Meredith's Guestbook

Meredith Bray  Hi Jason! Thanks for reaching out - I remember how hard it was to ask questions.
VALVE TICKING: I find the clicking to be comforting. Most of the time I can't hear it. Even in a silent room, it can be tough to hear if my body is in a specific position. Have you ever been underwater and hear someone knocking two rocks together underwater for maybe 20 yards away? Oddly specific I know, but that's what it sounds like to me. My husband can hear it sometimes.

RECOVERY TIMELINE - Everyone is different. I was sitting up in a chair within a few hours of waking up after surgery, and went for my first walk later that day (it was only a few steps, but there I was). I was a bus driver then, I went back to work after 12 weeks and felt fine. (I rode roller coasters before I went back to work). I would say that 9 years later I'm at 99%. Something weird that I cane out of recovery with is I really can't roll over in bed without looking like a floppy fish, and I did not have that issue before.

INR- I took about 6 months to settle in to a dosage that kept me in the typical valve replacement range of 2.5-3.5. I had a lot of bruising. I've never had a bleeding issue. About 2 years after surgery I received a letter from FDA stating the On-X valve had been approved for a lower INR. I took the letter to my doctor, and we changed my range to 1.5-2.5. I go to the "coumadin clinic" nurse at my cardiologist office about every 6 weeks. I take several other maintenance medications, so adding another daily pill wasn't a big deal for me. I have absolutely NOT changed my diet or lifestyle because of the medication. I just can't eat 5 servings of kale in a week (thank goodness!)

EMOTIONAL ISSUES I'm not sure. I mean I was a complete wreck for about a month prior to surgery. I came out of the hospital with a positive outlook - we planned a vacation for 4 months post op and I was really looking forward to it. I know some people have difficulty, and the best advise I can give is to have something to look forward to. 

VALVE SELECTION My cardio wanted me to get a bio valve, and my surgeon wanted to give me the On-X valve, and both were very upfront about going along with whichever choice I made. I trusted them and did not research other options. 

 ADVISE - you'll feel better when you have a surgery date instead of waiting. The waiting is the hardest part, in my opinion. Get a travel pillow to hold your head up when you're sleeping in your recliner. Practice standing up from a chair without using your arms. Get something to sit on in the shower. You'll need a lot of rest - here's how to get good rest instead of waking up in the recliner with sore shoulders: Use your travel pillow for your neck. Get 2 bed pillows and use them to support your arms. Get another pillow and put it under your knees. I slept in the recliner a lot for about 3 weeks because I couldn't get out of bed on my own and didn't want to wake someone up every time I needed to walk or go to the bathroom.


POSTURE - practice excellent posture! It's natural to lean over and protect your chest area post-op. Stand up as straight as you can, hold your head up high. Get those core muscles back in shape. You'll have a lot of back and shoulder pain from the operating position and the drain tubes. Make sure you get up and stand up tall like a king/queen/giant dragon/whatever every time you use your breathing therapy device. It WILL help with your back pain and recovery.


I could write forever about my recovery. Feel free to read through my journal. Ask more questions!


Meredith

Oak Ridge TN (formerly Clearwater FL)

PS keep a sense of humor and lose your modesty for the hospital, lol

Greg Lewis  Great response, Meredith! My Dad taught me, " you hang your dignity by the door on your way in, and pick it up when you leave "  😁

Jason Hyrup  Thanks Meredith for responding so fast. Your reply will help me, and maybe others here. I will check your journal ASAP. 
Again thanks

Meredith Bray  Hi Lauren,
The ventilator tube was removed before I woke up - I have no recollection of it at all (very thankful - hope it works that way for you as well!) When I woke up I only had the oxygen in my nose. The guy put the cpap on me after dinner-time (I don't think I ate anything). I think there was oxygen on the cpap for the first 3 nights? The reason the guy put my mask on for me was because I couldn't lift my arms up over my shoulders. Surgery was on Wednesday morning, and I put it on myself for my Friday afternoon nap.
The waiting is the worst part of all because you don't know what to expect. Recovery was far less scarier than I imagined it would be. FAR less.

You're in great hands at CC, and you have youth on your side :)

Meredith
Clearwater, Florida

Meredith Bray  Absolutely! If you feel you'd like a second opinion, by all means go for it! It looks like Heric is in the same office as Rovin & Ofenloch. I know it sounds weird, but the worst part for me was the waiting. Once I had my surgery date I calmed down a lot. The day before my surgery, I almost drove myself to the hospital to see if they could get an earlier start. Everything will be so much easier once you have the date, and then once the actual surgery is over and you can focus on recovery.

