Jerry's Heart Valve Journal

Met surgeon for post op today

July 9, 2012

Got the all clear from him and I can drive again and gradually build up the amount of weight I can handle.

I told him that I like to swim lengths in our pool and he OK'd it, but build up very gradually.

I found out from his secretary that he enjoys red wine and chocolate so we bought him a very good bottle of chateauneuf de pape which he really appreciated. I again thanked him for giving me many additional years of quality life.

I start cardio rehab next week.

Today made me think again how fortunate we are to live in an era where this life saving surgery is becoming routine.

All us HVJ'rs are truly blessed.

5 weeks post AVR and double bypass surgery

July 5, 2012

I have just had a rather uneventful and successful week.

My sleeping continues to be good with one tylenol ES at bed time to allow me to roll around a bit in bed without waking up. I can now sleep on both sides, but woke up with some pain when I tried to sleep on my stomach while in a deep sleep.

My energy levels continue to increase, but I have scaled down the walking a bit because we are experiencing extreme heat and humidity.

Coumadin levels have been very easy for me to maintain and I am a remarkably consistent 2.5. Testing intervals are once a week now and will be increased shortly.

My chest incision looks really good and the final drainage tube scab fell off this morning. The incision is a little more uncomfortable during the day now as it feels if it is tightening or something. There is a bit of a lump at the top which is somewhat tender. I put padding over it when I put my seatbelt on in the car.

I see my surgeon on Monday and start cardio rehab the following week. Hopefully he will let me drive so I can take some of the load of my wife Jackie.

In short, I am absolutely delighted with my progress to date. Looking back, only the week in the hospital and the first three or four days at home were a bit challenging, and after that it has been almost a continous upward curve.

My heart seems so much stronger now. It was pumping through a valve that was 0.8 cm2 in area and now has about four times the effective area. When I was in the hospital you could see my neck artery bulge with each beat because the heart hadn't adjusted to the reduced workload yet. This doesn't happen any more.

To all the people awaiting surgery I would say it is not nearly as difficult as you imagine. The level of care in the hospital is superb and pain management is excellent. My leg incision was more painful than the chest incision! The next thing you know you will be at home with your loved ones and getting stronger every day.

We are so blessed to live in an era where this surgery can be done on a routine basis. I am very grateful for the extension of quality life it has given me and can't wait to fully enjoy it soon.

4 weeks post AVR and double bypass surgery -

June 28, 2012

Things are going very well with me with one exception.

About a week ago I lifted the pool ladder out of the pool which is much higher than my 5 lb limit. Everything felt fine at the time but I started to feel chest pain and left arm and shoulder pain shortly before bed time. The pain was related to breathing.

We decided to not take any chances and went to the emergency room. They did an EKG, a blood test for a heart attack and chest x rays.

The net result was that everything was normal and they thought that my lifting may have moved something in the chest cavity. We'll take this as a lesson learned and I won't be doing that again.

In general I am sleeping well most nights in our bed. I can now sleep on my right side but the left side is still uncomfortable. I take one tylenol ES at bed time to make it easier to sleep.

Looking back now my recovery has been easier than I anticipated. I still have a long way to go, but almost every day is better than the previous one.

Three Weeks After Surgery - 2nd Week at Home

June 20, 2012

The last week has been very good for me. I am sleeping in our bed again and able to sleep on my side again. Last night I managed an eight hour uninterupted sleep! I continue to try to eliminate the afternoon naps.

I have reduced the pain meds to one Tylenol ES at bed time. I find that this allows me to roll over in bed without much pain. My chest pain during the day ranges between 0 and 2 and is completely tolerable.

My appetite continues to improve but I slowly lose weight which doesn't bother me. I am now twelve pounds under my pre-op weight.

My chest incision scabs are 95% gone, and the leg scab is 80% gone.

Coumadin level control has been very easy so far, but I am still having twice weekly blood tests to fine tune it. The blood tests will scale back considerably in a couple of weeks.

We are still walking actively, but have scaled it back a little as we are in the middle of a heat wave with temps near 90 degrees.

