Post AVR: 12 weeks, post OHS.

[IanGordon]

Well, quite a journey , bu t largely uneventful - thankfully. I continue to share my road to recovery in the hope it may instill confidence and dispel some of the fears and concerns for those awaiting diagnosis and surgery.

So after 12 weeks, I am generally leading a normal life, albeit still medicated with both bisoprolol and amlodopine. I am now free of any of the pre surgery discomfort and my life as part man, part pig (bioprosthetic valve) , is good. I've now been through the cardio rehab process. I was already ahead of the game with my exercise regime so this only involved two meetings; an initial assessment and setting of goals with a follow up meeting to measure progress and discuss blood test results. All indicators hit target levels so no additional lifestyle adjustments are needed. So just more of the same - regular exercise and.a healthy diet.

Final sign-off from my surgeon is still a week away so I'm still logging daily blood pressure readings to support my case for reducing / withdrawing my meds. Amlodopine was only prescribed to reduce angina symptoms - now a thing of the past. Bisoprolol I know slows me down and blood pressure has not been an issue for me, so I'm optimistic

So what insight can I share with fellow pre-op hearties? For me, being as fit and healthy as possible, going into surgery was something I focussed on so exercise and diet were a priority in the weeks prior to surgery. I honestly believe this helped me dodge any of the bullets represented by statistical risk so no AF or infections , just a drop in potassium levels which were easily adjusted prior to hospital discharge on day 5.

So firstly, surgery was less painful than anticipated but drastically more debilitating so don't expect any real progress for the first two weeks - so just take one day at a time but commit to daily mobility. You have to actively pursue your lost fitness because it won't come and find you. Secondly, the unexpected will test and potentially demoralise you. I had to deal with oral thrush which compounded appetite loss plus quite severe constipation, albeit only for five days. Self-administered enemas are one of life's less enriching experiences, believe me. And the operation site seems to take forever to fully heal with small areas erupting from time to time. Nothing serious, just surprising how long it takes and a reminder of the brutality if the incision. Thirdly, you will need social contact to avoid feeling isolated and maybe indulge in some self-pity. Understandable but avoidable. I found that generally people were keen to visit and once I started to recover I was able to meet for a coffee and a chat. Getting out and about is the best thing you can do for both heart and mind. Finally, do the walking and the exercises, using cardio rehab to give you structure and feedback. You will be amazed how you begin to see and feel real improvements to strength, energy levels and exercise tolerance. You really will walk yourself well, but as everyone says 'listen to your body' and if it says ' buddy, you need a rest day' that's fine. Oh and don't forget this fabulous forum and the members who empathise and are happy to share their knowledge and experience. You don't have to be alone, isolated or uninformed with these guys looking out for you. Good on you all and thank you for being with me on the journey so far.

[Kirsty131]

Beautifully written with amazing sentiment, this will help a lot of fearful people ❤️

[IanGordon in reply to Kirsty131]

Feedback much appreciated,Kirsty. Knowledge is not just powerful but supportive as we all deal, as best we can, with these unanticipated health episodes.

[Zena166]

Hi Ian. Delighted to read you are doing so well. Thank you for sharing your thoughts experiences and emotions. A brilliant read and as Kirsty says beautifully written. Take care. Zena x

[IanGordon in reply to Zena166]

I always enjoy your posts, Zena, and admire your written style - always informative and supportive. Good job!

[Winston61]

Thank you so much for taking the time to write this. I am waiting for my date in Bristol and I can’t wait to be where you are now. Thank you again for your encouraging words and I am so glad you are doing so well. X

[IanGordon in reply to Winston61]

You seem to be in the right mindset, Winston, looking forward to being fixed. Being outdoors in this amazing weather has been a big plus for me, walking, cycling and returning to tennis

I wish you well with your surgery and a speedy and full recovery.

[marypw]

Thank you Ian and glad things are going well for you. It's always encouraging to read positive news and constructive advice.

