Guest Blog: Gary Poltorak, Three Weeks After Heart Valve Surgery
All,
As with any surgical procedure, heart valve surgery carries with it risks of post-operative complications. I just received an interesting email from Gary Poltorak, from New York. Gary’s story is filled with unique patient perspective, a unique will to help future patients and a unique will to recover.
Dear Adam,
I finally had my aortic valve replacement, aortic root replacement and cardiac bypass all at once. The surgery was on January 29th, but I just got home this past Saturday, February 16th.
Yes. I was in the hospital for three weeks. That said, I thought you and your readers might want to hear about my experience, considering that most patients are in the hospital for five days, according to the research in your book.
After my aortic root and valve replacement, I developed a strange block and, as a result, the atrium was not properly communicating with the ventricles. Soooo, I needed to get a pacemaker.
However, the doctors couldn’t do that for 10 days following surgery because I was running a low fever. The electrophysiologist and surgeons did not want to take any unnecessary chances. Lo and behold, they never did find out where the fever was coming from, although the medical consensus was leaning towards a small hematoma that would eventually be reabsorbed into my body.
The valve I received was the Edwards, “Theon” valve - in which the leaflets are treated with Thermafix, the latest and greatest treatment to extend the life of the leaflets.
Adam, your book helped a great deal in my preparation for the operation. Still, even with your research and my research, the procedure was overwhelming.
I know former patients say that it feels like you have been hit by a bus after open heart surgery. In my opinion… that analogy just doesn’t cut it.
The first time I got out of bed was tough. When I stood up it felt like the ‘metaphorical bus’ was still sitting right on top of me. Then, a day later, I was encouraged to walk. Well, that was just indescribable. But, as the days went by, I did get stronger and more mobile.
I came home form the hospital last Saturday. Today, I walked about 40 minutes - about a mile and a half. I also drove myself to the gym. It was a short way, and no hand over hand maneuvers were called for.
I am on the mend and hope to get back to normal as soon as possible. I don’t surf like you, but I do play tennis and mountain bike. Needless to say, I’m on my way to a full recovery.
Adam, I think once piece of information that you may want to emphasize to future patients is as follows:
Lots of patients and caregivers ask for advice on the best surgeons and the best hospitals during the pre-op phase. However, I feel a missing piece of the puzzle is that folks should also try to find those hospitals where post-acute care is good.
I was at New York Presbyterian Hospital (Columbia University Medical Center). Dr. Craig Smith did my surgery. The surgery was successful, the ICU care was great, and the initial step-down care was good.
BUT THEN… After the acute care was gone… Well, the service and care was all over the board. Some nurses / aids were amazing, and others were soooooooo apathetic, with no compassion or work ethic. Simply put, that really put a damper on the experience.
That said, you may want to encourage future caregivers and patients to really ask questions about the post-operative experience within the hospital. It might help to get a sense of what the post-acute care is like, etc.
Anyways, I’m now in the recovery phase. Thanks for all your help.
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February 22nd, 2008 at 12:41 pm
Gary writes: BUT THEN… After the acute care was gone… Well, the service and care was all over the board. Some nurses / aids were amazing, and others were soooooooo apathetic, with no compassion or work ethic. Simply put, that really put a damper on the experience. >>
Yes! Yes yes yes. I was moved from ICU the very next day after my surgery and indeed you feel as if you have been blindsided by a bus, although again I suspect my robotic experience was a little less traumatic than full sternotomy. But you are put into a 2-person room (at least with my insurance) and the nurses are VERY inconsistent. Some are okay, some are LOUSY, many are NOT educated in heart issues and in fact I knew more than they did, and I was constantly keeping my eye on what was going on. To top it off, on my second day after surgery I went into atrial fibrillation and had to tell my nurse and she thought I was just having a hot flash! I insisted and they then put my bed up, put the leads on and lo and behold realized I had converted into afib. At that point a private room came available (UCLA does not have enough private rooms) for $300 more a night (I put it on thecredit card!) and I was moved. It was easier to rest and deal with the afib, which converted the next day. Even in the private room, the nurses were inconsistent. One of them, a very nice young woman, had too many fluids going into my left arm. It was swollen to above the elbow! I told her not to do it, but it took the charge nurse coming in on her rounds to say “Hey! Take that off! Too many fluids!” My arm was purple and took two weeks for the pain to go away in it. It was swollen like a sausage. The girl was simply inexperienced. This is why the patient needs to be vigilant and educated, and why the patient needs an advocate and a loved one at the hospital. I will say that UCLA does offer advocates and they do come around to your room and will do whatever you need done.
My advice, take NO medication until you know what it is and they have read the number on the order and the number on your wristband. Question everything someone does when she or he comes into your room. If you arer unwell or sleeping, your family member should do this for you. Good luck Gary! Sounds as if you are doing great!
Best, Leslie
now one month out, driving, walking, no pain killers, thrilled with my robotic surgery, 3 1″ incisions, that’s it.
