Alex's Journal

Marie Myers  Do antacids help the pain? If so, it could be reflux. Have you seen a gastroenterologist about this?

Alex Sigalov  I should try taking that, i am going to gastro in Jan, but also feel like some muscle issues because when i move it hurts more. Just a little concerned having discomfort in chest area i guess and was wondering if others had similar experience after open heart surgery

Marie Myers  I thought that the back and shoulder pain post op was worse than any sternal pain I had. Looking back, I wish I had asked for muscle relaxants in my early post op period. I was feeling better by month 2 , and at month 3 ,I got a massage. It was wonderful!

Deepak Khanka  Alex , my back pains kept on moving . From under the left and right shoulder blades to lower back . These pains usually came during the evenings . I couldn’t sleep on left or right hand side and had to sleep on the back . After 9 months I still get pains on my upper shoulder below the collar . Chest pains were ongoing more muscular . I had a full sterectomy.

Deepak Khanka  Alex , I hope you feel better and better. I have a question to ask. I’ve asked few people in this forum why they went for SJV as compared to ONX but I didn’t get any response . I know that you went for a ONX could you shed some light why few of them must have gone or SJV instead of ONX. They are in similar age group as us

Alex Sigalov  Deepak, sometime it depends on surgeon what they have most experience implanting. I requested my surgen to put in OnX into me from my research i believe their lifespan is similar but OnX has an aproval for u to have less INR 1.5-2 then SJM valve, and OnX parent company are sponsering more clinical trials loke for Plavix instead of warfrin. I feel like OnX parent company does more research and sponsers more clinical trial. So the lowest INR and they companies contiud research what has led me to choose OnX over SJM

Rose Madura  I had been little chest pain at the incision. In fact I don't remember any pain. But I DO remember the shoulder pain. ....

Rose Madura  I had a PVC issue about 1-1/2 years after my surgery. It was caused when PCP took me off BP medication. Once back in it, I had no more issues. I'm sorry you are experiencing this. Having to go to ER with heart issues is never ever a good time. Hope you a re w stabilized now.

Skipper Kagamaster  I don't have any experience with that yet; hoping not to. But I hear that some 1/3 of post heart surgery patients suffer from at least afib. I'll be curious to see the responses to this with people's personal experiences.

Mark Abbotoy  I had a lot more PVCs and PAC after my surgery until about 4 months post op and then they seemed to return to normal. I've recently stopped caffeine and that's helped some (haven't been able to stop chocolate yet but that seems to exacerbate the PVCs/PACs).

Alex Sigalov  thank you for your comments, its good to know what i could take longer for them to go away, because from everything i have read it should have subsided by 8 weeks. i have cut back to 1 cup of coffee in the morning, hopefully it will help. I also have indemitened high hear rate 90-100Bpm, which i have to take zanax to help me calm down.

Civita Fahey  Hi Alex I am almost 3 years post AVR and I still get PVCs every so often..I did go to an electrophysiologist who specializes in irregular heart rythms and she said the same thing, they are not dangerous unless there are too many and for too long. This could cause damage to the heart muscle. If you feel they are a lot them maybe ask for a Holter monitor for 24 hours to see how many you have. but all in all, they are not dangerous.

Rose Madura  I did have Afib and Aflutter for about six weeks post op. But nothing since and I'm over 2 years out. I was on megadoses of Amiodadrone and Metoprolol for that time. It would probably make you feel better to talk to your cardiologist.

Barbara Wood  Hi Alex, are you sure you are having Afib & not pvcs? Afib is irregular & fast - over 100 pulse. Like Rose, I was on amiodorone ( for 5 months, because I had a previous history of afib & had a maze procedure as well as a mitral valve repair). I had pvcs for a year or more after surgery - but no afib. I'm almost 3 years past surgery now & no longer have pvcs. But I agree with Rose, always run any concerns by your cardiologist. Best wishes:)

Alex Sigalov  Hi Barbara thank you for your input, i guess my just qualify as PVC, my heart rate is 60-80 thru out the day just the beating feels irregular.

