higher as a diabetic, otherwise I was generally at best case risk levels. I didn't really grill my surgeon about complication rates, but he gladly shared those I listed. Depending where you are in the valve replacement process, it would be good for you to inquire specifically with a surgeon who can speak to the specifics of your situation. Also, the Society of Thoracic Surgeons has an online risk calculator based on national data, but you have to be pretty educated about your condition to accurately use it, and it only covers certain complications (renal failure, reop, prolonged ventilation, and a few others): http://www.sts.org/quality-research-patient-safety/quality/risk-calculator-and-models
By the way, I did end up with a pacemaker (2% risk). No big deal, though, put in on Day 4 and problem free from that point forward.
I would like o add tha there would be very few that would post "hey I am doing so much better than you did" most that do post are looking for answers to bumps in the road to recovery some big and some small.....it is nice to know that you are not alone.....that is how I ended up here I thought I was the only person ever to have a radical sternctomy was searcching the internet to find others http://www.valvereplacement.org/forums/showthread.php?35064-Radical-Sternectomy&p=453639#post453639 Here I found that Lynn's son had had a partial sternectomy and to date via various sites i have been in touch with 16 others all who have expressed the greatest relief to speak to another person with a radical sternectomy....and so mamny of my days are filled with calling others to measure their progress
Fundy
Well-known member
I'd say a few get through with zero complications and a few more get through with major lifelong complications. Most from what I'm seeing posted here go through with a complication or two that when compared to complications from treatment of many other killer diseases; aren't really all that major or longlasting.
I myself experienced ileus complications the first day or so, then it was as almost as if I were on vacation upto end of week five. Then woke with sore and tense back and shoulder muscles; to which I aggressively stretched them in range of motion exercises and some Christmas time furniture moving. Next thing I know I'm begging wife to take me to ER because I must have cracked strernum somehow. Turns out it somehow is just torn or traumatized back muscles. Althogh I still have doubts, as after a few hours pain goes completely away until I try to lie down again. Then its back for at leasst an hour or two in severe number 10 pain level form.
The pain then and still now a week later is worse then I experienced in life and that included OHS just over a month ago. Anyway, If i had to choose a killer disease to get amongst the likes of cancer, Lou Gehrig's,etc... I think aortic stenosis would be my choice. The treatment is not easy, but its hasn't been all that bad.
I myself experienced ileus complications the first day or so, then it was as almost as if I were on vacation upto end of week five. Then woke with sore and tense back and shoulder muscles; to which I aggressively stretched them in range of motion exercises and some Christmas time furniture moving. Next thing I know I'm begging wife to take me to ER because I must have cracked strernum somehow. Turns out it somehow is just torn or traumatized back muscles. Althogh I still have doubts, as after a few hours pain goes completely away until I try to lie down again. Then its back for at leasst an hour or two in severe number 10 pain level form.
The pain then and still now a week later is worse then I experienced in life and that included OHS just over a month ago. Anyway, If i had to choose a killer disease to get amongst the likes of cancer, Lou Gehrig's,etc... I think aortic stenosis would be my choice. The treatment is not easy, but its hasn't been all that bad.
I hate to side track this thread, but beside going to the ER did you call your surgeon, or did someone from heart surgery check you out? What tests did they do to make the diagnosis of torn or traumatized back muscles? Since you thought your broke your sternum that sounds to me like the pain was in the front of your chest so that seems odd, or does the pain seem to move?
Boston Tiger
Well-known member
You can absolutely go through with no major complications, because everybody heals differently. The only issue I had in the hospital was an irregular heartbeat, that kept me in the ICU and the regular ward for a bit longer than the insurance company planned. But I was cleared to go back to my office job in four weeks, although it took a good deal of time longer before I rebuilt my stamina. But the big payoff comes when you realize that you can do things post-surgery that caused you some problems before you went in!