I am still anemic with a RBC of 94 versus 150 at the preop. My stamina is still reduced but I can feel it improving. My BP is on the low side at about 115/60, but my GP will be reviewing the meds shortly. Resting pulse rate is about 70.

In short my recovery has gone much better than I expected.

Two Weeks After Surgery - First Week at Home

June 14, 2012

It's been four days since my last post and we have accomplished a few things.

The most important issue was pain meds. The hospital had me on two percocets every six hours and it was very effective at pain control. My major side effects were dry mouth and some halucinations. You could forget about reading also. The nurses wanted me to not have to worry about pain so I could focus on breathing deeply and walking and it was effective. Coughs still felt like an ice pick in the chest, but the pain subsided quickly.

They suggested that I stay on the same pain controls for the first couple of days at home and then start to wean off the percocets.

So first I went to two percs at bed time, and the one perc plus two tylenol extra strength every six hours. This went smoothly and then I went to one perc plus two tylenol at bed also - again no problem. Next step was to go to one perc per day at bed time and then tylenol for the rest of the day. All of this change occurred over about three days.

Finally I quit the percs totally and went to tylenol ES exclusively and this is when I felt the changes. The pain was a bit higher overnight but manageable, but I started to feel sore muscles, experienced diarhia (sp) and my mood was very depressed for a day.

A day later I felt much happier and now things are moving forward again.

My goals for this week are to reduce the tylenol much further, increase my walk lengths and try and get my sleep patterns under control. Currently, I get a bit too tired and wind up taking an nap in the afternoon, but then wake up for good at 4am.

As an aside, coumadin levels were easy to stabilize for me, the water is 95% gone from my legs, and my appetite is starting to come back. I had gained about 30 pounds of fluid at the peak, and now am about 5 pounds below my pre-op weight.

Ten days after surgery

June 10, 2012

Well, here I am on the other side and I can say that things turned out a liitle different than I anticipated.

The waiting before the operation didn't bother me at all. I was a little concerrned about gettting enough sleep the few nights befores surgery, but I asked for and received lorarazapam for a sleep aid, but only used two. I somehow just kept my mind occupied. The only time I had any issues was when I was in the shower or driving the car by myself.

The first three days after surgery are a blur and I remember having difficulty focusing and recognizing faces. Things kept seeming to move to me. My comfort zone was the touch and voices of my loved ones, I found it scary to get out of bed the first few times as you feel very fragile. I had some pretty weird dreams and halucinations.

After about three days I became very impatient and wanted to be home. Sleeping was difficult for me mostly because of HVAC issues and interuptions at night. All of that terriific care they provide you does interupt your sleep.

I can't say enough good things about the professionalism and compassion of my doctors and nurses. THEY WERE SIMPLY AMAZING! I had a bit of a set back the first day and the surgeeon really spent the time to make my wife and family feel his confidence. He visited me every day and connected with me emotionally even though he must have been working 12 hour days. I always felt compassion from all the staff.

My mental capacity feels 100% to me, but I am far more emotional than normal.

Biggest surprises to date:

funny squeaking sounds from lungs in first week

how strong my heart feels

how easily the pain is managed

that my leg incision hurts more than the chest incision

how many blood samples they take

how routine this surgery has become

how much stronger the sense of taste is after surgery - not necessarily a good thing

Jerry

AVR, double bypass May 31, 2012

Wow - what a difference a day makes

June 8, 2012

Yesterday morning I was in the hospital and was nearing my witt's end. The system was working very well for me with one big exception - I was just not able to get enough quality sleep and it was wearing me down. In my mind (probably distorted) I was losing whatever I was gaining through meds, activity and excellent care to sleep deprevation. I made up my mind that I would be discharged, or I would just grab a cab in my PJ's.

I still had a lot of water in my legs that needed to be eliminated. Other than that I had passed every required milestone.

So the doctor said we want to hold you another day for the water and I looked her in the eye and said I can pee at home and I only live 15 minutes away. After about a 30 second eye contact I won her over!

It still took a while to get settled at home and Ispent the afternoon parading to the washroom and knapping wile loosing ten pounds.

I slept very well last night in about four hour intervals interspersed with freash pain meds.

