Ahh yes… The good ole’ sternum cracking question. I’ve received this question a number of times from friends and family following my surgery. As you can read in my story, [1] I had aortic and pulmonary valve replacements (using the Ross Procedure).

Unfortunately, my cardiothoracic surgeon, [2] calcified during my 34 years of life prior to the surgery.

In any case, Dr. Starnes needed to perform a median sternomoy to perform the valve replacement. So you know, median sternotomy is a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or “cracked”. This procedure provides access to the heart and lungs for surgical procedures such as heart transplants, corrective surgery for congenital heart defects including heart valve replacements.

FYI, median sternotomy is often mistakenly referred to as open-heart surgery; however, open heart involves incision of the pericadium, and many median sternotomy procedures do not require this. Open heart usually involves the use of a cardiac pump, also known as a heart-lung machine. In the case of valve surgery, however, the pericardium is pierced is the procedure is “open-heart”.

That said, back to the pain… “HOW PAINFUL WAS IT?”

Well, let me just say that it wasn’t fun. Similar to the entire heart valve surgery experience, it was like a rollercoaster - a number of ups and downs. Sometimes I didn’t notice it. Other times the incision throbbed.

For example, following my aortic replacement, I was given a prescription of Vicodin as I left USC Medical Center in Los Angeles. Upon departure from the hospital, I was taking eight to twelve Vicodin per day. As you might imagine, I didn’t feel much pain on those days.

However, as the Vicodin levels were brought down and the dosage reduced, the pain started to be much more noticeable and quite uncomfortable. As you can read in my book, [3] The Patient’s Guide To Heart Valve Surgery, the pain brought about a number of issues for me which led to a little bit of a “problem”, or dependence, on Vicodin.

Ultimately, I think the heavy use of pain medication and sleeping pills triggered cardiac depression during my [4] recovery. This was a very trying time for me and my family. Had I known a little bit more about the realities of the recovery, I could have avoided these issues. Again, for a patient’s perspective on the heart valve surgery experience, I highly encourage you to read my book. I wrote it for both patients and caregivers.
THE GOOD NEWS: It’s been 14 months since my surgery… The pain has pretty much subsided. I’m working on my big physical goal right now — TO SURF AGAIN!!! That said, sternum cracking pain in the incision is simply, an uncomfortable, but temporary part of the [5] valve repair and valve replacement experience. Besides, what is the alternative to a little bit of pain - A dialated heart and eventual death? I’ll take the pain!

Keep on tickin,

Adam

[6] The Patient’s Guide To Heart Valve Surgery, a unique book which integrates the clinical facts of heart valve surgery with the personal experiences of an actual heart valve surgery patient. This special book divides the valve surgery process into four sections which address the challenges and opportunities faced by both patients and caregivers.