Gregory's Journal

Nancy LeClair Gottlieb  Yes it shrunk. About the size of a pea now. My neck is a little sore still. Will be three weeks on Friday.

Susan Lynn  I didn't have a bump in that area, but had a significant one where my femoral cannula was placed If my memory serves me correctly, it took about six or eight weeks to dissipate. Since these are entries into major arteries, they can't take a chance of bleeding starting. They must put something in there that dissolves over time. I wouldn't worry as long as it continues to get smaller. You can also give a call to your surgeon's office if you're concerned. All the best, Gregory.

Meredith Geneja  Have the same bump, Gregory Brummett! Trusting it will go down in time. There are a few areas enjoying their last Hurrah! :)

Gregory Brummett  My doc said it is scar tissue & should go away in 3-6 months......thanks for your input...keep on ticking!

Gregory Brummett  Dr. Schaffer says my echo and CT test results are excellent! I am cleared to start cardiac rehab and drive, but sternal precautions still in effect for three more weeks......surgery was on Monday, October 1st. I'm either a fast healer or I had one of the best surgeons ever! (I choose option 2).......Last day to take Coumadin will be Christmas Eve!

Terry Goin  Hi Gregory - Sorry I don't have an answer for you, yet. But I am glad to see you posting and hope you are recovering nicely.

Marie Myers  They healed fairly quickly, but the marks were quite prominent for about a year. They are starting to really fade away now at 1 1/2 yrs past surgery.

Rob Sparling  I had same issue as Catie on one of my two. I kept it dry during showers to help it scab up and heal from the inside out (which is what CC nurse instructed when I called for feedback). Am now into 4th week post-op and it has been fully closed, but heavily scabbed, for last 10 days.

Dan Baltazor  Thanks for posting this. We are at the valve decision part of this and are struggling which one to pick.

Meredith Geneja  Gregory, thank you, for the educational posts. Much appreciated as a confirmation of some decisions made. Grateful!

Judy S  The anesthesia can cause nausea depending on how your system reacts. Because I had abdominal surgery many years ago, I feared nausea would happen again. I told the anesthesiologist of my previous experience. I don’t know if they did anything different this time but I was okay. I had a brief moment when I woke up and the nurse gave me something right away and it was gone.

Jennifer McInerney  I have the same issue do I plan to let anaesthetist know when we meet. According to my dr. Friend they can give you drugs in your iv before you wake up.

Adam Boyadjis  They’ll take care of you well in ICU. If you have nausea they work to get in front of it or they work to fix it once you have it. Adivan ended up working for me.

Thomas Brusstar  I felt a wave of nausea coming on when I was in ICU, immediately after they gave me some mineral pill (like magnesium or something, I should know that), I told the nurse and he shot some magic anti -nausea drug in my iv. All gone instantly.

Marie Myers  I had one bout of nausea and vomiting. It did not last too long once they gave me phenergan (promethazine) for It. Zofran ( ondansetron) works for most people, but did not help me. I took minimal post op narcotics for pain due to the fear of nausea and voting.

Susan Lynn  I asked the anesthesiologist about it before surgery and i believe he gave me something. Didn't have any nausea.

Louanna Miller  The anesthesiologist will ask you if you have issues with nausea when given anesthesia. Tell them your history and they will provide necessary precautions so it’s not an issue.

Rita Savelis  Oh, yes, definitely let the anesthesiologist know that you get nausea and he/she can put something in your magic sleep potion to alleviate that. Here in France there is an obligatory meeting with an anesthesiologist at least one week before surgery and it's when you tell him/her all about yourself and he/she tells you all about the procedure. I used to always feel nauseated and vomit in ICU after surgery but this time I was vocal about my past anesthesias and so I had NO nausea after OHS (I had lots of other problems, but no pain at all and no nausea). Here's hoping that's how it will be for you.

Susan Lynn  I agonized over that question, too. It's absolutely AFTER. These medical professionals really know how to keep trauma and embarrassment to a minimum.

