Aortic valve replacement : Hi again now... - British Heart Fou...

British Heart Foundation

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Aortic valve replacement

Fletch73
Fletch73

Hi again now less than a week to my AVR! I’ve been amazed at how calm I’ve been but yesterday things got very real as I realised this time next week I hope I’m in intensive care 😱

Anyone got any hints or tips that I should be doing in the week leading up to op like diet and exercise? Thanks ❤️❤️

32 Replies
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MichaelJH
MichaelJHHeart Star

At this stage there is little more you can do. You should have been given advice on which drugs to discontinue (if any). Eat a healthy Mediterranean diet to give the healing process a kick start, become teetotal and limit caffeine, but have a treat like a slice of cake the day before! 😁 Also focus on your core strength and practice getting up from a chair without using your arms as you will not be able to afterwards.

Also think about when you get home. S backrest or V-pillow is useful for sleeping, a raised toilet seat if you have a low level suite, etc. If appropriate stock up the freezer as you will not be able to carry shopping for weeks. Everybody's home set up is different so go through things with a critical eye. Good luck!

Fletch73
Fletch73 in reply to MichaelJH

Thanks for the advice

Hi, in addition to Michael’s tips my husband found a shower stool really useful when he got home.

All the best.

Fletch73
Fletch73 in reply to Shar28

Didn’t think of that thanks

Go onto Youtube and look up Dr Esselstyns whole plant based diet, it is the closest to logic I can find. I am a 95% follower. I find I don't crave treats, aside from dark chocolate with 75% cocoa solids. I walk as far as I can, do leg lifts and lift a few weights 2kg in each hand. I see how I feel at all times. I try to do things that improve my mood, watch comedy and listen to music. Talk to friends and live life.

Nic25
Nic25 in reply to Khonkaen

I'm sorry I strongly feel this is an appalling answer to this post and even potentially dangerous in my view. Advising someone with clearly a serious heart condition to lift weights? Are you mad? I'm not going to report it as I suspect you meant well but please think more carefully next time before pushing such a tangential and as I say potentially dangerous agenda in the context of this forum

Khonkaen
Khonkaen in reply to Nic25

My main suggestion was one of a dietary change. I said "I" walk, 2-4km which is more thtn some, less than others here and 2kg is hardly "weight lifting", merely gentle exercise, as recomended by a number of physiotherapists for heart patients. Besides I would have thought his/her aftercare specialist/physio would have worked out a recovery exercise routine.

My Heart Story (or How I came to this site)

Oct 2015 (age 57) Underwent a pre-emptive double by-pass and AVR replacement Prior to this had three angiograms to monitor BP symptoms AVR is a titanium ON-X valve

An tissue valve was not an option as it would present a risk in creating difficulty in replacing it over time. Interfering with the double by-pass etc. to replace.

Warfarin took a while to get settled readings but is now okay, the ON-X requires lower Warfarin reading than other valves.

The initial recovery took about 16 weeks (scientific measure for me was getting back to driving, walking and swimming pool time!) Experiencing the usual problems that come with major surgery – lack of any confidence, worry, guilt of putting the NHS through the tasks of helping me, pain and overwhelming relief and happiness that I was still on planet earth.

Exercise (post op)

My exercise plan was simple after the op - walk from my house door to the first lamp post and back - twice a day for three days

Day three - walk to second lamp post and back and repeat to build up till 7 lamp posts

Warning walking in a strong wing blowing into your face is very tough!

Also lifting a kettle to fill at a tap -was also tough and went through 2 kettles over 10 weeks!!

Restrict family and friends visits as it takes a lot out of you and you need to rest!

If on Warfarin Stay of Green veg at first! Vit K nullifies warfarin and stops it being effective

Other than that all the best

My only regret was wishing it was done long before it was!