I think I have this thing beat, but have to be careful not to overdo it.

back home

June 7, 2012

Sorry I didn't write from the hospital, but they didn't have wifi.

Using my android phone seemed next to impossible because of fat clumbsy fingers and a slow brain.

The nursing care and doctors were fantastic. I will provide details soon, but I am still exhausted because of problems sleeping.

I've got to be the luckiest person on earth to have the family that I have. They were there for me all the time and made it much easier to cope. I choke up just thinking about it - especially my wife Jackie.

More later after some rest.

Discharge day!

June 7, 2012

As I write this my Dad is being discharged from hospital to continue his recovery at home.

The last few nights have been rough on him as he isn't able to sleep much with the overly heated room and noctournal blood draws etc.

He is very anxious to get home and hopefully soon he will be able to update this journal with his perspective of this experience.

Welcome home Dad! See you soon!

Steady Progress

June 5, 2012

Since I saw my father on June 3, many good things have happened.

He has had his catheter and chest tube removed.

He is now able to walk without a walker! For 3 consecutive laps around the entire 3rd floor.

He has had no further episodes of atrial fibrillation.

He is no longer on IV Heparin, and has started on oral Coumadin.

He has gained a significant amount of weight due to all the fluids retained. He had a miserable night yet again, but this was exacerbated by the diuretic he was given with dinner. He was up all night, having to urinate every 30 minutes.

He looked great today. Was able to sit in his chair and enjoy our company for a nice visit. I expect my Mom will be bringing in more food for him because as his strength increases, so does his distaste for the hospital food.

They have started planning for a tentative discharge date of Friday!

Just a few more things.

June 3, 2012

Dad had a good dinner. Sat up in his chair and did his breathing exercises. His RN helped him get set up and we all went for another stroll around the unit.

The RN Charlene informed is that the atrial fibrillation has returned and just as a precaution they have hooked up a pacemaker, but it will not be turned on unless they need it again. It seems to come and go, but is expected to resolve and not cause any problems with his recovery.

Dad is tired from all the activity, we will be leaving him shortly so he can hopefully have a better sleep than last night.

Post op day 2.5

June 3, 2012

The updates will probably be only once per day from this point forward.

Jerry has settled into hopefully a steady and stable road to recovery.

He told me today that he had a horrible nights sleep last night, but even so he looked even better today than he did yesterday.

He did some more walking, with the help of his RN Charlene. Managing to walk to complete length of the unit before returning to lie down.

His surgeon, Dr. Leclerc stopped by his bedside and was pleased with his progress. He informed my Dad that the atrial fibrillation that Dad had been experiencing since just before he left the CVICU had resolved, as expected. His heart rate is still a bit high, but being treated with beta-blockers and is expected to resolve itself over the next few days as his heart continues to heal.

Drainage from the chest tube is very minimal at this point and the tube will most likely be removed tomorrow.

Dad was able to have a short visit with his Grandkids, and they were very happy to finally see their beloved Papa Jerry looking well sitting up in his bed.

His sister Marlene and his BIL Bob also stopped by for a short visit and were amazed at how quickly Jerry has recovered. The last time they saw him, he was still intubated and sedated in the CVICU. It is amazing what a difference just over two days can make!

Perhaps the next update shall come directly from Jerry himself. I will see if he is feeling up for it tomorrow!

Settled in the Cardiac Surgery unit.

June 2, 2012

Just came back from seeing Dad in his new room. He reports that he had a great nap since we last saw him and he is feeling "pretty good".

He looks good, all things considered. Wonderful to see him with some of the lines and tubes removed. Plan is to keep his chest tube in for another day at least. It is still draining some fluids which is totally normal and nothing to worry about at 40 hours post-op.

Leaving the CVICU today.

June 2, 2012

As usual I woke up early this morning so I could phone the RN who cared for Dad overnight.

This morning John (an Aussie sounding RN) was happy to tell me that Dad had a good sleep for most of the night, had woken around 0400, and had been more awake since then. He is experiencing some atrial fibrillation, but John was quick to reassure me that this is common after undergoing AVR and CABG.

When I arrived at the CVICU around 0815 I had to wait to see him, the unit is at or over capacity and very busy this morning.