Thomas Brusstar  After. The only thing they did while I was conscious was placing the IV in my forearm. They started some sedation in that before they wheeled me into the operating room, and I barely have any images of even arriving in the operating room. The central arterial line in the neck must have been one of their first duties (after they shaved bald landing strips down the insides of my calves and thighs into the groin area, and drew with black markers where they would access veins and arteries if needed, even though I wasn't having any bypasses and didn't need any arterial or venous access down there for my open procedure -- I guess just in case?).
I wish I could say I don't remember getting the bladder cath out....

Adam Boyadjis  I can vouch for the same experience as Thomas. Plus if you tell them your really anxious about he surgery they’ll set you up with versed so you think you’re getting wheeled into a party rather than an OR. The bladder cath and tube removal wasn’t bad... just not very fun.

Marie Myers  Adam is right. I asked the nurse anesthetist to keep the Versed coming, and I don't remember leaving the preop area. Woke up later that afternoon with the surgery done!! So relieved!

Anna Jones  Ask your doctor. I had a pneumonia shot and a tetanus shot 2 months before surgery. I had wanted a shingles vaccine but was told that it would overload my immune system prior to surgery,

Kelly Stoll  Ask the doctor. I was told to get all shots, etc. done a few weeks prior to surgery. They even gave me a deadline date to be sure.

Anna Jones  Yes. I think most, if not all of us, have been told to take antibiotics prior to invasive procedures ,including dental cleanings.

Kirk Bepler  Yes, my dentist has had stents put in. He called me canceling a cleaning appointment I had saying it was too soon and his office has the antibiotics to take when I can have my cleaning.

Gregory Brummett  I took the antibiotics & had thorough teeth cleaning, dental xrays, and exam.......got the works in preparation for October 2. Thanks for your advice!

Gregory Brummett  When they need lab work, can they just get the blood out of one of the IV's? Or do they have you stick you multiple times for blood draws???

Adam Pick  Hi Gregory, Great question. Way to think forward. Here's a post from awhile back. https://www.heart-valve-surgery.com/heart-surgery-blog/2009/09/01/tubes-waking-up-intensive-care-unit/

Lisa McLaughlin  I remember they were able to get blood from the IVs for lab work. In fact, I was a little sad when the IV came out because I hate getting stuck for bloodwork.

Steve Farthing  Depending on what type of incision you have, there could be 1, 2, or 3 chest drain tubes. In some cases, the throat tube is removed before you become aware of it in the first place.

Thomas Brusstar  I think you’re right on your estimate, but I think it was pretty much just the one arm IV, not both. The ventilator tube comes out first, then they yank the two chest drainage tubes later that first day. It didn’t really hurt, it was just disconcerting, I’d say. But it feels good getting less “connected.” And the two chest drainage tubes were kind of uncomfortable in there, as I think they were pressing under ribs, so I was glad to get them out. Every tube out is progress! The neck cath comes out later, and I couldn’t really even feel that. The bladder cath was the most uncomfortable coming out. And they still had to stick me a fair amount for later blood draws, for some reason.

AMIR SEGEV  Yes! That's what I had when I woke up 5 weeks ago in ICU. The ventilator (throat) pipe was actually removed while I woke up, as was a third drainage tube.
(But frankly, whos counting???)

Steve Fauntleroy  Gregory, I think it's entirely dependent on how the surgery goes and what needs to be done. I had 4 chest tubes - I think the extra 1-2 resulted from needing a hemi-arch aortic graft. FWIW, it truly doesn't matter at all because it won't affect you any differently. Do your breathing exercises (!) and rest. You'll do great.

Rita Savelis  When you meet with your surgeon or your anasthesiologist at least a week before surgery either one should explain to you exactly what tubes, drains, IVs etc you will have and the exact rundown on the surgery. When you wake up in ICU you will probably be rather unaware of the various tubes and they come out fast. I still got pricked a lot for various blood tests..... I don't remember the throat tube coming out - I was probably still groggy. Many patients worry about that but it's usually not an issue. I'm probably the only one here who had no complaints about chest tubes either. They were there and then they went about a week later, no problem. Sometimes you will have IVs in both arms so that if one fails the other one works. There are a lot of precautions like this that are taken. Wishing you a smooth ride!