Hi there

It can be a stressful time and the other replies give some very good advice. I had AVR in May and am just coming up to 13 weeks post surgery. Like you I was quite anxious pre-surgery with quite wide swings in degree! One day calm and the next worried as heck! Two things made a difference to me, one conscious and the other unplanned.

For the conscious element I considered my surgery like flying. Every time you get on a plane you are in the hands of an experienced, trained pilot and high tech aircraft. We take flying for granted but when you think about it you are totally in the hands of other people. You explicitly trust they will get you were you need to go. AVR surgery is like that. Your "pilots" are surgeons who have been doing this for years and are experts in their field. Your "flight attendants" are the spectacular nurses who take the most amazing care of you. So I decided to lay back and take my surgery "flight".

The unplanned epiphany came about when I was admitted but had my surgery cancelled. As my wife and I were leaving to return to Cardiff we passed a ward filled with folks like myself. Similar age and all of them had their open heart surgery dressing showing. They were all chatting and joking - they looked amazing. And I just thought that is going to be me in a week. And you know what - it was me.

So take heart - you will get through and then can get on with your life.

Fletch73
Fletch73 in reply to aussie63

Thanks for your kind words. It’s kinda cheered me up a bit ❤️❤️

Alison1960
Alison1960 in reply to aussie63

What a lovely post - my sentiments entirely. Having chosen which surgeon and hospital I relaxed and left it all up to them. They want us to have a safe journey and reach our destination!

I also think seeing patients before surgery who have already been through it is hugely helpful psychologically and would have loved if , for example, an ex-patient volunteer had come round the ward pre-op.

aussie63
aussie63 in reply to Alison1960

Thanks so much! Have you had your operation? I couldn't quite tell. I was lucky at the Royal Brompton we did have a day of talks a few months before the surgery which was really helpful but no tour. I think your idea of the volunteer is a great one and would help calm nerves before the big day. It would also be a good way for us to give back after our surgery as well. In any event I hope you are well and recovering brilliantly!

Wildmeadow
Wildmeadow in reply to aussie63

Hi Aussie63, thank you for poetic analogy- very helpful!

It's useful and reassuring to have a blood pressure monitor, a pulse oximeter and a clinical thermometer

Fletch73
Fletch73 in reply to marypw

Thanks

After 8 - 10 weeks (to allow your breast bone to knit together ) you should get a call/invite to go and do a recovery course run by your local hospital. Go and do it - it strongly linked to a good recovery process.

Hidden
Hidden

The most useful post op items for me in addition to the raised toilet seat already mentioned (had AVR 1st July) were:

(Urine) bottle

Plastic beaker with spout which has tube going to bottom (you have to suck water out) -it will not spill water if dropped. For first two nights I was trying to raise my head and shoulders to drink from a glass. This was very painful and you ended up with water running down your chin. This beaker meant I could drink with my head horizontal! No pain at all! Ideal for taking pills or just a drink (I found my mouth very dry at night).

I slept on a couch which I raised an extra 8" from the floor. I also had thick seat cushions so that when lying down I was at least 2' above floor level. This makes it MUCH easier to get 'out of bed'. You really miss the fully adjustable bed in hospital!

One additional point: make sure your surgeon mentions that between 30 and 40% of AVR patients experience atrial fibrillation shortly after surgery. He should explain what this is and the implications (not serious). I was not told about this by anyone and had AF at night two days after my op. I found it terrifying as I had no idea what it was (it felt like my whole heart was bouncing up an down (the pattern was three 'bounces' followed by four to 5 secs of nothing making you wonder if your heart was not going to restart). This pattern was continuously repeated until I was put on a special drip (a strong drug called Amiodarone) it stopped after about an hour on the drip.

The following morning I was walking down the hospital corridor...

Regards, Mike.