Meredith Bray  Thanks for posting, Lori! I am incredibly thankful for having my surgery done at Morton Plant! The staff there is amazing, and the food is decent too, ha! Just an FYI - 5 of my coworkers (that I am aware of) have also had valve work done at Morton Plant by Rovin and/or Ofenloch.

Also, whichever valve you choose will be the perfect one for you. My cardiologist suggest one type and my surgeon suggested the other, I did my research and choose what I thought suited me best, and discussed it with both doctors - who then discussed it with each other - and that's what I got. There is no right or wrong choice.

I hope you enjoy your waking up as much as I did!

Meredith
Clearwater, FL

Meredith Bray  I would find a new dentist, actually! I, like Anna, am prescribed 2000 mg amoxicillin to take 1 hour before my appointment. Your dentist & hygienist really should know this. Please don't have any dental work done without a pre-med. Perhaps your cardiologist or their nurse can recommend a dentist that has had cardiac patients before.

Susan Lynn  You definitely need to find a new dentist. Pre-medication for those with heart conditions has been common protocol for decades in the profession.

Josie Saunders  Been trying to get information from my surgeon, but keep waiting for someone to ring me back, a lot of the dentist keep saying they don't do pre med no more
But thank you ladies I will take your advise so you don't have to carry on with the antibiotics after treatment.

Susan Lynn  I began my career working for a group of dentists and oral surgeons several decades ago. Over the years, the American Heart Association, has changed their recommendations about pre-medication to eventually eliminating them - at least for people like me who had mitral valve prolapse. However, since I rarely take antibiotics and my dentist still believed in the value of pre-medication, I continued to do it before each appointment. Now, my cardiologist has informed me, since my surgery, that pre-medication is required and it didn't sound terribly negotiable.
I suspect with all the research about antibiotic-resistant strains of viruses, many people and dentists are opting to forego this process. I am fortunate that my use of antibiotics has been limited to my few dental appointments a year and I felt there was more upside than risk.

Susan Lynn  http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp#.WvxbPqQvzIU

Josie Saunders  Thanks for that Susan when you read about endocarditis it scares the life out of you, and my brain will look for all the symptoms after, so I'll pre med 1 hour before do I have to take any more after dental treatment .

Meredith Bray  Hi Chris, I don't remember a whole lot about the time I spent in the hospital. I do remember waking up with the vent tube still in, realizing I made it through surgery, and going back to sleep. Best 2 seconds of my entire life! :)

My biggest issue the first few days was breathing deeply. I did NOT want to take a deep breath because I didn't want to hurt myself. At the same time, I was afraid to fall asleep because I was breathing so shallow. I have a cPap machine, and that helped, especially when the nurse hooked up the oxygen for me.

My biggest issue the first week was back pain, and getting in/out of bed. The back pain was alleviated by supporting my body weight while resting - stuffed pillows under my arms, and used a travel pillow under my neck. Then I could relax and get a few hours of good sleep. Getting in & out of bed was a challenge because my core muscles were very weak and sore. I think I could do it myself by week three. However, I still battle insomnia from time to time, and still have moderate difficulty turning over in bed. Yes, even 4 years later.

The first month was consumed with sleeping, walking, and eating. The first day I got home I went for a walk to the end of the driveway and back, then took a 2 hour nap. Even the simplest things required a LOT of energy: showering, + getting dressed + breakfast = 3 hour nap. All the little naps plus the after-effects of the anesthesia meant there was NO WAY I could sleep through the night. I was probably 6 weeks out before I could sleep more than 4 hours. Even today, about 6 hours at a time is my limit.

The thing is, everyone's experience is different. It wasn't as awful and painful as I imagined it would be. You have to be flexible and approach life in an easy way. Like, I did a load of laundry my first week home. I couldn't carry a laundry basket, but I could carry one outfit at a time to the washer. And I used the long BBQ tongs to get the wet clothes in to the dryer. The clothes were all wrinkled though, because I fell asleep before the dryer finished, ha!

