workload stenotic aortic valve patients

[Robbyha]

Hi all,

I'm a 50 years old heartpatient with a stenotic aortic valve (AVA 1,1 cm2, AVG 68 mmHg),
bicuspid by birth, looking for advice to decrease my workload, pressure and presence at work.
I've got a fulltime-job as software-engineer at an softwarehouse for 8 hours a day and travels 4 hours (commuter traffic) a day totaly 12 hours from home !!!
After a long day from home i'm very tired.
I want to make some new agreements with my boss.

Maybe there are medical directions and answers for patients with a stenotic aortic valve based on numerical data.

I'll hope to find the answer for a very difficult question:
How many days a week and hours a day can we be sure you be present at work, when you have to travel 4 hours a day (....because of a stenotic AO AVA 1,1cm2 and AVG 68mmHg) ?

Does anyone have suggestions based on one's own experiences?

RobbyHa

 

[Lynlw]

I don't know anything about your job or what is allowed, but since you live so far awy, would it be possible to work 2 extra hours a day and work 4 days with 10 hours a day? That way you would have an extra day off to rest up ect

 

[ctyguy]

If your job isn't physically demanding and your heart rate doesn't elevate I don't think your at risk of damaging your heart. For me I was fine at my desk and doing pretty much any non-physical type task.

Now from a energy standpoint I can see why you would be wiped out each day. Can you work from home ? Im an I.T. guy and I can dial in and have access to everything I need. If you can't work from home maybe work a 4 day week and take off on Wednesdays to help recover ?

 

[netmiff]

Hi, Robbyha!

I think that is something you should talk over with your doctor and your people at work. If working from home is an option, even two or three days a week, I would suggest that first. Maybe another solution is to find a small apartment, hostel or bed and breakfast close to work, and stay there 2 or 3 nights a week to give you a chance to relax - but that one might be something you would have to talk over with your family, if you have one.

 

[tobagotwo]

You won't be able to put anything medical in that recommendation, most likely. Without something from a cardiologist, the company's not likely to take you as seriously as you want them to. In the US, this isn't considered a handicap until you're just about ready for surgery.

You can point out that you are having difficulty, and if you have a surgery date, they may give you some leeway because they see an end to the tunnel. Other than that, you may need to live with it, because of people's misunderstanding of the issues. The stress and commuting are real issues for you, and are wearing you out, but most companies will consider them your issues, rather than theirs. Fortunately, your job is not likely to be causing actual injury to your heart, just cuasing you general, excessive fatigue.

Best wishes,

 

[Fundy]

I'm not sure if you tried dietary changes yet or not. Maybe your fatigue problems can be improved by changes in that respect.

I was having horrible problems with muscle aches and pains, especially neck and shoulders. Muscles seemed to always be tight. I was maxing daily tylenol and muscle relaxant in half a day. It was affecting my brain too, as I was geting nauseous, having trouble concentating, and severe head aches.

Lot of tests led to my knowledge of having severe aortic stenosis and emphysema; but still not cause of muscle pain. Doc put me on cipralex,clozonapm,celebrex. But no relief until I started chiro and massage therapy two years ago. Which helped reduce pain but still muscles stayed tight. But at least I got rid of all meds. So last year I while researching myofacial pain and trigger points on the net, I found out that avoiding acid food and beverages especially the heavy acids should be necessary.

So I swapped green tea for coffee,juice for cola, almonds and garden salad for junk food snacks, fish for beef,avoided chocolate, and started drinking 5-10 glasses of spring water usually with lemon juice.

And now my energy levels are way higher than probably ten years ago actually. Maybe a diet change can help you too. Also, you may want to look into a list of top stress causing items to see if they apply to you. Once your aware of what's causing stress, you may be able to find solutions. Stress doesn't just add up, it multiplies; so anything you can do to relieve even one stressful item should help immensely.

 

[acr]

If you're a software engineer can't you ask to work from home using access via Web/VPN? I'm an Oracle/SQL Server DBA and did this post-op after the 3 months sick-leave and still do, generally 3 days in the office and two days at home.

Ade

 

[Robbyha]

Thank you for all your replies. I am not able to banish all the stress. I'm on a low-fat diet (natrium <2,5 gr a day).
For a couple of weeks i could work 2 days a week at home using a VPN-connection to logon on my computer in the office. A perfect solution, until my laptop at home had been crashed.

But is it necessary to work part-time at home? What kind of workpressure is he able to be manage? For how long must he be present in the office? Questions that an employer could put to a cardiologist, (without contacting me) but the cardiologist is not be abled to answer those questions.
It varies from person to person and in my own situation it varies from week to week.
Some days i still can run for half an hour (with a heartrate of 85% the max. without fatique) On other days and weeks i'm completely exhausted.
Sometimes i measure my bloodpressure and heartrate under different circumstances (very fit or very tired) at the same moment of a the day.
The results are excactly the same !?!?!?! (i must say: i'm using medicines to decrease the bloodpressure)
I can't give myself the right answers for that but the best comparison i can give is a low-battery.