Susan Lynn  Two chest drains, one IV, one urinary catheter, one neck tube.... and a partridge in a pear tree! Everything came out on day 2. My main concern was the breathing tube, but that was out by the time I woke up. You will be so happy that surgery is over, you won't even think about the tubes. You're going to be just fine!

Willie Radl  I had cathether, 2 ivs, swan, one drain tube, plus temporary pacemaker wires, also there was some sort of vaccum pump suction on the chest incision. The vent tube came out so soon I wouldn't even count it, it didn't bother me at all but I know some people hate it. There were also some air bag pumps on my calves that were keeping my blood flowing through my legs.

Anna Jones  I wasn't told that. I was told not to lift my hands above my head for any significant amount of time.

Thomas Brusstar  Both hands behind back at once was forbidden, but that’s easy. You just have to mind your habits on tucking in shirts and threading your belt. One hand at a time is fine. They just didn’t want the skin in front and the sternum pulled apart. And why were the nurses bothered about how I would wash my back? Maybe I’m odd, but my back doesn’t really get dirty on a given day.

Diane Maher  Just came back from my pre op orientation and they said no to putting your hands behind your back or reaching with any arm to the side for 6 weeks. This movement ‘pulls/stretches your sternum ‘apart’. Only arm movements that ‘push toward the sternum.

Marie Myers  I was not told that restriction either. But if a specific movement felt painful or wrong, I just stopped. Learned the first week It was a bad idea to reach up to my higher kitchen shelves..

Rita Savelis  No one told me not to do anything. However, I couldn't, so I didn't need to be told. My first shower (with the help of a male nurse) was 2 weeks later. Obviously I am not a typical OHS patient, but all this is to say that it's okay to do whatever feels right. You'll know when it doesn't feel right. And it's okay to not be able to do everything immediately. And to let certain things slide for a few days, weeks. Like showers. Or washing your back. Take care.

Bob Fessler  I was told you could use one hand behind the back but not two as that would stretch the chest. If it feels funny, don't do it. You can also turn your body some to help getting clean.

David Brunkhorst  The first time I had to, I couldn't do the paperwork. But It didn't take too long and I got it. Wifey was helpful in the shower. I was pretty stiff for a while.

Ruth Coleman  I was not told I should not reach behind my back and am able to do that as well now as before surgery nearly 6 mos ago. I was very encouraged to exercise after returning home. I am strong again!

Adam Pick  Hi Gregory, Here's some information about the Trifecta that might help you learn more about the Trifecta and its Glide technology - https://www.heart-valve-surgery.com/heart-surgery-blog/2016/08/09/trifecta-gt-fda-approval/.

Gregory Brummett  https://www.houstonchronicle.com/news/investigations/article/Heart-Failure-patients-suffer-at-St-Lukes-Houston-12916224.php

Susan Lynn  You need to take statistics with a grain of salt. Some of these experienced surgeons get the most complex cases. A patient is not a patient - all things are not equal. In addition, one surgeon I met with, who was very highly rated, was working with the joint commission to improve the accuracy of the way surgeons statistics and mortality rates are reported. It would be great if variables could be held constant to evaluate only the effectiveness of a surgeon, but ORs are not laboratories. Use statistics as part of your research, but not your only method of choosing a physician or facility.

Chris Purvis  Agree with Susan. I’m a statistic of Baylor and can function at pre surgery levels before 7 weeks time period. That’s not happening at Plano or whatever that hospital is called. Most of those use a specific group of patients not the entire population.

Rita Savelis  There are a lot of different calculations that go into those scores. Hospitals that take on more difficult cases don't get the high scores. I'm not saying this is the reason here, but everything needs to be taken with a grain of salt. There is a lot of good care everywhere. And some hospitals will get the right statistics to score high. It's the same with universities....

Anna Jones  Texas Heart Institute at Baylor St. Luke’s Medical Center dropped from National Ranking #16 last year (tied with Houston Methodist) to #22 this year. Houston Methodist rose from National Ranking #16 last year to #14 this year.

Gregory Brummett  Baylor Scott & White Heart Hospital Plano is ranked at #21. I'm on the surgery schedule there for 7:30Am October 2 with Dr. William H. Ryan and Dr. Justin Schaffer. It's less than 30 miles from my house! Feeling very blessed & fortunate!