When I was finally able to get to his bedside a short time later, I found him sitting up and just finishing up his breakfast. Which included his first real/solid food since Wednesday evening. He looks great, we had a wonderful conversation and it was great to hear from him, how this experience has been from his perspective.

Dad also told me that he has been up and walking short distances with his RN at his side!

Biggest news though is that they are getting him ready to move to the regular unit. As I write this his RN Joanne, is removing his ART line and giving him a bit of a freshening up before he leaves the CVICU. Estimated time of move to the new unit is 1100.

Amazed

June 1, 2012

I am truly amazed at the strength my father displayed today.

By late afternoon I arrived at his bedside to see him sitting in a chair, about to start eating his liquid dinner, able to speak and feed himself. I have no words, I am just so very thankful to see him start recovering from this challenge...

Good progress continues...

June 1, 2012

We have spent lots of time at Dad's bedside today. He is starting to speak, and respond to simple commands.

He is still waking up, but he was able to voice out that he loves us and when the nurse asked him how he was feeling he said "miserable".

He is taking some ice chips and chewing them. Coughing and clearing his airway. All good things to see on this first day with his newly healthy and repaired heart.

Extubated!

June 1, 2012

Best update yet!

I checked in at Dad's bedside with his RN Joanne. He is breathing on his own! Somewhat conscious! Opening his eyes and turning his head towards the sound of my voice!

He is still very groggy, not able to speak yet, but he squeezed my hand and was moving his legs and trying to focus on the nurse and I as we spoke about his condition.

He will probably spend most of the day and night tonight in the CVICU, but he is getting stronger by the moment!

Time to wake up...

June 1, 2012

Or at least start waking up. Arrived today at Dad's bedside, to see him sitting up a bit.

He looks good, and the RN quickly informed me that they have turned off the medication keeping him asleep (diprivan/propofol, aka Michael Jackson's sleep aid). We were asked to not speak to him, as they would like his return to consciousness be gradual and gentle.

I hope the next update to follow shortly will include Dad waking up and breathing on his own.

Can't wait to talk to him!

A new day

June 1, 2012

This is still Jerry's daughter Macie updating this blog until my Dad is able to do so....

I set my alarm early today, as I wanted to speak with the RN (Barbara) who spent the night caring for my Dad. She told me that he had a good night, no problems, no bleeding and no surprises. Plan for today is for Dr. L (and the rest of the care team) to see him this morning and to start working towards getting Dad off the ventilator.

All good news, we look forward to seeing Dad this morning when we return to the hospital. Hopefully today, the first day of recovery with his healthy heart, will see my Dad awake and breathing on his own!

I will keep updating his recovery progress throughout the day.

Resolved

May 31, 2012

The RN (Barbara) updated us and brought the whole family to his beside. BP has stabilized, hopefully he is resting and healing. Plan is to start to wean Dad off the vent in the early morning if all goes well overnight.

Hopefully last update from me until I speak with dad's nurse when I call her between 0500-0600.

Blood Pressure issues

May 31, 2012

We were just able to visit his bedside. We got the rundown from his RN for the night, who is Barbara.

Bleeding is controlled, but they are concerned because his blood pressure is labile (going up and down constantly). Two RNs and the anesthesiologist were at his bedside, watching him closely and all the while explaining to us why this is happening and what the plan is to take care of it. In a nutshell, due to the amount of trauma and manipulation his heart has endured today, his body is adjusting and in the meantime having a hard time regulating his BP.

It seemed to be stabilizing even in the short time we were at his bedside, and we will hopefully have a good update to share in the next few hours....

Good news!

May 31, 2012

Deep breath, huge sigh. Dr. L just came and updated us, Dad is getting settled back in the CVICU, some "little bleeders" were dealt with, and the bleeding seems to be stopped.

We can hopefully see him again in about 20 minutes. Back on track with hopefully a smooth recovery, possible extubation in a few hours if everything goes well.

I will keep the updates coming as things progress tonight ....

Bump in the road

May 31, 2012

Just when we started to relax, things are getting A bit more complicated.

