Travis's Journal

A recent TEE shows that my valve is now leaking worse than it was after my surgery. And it looks like it\'s been leaking like this since about 6 months post op. My cardiologist says on a scale from 1 to 10 (10 being worse) it\'s a 6. That sounds bad to me but he just wants to keep an eye on it and have another TEE in 6 months to see if it\'s staying the same or getting worse. So it\'s looking like re-surgery is going to happen here in a couple years. My chest/shoulder/back pains are still a problem and I have seen a neurologist about it and so far there is no idea to why I am getting these pains. I have two MRI\'s of my upper and mid spine scheduled this week to try and find some answers I will post next week if anything is discoverd.

I am still having random chest pain episodes. My physical stanima in the pool has been great. But I\'ve been getting the pain episodes very frequently. The pain could be in my back, neck, shoulder, or chest. It isn\'t as severe and as it was 6 months to a year ago and they don\'t physically set me back a month or two like they did, but they are still there lingering for days. But I can pick up where I left off. Running seems to really irritate and maybe even cause the pain episodes. And maybe push ups and pull ups do too. I saw 4 doctors about but stopped going over a year ago because I have got no answers from them. All I get is nice big bill in the mail. The Navy wouldn\'t even consider me because of the condition I HAD despite being able to have highly competitive physical scores and having high ranking officers and congressmen on the Armed Forces Committee trying to puch me through. I thinking it could have something to do with the drawdown and me needing an age and medical waiver and not the actual condition that I had. I have noticed that I can\'t gain wait at all. I don\'t think it\'s in a bad way though. Could be from two a day swimming workouts or just the fact that I have a more efficient heart. I do know that I weighed about 10 more pounds 8 years ago when I swam twice as much in college.

This is a review of some key points and timelines over the past year after my mitral valve repair. Second week: -I increased my walks to 4 miles a day. Stretching and doing 5 lb weight lifts at high repititons. Third week: -Started adding in short jogs during my walks. My heart felt like it was bouncing around in my chest and was very uncomfortable. This feeling got less and less over the next couple weeks. Fourth week: -Returned to work. Started swimming 1000 yard workouts 80% kicking, 20% pulling lightly with right arm. Fifth week: -Bouncing feeling in my heart when I run almost gone. -Able to jog my first non-stop mile in 9:30 Sixth week: -Incisions look like clean lines now with a little redness around them. -Still a little bit of that hard scar tissue under some of my incisions. -Chest and lat muscles feel about 80% healed from the incisions. -The deformity in my right chest from the main incision is practically gone. -Still have some loss of feeling in my right chest form nerve damage. -Able to hold a 8:00 pace for two miles straight, heart rate in the 160\'s. -1600 meter swim workouts, only 600 yards of actually pulling. -Still cannot put full pressure on my lats when pulling. 2 months: -I feel normal now doing normal, everyday things. -Working out though I feel about 75%. -Ran a 6:45 mile on the street and a 3 mile at 7:50 pace. -Swimming, I can now pull I has hard as I want to. -Returned to doing push-ups and pull-ups -No muscular pain anywhere. -I still don\'t have all of the feeling back in my chest or lat 3 months: -First chest pain episode. Extreme pain lasted for 5 days. -Profuse sweating at night comes along with these pain episodes. -I\'m almost positive this is from nerve growth or healing. -With the chest pains comes: 1. Increased PVC\'s 2. Chest/back/shoulder pain on the left side. 3. Profuse sweating at night. I will wake up completely soaking wet like I just jumped out of the swimming pool. But I\'m not hot. 4. Increased sensitivity and numbness in my right nipple because the nerves that go to the nipple go between the 4th and 5th rib....The same place where the incision is made. 5. Bouncing feeling in my heart comes back when I run. 4 months: -Great progress and recovery form first pain episode. -Second chest pain episode. 5 Months: -Still getting random 5 day chest pain episodes every couple of weeks. -In between pain episodes, I\'ve increased my runs to 5 miles, and swims to 4000 yards. 6 Months: -It took my chest 3 to 4 weeks to feel \"right\" again from my last pain episode. -Cut back on intensity of workouts. -Increased swim workouts to around 5000 yards when I have time. -Decreased my runs to 3 miles since my chest doesn\'t feel right from the last episode. 8 Months: -Drastic increase in physical activity. -3000 to 6000 yard swim workouts. Sometimes twice a day. -1 mile run time 6:08 -Navy SEAL PST times are getting a little closer to pre surgery levels except my run time is still lagging drastically: -7:15 500 yard breaststroke swim. -2 minute push up, 100 reps. -2 minute sit up, 90 reps. -pull ups, 30 reps. -1.5 mile run 11:00 9 Months: -Swam in a US Masters swim meet. -Chest pain episode returned. -Took two months for my chest to feel good after this episode. 12 Months: -Swimming and running feels great -Push ups and pull ups fell great -Still not back to pre surgery run and swim times. -I do not feel fully recovered. -Still sometimes get feeling like the chest pain episodes could come back.

