Pseudo bi-cusped goes bad!

[IanGordon]

So my most recent echo cardiogram takes me into the 'severe' stenotic zone and a candidate for aortic valve replacement. I've selected and met my surgeon and valve type so now await a date for this routine op. Dr Google can answer most of my questions apart from when? and how much and long is the sternum pain? Did do some searching for a faster recovery option offered by minally invasive surgery - not TAVI as I'm a relatively fit 65 yr old. This proved elusive so I'm up for the 'Gold standard' which I feel is a somewhat strange title for something that involves separating two sides of the rib cage. Then there's the protracted recovery over 2- 3 months. But the risk of doing nothing is now too great - so bring it on! Interested to hear any pre- or post op experiences from those in similar situations.

[MichaelJH Heart Star]

Similar situation to yourself but awaiting date for quadruple (possibly quintuple) bypass. When I saw the surgeon he said it was quite routine - for him but not for me!

Be wary of Dr Google as there is both out-of-date and mis-information out there. BHF do some informative pamphlets.

[IanGordon in reply to MichaelJH]

Thanks, Michael. Appreciate your response and accept that www can both inform and confuse. BHF continues to be an invaluable resource.

[MichaelJH Heart Star in reply to IanGordon]

I suffered cracked/broken ribs with a displaced breastbone (according to my GP). It was about 3 months before I was relatively pain free but over six before I didn't get twinges. Expecting much the same post bypass but with increased tiredness. But then I am pretty tired already...

[IanGordon in reply to MichaelJH]

Familiar with sternum and rib damage pain following impact damage. Mountain biking and snowboarding injuries, respectively. It's the comparative severity of invasive surgery which is the unknown and therefore my worry although I guess I will have pain management expertise on my side and a selection of opiates!

[MichaelJH Heart Star in reply to IanGordon]

I broke my femur (my foot pointed outwards" some years ago. In A&E they gave me morphine but once I had been back form theatre for a few hours (plated using epidural) I was pout on Tramadol - very effective!

[Mary_Janet]

Hi,

I had what I think is described as a gold standard AVR also for bicuspid valve. In my case I had no warning and my surgery was classed as urgent.

Initially I was in ITU post op and my pain was controlled on a morphine analgesia pump. Once I was on the ward I given regular oral painkillers, two types, as I felt better and got more mobile I was able to reduce my pain killers. I found that I needed them particularly at bedtime as by that time I was sore and tired. Also I needed painkillers in the morning to get me moving.

The staff are very keen to keep you pain controlled as if your pain is controlled you move better, take deeper breathes and feel better. No medals for bravery given out. Pain for me was not my biggest problem and hopefully it won't be for you either. All the best and keep in touch with your progress.

[IanGordon in reply to Mary_Janet]

That's useful advice regarding the role analgesia can play, if you embrace it, in aiding recovery. Had not really thought that one through but now appreciate that it less pain means earlier and therefore more effective mobility. Not looking forward to the restrained mobility during recovery but just have to roll with it. Too much time to think about things and becoming increasingly preoccupied with the impending surgery. In limbo until a date is fixed. Only then can I plan anything other than my hopefully speedy recovery.

[mewg]

hi mate im 12 or 13 weeks since my avr and ive had the gold treatmeant as you call it im still getting pain in my sternum i have 2 small kids which ive been over doing it since the surgery im back doing light weights now but sum days it still feels like a bus has hit me.so i think the sternum recovery can still give you discomfort 4 a while my mate still has pain and he had it 3 yrs ago.i think the gold treatment apart from a smaller scar is the same i think.goodluck and if you have a mechanical valve the clicking can drive you mad lol

[IanGordon]

Thanks for telling it how it is mewg. Lifting light weights is probably the better option though not as popular as lifting your kids! I've opted for the silent pig - so one less thing to concern me.

Good luck with the continuing recovery.

[MKB38]

Hi IanGordon, I had AVR surgery in November. My scar is very small. I am virtually pain free now, but I did get a cough last week, so that made it a bit sore again. I just take paracetamol as and when I need it.

In respect of lifting things, I thought it was 12 weeks, but my surgeon said that it is only a guideline for those people who had the incision right down to their abdomen, not for those with the small incision.

My stamina is still below par, but I am doing the cardiac rehab, which is great.

Best of luck with your op and recovery.

Margaret

[IanGordon]

Good to hear you are on the mend, Margaret. Sounds like you have done all the right rehab things and are slowly beginning to reap the benefits. Seems to me that PMA is the vital component to recovery , irrespective of the physiology. Hope you get to the promised land of freedom from sternum discomfort.

[Fredders]

Hi Ian

I had my second AVR last November, went down the same incision as last time, which runs from just below my throat to the bottom of my sternum - which then meets up with my other scar from there to just brpelow my bellybutton from having my spleen removed! Heart surgeon did a better job putting me back together though 😜

Like someone else has said, make sure you take the painkillers, this is no time for heroics. You can gradually reduce them once you are home, but I still needed to take them at bedtime and in the morning for several weeks, but now just need to take them at night, but more for pre-existing problems than as a result of the surgery. I still occasionally get aches in my sternum area, but gets easier by the week.

I am back at work now, full-time as a secretary, and the only real problem I still have is breathlessness. I am alright indoors, but the cold weather makes it a real struggle when I am outside, but my surgeon says that is quite common and several on here have also had the same problem - roll on summer!

I never got offered rehab after either op, but from what others have said it is worth going to if you can. I’m treating work as my rehab.

I had a mechanical valve this time so now have warfarin added to my list of medicines, but I seem to be getting on okay with it and keeping my INR level.

Hope you don’t have to wait too long for your op, I think the waiting is the hardest part, gives you too much time to think about it.

Wendy

[IanGordon]

Wendy,hi Thanks for the pain management advice. Seems to be an incidence of post-op breathlessness some weeks into recovery which is worrying. Not to say it will happen to me so just hope that preparation and as good a level of fitness as is achievable will see me through.Fingers crossed.

[Fredders in reply to IanGordon]

I didn’t have the breathlessness after my first AVR, but the weather wasn’t so cold then, and it is very noticeable that it is worse when the temperature drops. I wasn’t able to do as much walking as I should have, because the cold also made me cough initially so I didn’t go out very much, but now I’m back at work it’s slowly improving. Hopefully you’ll be fine.

Wendy

[Nanny72]

Seven weeks post aortic valve replacement never had much sternum pain but pain in last couple of weeks from fractured rib. Improving now. Recovery period is long but just started cardiac rehab.

For me the worse part is having to rely on husband for housework and others to walk my dog. Although I am now walking 2-3 miles a day with whoever is holding the lead.

I found I needed a shower stool because my legs were week from prolonged bed time. I was ventilated for 8 days post op which is apparently unusual.

You will probably have a lot of visitors when you get home. The cardiac nurses are great support. My gp was a waste of time both pre and post op which is why my surgery was emergency with no time to think about it.

You will feel tired for the first 4-6 weeks. I am not allowed to drive until after my follow up appointment but I don't know if that is general or just my hospital.

That is also frustrating.

7 weeks post op I feel great but am aware that sternum takes 12 weeks to heal.

Hope all goes well for you.

[IanGordon in reply to Nanny72]

Thank you, Nanny82. Comming to terms with what will be enforced inactivity. Hearing real experiences helps enormously. Seems to be a long haul to recovery but small price in the overall scene of things.