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Open Heart Surgery Coming Up: Questions and Advise

danny10 profile image
26 Replies

Hi all! Happy New Year.

I have been lurking around for a while and found some great tips here!

My first post/question.

I am 45 years old and will have aortic valve replacement next week. Mechanical valve. I will be in blood thinners for life?

How bad is bleeding on a minor cut? Or on a nose bleeding? Or from a anal fissure? Or from scratching from following on the floor on asphalt type of floor?

Other than that any tips for home recovery are welcome. Walking, breathing, taking care of the stern, v pillow, chest pillow. What am I missing?

Thank you everyone! Blessings. Daniele

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danny10
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26 Replies

Dear danny10

Hello and welcome to your first post, you have asked for many answers but the main one concerning the blood thinners is the hardest to answer.

Mainly because of the individuals response to drugs.

Also it’s type, its strength and how you bled in the first place, { but it’s important if you suffer from piles/ anal fissures etc to tell your GP/ heart team }

Please remember I am not medically trained.

All your other questions, about pillows etc can be answered when you need them as it’s impossible to know at the moment what your needs will be.

Good luck with everything, your journey has just begun, we are here to help and support you in any way we can.

Take care

danny10 profile image
danny10 in reply to

I have a fissure from hemorrhoids surgery. Which was about 10 month ago. Yes of course they know about it. The surgeon said there is nothing and I can be operated. But I still bleed a little bit every time. So I am concerned with my first bowel movement after my surgery and especially bleeding from there.

danny10 profile image
danny10 in reply to

For the other things I meant I am covered with it somehow by having it and knowing how important they are. And I was wondering if I may be missing something very important and vital. Sorry if it was not clear and thanks for answering.

Heather1957 profile image
Heather1957

I was on Clopidogrel for nearly 4 years and didn't actually notice any difference, I also had 2 teeth extractions and the dentist wasn't bothered and I certainly didn't bleed very much.I am now on Brilique and aspirin and have noticed I bleed a lot more if I accidentally scratch my psoriasis and I bruise a lot easier. The bleeding is more annoying than frightening, it has marked my bedding! I am sure a lot depends on what thinners you are taking.

danny10 profile image
danny10 in reply toHeather1957

Thank you for answering. My surgeon told me Warfarin (Coumadin). Not sure if that make it worse or better.

Heather1957 profile image
Heather1957 in reply todanny10

From my understanding Warfarin is 'full on' but as long as everyone knows you are on it they can prepare you for any problems.

Isobel1 profile image
Isobel1

Hello Daniele, although you'll get lots of good advice on here, there's also this facebook group, specifically for those who' ve had, or are going to have aortic valve replacement surgery. They're a very friendly helpful bunch ! facebook.com/groups/1864350...

64AF profile image
64AF in reply toIsobel1

Hi DannyI am on blood thinners for life ask your Dr if you can have rivaroxaban no need for blood tests and I have found them to be ok. You bruise easily and bleed a little more you have to be careful they are a good alternative to warfarin.

080311 profile image
080311

Hello danny10

Welcome to the forum, I had my surgery over 5 years ago so I will talk you through the normal stuff we need to know, you probably no most but here goes.

After surgery no arms above your head, no lifting anything heavier than half a kettle of water, no pushing or pulling movements. So before you go in look in the kitchen and anything you use regularly and is high up move down. It takes 8-10 weeks for the sternum to heal.

You will be given breathing exercises and coughing one by the physios keep doing them when you get home, they really help. Remember our lungs collapse when we are put on bypass so they need a bit of help getting all those little pockets filled out again.

A rolled up towel/ baby blanket is really useful coughing/ sneezing can be painful until the sternum is healed. I used to sleep with my arms wrapped around it, I am a side sleeper so sleeping on my back I found difficult, the first time I managed to get on my side to sleep was bliss😂

Listen to your body if it says I am tired you need to rest. If you feel emotional it’s normal your brain will still be trying to figure out what has happened to you. We are given a huge dose of anesthetiser and some very exotic drugs and these take longer to leave our system than we think.

