Post-AVR: As one door closes, another opens.

[IanGordon]

Another milestone-another post. So finally, at post-op week 14, I get to see my surgeon. So X-Ray and ECG completed I'm ushered in to see my surgeon. But no. So another member of the team, whom I've never seen before, asks me to cough whilst he places his fingers on my sternum, presumably to detect any movement. Blood pressure taken and a cursory session with the stethoscope and I'm invited to ask questions. We discuss whether I have any remaining discomfort or breathlessness - I don't.

I query the louder heartbeat that I'm now aware of which apparently is due to the stiffer nature of the bovine tissue - not as flexible as the real thing. I'm told that this is nothing compared with the sound of a mechanical valve which bystanders would be able to hear.

I also query the ongoing necessity for both Amlodopine and Bisoprolol and told this is something I need to discuss with my GP/Cardiologist. I've now negotiated a reduction to 1.25 mg Bisoprolol but this will be an ongoing battle with my GP.

So with the surgical process complete, satisfactory recovery and cardio rehab well established I'm placed back under the care of my GP. Feels a little strange that this significant milestone has been the focus of all my effort and rehab commitment , yet feels so cursory. 30 minutes from start to finish. But I need to tell myself this is a good thing. Normal and uncomplicated is what we all hope for, so rejoice in the simplicity!

An enormous 'Thank you' to Liverpool Heart and Chest Hospital for your splendid work in restoring my life expectancy and quality of life. Routine for you guys yet life changing for me.

Happy to report that my strength and stamina is still improving, week on week, with regular cycling, walking and tennis. I've managed to remain relatively impervious to the heat last week, during walks and bike rides in the 35+ degree heat in the hills of Mallorca. This was a real test of my resilience and the efficacy of my AVR surgery. Didn't miss a beat! Today I've returned to and ridden a local hill that's been impossible for me to ride for18 months and uncomfortable for a lot longer. Smashed it!

It's good to be back and appreciate that the wait, anxiety and discomfort was all worthwhile. Sorry if this sounds a little smug, but please allow me a little self-indulgence as I think I've probably paid my dues.

I wish all of you awaiting AVR or in recovery from OHS good fortune and the best recovery available to you. As I've said before, some of it's down to luck, but some of the luck you can create by your commitment to regular exercise and diet. Oh and yes the standard Hearties mantra - 'listen to your body'.

[Zena166]

Hi Ian

What an uplifting message. Really pleased that you have done so well and I am sure you will continue to improve in the coming months. And you are more than entitled to some self indulgence (but not too much mind!!). Yes it’s strange how our focus centres around our appointments but to the health care professionals it is as you say cursory and ‘just another day at the office ‘. Not with any malice rather that it’s just the way it is. Well done you. Really pleased for you. Take care and stay strong. My mantra is I cannot change my past but I absolutely can control my future. Best wishes Zena x (nope can’t cope with that heat or Hill I am in awe.....)

[IanGordon in reply to Zena166]

Thanks, Zena. Positive and supportive as ever. I was fortunate not to have a bundle of comorbidities to complicate my journey - just a stenotic pseudo bicusped aortic valve plus some stented coronary arteries. Blessed in our world!

[Alison_L]

Hi Ian. Thank you so much for that uplifting post! I'm at the beginning of this journey - had an icd fitted 3 weeks ago, and now awaiting mitral valve replacement + CABG - so it's great to read the smugness (yes, that's allowed) of someone coming out the other side. I can't wait to get back on my bike (but I don't do hills!), but fear it will be a few months yet.

[IanGordon in reply to Alison_L]

Hi, Alison. It may be with the replumbed you, hills will be less of a challenge. It was post-op week 7 that the cardio nurse gave me the ok for cycling. Major lifestyle change - I could walk or ride !

Once you get your date, everything gets in focus and things improve enormously. Although life does take a dip before you mend.

Good luck!

[thetidders]

Hi Ian, glad everything is progressing well. I’m due at Liverpool Heart & Chest today (Friday) for a check up after my triple CABG in April. I had a few problems after the op but am progressing well now so I hope to have good news today as well.