Deepak Khanka  Alex , I’d Afib . This actually got better with time I was taken off from amiodarone in 2 months. Post David’s procedure for aneurysm and aortic root repair

Alex Sigalov  Thank Deepak, its juts everything i read was saying after 6 weeks it would go away but i am still having irregular heart beats so was starting to get get concerned, they keep on telling even if i have its not dangerous especially that i am on blood thinners

Marie Myers  In my experience, I had a lot of palpitations in the early weeks/months of recovery. The palpitations were a little unnerving at times, and it made me feel anxious. If I checked my BP at that time, it could be 170-180 ish. If I could settle myself down through breathing, meditation, and / or a .25 mg Xanax, my pressure would come down. I think anxiety was the biggest cause of my high BP in the early months. I am now approaching 3 yrs since surgery, I feel I am much more relaxed about the whole thing. My pressure is rarely over 130, and I rarely feel any palpitations. Looking back, I now know that the whole experience of open heart surgery was one intense experience. A kind of controlled-trauma of sorts. And it takes longer than we think to get through it , both emotionally and physically. And I had an uncomplicated surgery and recovery. Imagine the added stress of complications! You could talk this over with your primary doc or cardiologist at your next visit to get their input. Does your BP stay up all day , every day? If that is the case, the doc may want to add an anti hypertensive or diuretic to your regimen. But I also think “tincture of time” will help your situation as it did mine. Hope that helps.

Alex Sigalov  Hi Marie thank you for sharing that, its very helpful, unless i have these episodes my BP ranges from 125-135/75-85 thru out the day, so my Dr did not want to put me on any BP medication since i dont really have high BP, just when i have these palpitations/arythmias which induces the jupms in my BP

Marie Myers  Could be the experience and anxiety of the arrhythmias that causes the jump in BP. I know the second day home for me, a visiting nurse came and checked my BP, which was 180-something. She immediately called my cardiologist, who set me up for an appointment. I was 170 systolic in the office, but when checking my BP at home, it was rarely over 140. I think I was still wound up from the whole hospitalization/surgery/recovery thing. Hope your BP settles down like mine did.

Jeffrey Dyer  Sounds like anxiety to me...especially if Xanax calms things down. I know that I had a tough time with my anxiety/depression after surgery. I read that I would, so I was ready for it. I would be fine and all of a sudden I'd have a wave of anxiety/depression wash over me for no apparent reason. But the reason is, I (and you) have just had a traumatic life event. It really is normal to experience anxiety/depression from OHS. And you should have a team of Dr's now that you can email/text/call when you have things like this come up. Keep in contact with them. That's why they're there. If it's a question in your mind, ask them. It brings peace to your mind.

Alex Sigalov  Thanks Jeffrey for your suggestion, i also realized that my BP goes up only when feel these palpitations, otherwise i am totally fine during the day, i will mention it to at my 6 week appointment tomorrow.

Frank Giovanniello   Alex, I have it really bad. But like you said, no pain. Doctor wants to see if it heals up on its own. Otherwise he said i'll need plates and screws. I'm five months post.

Alex Sigalov  Frank thanks for your response, i mentioned something to my cardiologist like the first week i was home she kind of dismissed it. I am going back to the surgions office in about a week for my 6 week visit and will definitely bring it up again. Did your Dr say how long he would give to heal. Did they send u for any X-ray(or other test)

Marie Myers  Keep in mind that it takes 6-8 weeks to heal the chest, so try to follow all directions to give the sternum time to heal. Asking the surgeon at your follow up visit is the best idea, since they hear these questions frequently. If they are concerned about what you are feeling, I am sure they will order tests like an x-ray to check out your healing.

Frank Giovanniello   Alex, no he didn't, plus i'm diabetic and have copd so it's that much longer to heal. I figure i'll wait until I see my cardio.

Joe Tarango  Alex, my chest felt like it moved and shifted for 2-3 months. It eventually healed and became solid.

Alex Sigalov  Hi Joe, thanks this helps so much, i feel like people that have gone thru it are much better source of information than Dr.

Marie Myers  My pressure tended to be high in the months after surgery, especially in the evening. As time went on and I worried less and less about things in general, my pressure did stabilize. Like Chris said, sometimes meds need to be changed or adjusted. Hope you get all settled down soon!

Alex Sigalov  Hi Chris and Marie, thank you so much for your advice, its just so weird thats its only in the evening and not every evening either(maybe just my nurves), i will speak to my Dr asking if they could adjust my med to see if it helps

Marie Myers  I remember having some disturbing palpitations during my early recovery. Luckily, they did not last too long . Sometimes it was just a few seconds, sometimes a few minutes, and once or twice they lasted about 20 minutes. My understanding is not to be too concerned unless they are lasting 30minutes or more, or causing dizziness, fainting or other symptoms. I came home on 12.5 mg metoprolol which I have stayed on since 2017. It helps prevent some arrhythmias, and keeps your heart rate a little slower.Hope that info helps.