When you get home after about six weeks you should start cardio rehab, make sure your on the list, it’s great for your stamina but also your mental health. Being around others who have been through the same experiences is so helpful. You can say I have this pain or ache and someone will say me too.

Can’t help with your warfarin I have a tissue valve, though I am on 75mg aspirin and can get some lovely bruises 😂

I wish you well for the op, remember your surgical team do this as their day job.

Best wishes Pauline

danny10 profile image
danny10 in reply to080311

Thanks Pauline :)

Beatles1956 profile image
Beatles1956 in reply to080311

Hi. I am nearly 6 weeks post op. I remember a physio coming round to see us on ICU, the day after op. I was high as a kite, so can't remember much of what she said, but she hoped she would see us again when we were back on the ward. She didn't. So I picked up the exercises from the information booklet that the hospital sent (you should get one), and also from useful people on here. If you are unsure about exercises, or anything, just ask, you will get so much help on here.All the best👍

080311 profile image
080311 in reply toBeatles1956

Hi Beatles1956

Think you meant to send to danny10 not me, would hate him to miss your post.

Pauline

Beatles1956 profile image
Beatles1956 in reply to080311

Sorry about that, Pauline. It seems that danny10 has seen my reply. 🤪

080311 profile image
080311 in reply toBeatles1956

Really not a problem, have done the same thing.

Clairealou profile image
Clairealou

Hi Danny. I’ve just had a mechanical aortic valve and been on warfarin for about 6 months now. It does take a little while to get it stable but I’ve also invested in a machine to test my own blood which as my INR becomes more stable, is helping save lots of trips to the GP as I can do it myself (bought directly from Roche, cost about £300 which I thought was worth it as it’s for the rest of my life). As for bleeding, maybe a little more than usual and do bruise more easily but nothing to write home about although I am more careful now to avoid accidents. My dentist said they needed to be aware but would not prevent any treatment. I have invested in a medical bracelet engraved to say I’m on warfarin with my NHS number. The main change is that I have taken the decision not to drink and of course, my diet has changed a bit to avoid high vitamin K. The dr8nking is my choice and I have found lots of really good substitutes. I did like a good drink before and am only 53. However, I feel better than I have done for a long time, have lost weight and accepted that this is my new norm. Not really missing the drink. Message me if you want to chat further on anything as I have had a lot of surgery so have lots of experience I can share. Take care

G0dfather profile image
G0dfather

I've been on both Warfarin and Rivoroxaban for 10 years now (not at the same time lol) Ive never had any issues with bleeding had teeth out major operations no problems. I take my Warfarin at night to me it makes sense that the first 8 or 9 hours I will be asleep and can't do anything that could cause bleeding.

danny10 profile image
danny10 in reply toG0dfather

Thanks Andre! Any difference between the 2 blood thinners according to your experience and which one you prefer?

G0dfather profile image
G0dfather in reply todanny10

Rivoroxaban mainly because I work shifts and having to book time off for INR testing is a pain on Warfarin

Coper10 profile image
Coper10

Hi DanieleI had my AVR at the end of March. It took a little while for my INR to get stable with the warfarin but now I usually need a check about 6 weekly. I haven't had any issues with bleeding so far but make sure I warn people before injections, dentist etc.

You seem aware of the limits on lifting, being cautious coughing etc so the main advice I would give is to think of recovery as being the start. It is a slow but steady process. It is easy to feel exhausted from doing very little. Take each day as it comes, each day will be different, some better than others. Don't be hard on yourself - if it feels like a bad day, take it easy, be kind to yourself and just think that the next day will be different. Your emotions may be all over the place - that too is normal!! Everyone's experience is different - do what is right for you on any particular day. I used to make s note of any tough day and it was encouraging to see that these got less as time went on.

I wish you all the very best 🤗

Markp7119 profile image
Markp7119

Good luck with opI had an elasticated chest dressing that helped with sternum recovery well worth asking for

Hope all goes well

Best wishes

Mark

andy110519 profile image
andy110519

Hi, I had AVR May'19 and am on warfarin. The valve I have only needs inr to be between 1.5 and 2 so not too bad. I had a couple of minor ops within 6 mths, not heart related, and no problems so all good.Ensure to carry on with laxatives whilst still on heavy duty pain killers.