I'm still waiting for my latest echo results on my leaky mitral valve, but I'm now starting to get some breathlessness and more palpitations. Hoping to get some news when my consultant gets back from holiday.

I've just done 5 months walking to get my hip replacement happy and healthy, so it will just be more of the same!

[IanGordon in reply to marypw]

Same old, same old regarding the walk of health. Be sure to give full disclosure of your symptoms as this is used with echo measurements to reach the clinical decision. If you understate your symptoms it may mean surgery is deferred. Good luck!

[marypw in reply to IanGordon]

Thank you Ian!

[MKB38]

I fully agree with you IanGordon. My AVR was in November and I too got as fit as I was able to before the op. I enjoyed the rehab and have continued at the gym subsequently. I walked 9 miles on Sunday, in the heat without any ill effects. Have a positive mental attitude, listen to your body, and it will pay off. Good luck.

[IanGordon in reply to MKB38]

9 miles is a good workout - you can be justly proud of the time and effort you have invested in your fitness. Keep up the good work!

[RoyM]

Well done Ian. I real success story indeed. Roy

[ozchrissy]

I am in Australia and I was the first person here and 5th in the World, to have a Mitral Valve replacement via trans catheter with this particular manufacturer of the valve. (Twelve now Medtronics) I know that there are teams at some of our hospitals (where I got my valve) that are also doing AVR via that route as well. It does not involve the rib cutting and the results are the same. With mine they went in through a small incision under my ribs, up through the apex (the bottom of my left ventricle) and were able to place my new valve, bovine in a metal casing like a stent, over my existing mitral valve. All this was done under general aesthetic and my heart was beating. I was only the 6th person in the World to get this done this way as I was not well enough for full surgery, but it has been very successful. It is 3 years since the procedure, and my little valve is working beautifully. Pretty miraculous don't you think. The trial is for 5 years, and if all goes as planned, and I am doing my best to get it there, then it may also be available to others. I do know however, that they are putting in the Aortic Valve via a catheter as we speak and many Australian patients are benefiting as a result.

[IanGordon in reply to ozchrissy]

I was hoping for a minimally invasive option for AVR but as I'm fortunate enough to be relatively robust, the "gold standard" is a full sternotomy which is what I chose . TAVI is reserved for frailer patients where the risk of mortality would be greater with OHS. Medical science continues to produce quicker,safer options which enhance life expectancy and quality of life. You're fortunate to be the recipient of this ground breaking surgery. I wish you well.

[ozchrissy in reply to IanGordon]

ncbi.nlm.nih.gov/pubmed/291...

Ian, yes I am very very lucky. The above is the interim report and the conclusion relates favourably to the next phase of the trials, where it may be offered to people like you also. I think this is the future, and anything that can reduce the trauma and recovery time for everyone is a breakthrough. You do sound like an incredible person, and you have shown a great deal of strength in your recovery. Congratulations, you have a very bright future now. Did they give you the expected life of the valve, being bovine, I got 10 years, but heck, who knows. Just think, if you do need it done again, it may end up being like having an angiogram next time.

[IanGordon in reply to ozchrissy]

Thanks for your kind words , Chrissy.

I'm part man , part pig with 10 - 12 years, maybe 15, before aortic valve replacement, by which time technology should make this less of a physical trauma. Claimed 25 yr bioprosthetic valves are now being fitted here, but without a track record longer than a couple of years, my surgeon and I went the tried and tested route. Here's hoping, fingers crossed, etc.

[markhig]

Thank you for this... less than a month to go until my OHS and AVR, root and hemiarch replacement and I still cannot believe this is actually going to happen. I am lucky that I have no symptoms now although it’s hard to contemplate what I’m going to go through at 47. Your diary posts have really helped focus my positivity and your advice on the diet now will do me good later.

[IanGordon in reply to markhig]

That's a big event, markhig, but it sounds like you're in good shape and to some extent , have youth on your side. I hope all goes to plan and you are soon enjoying a new lease of life - literally!