Rose Madura  Yes, I had a lot of complications and being very symptomatic, I required re-hospitalation. You can read my journals if you'd like. I'd say it lasted about six werks post op. No issues since. Communicate with your doctor to ser if any meds would help. I was on Amiodadrone and Metoprolol. Still taking Metoprolol 3+ years later. Amiodadrone is recommended short term. It affected my eyesight as I was on it longer than normal. Everybody is different which is why a call to the cardiologist may help. Let us know...

Kathleen Shore  Common, but be sure to keep your surgeon informed. They will determine if you need a round of antibiotics or not.

Catie B  Hi Alex. Sorry to hear you're struggling. I don't imagine you've been home very long, with you having surgery five days ago. I trust you were able to have a BM before they sent you home. Re: the constipation, are you taking stool softeners? Those can help much. They gave me those and senna in the hospital, but I was released on Tylenol. Prunes or prune juice and fiber-rich foods could also help relieve. But if you are having severe pain and it is lasting, you should seek help, because severe cases of constipation from pain meds can lead to fecal impaction.

I'd encourage you to speak with your cardiologist about the pain with breathing. I experienced some pain with complications and there are several things that could cause you pain while breathing.

Dan Baltazor  Alex. I'm really sorry that you're having such a hard time with recovery. It's not easy that's for sure, especially just five days out. I also had major issues with constipation and discomfort from it. I was released from the hospital without having a bowel movement and struggled at home for several days. Looking back I wish I would have been more adamant about this before leaving the hospital. I also think the pain killers were a big part of that so once I got home I stopped taking them. I tried smoothies, but ultimately I drank a lot of water and starting getting back to normal. The process takes time. For me this was one the worst parts of my recovery. It sucks, but it will pass and you'll get on the other side of it. You're in my thoughts and prayers.

Marie Myers  Good advice from Catie. I would add to be sure you are drinking plenty of water and walking often as you can.
If you can substitute an extra strength
Tylenol (acetaminophen) now and then, you may avoid some of the narcotic side effects like constipation.
On the difficulty breathing, I would ask your cardiologist. Might be a good time for an appointment to see what he/she thinks. Hope things ease up for you soon!

Alex Sigalov  Thanks everyone for their advice, i thought the worts was at th hospital, but i guess i was wrong, but will just take it one day at at time, I am also have on and off low grade fever so a little concerned that

Chris Calhoun  Alex - get off the pain killers- tylenol should do you just fine this far out - use that damn spirometer every hour and get good at it - thats it - the hard part is over - good choice on the On X

Alex Sigalov  Hi Chris
I do do the spiirometer every hour that i am awake. I tired to stop taking paercaset last night and felt like someone was tearing my chest from front and backand i could hear my valvle cliking in my head, but maybe that was due to all of gas/gastro discomfort thats was going on, so for now i just cut percuset in half dose prescribed to see how it goes.
Question for everyone did eveyone try to sleep in a chair afterwards or bed, and did anyone deal with low temperature and for how long

Chris Calhoun  remember that tylenol does relieve pain - get off the percoset as quickly as possible even if its painful - take the tylenol - the clicking is normal and sometimes it will seem louder than others- do not think about it - do not let it get into your head- and remember that is the sound of your heart working !!! get into the bed you do not have to sleep in a chair

Dan Baltazor  I slept half upright on the sofa for a few weeks before I was able to move to the bed. Switching to Tylenol is a really great idea at this point. I had a low grade fever on and off. I think it's our bodies just recovering and trying to process and reset everything it just went through. OHS effects every part in our bodies not just our heart. It's a process for sure. Hang in there.

Marie Myers  I slept in the recliner for 4 weeks. It took me that long to be comfortable lying flat. Sometimes even after that, I moved between the bed and the couch at times.

Deepak Khanka  Alex, walking is a must , drinking water, and doing the breathing excersise using the device given to you. Wait for the first echo to check water in the lungs too.

Joey Hardee  Hey Alex. I slept in the recliner for about 6 weeks on my back. I really didn't want to take a chance on compromising my sternum healing. It may not have made a difference but I at least THINK it did. For me, the first week or so at home was tough and I spent a lot of time in my recliner. I did get off the pain med and onto Tylenol only once I was home. I just had to put up with a little pain until it subsided. The Tylenol took the edge off so I could tolerate it pretty well. Hope and pray you see improvements soon.