Gregory Brummett  Thanks, Anna. I'm curious to see where they rank The Heart Hospital Baylor Plano this time. I'm scheduled for surgery there on 10-2-2018. also, wonder if Cleveland Clinic retains it's top spot; I bet it does...

Anna Jones  I bet it does too. Cleveland Clinic never misses! You've picked a great surgeon and hospital. I would have gone there too if my insurance had covered it. Instead I went to Houston Methodist ranked #16 in the Nation and to the top cardio-thoracic surgeon there. You're going to do great with the surgery. Once you start feeling better you wonder what you worried about! Best wishes at Baylor Plano.

Gregory Brummett  I definitely considered going to Cleveland (Roselli) or Houston (Coselli).............still possibilities, I guess, but I'd rather not travel too far.....Plano is only 29 miles from my house............

Rick Holstein  Well, I jump out of airplanes from 14,000 ft with a mechanical aortic valve, so you'll probably be OK!

Marie Myers  How large is your aneurysm? My understanding is that the risk goes way up at 6 cm. Mine was 4.8 cm, but I am only 5'5 and 103 lbs. They recommended I get it done in a "timely manner"

Chris Purvis  That’s how I felt. Waited 45 days from discovery and mine was measured at 5.3. Worried constantly..surgeons didn’t seem too concerned.

Steve Farthing  In John Ritter's case, his cardiac issue was not known and they misdiagnosed him at the ER and lost too much time guessing at his problem. Otherwise, he may well have survived if he had been previously diagnosed.

Rose Madura  My aneurysm was 5.4 and I didn't know about it until the surgeon told me at our initial consult. So my surgery was about 3-1/2 weeks later. I guess I didn't have too much time to worry. But the surgeon made it sound so routine, he calmed my nerves. I'm sure if it were dangerous the would schedule you for surgery on an emergency basis. Please keep us posted on your journey.

Catie B  I don't believe Dr. Ryan would let things roll for another few weeks if he thought you were in danger. I hope having a date scheduled gives you some peace of mind. It was time, but not urgent, for mine at 4.8/4.9 but only because of my relative, small body size--otherwise I'd have been counseled to wait.

Gregory Brummett  It's at 5.2 at this time. I see Dr. Ryan again on 12 Sept for another CT. Then I have a pre-op appt on 24 Sept with surgery on 25 Sept.

Gregory Brummett  I'm wondering what they do at the "pre-op" (day before surgery) appointment besides blood tests? Chest Xray? and ???

Gregory Brummett  With my BP under control and knowing to avoid stress and heavy lifting, the doc is in no hurry & says the risk of surgery is roughly equivalent to risk of rupture/dissection at this time. Apparently they prefer to get a CT as shortly before surgery as possible to have a fresh measurement.

Marie Myers  The preop testing was much more extensive than I expected. I spent several hours getting Chest X-ray, pulmonary function test, blood gases, regular blood work, urinalysis, EKG, ultrasound of carotids and leg vessels, all done in different areas of the hospital... I had done the TEE and cardiac cath a month or so prior to this testing.

Marie Myers  Arterial stick in the wrist. I was dreading that, but it was not as painful as I expected even though the tech had to stick me several times to get it.

Chris Purvis  Gregory my wrist hurt and it felt like I had a snag in my bi cep as well but that went away within 2 weeks. Thanks

Valerie Herndon-Vitarella  My second heart cath was bruised and tender, but not actually painful for about that long. Can you feel your pulse there? Might be a good idea to check with the doctor.

Judy Shaw  My heart cath was done in the right wrist on May 29th. It was bruised and tender at first. No bad pain though. I still have a red spot where the cath was placed and occasionally it will hurt when I turn my hand a certain way. The skin in that area feels sensitive sometimes.

Gregory Brummett  Maybe I'm too impatient, but, after nearly two weeks, I thought the pain and bruising would resolve. I guess it's possible there was some nerve damage. I'll call my doctor again if it's not better tomorrow. Thanks!

Steve Farthing  My entire right forearm was black for 2 weeks. They ended up pulling the cath wire and going in thru the femoral artery instead because the radial artery went into spasm. But the wrist usually works and it is quicker and easier. But mine was on the mend after 2 weeks.