Well, I had an almost completely uneventful recovery. The fact is I NEVER experienced any pain or even discomfort from the surgery and rquired no pain meds at all post-op. That may be exceptional. Post-op I was very anemic, had some quickly reversible renal impairment, my stomach was slow to recover its motility (although I was still able to eat like a horse), and I had some trouble sleeping, but this all cleared up within a couple of weeks. No ER visits for me. Others have summarized that recovery is fairly benign for most people but not all. The more troubled recoveries may get more attention, but they are not the rule or even all that common.
Fundy
Well-known member
Lyn,
yeah, i'm not too sure of the torn muscle theory, although it was probably my first guess too. The pain then was across back from shoulder to shoulder, outer pecs, inner pecs, and top half of sternum seemed to get a lot of pressure. Nothing I did justifies cracking the sternum really. But other than several hours of range of motion exercises with arms, nothing else could traumatize muscles either.
Two days ago went to massage therapist and pain level lying on back went from 0 to 10 real fast. Had massage to back and shoulders and none of the pressure hurt.
I also noticed a small infection at lower sternum that day and went to ER again for that. Waited four hours in a low back chair with zero pain level. But as soon as doctor/surgeon had me lay down on bed, pain level went to 10 fast, I rolled off the bed quick and we finished that procedure sitting up. Real stange is that i slept flat on back first day home and four plus weeks thereafter with zero problems.
At present I feel given its been over a week, I need to pursue it somehow different. ER trip in this area again would be same result as before and is probably pointless. Getting an appointment to see family doctor will most likely take a week. Driving an hour to city ER is what wife thinks we should do tomorrow. But to me that just seems like it will be a longer version of the local ER trip. I'm thinking maybe I can contact either family doctor or cardiologists office and ask them to get the Xrays sent to cardiologist or surgeon.
If I keep the pressure of my back I'm basically pain free really, but pressure from lying down and I'm good for three hours of discomfort.
Do chest incision infections ever seem to get accompanied by other infections? I don't recall seeing any posts like that?
But yeah, i'm almost certain xrays were never sent to anyone heart surgery knowledgable. However, they did say yesterday they needed the heart surgeons permission to allow an ER doctor to work on my incision infection, otherwise i may need to wait until a local surgeon was free.
yeah, i'm not too sure of the torn muscle theory, although it was probably my first guess too. The pain then was across back from shoulder to shoulder, outer pecs, inner pecs, and top half of sternum seemed to get a lot of pressure. Nothing I did justifies cracking the sternum really. But other than several hours of range of motion exercises with arms, nothing else could traumatize muscles either.
Two days ago went to massage therapist and pain level lying on back went from 0 to 10 real fast. Had massage to back and shoulders and none of the pressure hurt.
I also noticed a small infection at lower sternum that day and went to ER again for that. Waited four hours in a low back chair with zero pain level. But as soon as doctor/surgeon had me lay down on bed, pain level went to 10 fast, I rolled off the bed quick and we finished that procedure sitting up. Real stange is that i slept flat on back first day home and four plus weeks thereafter with zero problems.
At present I feel given its been over a week, I need to pursue it somehow different. ER trip in this area again would be same result as before and is probably pointless. Getting an appointment to see family doctor will most likely take a week. Driving an hour to city ER is what wife thinks we should do tomorrow. But to me that just seems like it will be a longer version of the local ER trip. I'm thinking maybe I can contact either family doctor or cardiologists office and ask them to get the Xrays sent to cardiologist or surgeon.
If I keep the pressure of my back I'm basically pain free really, but pressure from lying down and I'm good for three hours of discomfort.
Do chest incision infections ever seem to get accompanied by other infections? I don't recall seeing any posts like that?
But yeah, i'm almost certain xrays were never sent to anyone heart surgery knowledgable. However, they did say yesterday they needed the heart surgeons permission to allow an ER doctor to work on my incision infection, otherwise i may need to wait until a local surgeon was free.
I don't know what the statistics show. It is possible to have the surgery with a smooth recovery.
But also from what I've read here over the past years, it doesn't seem to be uncommon to have at least one minor post-op issue that is easily resolved, like post-op A-fib/A-flutter or pleursy or bleeding. Choose your surgeon very carefully, one with a lot of experience and a high success rate. And some of the other post-op stuff might be addressed by a cardiologist.