Meredith Bray  Keep walking - that's the best thing for you to do. Try to get off the pain pills. My physical therapist made it a point to insist that I stand up as straight and tall as I could - it helps re-strengthen the core muscles and helps open up your rib cage and makes breathing easier.
Make sure you are supporting your head/neck/shoulders when you are resting. Use a travel pillow around your neck and stuff a couple throw pillows under your arms when you are in the recliner.
I was scared to fall asleep - I was terrified I would move in my sleep and hurt myself, so I never really fell asleep for several weeks. It wasn't until I realized I could support my upper body and sleep in the recliner that I got my first real good sleep hours.
You get better each day - don't give up!
Meredith
Clearwater, FL

Adam Collins  I'm about your age, and I had my surgery back in July of this year.

My surgeon did something called the Ross Procedure. With the Ross Procedure, they take out the bad aortic valve, replace it with your own pulmonary valve, and then they replace your pulmonary valve with a human donor valve. The advantages over a mechanical valve is that I don't need to be on blood thinners for the rest of my life, and since my aortic valve is my own living tissue, it should last longer than an animal tissue valve. The major disadvantage is that now I have two valves that have been surgically messed with, instead of just one. My understanding is that some surgeons think it's a great option, while some others think it's more trouble than it's worth. No one can answer that question for you other than yourself and your surgeon, but it might be something to ask about or investigate, if you're curious.

Alex Sigalov  Adam, thank you very much for your input, i have read about this procedure before(did they tell you that at some point there is a possibility you would need both of valves replaced?, and if yest at what stage of life), very few doctor like to perform due to its complexity; Also I am not that active in sports, maybe a basketball ball game here or there and i have a desk job; so i think for me it would not be the worst thing to be on blood thinners, also per my cardiologist half of her patients are on blood thinners for other reasons and she is saying they seem to be doing fine; but i will do some more research and bring it to my surgeon for discussion; once again thank you for your input about ur experience.

Bradley Dunn  I am little older than you. My surgeon said any tissue valve in me would last about 5 years. I have the On-X. It is my new best friend. I am pretty active with my kids and such. I also coach their sports teams, lift a little and try to do some cardio.

I do what I want when I want. Sure - my diet is stable as are most people's. Hence, my INR is stable as well. I do drink a little but not too much (except maybe during college football). I do somewhat worry about injuries with blood thinner especially getting hit in the head with a baseball!!!! That is scary. I had a severe bruise in my inner thigh in the spring. My son threw a really good fastball and hit me perfectly in the thigh. I was really HAPPY!!! My reply, "NICE PITCH!!!!"

Make a good choice for you. You don't want this surgery again. It isn't fun.

If you get the On-X valve. They give you a ring too made out of the same material.

Any other questions?

Tom McDonald  Hi Alex,
I'm in my early 50's and had the ON-X put in June 2019 @ the Mayo Clinic with no regrets. Don't let the thought of being on blood thinners for ever detour "your" choice. They really are not that big of a deal. This particular valve can take a lower dosage of blood thinner. Discuss the pros and cons with your cardiologist/ surgeon but, in the end, the choice is yours. In my case I only wanted to go through OHS once and with the ON-X that hopefully will be the case. It should last my lifetime I was told by both my surgeon and cardiologist. As far as the ticking of the valve I have hardley heard it. Hope this helps you. Wishing all the best in whatever you decide. https://www.cryolife.com/products/on-x-heart-valves/

Justin Eilermann  I had an aortic valve replacement with the St. Jude mechanical valve completed on November 7th. I talked with several people I knew in my community that have had same surgeon, & various valves. I am 35, & I weighed the options, & the St. Jude mechanical seemed best. I spoke with my business partners father, & he had the St. Jude put in back in the 80's...I think 36 years ago. Still doing well.

Being on Coumidin doesn't bother me. I have been on Xarelto for 4 years after a retinal artery occlusion caused permanent blindness in my right eye.

Loving life, & recovering now. Check out my journal, & hit me up if you have any questions.

Best of luck & keep thinking positive!

Alex Sigalov  hi Bradley, thank you so much for the information this is very helpful; i have 3 young kids to keep up with and having some tough time with it now as my BP is all over the place and stairs are a no friend of mine; hoping to get this over with as soon as possible, so wanted to make a good informed decision. How long was your recovery process?