Maybe can someone give me some tips to handle stupid questions.

 

[ALCapshaw2]

I concur with the idea of approaching your employer about changing your schedule to reduce the number of days you need to commute. Taking Wednesday off as a Stress Reduction Day seems like a Good Idea to me.

I was also going to suggest an exercise program to build your stamina but it appears you may already be doing that.

My guess is there is not much that your cardiologist will be able to do for you since mild to moderate Aortic Stenosis should not have a serious impact on performing a Desk Job.

I'm hoping that you will be able to find a combination of life style changes that will improve your quality of life.

'AL C'

 

[Robbyha]

my cardiologist has been qualified it as an moderate(->almost severe) AS.
AVGradient 68 mmHG, AVArea 1,1 cm2. (How long will it takes to become severe?)
Aortic and mitral valve both have been calcified.
LVH etc.

 

[Fundy]

From what my cardiologist and another also which performed my last echo, both mention that my factory work of 5-6 days week 8-12 hour days shouldn't be a problem for me. as the weight lifting involved is only 10-20 lbs. But the cardio doing the tech work mentioned I shouldn't be doing much heavier than that. I had an echo in Sept08 that was moderate-severe with 1.09 cm2 area. Then stress echo 4 months later in Jan 09 that was mentioned to me as now being classed as severe but just barely. Hope that can anser your question partly as to how fast.

For your work fatigue problem I'd suggest seing your doctor instead of cardio and discuss your stress situation with him. Here in Nova Scotia,Canada I'm almost certain you could get a doctor to script you max 2 days without a days rest; continued for a month or two to start with. There could be any number of things causing fatigue for you. Lack of sleep or quality sleep maybe. For me I think the sleep thing was major. As after severely reducing caffeine intake I one day woke up remembering a cool dream. Then thinking its been years since I remember waking up remembering a dream. so I think my deep sleep just wasn't occurring.

A doc maybe might even suggest weeks or months from work. Either way it sounds like you need your health situation addressed from a stress angle and not a heart valve one. What a doctor can or can't prescribe depends a lot on where you live though I guess.

 

[Robbyha]

Before i became ill last year (endocarditis), i trained a lot, 4 times a week natural bodybuilding (10 reps 300 Lbs benchpresses without steroids), bicycle racing and mountain biking about 300 miles a week. Also running a lot!
Several sports have been functioned like a stress reduction programm to me.
Now it's out of question.
A sportless life has a deep impact to me but i'm not depressed and i've a nice job, nice family etc.

Lack of sleep could be a big part of the problem but not 100%, i think.
Is it correct that fatique could never be a symptom to describe to a severe aortic stenosis, when you're not suffering ischemia or LV fibrillations?

Maybe that lack of sleep at this moment the problem is, and i hope so, but in earlier day's is was never a reason to be exhausted.

Thanks for your reply.

 

[ALCapshaw2]

Lack of sleep is becoming more emphasized as a Risk Factor for Heart Issues.

Many of our members report sleeping in short periods after OHS. Some even report never getting back to a full 7 or 8 hours per night in one session. Age and 'other issues' (having to go to the bathroom) are contributing factors. "NAPS are Great" as reported by several members but Doctors continue to stress the desirability of sleeping through the night for a full 7 to 8 hours.

'AL Capshaw'

 

[Robbyha]

I've got LVH, because of endurance and strength training in the past, not knowing to have a bicuspid aortic valve by birth.
On different moments at a deep nightly sleep my heart rhythm slows down to 30 beats a minute. A few seconds later my heart beats 70 times.
In my case, this heart issue (LVH / very low heartbeat ) is becoming more emphasized as a riskfactor for lack of sleep, seems to me.
(I've got about 3 naps last night)

When this happens i'm tired at day.

 

[ALCapshaw2]

I think you have identified the source of your sleep problem and therefore your tiredness at the end of the day.

Have you ever discussed your slow heart rate with an electrophysiologist (i.e. a Cardiologist who specializes in the electrical behavior of the heart)? That may be worth investigating.

I'm guessing that a Pacemaker may be one option. I've never heard of anyone taking medication to 'increase' their resting heart rate...

Let us know what you learn.

'AL C'

 

[khnckevin]

from personal experience, I had a avr replacement 26 years ago. This last year has been a little rougher. I work in retail and was working 6 days a week for 2 months straight and was getting tired, so to put an end to I got a dr. note with a work restriciton that I can only work 5 days a week. I still feel tired, but it is a little more manageable.