Marie Myers  My wrist was black and midnight blue for a couple weeksor so, but I did not have a lot of pain with it. The bruising was slow to disappear ....

Dan Vechiola  I guess I was lucky. My right wrist healed nicely and was not a problem. Sorry you are experienced this. Hopefully it will heal very soon.

Kirk Bepler  Mine was sore for about a week and some bruising, but also more bruising showed up further up my arm about 4 days later. It's normal, just depends on how your body reacts.

Thomas Brusstar  I have a cath in two days. I thought it would be easy, but maybe not! But it’s actually helpful to know it’s normal to have those problems, so I won’t freak out if it bruises up. Surgery is two and a half weeks later.

Barbara Maw  My wrist was sore and bruised for 2.5 weeks. I was a also a little concerned about nerve damage because I was having a hard time holding a pen. Was probably only stiffness from favoring it! Now 3 weeks, bruising gone and able to write again.

Gregory Brummett  I should have at least requested they use the left wrist (I'm right handed), but I didn't think about it at the time. I wonder:can they even use the left wrist? Anybody have it done using the left wrist??

Marie Myers  Mine was right side due to the setup of the room. The doc was on my right. Interestingly enough, at the time of surgery, the anesthesia team tried to start the Arterial line in my left wrist, and they were unsuccessful. The line went back into my right wrist.

Barbara Maw  Hi Gregory, Where are you having OHS? This valve is not yet available at the hospital where my surgeon ooerates. Can't decide to wait for it or go elsewhere.

Gregory Brummett  Tentatively, surgery is set for 9-25-2018 at The Heart Hospital Baylor Plano, Tx with Dr. William Ryan and Dr. Schaffer. My heart cath appt is next Friday. If travel is not an issue for you, then I suggest you go to Cleveland Clinic & ask for Eric Roselli, MD. I am hoping the valve will be available by September in Plano, but I'm fairly sure you could get it now at Cleveland Clinic. Good luck!

Barbara Maw  Thank you Gregory! Travel is an issue for me.. With waiting being the hardest part of this journey., dont want to wait for the valve and leaning toward going with surgeon that will attempt minimum access. I had my cardiac catherization today and no additional complications were found. YAY. I will call Monday to schedule surgery. Anxious to be on the healing side.
Best wishes to you along this journey!

Susan Lynn  I am not an expert, but I don't think the stress test is an indicator of the status of your arteries. I suspect that's why some active people are caught by surprise with the diagnosis of blockages.

Marie Myers  Even if the docs find blockages, the blockages have to be a certain % before they will bypass it. It might be 70-80%, not sure. I know for carotid blockages without symptoms, some do not advocate surgery till 70-80 % blockage.

Michael Eichhorn  I have a BAV with a 4.9cm Aortic Root and Ascending Aorta no symptoms either. Stumbled on this with a CT of my chest. Unaware of any upcoming new procedures. Been to two surgeons and both recommend OHS.

Marie Myers  That is what I thought Greg meant. I, too, had a BAV, and was found to have an ascending aortic aneurysm 4.5x 4.8 cm on a routine echo. Same story that 2 surgeons recommended surgery "sooner rather than later". I had no symptoms and was playing tennis and working, blissfully unaware. Fast forward to now...I had surgery 1 year ago and did well. I have heard something about "wrapping the aorta", but really don't know the full details. It is a load of unwelcome news to find out you need heart surgery, but it is done every day. The vast majority of patients do well. All the best to you in your heart journey!

Gregory Brummett  Michael Eichhorn What restrictions are you on? My cardio says no heavy lifting, strict blood pressure control, and stress reduction. I'm taking Metaprolol which has my BP down into a very good range, usually about 105/60 (ish). Maybe it's giving me a false sense of security, but I'm in no hurry to schedule surgery. I'm concerned that I'll never get back to feeling as healthy as I do now.

Michael Eichhorn  Hi Greg, no lifting,Mediterranean diet, walking 35 minutes a day and 50mg Metraprolol daily with baby aspirin. I also feel great and can’t believe I need this quite frankly. But I have spoken to two Cardioligist’s and two Surgeon’s and all believe I should have the surgery sometime in the next 6 months. So, I am scheduled May 15th. I chose to have the surgery while I feel good instead of waiting.