One year post surgery, I am still having ups and downs. The downs are less frequent and not as bad as a few months ago. I haven\'t had a chest pain episode since mid March but that episode took two months for my chest to feel right. The last week in May, I went to Colorado for a week and my chest felt a lot better. It may have been from the low humidity but I\'m not sure. Now, sometimes I notice my chest feels better on low humid days but I\'m not sure yet if that is consistent. I\'ve been feeling great the past few weeks but my chest is starting to feel a little shaken up, like maybe I had an episode but there wasn\'t pain involved. Even though my chest has felt good, I\'ve been getting these random heart beats. It\'s just one beat that feels slower, and that one beat has a little pain to it. And that\'s it and it goes back to normal. Sometimes I also feel some \"nerve\" feelings near my incisions under my arm and chest when I turn my head a certain way. Exercising has been great, however I am still not to where I was physically prior to surgery. I really have no limitations except when I do get the chest pain episodes. See my pictures for pictures of my 1 year scars.

It looks like I spoke too soon. The Chest/back/shoulder pains came back with a vengeance. Pain so bad that I can\'t move for most of the week. The month started off great. My run times where coming down and I was finally getting my stamina back. I swam in a US Masters swim meet and did pretty good. The week before the meet I cut back on my workouts to rest. I started having increased PVC\'s the two weeks leading up to the 7 days of pain. The pain is gone now but my chest is still a little shaken up. I now think that over working myself has nothing to do with it. I think it\'s just nerves going through cycles of growth or healing because when I get the chest pain episodes I experience four things.... 1. Increased PVC\'s 2. Chest/back/shoulder pain on the left side. 3. Profuse sweating at night. I will wake up completely soaking wet like I just jumped out of the swimming pool. But I\'m not hot. 4. Increased sensitivity and numbness in my right nipple because the nerves that go to the nipple go between the 4th and 5th rib....The same place where the incision is made.

It\'s now been over two months since my last chest pain episode. I hopefully can say that that is now behind me. I took 1 or two breaks a week over the past 2 months and it really helped me recover better. I am pretty confident now that these chest pain episodes where not periocarditis. I\'ve also had times shortly after 6 months that it would feel like the my heart was angry but it never lead to pain. When i would feel this, I would also have a little more activity in my nerves around my insision which leads me to beleive that this pain occured during periods of nerve healing. The past month and half, I have seen drastic improvement in my physical activities. I can still tell that I am not fully recovered but things are steadily improving. I\'m swimming anywhere from 3000 to 6000 yards in one workout and some days I will even swim two workouts a day. I\'ve noticed in swimming and running that there hasn\'t been any decrease in anerobic, sprinting, and strentgh (pushups & pullups) performance compared to presurgery, but I am still lagging a bit in long endurance despite the longer workouts. I just can\'t keep the high intensity for the amount of time that I used to. Hopefully that will change within the next few months but only time will tell. The numbness in my right breast is practically gone. The nipple area is about 95% gone. Some days there\'s more sensitivity than others and I\'m assuming that is these periods of nerve healing. I can also say that I am finally back to my normal weight.

It\'s been about 4 weeks since my last chest pain episode. The effects of the last episode lingered on for 3, almost 4 weeks. The bouncing feeling around my heart when I run, lasted weeks longer than it has in past episodes. I\'ve cut back on the frequency of my workouts only swiming and running every other day. I\'ve been feeling great. On a couple of occasions, I did workout two days in a row and I could tell that my heart was a little angry with me. So, it\'s looking like over working myself is very strong possibility for my reoccuring chest pains. I guess the nerves in my heart are still healing. I\'ve increased the distance of my swim workouts to around 5000 yards when I have the time. Running still irritates my heart or chest since my last pain episode so I\'ve decreased my runs to 3 to 4 miles. But on a good note, I ran my fastest mile since my surgery. The numbness in my right breast and nipple is around 90% gone. Feeling has almost completly returned the area. My scars look great. Most are hardly noticable except the main incision. (See Pictures)