My Dad is bleeding still, it seems his blood is coagulating normally now, bit he is still losing blood from his chest tubes. A significant enough amount that Dr. L has told us that he taking him back to the OR to assess and try to stop the blood loss.

In another 2 or 3 hours we shall know more as we will speak with Dr. L when he comes back from fixing my Dad.

Please send all your good thoughts and healing vibes to him, as he could certainly use them at this time.

Out of surgery!

May 31, 2012

We just got the update from the amazing Dr. L. Jerry is out of surgery, which went well with no surprises.

He is in the ICU, getting settled. We should be able to see him in about a half hour, but he will be unconscious for another 2 or 3 hours.

We are tremendously relieved that this first hurdle has been cleared. Looking forward to helping Dad continue his recovery from this point forward.

Thank you to everyone reading this blog, your support has given my dad much comfort and support during this challenging time.

In surgery!

May 31, 2012

Hi everybody, this is Jerry's daughter Macie writing these updates for the next day or so.

My Dad was taken to the OR just after 8am, he looked pretty relaxed and was joking with the nurse even as they wheeled him down the hallway to the operating room.

We will be expecting the next update when the surgery is finished, probably sometime between noon and 2pm.

Until then please send him all your good thoughts and healthy healing vibes....

Ready for Tomorrow

May 30, 2012

Had a great day today. Got some things done around the house, got lots of phone calls from friends and family and wonderful support messages through HVJ.

I want to thank everybody for their support as it helps me greatly in dealing with this surgery.

I'm going to have my shower and germicidal bath and get a good nights sleep.

We'll talk from the other side when I am able.

Thanks again,

Jerry

Ready for 5:45am Tomorrow

May 30, 2012

I slept surprisingly well last night and have stayed busy today organizing the garage, setting the pool up for a week on autopilot, and some pruning that I won't be able to do for quite a whille after surgery.

All in all things are going well and time is moving quickly.

My in laws are coming in this afternoon and my son and daughter-in-law later tonight. I expect that we will probably go see the grandkids play t-ball tonight as that is always entertaining.

I need to load some audio books onto my phone as I don't know how well I will be able to read because of the meds. I got some noise cancelling headphones to block out some of the extraneous sounds.

They tell me that there is no wifi available at the hospital, so I will have my daughter Macie post a few updates. I feel bad, because my kids bought me a new tablet computer and I may not be able to use it until I get home.

So basically, all my ducks are lined up, and I will be in the hands of the surgical team tomorrow.

Thanks again for all the kind expressions of support and knowledge that HVJ'ers and friends have provided me. It has made it much easier to cope with everything associated with this surgery. I feel very comfortable, that I have made the right decisions, have a great surgeon and Hospital and have done absolutely everything that I could do to prepare for this.

It's time to climb this mountain!

We'll talk from the other side.

Regards,

Jerry

Countdown to Thursday

May 26, 2012

I have been pretty successful so far in keeping my mind busy and not thinking about the upcoming surgery on the 31st.

I was originally scheduled for the 14th but was postponed because of a rash of emergencies that came up.

It is now time to get off the daily aspirin. My surgeon has also given me instructions to apply an antibiotic ointment in my nose three times a day for five days. He does this with all his patients.

The ointment is Mupirocin and he says it controls the bacteria that reside in the nostrils. Has anybody else heard of this treatment? I can't see any downside to it however.

Jackie and I had our two grandkids over for one last overnight sleepover last week and today visited our son and daughter-in-law for a dinner and a movie. They live about an hour away and I wanted to prepare them for what they will be seeing when I am in the hospital so they wouldn't be surprised. Thank God for HVJ which allowed me to get a good understanding of what is in front of me. It is a lot less stressful if you know what to expect and are not surprised.

I am comfortable with my upcoming surgery. I obviously would rather not have it, but feel very blessed that medical science has allowed me the opportunity to live a full and productive life which would not have been possible not too many years ago.

I'm looking forward to getting this done and then recovering and getting on with our lives.

I've been postponed until May 31st

May 10, 2012

Just got a call from the hospital and they have a backlog of emergency surgeries and that they are canceling everybody for next week.

I'm not too bad with it, but my wife is upset.