Marie Myers  Everyone is different, but I can say that I feel physically back to normal since my AVR and ascending aneurysm resection. I actually was back at work part time in 8 weeks, and I have been back to tennis and bike riding.
I also felt disbelief that I needed such a huge surgery, but I trusted in the 2 docs that they knew what they were talking about when recommending surgery. BTW, I was placed on the same restrictions as you in the preop phase of my journey.

Gregory Brummett  Marie, where did you have your surgery? Sounds like you had excellent care! I am in DFW TX & would have surgery in Plano Tx at Heart Hospital Baylor Plano (HHBP). HHBP is rated #16 in the country by US News & World Report.

Gregory Brummett  Is not having full range of movement one of the main annoyances in the first days and weeks after surgery? or what? Pain?

Marie Myers  I had my surgery locally at a smaller hospital in Lake Worth FL. I was too overwhelmed with the idea of traveling to a major center. But I feel because I am " in the business" (I am a nurse anesthetist) I could find out who had good results here in Palm Beach County. I also had worked with the anesthesiologist from 30 years ago, and I felt he would take good care of me. I also felt that being a healthy 63 yr old, I would do well anywhere.. I felt that complications can occur at any hospital, even at a big name place. So, I had the whole surgery here, and did well. Not to say that a major center is not good, but having worked in the OR for 40 years, I know there are good doctors everywhere. Just have to find them. You are close to a great major center in Tx, so I would say go for it.
As far as pain, I would say pain was very minimal in my sternum. My back and shoulders were very sore, and I could not wait to be able to get on my stomach for a massage. That took about 8 weeks. Could not stretch to use high shelves for a few weeks either. Took very few narcotic pain pills post op; Tylenol worked pretty well. fatigue was more of a problem than pain.
I hope that all makes sense. Feel free to ask any other questions. I got a lot of comfort and reassurance from this site, and I hope I can pass some on.

Gregory Brummett  Marie, did you have a heart cath before your surgery? Can you suggest which sedation drugs I should request for the heart cath procedure? I know they won't apply "deep" sedation, but I prefer to be as near as possible to "knocked out" for the heart cath. Thanks...

Marie Myers  I got intravenous midazolam (Versed) for my sedation. I remember little bits of the procedure, but no pain or anxiety. It was much easier than I thought it would be.
On the day of my surgery, the nurse anesthetist gave me the same drug as I was being taken to the OR. I remember absolutely nothing until waking up in ICU. It was great!

Gregory Brummett  I've had Versed with Fentanyl for a colonoscopy & it worked great. Also had 2 Halcions for a dental procedure which was very effective. Probably better not to mix anything though.....I'll ask for versed only and see what they say.....I see my surgeon on Wedsnesday.....

Gregory Brummett  Did you have your surgery right after the cath? or can you wait a while between cath and surgery? I wonder how long you can wait before another cath would be required?

Gregory Brummett  Which pain meds do they give you right after surgery? Morphine? or ?? Is the self-administered pain pump standard now? or must the patient request it?

Marie Myers  Versed and fentanyl is a great combo for the cath. I had my cath in February, and my surgery on March 28 2017. I was told the cath should be within 6 months of the surgery.
They tried to give me Dilaudid post op, and I was nauseated. I did not experience severe pain, and a hydrocodone 5 mg was enough. Then I switched to Tylenol, and that was sufficient. Once I was home, I took a hydrocodone 5 mg at night to get some better sleep.Only did that for a few days. Mostly took Tylenol or ibuprofen if I needed it during the day. I think a lot of hospitals have the "self-serve" pain pump, but honestly, I did not need it.

Marie Myers  Forgot to add- it was difficult to sleep in the hospital. Even though I had ear plugs and eye mask, I was awake the better part of 5 days. Should have asked for a sleeping pill, for sure. Also, I read someone on this site who requested not to be awakened at unGodly hours for weigh-ins, blood work, vital signs, ect. I sure would have done that if I knew it was possible...I had never been in the hospital as a patient before, and I just did not know!