The past month and a half to two months I\'ve been randomly getting chest pains and stabbing pains in my left shoulder. The pain will come on slowly at first then get severe and last for about 5 or 6 days than go away. Then a few days after that, I\'ll feel like a million bucks, go run 5 miles or swim 4000 yards, then two weeks later it comes back. And the cycle repeats. The pain will sometimes move around from right around my heart to the front of my shoulder (Mostly left but sometimes both) then to the back of my shoulder, and mid back. When the pain is really bad I can feel it pulsate up the left side of my neck. It will be so bad that I can\'t move and I can\'t sleep on my back. It also hurts to take a deep breath when this is going on. I get hot and cold flashes like I\'m running a fever but my temperature will be normal. I went to the ER and had a CT scan, XRay, EKG and the doctor there said everything looked fine. He sent the images to my surgeon and he too said everything looks fine and he has no clue what is going on. He said he wouldn\'t think it would be from the incisions because everything is done from the right side and they don\'t touch anything on the left. Maybe there is a possible of periocarditis but my surgeon said that that is very rare 3 or 4 months after surgery. I have had three episodes since my ER visit. When I first started jogging 3 weeks after surgery my hearth would feel like it\'s bouncing around in my chest. That feeling slowly went away and I was good for about 3 months. Now when I have these episodes, and the episodes are over, I start jogging again and that bouncing feeling is back then it takes about a week or so for it to go away. Dressler\'s syndrome has not been mentioned to me by any of my doctors but after researching a bit and reading some other journals, it seems like that\'s what I might have. Or possibly muscle spasms somewhere in my chest cavity or inner back. I\'m just not sure.

Two Weeks ago I was making great progress physically, then the stabbing shoulder pain, and chest pain came back. It hurt to breath. The pain started mild in the middle of my chest, then over the next few days it spread to my left side, both sholdrs, then to top of my left shoulder and behind my shoulder blade. If I would bend over or slightly get my heart rate up I could feel throbbing pain shooting up the left side of my neck and into my head. Went to the ER on the second day and had a CT scan, Xray, blood work done. Everything checked out fine. No blood clots in my lungs, no tear in the aorta, no infections etc...The ER doctor and my surgeon said they have no clue where this pain is commig from. Could it possible be periocarditus? Or muscle spasms inside my chest cavity? The pain was very bad laying on my back. The pain was probably worse than the actual surgery pain. This lasted for 6 days then just stopped. I was on anti inflamatories. Physically it feels like it set me back about a month at first. Does anyone have any clue what this could be or experienced anything similar?

Two days after week 12, I had stabbing pain in my left shoulder and the area directly below the heart. From what I could tell this wasn\'t my heart. This lasted for about five days. Finally on the 5th day before bed, I took a Ibuprofin to block any inflamation. When I woke up, it was all gone. This five day episode forced me to take a break from my intense workouts. On that 6th day I felt like a new person and the uncomfortable feeling I had from holding my heart rate high for long periods of time was gone. This may have been from me just needing rest. The past two weeks I have been making great progress in the swimming pool. I am still lacking a little in my runs compared to pre-surgery mainly because I\'ve been focusing more on swimming. The past week I\'ve been giving running more attention and I am getting back to pre-surgery times much quicker. I still have some pain and numbness in my left nipple area. The pain isn\'t so much on the incision(1 inch below the nipple), it\'s more on and surrounding the nipple. I also have some numbness on my lats that aren\'t close to any incisions. This pain doesn\'t inhibit me from doing push ups and pull ups. Push ups and pull ups do not effect the pain at all. It seems to be more of a nerve issue. My scars still look the same. All healed up but pink in color.

Around the end of week 10, week 11, and week 12 I\'ve noticed more pain in the incision under my nipple than previous weeks. I\'m assuming this is because my nevrves are starting heal alot more. I still have some tenderness in my ribs also. My workout intensity has increased drastically. Especially in swimming. I\'m able to push my self very hard but I still feel uncomfortable about holding my heart at a high rate for long periods of time. I\'m not sure if this is mental just because I know that I had heart surgery or if my heart physicall isn\'t ready? But none the less, I\'m improving every week. There isn\'t really much differences in my scars since a month ago. They are all healed up but still a red/pink color.

I had my post op visit with my cardiologist at week 7 and he cleared me to live a normal life from here on out. The only medicine i\'ve been taking since week 4 was aspirin and now I am not taking anything! Not even aspirin! I feel 100% normal doing normal things now. Working out though, I feel only about 75%. I have no pain anywhere when I workout. I just feel a little out of shape. I am slowly getting my run times down. Yesterday I ran a 6:45 mile on the street and today I ran a 3 mile at 7:50 pace on the tredmill. In the pool, I am now able to swim butterfly and pull as hard as I want. Week 7, I\'ve started doing lat pull downs lightly at 50 reps and I\'ve increased the weight on my 100 rep bumbell bench. All of this light weight, high reps was to ease into push up and pull up type movements without damaging scar tissue or unhealed muscle. This week I am back to doing normal push ups and pull ups with no pain. The only hint of pain I feel is if I push on the two ribs that where spread apart but it is very mild and I have absolutly no muscular pain. I still don\'t have all of the feeling back in my chest or lat but it Improves slowly every week. Scars are looking great and there is no deformity in my right chest muscle from the main incision.

