Jim's Journal

It was just over a year ago that Jim had surgery to replace his aortic valve. And the way he was body surfing in Ocean City MD, you\'d never know how sick he was last year. He gets his blood taken for INR levels every 3 weeks now. He joined a gym to continue rehabilitation. He still has range of motion issues with his left leg, knee and ankle being stiff. But it hasn\'t stopped him from hunting, fishing, camping, yardwork, house renovation and battling the waves of the Atlantic Ocean. He recently told a family member he felt he was at 95% of his old self, so that\'s pretty good! I hope these updates have helped people going through this (I know I read through many many updates with what to expect at different points of recovery). Good luck if you are facing this surgery, I hope things go well for you!

Today is 6 months post surgery. Jim has been back to work for 4 months now, getting back in the swing of things, and even getting some overtime hours. He finished up cardiac rehab in December (insurance limits), but only at 6.3 METS, so there are still some limits as to what he can do. He has been bowling and hunting with his sons (13 yr old got his his 1st buck!), but he does tire more easily. His INR levels have been stable, and he gets his blood drawn every 3 weeks now. He said he doesn\'t quite feel normal yet. He saw his surgeon last month who said he is looking pretty good and his next follow up will be at the one year mark. He is still having a lot of issues with his left leg and ankle, the original site of his strep G infection. The ankle is swollen and stiff and he has pains in his knee. Hopefully these will resolve with more physical therapy so we can be ready for the fun of summer. (Last summer wasn\'t so fun).

Exactly 2 months post surgery (and 5 months off on disability), Jim returned to his job with Verizon on \"light duty\". He said it was more tiring than he remembered, with walking and carrying things. He does well at cardiac rehab 3 times a week (says he\'s the young guy there, haha) and physical therapy 2 times a week (he is still having issues with tendonitis in his ankle from the original infection, and his shoulders are also locked up). This causes him a lot of pain and stiffness at night and upon wakening. He has occasional high bp readings and has been given a med for that (as needed). His recent echo was good, and his INR levels have been stable. He hasn\'t had as much dizziness as before. Things are looking pretty good!

Its 6 weeks after Jim\'s heart valve replacement surgery. Jim\'s recently had trouble with shortness of breath and dizziness and just feeling \"off\", He sees his cardiologist tomorrow, so we\'ll discuss it with him. He also started cardiac rehab yesterday which he said actually made him feel a lot better. His scar looks remarkably good, fading into a thin line. He\'s been sleeping comfortably in bed, but hasn\'t returned to work yet. The good days are outnumbering the bad days!

It\'s hard to believe 4 weeks ago Jim was being prepared for his valve replacement surgery. Yesterday he had a follow up with Dr Badhwar, his surgeon, after a chest x ray. Dr Badhwar was very pleased with how he was recovering, his incisions healed nicely (he can swim now) and he is getting stronger. He can test driving ability in a parking lot with a passenger, making sure he can swerve and brake without pain. At 4 weeks, Jim is only using Advil for pain. He is also ready to begin cardiac rehab. Jim was having issues with swelling in his legs with activity, so he was prescribed Lasix, a diuretic, for one month. He is still sleeping in a recliner, tried bed once, but was too uncomfortable. His protime bookwork has been able to be obtained by fingerstick, and INR levels have been steady. Jim says he doesn\'t quite feel 100%, but he is getting better each day.

Jim is getting better each day. He even joined us at church this morning and then grocery shopping. He walks about a half mile (broken up) each day, and takes a short nap. The home health nurse was able to get his last protime bloodwork via fingerstick instead of IV, so we are hoping they can continue that way. His INR levels have been pretty steady. Pain is still an issue, across his chest and back. He only takes a pain pill 1-2x a day, if that. He said he still feels occasional \"flutterings\" in his heart, which the nurse says is normal.

5:00pm Walking, walking, walking. Jim has been walking almost a half a mile each day the last 2 days and feeling good about that. His INR levels have reached their goal, so we know he is taking 5mg Coumadin for the next 3 days at least. The pain has been minimal to moderate, he is still sleeping in the recliner at night. Hopefully things continue to move forward and he heals quickly.