I was cleared by cardiac rehab, my cardiologist, and my surgeon at 12 weeks to go out and do whatever I wanted. The only limits I have are the ones I've created in my own mind. Prior to surgery, if my heartrate went over 120 I felt a sense of dread and doom, I was very uncomfortable. Now, I don't even think about it. I ride roller coasters, kayak, horseback ride, mountain hiking...

That was probably too many words, more than you wanted. I ramble. What else?

-Meredith

Meredith Bray  Everybody has occasional issues. My personal experience: It took me about 3 months after surgery to really get solidly consistent with my doses and INR. I was working in a warehouse throwing boxes around and driving a truck/bus, and consistently had bruises up and down my arms. Running my hip in to a counter would leave bruises that lasted for weeks. A year after surgery I was told by the manufacturer and the surgeon that I could maintain a lower INR. After an adjustment period, I stopped having the bruises.
I eat dark greens 3-5 times a week, just like I did before surgery. One of the reasons I struggled right after surgery was my eating habits were thrown off by the surgery. As long as you eat a consistent diet, your INR manager should dose you to your diet, and not make any changes to your diet/lifestyle.
I am confident that my valve will outlive me.

What other questions do you have?

-Meredith

Marie Myers  You made a good choice for your age group. I am wondering if ,at my age of 63, I should just go with the tissue and hope for 17 years plus TAVR if necessary...

Meredith Bray  I think the On-X is the only valve approved for the lower INR, and it's 3-6 months post op. You could ask to speak with the coumidin nurse at your cardiologists practice. I see my nurse every 5 weeks. She's much more informed than many doctors and surgeons.

Meredith Bray  I have a conflict when I have to check the "I am not a robot" box because that was a joke one of my friends made before my surgery - that with my mechanical valve, I am PART robot now, haHA!
I'm happy to answer any questions for you that I can regarding surgery and the On-X valve.
-Meredith

Meredith Bray  Well...I don't really have anything to compare it to other than my bicuspid & stenotic natural valve. It ticks, I can hear it sometimes, sometimes I can't. Sometimes people around me can hear it, but my sister can't hear it even with a stethoscope. I received a letter from On-X stating the FDA has approved a lower INR for On-X aortic valve recipients. It's on file at my cardiologist's office. After an adjustment period of about 4-6 months post-op, I get my blood tested every 5 weeks by a nurse who does a finger-stick. It's not a full blood-draw, and I get immediate feedback. I chose mechanical over tissue for several reasons. The main reason was I wanted to avoid another surgery if at all possible. I understand there are no guarantees against surgery, but I DID understand that if I chose a tissue valve at my age (42 at the time), I was guaranteeing myself a second surgery, as research indicates that tissue valves do not last as long in younger patients. My surgeon left the choice up to me, and told me that if I chose tissue to avoid "blood thinners', he would most certainly be seeing me in 5-15 years. The worst problem I've had is after a vacation where I didn't eat my usually dark greens that i am accustomed to, and had several nights of cocktails. I do bruise easier than I did before, but it's not an issue, I'd rather have a few extra bruises than another surgery. I haven't changed my diet or my lifestyle, I have a very understanding nurse who is up to date on any food restrictions (all things in moderation is her motto!) .

I love to talk about myself. What other questions do you have?
-Meredith

Clare Auten  I am right there with Meredith. I celebrated 2 years in Jan with my On-X valve. My warfarin has been consistent. Get my INR checked every 5 weeks. Same dosage for the past year. No restrictions on activity. Surgeon did say to try not to cut off a toe when I mow the yard. ;)

Meredith Bray  Helen, nice to meet you! I just signed up to "Follow You" so you can see my email address. PLEASE ask me any questions you might have! This site is a wonderful resource. i used it mainly as a way to communicate with friends, family, & coworkers. I've also met some people who will probably be life-long friends.
Again, feel free to ask any questions. Everyone that has been through surgery has experienced the emotions and anxiety of the weeks and months (and for some, years) leading up to surgery. You are not alone!
Meredith

Helen Yade  HI Thanks for the reply..I have been reading a lot of great stories..I am maybe going in on the 2nd of Oct..but not sure yet? Found out that I am a little anemic so we dealing with that,,did you go with a tissue valve or a Mechanical?? It seems to be the hardest decision to make !! I Know you live close ..maybe would be fun to meet for lunch when your up to it..I will keep in touch and let you know when the big day is! Hugs Helen

Helen Yade  ps would like your email.adress? not sure where to find it? I also am thinking of the On-x valve..we will see..! Thx Helen