Fletch73
Fletch73 in reply to Hidden

Cheers thanks for your inpu

hi make sure u take a pillow with u 2 hold against ur xhest after surgery.also take everyday as it comes these pll are excellant in there fields so goodluck

Fletch73
Fletch73 in reply to mewg

Thanks got one❤️❤️

Scour the second hand shops for a little hand bell that you can put by your side as you recline on the settee. It will help your carers to drop everything and come to your immediate aid. As you get better they will no doubt express their opinions on how much the bell has helped.

Fletch73
Fletch73 in reply to Ianc2

Already in place thanks❤️❤️

Hi Fletch

Read your post with interest and the replies you received.

I had a call from my surgeon’s PA this morning and I too will be having my surgery next week.

Think it’s good to know that there will be lots of us up and down the country all undergoing this amazing surgery - I’m having mine at The Liverpool Heart and Chest Hospital.

So Fletch, good luck with everything, hope all runs smoothly and that you are back home before you know it.

🌸

Thanks and good look with yours too! I’m at the James Cook hospital in Middlesbrough. I’m 45 and have opted for a biological valve which one are you having??❤️❤️

I’m having my surgery at Liverpool Heart and Chest Hospital. We talked it through with the surgeon and thought a bovine tissue one would probably best suit my lifestyle. However, after giving our discussion some thought I wrote to her to express my interest in the Edwards Inspiris Resilia Valve. Guess I won’t know for sure until Monday. 🌸

Hi Fletch73

My wife pulled together her thoughts on after the op care which may be of use:

healthunlocked.com/bhf/post...

Cheers

There's nothing for you to do before the op. Afterwards you'll be ok too. The only pain killers given were paracetamol which I didn't need. The real battle is getting fit again really. One thing I was surprised at was that after a month or so I was still very tired so my GP got a full blood count done. They had let me out of hospital while badly anemic from the blood loss. A month on the iron tablets and all was well. You will be on several drugs to begin with. Some of these will be stopped after a while. Some of the others they will happily leave you on forever. Even though you may no longer need them. The beta blockers for example. Not everyone needs to stay on them. They can make you dizzy when standing or getting out of bed etc. You also can't exercise fully as you have to be careful of heart rate when on them. After a year I asked to cut down. And then soon after asked my GP to contact the consultant cardiologist to ask if I could come off altogether. Which was agreed. After a very long weaning process I got off them and felt so much better. Also for many I would say it takes about 10 months to really get back to normal. Not the 3 months they tell you. Good luck. Stress is normal in your situation but try not to let it get out of hand.

Fletch73
Fletch73 in reply to Gazza01

Cheers thanks ❤️❤️

Good luck Fletch73! Sure it'll go fine for you and you'll be on the mend in no time and (eventually) feeling better. Main tips from me:

- Practise standing up from sitting without using your arms (as you won't be able to/shouldn't push at first)

- Just try and stay as generally active as you can

- Avoid if you can too many crowded places just to help with the chances of not going down with a cold

- Get a full dental check-up done if you can

- Just go with the flow and put yourself in their expert hands. There's actually not that much you can do to prepare to be honest, apart from trying to deal with the terror - and tell people if you're sick with fear and anxiety, it's only normal

Accept it's a 'process' and you're going to be part of it. Some of it won't be fun. Some of it will require patience and perseverance. But the end should/will hopefully be positive.

But good luck and fingers crossed!

Nic x

Oh yes Fletch if you want I have some useful "what to expect" pdfs from my hospital Guy's and St Thomas's that I can send you when next on my proper computer rather than phone? Unless you already have similar from your hospital?

N x

Hi Fletch, hope you're keeping well and have had a good weekend. Just as promised here is the GSTT stuff I mentioned if helpful...

guysandstthomas.nhs.uk/our-...

guysandstthomas.nhs.uk/reso...

guysandstthomas.nhs.uk/reso...

I certainly found it all useful. I think they've become a bit of a template for other hospitals, so you may already have them or something similar. But hopefully useful either way.

Cheers, and keep well.

Nic x

Fletch73
Fletch73 in reply to Nic25

Cheers thanks ❤️❤️

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