February 22nd, 2008 at 8:38 pm
Hi Gary, glad you are home and on your way to recovery. I had my Mitral Valve replaced on Jan 8th and was released from the hospital on the 16th.
I agree with you on some points that you made; One on the pain those first few days, it was rough for me also, even though 3 of my husband friends had open heart surgery and 2 were very active and with little pain within 2 weeks ( they are truck drivers ), the other was in a lot of pain.
It’s been 6 weeks for me and I’m ready to go back to work, yes I very tender and I can experience some pain but nothing I can’t deal with.
Dr. orders not yet.
Like you and Adam I did a lot of research on Surgeons and Hospital.
The best ones were out of State, It was hard to decide when time is “tickin”, so I put my trust on my MD., he recommended the group of Surgeons and the Hospital, and yes one of the main concerned was the care after Surgery. I met with the Surgeon, I visited the hospital even the ICU. I had my Surgery in University Hospital in Tampa, Fl by DR. Belisle with Cardiac Surgery ASS. of Tampa, Great, Great Surgeon the after care, I can’t say enough of the Nurses ( except for one ).
If anybody in Tampa is having Valve Surgery, I can help with the research and they can E Mail me and I will provide you with the research I have. Like you, I would have never could have done it without Adams.
Wish you the best and I’m looking forward to my ” First Birth Day ”
Keep On tickin
February 24th, 2008 at 4:12 pm
Hi Adam,
Your book has been invaluable as I am preparing for 2 valve replacements soon. I am planning to use Dr. Starnes at USC even though I live in Northern CA. I’m hoping you can answer a couple of questions for me. How long did it take you to get an appointment with Dr. Starnes & then how long was it until your scheduled surgery after your initial appointment?
I am also interested in hearing from any of your guests who might be around my age (67) who have had surgery regarding their recovery time. From reading your book & your blogs, it seems that the range is anywhere from 6 weeks to 3 to 4 months; but I was hoping for more specifics, even though I realize everyone is different. I am hoping to get this done & be able to fly to Texas for a reunion by the second week in June if possible.
Gary, I’m glad you are home & working on your recovery now. Your input will be good to have as I visit the hospital in Pasadena, CA. where I will have my surgery. You had a rough time, but you have it made now & seems that you will soon be back to your energetic hobbies. Good for you.
Thanks for all the input & help I’ve received from your book & blog, Adam.
Pat Renko
February 24th, 2008 at 6:06 pm
Gary has touched on a good point about the post operative care. I had my surgery at Yale New Haven Hospital. The ICU and Step Down care was excellent but there were some faults that were bothersome and caused some concern. In ICU initial communication is tough. The patient is not very alert. One caregiver was giving me instructions and obviously English was her second language. It was a tough situation since I did not understand what was being said to me. During the second shift there was unnecessary noise in both ICU and the Step Down. It sounded as though there was a party going on. I complained in Step Down and my nurse denied anything was out of order.
I was out of the hospital in 3.5 five days, I had great help 99% of the time. The surgery was Nov. 27th and I will play tennis on Mon. Feb 25 from 7:00am to 9:00am. I look forward to playing twice per week indoors thru April.
Jim
February 26th, 2008 at 7:11 pm
Hello, everyone, it is wonderful to share stories, what a gift Adam has given to all of us waiting and worrying, something to learn, something to quetion, something to be thankful for always. I am glad Gary is doing well.
I am a registered nurse, and worked in a small hospital ICU for over 8 years. (No open heart surgery in our hospital but we had plenty of people who just arrived through the ER and had to have touchy surgeries of other kinds). Because I am a nurse, and still work in that environment, I support Adam’s suggestion and Jim Hayden’s: have a family member with you 24-7, your support group members can rotate. Question everything, and if you don’t feel comfortable with the answer, call for the charge nurse, it is not an insult if you do it with kind words, and in the right manner, IT IS YOUR RIGHT! If your caregiver (family/friend) is not allowed to stay in the room, the hospital should have a nearby waiting room for families. Let everyone who takes care of you that your family member is there. Best is to be in room. I have been a nurse for 27 years, and seen my share of wonderful (knowledgeable as well as compassinate, sometimes both) nurses, but I have also seen my share of not good ones (knowledge and/or caring attitude). Some terrible ones too.
Love to hear people are recovering in spite of hard times, Bless you all.
February 29th, 2008 at 4:54 pm
I recently had my pulmanary valve replaced at UCSF the care I got there after the surgery was very good. I am only 28 years old and very frustrated that I cant do things yet only after 6 weeks. I am a very physical person and play every sport there is available. I am having some pvc’s but only when my heart rate gets to high. Reading your blogs really helped me because I became really depressed and yes I thought a few times that something was wrong after surgery. Finding that every day I’m starting to feel better and better but tired of being stuck around the house. The doc told me not to drive for 2 months in case of an accident so my kids are driving me up the wall, they are also a good motivation for me to get better because summer is coming up.