Jean

[IanGordon in reply to thetidders]

I wish you all the best, Jean. I cannot fault the care I received at LH&CH, also in April

[thetidders in reply to IanGordon]

Hi Ian, thanks, we’ve just got back from Liverpool Heart & I’ve been discharged 😀. We live on the Wirral & don’t have too far to go, it’s just awkward at times through the city but some people travel from miles away.

Jean

[IanGordon in reply to thetidders]

Great news, Jean. Well done. I spent the first 21 years of my life in the Wirral but travelled from Lincolnshire to see the surgeon of my choice at LH&CH. Well worth the journey.

[thetidders in reply to IanGordon]

That journey is not the easiest, Ian, it must take you a few hours to Liverpool, you obviously trust Liverpool Heart. It does have an excellent reputation doesn’t it. It’s certainly sorted me & you out.

Jean

[IanGordon in reply to thetidders]

Well worth the relatively minor inconvenience and the 4 hour AVR that my surgeon described in a letter to my GP as 'uneventful'

[gal4God]

I’m finding my Stammia is increasing but my strength is decreasing at the mo.

[IanGordon in reply to gal4God]

Maybe some light weights or resistance bands to build your muscular strength?

Good luck with your ongoing recovery

[Ticktock61]

High Ian

Fantastic hearing how well your doing after 14 weeks cycling up hills must feel amazing and I bet it’s all about confidence I bet the invaluable worry is thinking you may overdo things and by worrying about that probably not doing enough ....... dilemma

How long do you think you’ll be on bisoprolol for as I’m pre op and have been put on 1.25mg of this beta blocker and I’ve been on it now for approx 8 weeks and I know this is going to sound really weird but this week I feel like it’s my body but not me inside it ....... I know how stupid that sounds but it’s like it’s taken the edge off my personality and I’m a different version of me ......... or I suppose I could be just I imaging that there’s been a change don’t know if it made you or anyone you know feel like that

Try not to laugh too loud !!

Pete 👍

[IanGordon]

Pete, hi. In the early days of post op recovery, I did push myself too hard in the hope it may speed my healing. Soon learned that shortcuts are not an option. However, I've managed to balance things out and now know what my capacity is - and it just keeps incrementally increasing. So no fears or dilemas. The only uncertainty is how much fitter can I get?

My first experience of Bisoprolol was that it took the sharpness out of my life and featured lethargy and induced apathy. So yes, it wasn't me. My second time around with this beta blocker means that my heart rate and therefore exercise capacity is supressed so I'm monitoring blood pressure as my GP is reluctant to even consider zero Bisoprolol without evidence of acceptable BP. Impact on personality does not seem significant the second time around.

Good luck with your surgery and beyond.

[Fredders]

Hi Ian, so pleased everything is going so well with your recovery. You are allowed to be smug, it’s a great feeling to go through all the pain and discomfort and come out the other side! I have a mechanical valve but can only hear it at night or when it’s very quiet. My husband still can’t hear it, but personally I think he’s going deaf 😜.

Keep up the good work.

Wendy

[IanGordon]

Thanks, Wendy. It's only really recently that I've come anywhere near feeling that I've completed this health - related endurance course. And being able walk,cycle and even run, unrestricted by angina or fear of the worse, has suddenly made a colossal difference to my life. Realisation has been slow coming but oh so welcome.

[vinc]

Thank you Ian your post have been so helpful to me

Getting my head in the right place and my body healthier before my op

Although I have not followed your recovery closely, I will over the next few weeks go back it time and use your posts for great inspiration I am sure

Having a date of 24th september

Will focus my prep a bit more

Thanks again

Vin

[IanGordon in reply to vinc]

Cheers, Vin. Getting a date enabled me to focus and plan - sounds like the same for you. I wish you well in the run up to surgery and beyond.

[markhig in reply to vinc]

Hi Vin, we’re in this together as my op (originally planned for this Wednesday is now postponed until 18 September) hope we can help one another. I have certainly found it useful to talk to people on here as they can understand exactly what we’re going through. All the best for the next few weeks Vin and again Ian ... really pleased you’re doing so well on the other side

[IanGordon in reply to markhig]

Thank you, Best of outcomes for the 18th. Not long now.