After Jim\'s overnight stay at the hospital (along with a dose of Heparin), his other meds were figured out and he was discharged just before lunch. He is starting to feel a little better, and rested most of the evening. The home nurse will come the next 3 days and take blood for his INR levels.

7:30pm Jim was having sharp pains in his lung when breathing, so we went back down to the hospital. A chest x-ray was clear, but his INR level was low, so they decided to increase his Coumadin and keep him overnight to watch him more closely.

11:00am Jim\'s been home for 2 nights. He sleeps in the recliner at night to be more comfortable. He is still having pain, but taking his meds for that. He walks around the house several times a day for exercise. The home health nurse came today to take blood for his Coumadin level, and she will come back Thursday to repeat. Its a slow recovery, but going as expected.

10:30am This morning Jim walked up a flight of stairs and did well. His pacemaker wires that were in his heart during this post-op period were pulled and a cardiac doctor on rounds gave him the okay to go home this afternoon. We are ready to move forward with recovery and cardiac rehab. I can\'t thank everyone enough for the thoughtful prayers and comments in the guestbook - bless you all!

12:00pm Jim\'s heart was having some irregular beats, so he was given Lopressor for that. He also had a breathing treatment to help clear his lungs. He is still having pain, but walked in the hallway twice this morning. Slowly but surely he is moving forward and will hopefully be home in the next few days.

2:00pm Jim has been \"upgraded\" to the 5th floor from the ICU (D562 for visitors). having some dizziness and pain, resting in bed (waiting for his turkey sandwich). His nurse plans on getting him walking later tonight.

9:15am Jim had an uneventful night, nausea subsided, so he is beginning to take his meds by mouth. If that goes well he will move on to juice and jello. He had some elevated blood pressure which resolved with IV meds (and is normal in recovery). He was sitting in a chair watching the news, and had already seen physical therapy who have him some exercises for his legs. His nurse said he is 6th in line to go back upstairs on the 5th floor. In the meantime, visiting hours in the ICU are 10:30–2, 4–6:30 and 8:30–10.

At 6:30pm, Dr Badhwar came and told us that Jim\'s surgery was finished and he was stable. He replaced the aortic valve with the ON-X mechanical valve, and when he restarted his heart, the mitral valve, no longer under extra pressure, recovered enough to not need any repair. Dr Badhwar asked if anyone wanted to see pictures and the 3 kids\' hands went up! He showed us and explained everything very thoroughly. Jim\'s breathing tube came out right away and he was awake and responsive. The effects of the anesthesia made him nauseous and he was also dealing with pain. He is in the ICU tonight and will hopefully go to the recovery floor some time tomorrow. Thank you for all the thoughts, well wishes and prayers. The support is overwhelmingly wonderful. And special thanks to family members who spent the day waiting. (I think people were clapping when we left ~ we were quite a gang!) On to recovery!

This morning Jim is being prepared for surgery. He spoke with the surgeon this morning who was going to do his best to get him in. Jim said he is on the board for 2pm barring any delays.

10:00pm Jim said that a resident spoke with him and that Dr Badhwar had arranged his schedule and that the surgery WILL be taking place tomorrow, Tues, July 31. Jim said \"in the afternoon\", then he said \"at 11am\". He is going to call me back after he goes for an xray (?)

Jim met with his surgeon, Dr Badhwar, who reviewed with us the TEE that was done last week. The aortic valve is severely damaged and as a result, the pressure from the back flow of blood has also moderately damaged the mitral valve. Jim is currently in heart failure as his symptoms continue to worsen. The decision was made to replace the aortic valve with a mechanical valve and repair the mitral valve. Dr Badhwar will be out of town this Wed through Sun. The plan is to admit Jim to UPMC Presby today, run more tests, check the coronary arteries via catheter and begin a diuretic. If he improves, he will be discharged within a couple days, return home, and surgery will be done on Monday or Tuesday (Aug 6-7). If the results from the tests are unfavorable, he MAY be an add on for surgery Tues, July 31, before Dr Badhwar leaves town. Otherwise, another surgeon is being consulted if the surgery becomes necessary between Wed and Mon.