Alex Sigalov  hi Justin thank you so much for your response and your wishes, i hope your recovery is going well; would you mind sharing your thoughts on why u thought St Jude was the the better choice in your mind.

Alex Sigalov  hi Tom, thank you very much for your response, yeah having to take less blood thinners is what it attracting me to On-X, just wondering if there is any trade off in other areas vs the St. Jude one; i guess i will discuss it with my surgeon next week

Mike M  Hi Alex, I'm 37 and had my aortic valve replaced with a St. Judes in 1991 at 9 years old. Recently I just had my Mitral valve replaced with a mechanical valve as well. During the surgery, my surgeon stated that the Aortic St. Jude valve looked as good as the day it was put in.

The coumadin and clicking are non-issues. The key is consistency in diet and life. Eat your greens, do what you want, just be consistent so the anti-coagulation team can adjust your INR to a stable level. It hasn't casued me any strife in 28 years.

I spoke with the surgeon prior to my most recent Mitral Valve Replacement about ON-X vs. St. Jude. He said both are great options, but there is not enough history with the On-X valve yet because its relatively new. So another question is; What are you more comfortable with? Proven history dating 30 years, or newer technology that may be just as good, but not proven quite yet.

I'm more conservative, so the surgeon and I agreed to use the St. Jude Valve.

I wish you well! You'll do great!

Bradley Dunn  My surgery was Aug 28th, 2018. I was driving in 5.5 weeks, throwing a football in Dec and a baseball soon after. I did 27 cardiac rehab sessions ending around Dec 21st or so.

I was coaching a 12U baseball team in April and no kid or parent knew my heart wasn't beating 7 months prior.

I planned my surgery around college football and coaching baseball.

Mike Roskowinski  Hey Alex - I am also just like you. I found out earlier this year that I had to have OHS to replace an aneurysm and monocuspid valve. I am 39 years old and enjoy working out and playing sports. I agree with Bradley that this surgery is something I do not want to do again so try to get the best you can at the beginning. I also went with the On-X valve since I dont want to have the tissue one replaced in a few years. Let me know if you have any questions.

Herman Kanter  I am 55 years old. ON-X aortic valve installed 9 1/2 weeks ago. Feeling great, working out everyday. Just an occasional clicking sound and INR routine to get used to -- otherwise, FEELING GREAT! Good luck and a speedy recovery for you my friend.

Justin Eilermann  Alex, I actually just spoke with the surgeon, and he recommended the St. Jude, and told me to do research. I found pretty positive reviews, and also talked with a few recipients of the St. Jude, and they were all satisfied. 1 of them has had it since the 1980's, and I was born in 1984, so I figured it was suitable.

Carlos Banuelos  Hi Alex, I’m 44 and just had my AV replaced on July 16th at Cleveland Clinic. After a lot of research and talking to several surgeons, I chose the On-x over the st.jude’s valve bc of the lower INR requirement for the On-x. My recovery was very quick with minimal pain. I was back to surfing, gym and volleyball shortly after two months. The clicking is loud but I have gotten used to it, and taking warfarin hasn’t been that big of a deal. I would talk to your surgeon about using an internal fixation plate. I think it has really helped with my recovery process compared to others who only had wires to close there sternums. Good luck.

Chris Calhoun  did anyone have a decrease in ejection fraction after the surgery? I just had the On X done and feel great but now ejection fraction has gone down from 57 to 34 post op

Adam Collins  Alex Sigalov:

Nothing was mentioned to me specifically about the possibility of needing both valves replaced. I was told that there is still a chance of needing some sort of re-operation somewhere along the line, but that the chance was less than if I'd gotten a normal tissue valve.

Yeah, I know people who have mechanical valves, and they seem plenty happy with them, and the blood-thinner regimen doesn't bother them. I really don't think there is one right answer to the question of "what's the best way to fix these valve problems?" I wish there was, because then it would make things a lot easier!

Alex Sigalov  hi everyone, forgot to ask if any also had their aneurysm repaired at the same time and if that complicated things for any way; mine is at 4.3cm so i believe they will repair it at the same time.

Adam Collins  I had my aortic root replaced at the same time. My surgeon didn't act like it needing to be replaced was a complicating factor, and my impression is that having an aneurysm repaired at the same time as getting the valve replaced is pretty common.

Deepak Khanka  I my case aneurysm was replaced and valves saved. Then the buttons shared to shredded and had a double bypass