John's Guestbook

John Cook  I’m still doing good on my heart recovery.

I still have occasional dizziness when I stand up. It was much worse right after surgery. I think I’m finally getting used to my resting BP being around 105/60.

I thought I had was developing a low blood pressure once but figured out I accidentally took one of my medications twice.

You can try doing an orthostatic blood pressure test.  https://www.cdc.gov/steadi/media/pdfs/STEADI-Assessment-MeasuringBP-508.pdf

John Cook  I try to be an active guy but I don’t really lift anymore, at least not beyond increasing mobility with functional strength training and yoga.

My doctors called it the “Valsalva Maneuver” and also told me not to do it.  My recollection is that it was only for the first year, like maintaining a resting blood pressure below 120/80, but I could be wrong.

I wasn’t paying a lot of attention to those instructions.  I could barely hold a weight at the time because my PsA had gotten really bad.

I assume the reason they don’t want us to do it is because doing it increases pressure in the chest cavity including increasing blood pressure. It also changes blood flow out of the heart.

I was always taught to exhale through a lift anyway.  There is too much risk in fainting halfway through a lift if you’re holding your breath too long.

Scott Mills  Cool. I still like and plan to lift, but have been using the guidline of "if I can breath through it, you're good". If any lifting, even body weight begins to approach a grunt / breath hold, I stop. Hope the recovery continues to go well. I run my first 5k next month :)

John Cook  Thanks for your concern.  Carpel tunnel sucks.  I’ve not had it but my cubital nerves get pinched when I do things like play billiards or do pushups.

I’m pretty sure this is a surgery issue. I never had problems finger sensation until I woke up from surgery and I’ve had it 100% of the time since. It doesn’t get better or worse with how much time I spend typing.

One nerve connects those three fingers to the spine. I suspect the main nerve that connects both sides got pinched and that’s why I have it on both hands.

Every so often I notice it is slightly better. I definitely feel more now than I did back in June.  I’m just glad my arthritis is also a lot better now and I can pick things up and not worry about them sliding out of my hand if I’m not paying attention.

Richard Munson  Arthritis can cause that for sure. I have it everywhere being 83 but i try not to let it keep me down. Hence my 4 mile walk today with shadow. That nerve by the way is enclosed in a sheath that can become inflamed and puts pressure on it. Its called de quervains  syndrome. Spelling not right. To see if you have it you make a fist but with thumb inside fingers not outside and you bend your wrist forward. If your wrist hurts on the top  it could be that. Thats all my doctoring today. 

J Alexander Lassally  YESSSSSSS! I caught this thread John... I managed my sternotomy fine at Cleveland Clinic and then had a skin cancer done in Seattle 6 months after where the Dr was careless and positioned me poorly for an hour and have had all sorts of shoulder/arm/hand/finger nerve issues since - with no real resolution after. Never had a complete diagnosis either despite a few specialists
I think all of us are fragile after long sternotomy and the nerve and or skeletal issues are collateral damage ! 

I do find PT has helped so that is my suggestion...  Hang in there!  It sucks to have all of these collateral issues ... 

Melinda Donahue  John, I had cubital tunnel surgery and carpal tunnel surgery in both hands and elbows prior to ohs and in comparison it’s a walk in the park!!  I waited too long and suffered nerve damage and lose of muscle in both hands and arms near wrist. Don’t wait - get it done. The recovery is a life of cake in comparison to what you went thru. If you have to get an emg get it done by a neurologist not a tech. 

John Cook  Melinda, I gave up billiards and pushups years ago.  Nothing else seems to aggravate it.

Richard, my fist doesn’t hurt doing that, but I haven’t been able to do much of a fist for about a year.  Along with my PsA, I found out I also have ankylosing spondylitis in my fingers. For some reason, I have to be special and not get it in my back like everyone else.

I always feared I’d have my grandfather’s hands and now I do.  Sooner or later, I’ll have to have surgery on my right ring finger.  The cortisone shot loosened the knuckle only a tiny, tiny bit.

John Cook  Alexander, I’m sorry you went through all that.  They told me it may or may not completely go away.

John Cook  I’m probably not going to be much help.

I had two nights where my watch recorded a 60bpm jump in my heart rate.  I don’t know if it was real or if it was a bad reading.  I don’t want to wear a 24-hr monitor unless I’m sure it’s real.

I had arthritic edema going into surgery & bad cardiac edema coming out.  They put me on heavy doses of diuretics & electrolytes in the hospital.  If my electrolytes dropped too much, I’d have V-Tac.

Once my edema got under control and my body healed some, the V-Tac wasn’t a problem if I kept taking magnesium & potassium supplements.  I didn’t get off the diuretic & supplements until 4 weeks ago.

i was also on carvedilol pre-surgery (6.25mg) and on a maximum dose coming out (50mg).  I’m down to 12.5mg.

I need a lot of drugs to stay under 120 for my systolic. I’m also on 10mg amlodipine & 25mg losartan. I’ll probably stick with this combo unless it gives me bloodwork problems or starts interfering with my running.

Fidel Martínez Ruiz  Hey Scott and John, good morning from here. Regarding drugs I´m taking from surgery, 2 years ago, Losartan, bisoprolol, aldactone, Jardiance and Lixiana. I don´t know the equivalent in USA. Regarding pulse, I was worry in the beginning, because my watch read 120 when I start hiking and after got down to 65-70-80 bpm. I´ve come to think that these ups and downs don´t matter much. Clocks are not usually very precise.

Susan Lynn  Treadmill, stationary bike, arm bike, and free weights.  The resistance, speed, and reps were increased as our hearts became used to the exertion.  My rehab facility also had rowing machines and a universal machine we were able to use toward the end of the 12 week program.  It was well worth the time to attend. 

John Cook  At first they had me do 5 minutes of warmup on a treadmill and then 15 minutes of RPE (rate of perceived exertion)  2/3 walking on the treadmill.  Then I would switch to either a stationary bike or recumbent elliptical and do 15 minutes of RPE 2/3 (out of 5) and then a 5 minute cooldown.  They would take my blood pressure before, during, and about 5 minutes after exercise.

Now I’m starting with either the treadmill or the bike and then doing functional strength training with 5lb ir 6lb dumbbells depending on how I’m feeling.  I do: biceps curls, triceps extensions, squats, side lunges, standing wall push-ups, upright (military) press, front row, side laterals, and do a standing bench press using a light band.

i switched to the functional strength because I can do more cardio on my own at home and I also want to be able to golf 9-holes in mid-September.

I’m doing well enough on the treadmill now that I’m starting up walk/jog intervals this week (I was a runner pre-surgery).

My rehab sessions are  2 or 3 days a week.  On the weekends, I try to get on my treadmill at home or do some walk/jog trail running intervals.

John Cook  That’s for that info, Dan, and it’s reassuring.  I’ve only done one Bruce, not quite a year ago.  I made it just over a minute into Stage 4.  I’m not a fast runner, but I do enjoy it.  I also mix a lot of treadmill hikes in between my runs to help build my aerobic capacity while giving my joints a break.

My plan is to start off with flat treadmill walks and slowly build up the incline.  I’m not planning to do any running until I’m cleared for it.  I’m sure I’m going to lose some aerobic capacity that I’ll have to recover.

Thanks.

Dan Fouratt  Sounds like a good plan.  Every exercise I took my BP before and after, this is what they did in rehab. I also charted my BPM average during the exercise and max.  Good luck, Dan