I want to tell you that I was just amazed at how much better I felt after I began really recovering from the surgery. It's amazing what a properly functioning pump can do for your body!
Well, you got a lot of comments on this one; I hope it is encouraging to you.
Take care and best wishes
Sorry i just saw this. First i am NOT a doctor, just a Mom, but Honestly I would have contacted the surgeons office origonaly or even after you went to the ER. But has anyone done any tests like an ECHO?
From the beginning it sounded alot to me like you could have plueral or pericardial fluid,(fluid in the sacs around your heart or lung) that can get pretty bad if it isnt treated. Since you mentioned it wasnt like that in the beginning it makes me think of fluid even more
As for the "small infection", I'm pretty confused why they let you leave with an infection, they definately can get much worse if not treated.
I'm not sure how your healthccare system works, but during the post op period we always call the surgeon's service or surgical fellow or Resident on call on weekends night time, with any thing that even might be surgery related. Sometimes they might tell us to go to the ER but usually they have us come in to them if it isnt far from where we live.
jake
Well-known member
Sure it's possible! I went in for OHS to fix an aneurism on my ascending aorta a 100% healthy person and came out of the hospital a train wreck! I never ended up in the ER, and with the exception of my heart rate staying up around 100 for several weeks and a lot of post-operative pain which is typical for such a procedure, I have had very few problems.
After just over a year post op, the only things that I have now that I didn’t have before surgery was occasional bouts of tinnitus in the ears and some vertigo from time to time and very occasional and short lived optical anomalies (visual ora’s) that I didn’t have before surgery. I also suffered some damage to my urethra when they took my catheter out, but the Urologist fixed that right up in two visits. The urethra thing was defiantly operator error so I can’t fault the surgery.
All and all, I would say I was pretty lucky to not have any serious complications, and from what I understand from my surgeon, my recovery is pretty typical for a younger (44 at the time) patient with no other health issues.
I was VERY driven to recovery and the desire to get active and back on the job so I did exactly what I was told to do post op. One year later, I dont take ANY medications (at least none for my heart or heart related items) and my BP and HR are just fine (knock on wood).
I hope this helps.
After just over a year post op, the only things that I have now that I didn’t have before surgery was occasional bouts of tinnitus in the ears and some vertigo from time to time and very occasional and short lived optical anomalies (visual ora’s) that I didn’t have before surgery. I also suffered some damage to my urethra when they took my catheter out, but the Urologist fixed that right up in two visits. The urethra thing was defiantly operator error so I can’t fault the surgery.
All and all, I would say I was pretty lucky to not have any serious complications, and from what I understand from my surgeon, my recovery is pretty typical for a younger (44 at the time) patient with no other health issues.
I was VERY driven to recovery and the desire to get active and back on the job so I did exactly what I was told to do post op. One year later, I dont take ANY medications (at least none for my heart or heart related items) and my BP and HR are just fine (knock on wood).
I hope this helps.
Michelle D
Well-known member
I had many complications, luckily nothing too serious. I had fluid around my heart and my lungs, high doses of anti-inflammatories and a few shots of diuretics in the hospital took care of that. Then I had dressler's syndrome, where every few weeks I'd flair up with inflammation between my ribs. I had dizzy spells, insomnia, PTSD, and you name it. All of those issues are behind me now but I still have palpatations and a-fib occasionally. I can live with that.
All I have to say is when you feel so incredibly terrible for a couple months you really appreciate just feeling fine afterwards. The suffering freed me from my pessimistic ways and now I'm happier than ever. But not everyone has complications, and going to the ER will feel like no big deal after having your heart cut open.
All I have to say is when you feel so incredibly terrible for a couple months you really appreciate just feeling fine afterwards. The suffering freed me from my pessimistic ways and now I'm happier than ever. But not everyone has complications, and going to the ER will feel like no big deal after having your heart cut open.