Getting all the loose ends tied up for May 14th

May 9, 2012

I am pretty well finished with my consulting chores today and am now just finalizing the maintenance issues around the house.

I will need somebody to cut the lawn for about three months and also to open the pool shortly.

So far I have been able to keep my mind occupied so that don't think much about the surgery. Time is passing quickly for me.

That will change this weekend as we have my son and his wife, and my in-laws staying over at our house on Sunday. That will make it harder to put the surgery out of my mind. It will be interesting to see how much sleep I get the night before. We have to be at the hospital at 5:45 am, but it is only 20 minutes away.

I have done all the research, asked my surgeon all the questions I wanted, and am confident and relaxed about the procedure.

I feel very fortunate that I was born in era where they have perfected the techniques that will correct my problems and prolong my life.

Time to move on!

Did the pre-op today

May 3, 2012

Things were very well organized and I was in at 7:30 and out about one.

They took blood, chest xrays, and urine and did yet another EKG. Filled a bunch of forms (mostly health and family history).

They showed us a video of how they manage blood loss and transfusions. They are proud of their record in this regard as they have the lowest percentage of blood transfusions in Ontario for open heart surgery - less than 1%. They told me that my hemoglobin was quite high and I have a very low probability of needing a transfusion and no need for supplements to build up my blood prior to surgery.

They also showed a video of the entire operative process (without closeups) and walked us through the whole process, including the home recovery process.

They reviewed my meds and told me what and when to stop.

I have been given germicidic sponges and told to wash with them the night before and the morning of the surgery.

Then I met with the anestistist (sp) and he examined me, reviewed my medical history and meds, and walked me through the whole process. I learned that they use a very strong blood thinner when they put you on the heart lung machine and then reverse the drug when they take you off in order for the new sutures to clot up. They look at the rate the bleeding stops and sometimes will hold you in the OR a little longer to make sure that it stops.

There were four patients in my group and I was the youngest at 63. One woman is having a valve replacement at 89! We had a volunteer helping our group and she had her aortic valve replaced at 77 and is 83 now.

I am having the aortic valve replaced and two bypasses at the same time and he expects me to be in the OR for about four to five hours.

So, I am all set for my May 14th arrival at the hospital at 5:45 am. The trick now is to stay busy and keep my mind occupied.

Met with the Surgeon today

April 30, 2012

I was very impressed with my meeting.

The doctor is Yves Leclerc and he has done thousands of these surgeries. He was delighted that I came with an extensive list of questions and really took his time dealing with all of them. I left the meeting completely at ease.

We discussed the choice of valves and I am choosing a St. Jude mechanical valve. We discussed using a tissue valve, but he said that replacement valves installed via a catheter are currently having relatively short lives because of them being compressed during the procedure.

It's a difficult personal decision weighing the risks of lifetime coumadin therapy vs reoperation at an advanced age. I am 63, and would need another replacement in my late 70's, which is not something I was interested in. He stated that the difficulty of controlling coumadin levels is greatly reduced if you maintain a consistant diet. I will probably buy a home testing device to monitor my blood as my wife and I like to travel.

The pre-op is scheduled for this Thursday - May 3rd. and the surgery is scheduled for Monday May 14th.

Let's get this done!

Consultation with Surgeon on April 30th

April 23, 2012

Things keep moving along.

I have my consultation with the surgeon on April 30th.

I need to finalize my list of questions I will bring to the meeting. I hope the surgeon doesn't get annoyed with me, but I am a detail type person and want to fully understand and be actively involved in all the decisions. As a patient you can't make good decisions without knowledge so I have been reading extensively and have a good understanding of the various options,

I hope to have the surgery done in May so that I can avoid hot weather in the first weeks of walking outside.

Had my angiogram yesterday

April 17, 2012

Well I had my angiogram yesterday and it confirms the echo-cardiam in that the aortic valve has got to be replaced. Area is down to about 0.8 cm2 from a normal 3.0 cm2.

They also discovered that there are a couple of blockages that need to be resolved at the same time.

I meet my surgeon within a couple of weeks and will probably have the surgery a couple of weeks after that.

I feel no symptoms at this time.

I just want to get this behind me.