I tied a knotted webbing strap to the end of my bed at home to help me getting up.

Re alcohol, advice is 2 units a day max and from what I could find on the net (medical journals) the alcohol messes with the bodies ability to process the warfarin so I presume it makes it less effective.

Good luck, I'm only 52 and been back running 5ks faster than before op.

Andy

Faub profile image
Faub

Hi Danny, I am 40 years old and I had AVR as a Ross-Pears procedure on 1st October, so just passed 3 months mark. Everything that the lovely hearties before me mentioned is super accurate, but I thought being close to your age I might give you some insight too. I don't have a mechanical valve so I am not on blood thinners. In my experience I noticed that in the hospital they tend to make you stand up and walk as soon as you can manage a few steps (literally the day after surgery) and doing your daily walk trying to increase a little bit day by day really helps building back your stamina. Follow the instructions they will give you. Because of covid, I wasn't referred to any cardio rehab groups, but after my post op review (about 1.5 months after surgery) I was instructed to do a brisk walk, light jog every day to start bringing the heart rate up again. Again, they will tell you what to do and when, so listen to the instructions and don't be afraid to ask questions.The sternum takes a while to heal, I still have a bit of pain here and there, but I can completely lift my arms above my head now and my flexibility and range of movement is still improving. Give yourself time, listen to your body and be patient. You'll be fine sooner than you think. Good luck mate!

Cyprus12 profile image
Cyprus12

Hi Danny,I had my mechanical AVR 3 years ago. I opted for that, as opposed to an animal valve, as I didn't want to be opened up again as I got older. I was 53 when I had mine. Warfarin is ok. Takes getting used to, but once controlled and pretty much settled with your INR, buy a machine (£200) and the NHS will prescribe free slides annually (expensive) to do your own testing and call in results. So much easier!!

My chest pillow was my comfort blanket for several months and I used it all the time. I can only say, please don't rush! I'm sporty and I really had to stop myself going back to the gym, etc too early!! I found that walks everyday helped, getting longer and more gradient as I felt stronger (chest pillow under my coat!!). Water aerobics then, as after so long not exercising, pre/post surgery, this proved to be excellent. Working all the muscles at low impact injury. As I got stronger I started breast stroke again, 1 length at a time until I got to 50 of all 3 strokes. You know your body, so listen to it and work with it. After probably 18 months I was fitter than I had ever been, as I was born with Aortic Stenosis, but had been diagnosed with Asthma (never used an inhaler since 🙄🙄).

I can do anything and am living my best life! Good luck 👍👍

Cyprus12 profile image
Cyprus12

Also Danny, I know if my blood has thinned too much because I start to get a nose bleed and because I have my own INR machine I do a test and call into the GP with my reading and for advice if I am concerned. Bruising is a pain, but common side effect, but other than that I have no other issues with warfarin. It is a "diet based" anticoagulant, so alcohol, greens (broccoli, etc), cranberries all fluctuates your INR. D & K vitamin intake essentially. I am assuming it is still Warfarin, as that was all they were allowing at Papworth?

Do some research and familiarise yourself.

Darkshades profile image
Darkshades

… I don’t think I’ve cut myself yet, but I’ve noticed that when I have blood tests I bleed more and goes through the packer/plaster … so just add extra pressure on the point to stop it ..

you may have to be careful with any dental work you may need so you need to inform your dentist of changes in medication and if placed on Rivaroxaban you are meant to always carry the card that’s in each box with you and present it

Gundoglady profile image
Gundoglady

I had my avr in 2012, and have been on warfarin ever since, I have the occasional blip, generally it goes a bit low, so it just gets upped a little bit then it settles again, my INR is set between 2-3, I've not really changed my life that much, I still work my dogs ( we go beating), I still work doing a manual job ( tiling, plumbing, electrical works, kitchen/bathroom fitting) and I've never had a problem with bleeding, yes I bleed if I cut myself, but, nothing to worry about, small amount of pressure and it stops xI still drink, just not to excess, I still eat what ever I want ( green leafy veg, broccoli, spinach etc) the key is consistency.

Hope all goes well with your op.

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