My main incision scar is basically just a clean line now with some redness around it. The muscles around my incisions feel about 85% healed. But they feel normal when I\'m not working out. Most of the bulky scar tissue is gone except for a little bit that I can feel if I push in underneath my nipple. The deformity in my right chest muscle is practically gone. I still have some loss of feeling in my right chest. Jogging, I\'ve increased my pace to 8:00 pace per mile for a solid two miles keeping my heart rate in the 160\'s. In the pool I\'m doing mostly all kicking workouts. 1000 meters of 100 meter sets, plus 600 meters of light swimming. I\'m not putting full pressure on my lats when a take a stroke but there isn\'t much pain at all unless I twist my body the wrong way. I highly recomend swimming as a great rehab excercise if you have some swimming skills. You can keep yourself afloat and moving forward with your left arm or a kick board and you can control exactly how much pressure you are putting on your right arm. And if you lightly work that right arm your muscles will heal faster. Also if you are kicking you can get a good workout in and keep your heartrate lower than when your are standing up and running since you are laying horizontal.

Day 29 With the bouncing feeling in my heart almost all the way gone, I was able to lightly jog my first non stop mile in 9:30. I then finished that with a 3 mile walk. Day 32 Jogged a mile to the Gym then jogged a mile on the tredmill in 9:00, walked/ jogged another 3 miles after work. I\'ve increased my swim to 1200 meters all kicking except 300 meters of very light pulling. Not much pain in my chest and lats when pulling but the muscles don\'t feel all the way healed.

My full pre-surgery weight isn\'t back yet. I\'m still about 3 to 4 lbs light, but I am being sensible about my weight gain and not pigging out just to put the weight on. There is still mild to moderate skin irritation in my pectoral do to nerve damage from the incisions. It is slowly getting better. Day 22 I had a HUGE recovery which seemed to happen over night. Almost no pain at all and much more flexibility in my right pec and lat. Day 26 I walked 1 mile to the swimming pool and did a 600 yard kicking workout. My wounds and scar tissue don\'t feel strong enough to start pulling with my right arm. Day 28 Walk and jog 2 miles. 1000 yard swimming workout that was 800 yards kick and 200 yards lightly pulling with my right arm. The bouncing feeling in my heart when I jog is much much less now.

Towards the end of the 2nd week, more nerves came back in my pectoral. More feeling, less irritation in the skin but a little more pain was felt in my ribs. This pain didn’t require pain medication. Day 19, 20, 21 I could walk at faster than average walking pace without it feeling wrong in any way. Day 17, I increase the 5lb curls to 60 reps and added 25 reps of tricep kickbacks. I did this twice daily. Walked 4 miles in the evening. Day 21 I increased the 5lb curls to 100 reps, 50 rep triceps kickbacks, and 100 reps with 5lb dumb bell bench press. Day 21 I had my follow up with my surgeon. He cleared me to go back to work, drive and do what ever activity I felt comfortable doing. So I slowly added in a very short jogs into my walk and increased the distance of the jog everyday. The first time I jogged was very uncomfortable because it felt like my heart was bouncing around in my chest. Everyday I jogged after that that feeling was less and less.

I have lost somewhere around 6 to 8 pounds of muscle weight since the surgery. (One Week after surgery) Walked 1.5 miles in the morning, ½ mile in the evening. I took no pain medication Tuesday night. I felt great all night. I finally got good sleep. I awoke this morning with no pain at all except when I cough or sneeze. This is probably my best day of recovery progress yet. Day 8 Walked 1.5 miles in the morning, 1 mile in the evening. I haven’t taken pain medication since Sunday. I feel I will no longer have to take any. Started doing light stretching to my pectoral, latissimus and teres.. This took my back pain away. Day 9 Walked 2 miles in the morning. Out of the house all day walking around. Put together a porch swing. Stretched lat and arm throughout the day. This really helped get range of motion back into my arm. This was my first day without taking a nap. Day 10 Last night was another great night of recovery and sleep. Minimal pain in my ribs while sitting up in bed. Very slight pain in ribs when sitting up in bed. Very big improvement in my range of motion in my right arm. Cut the grass and did household chores. Continued doing light stretching to my pectoral, latissimus and teres. Calf raises. Day 11 Walked 2 miles in the morning, and 1 mile in the evening. Calf raises. Continued doing light stretching to my pectoral, latissimus and teres. Messaged pec and lat muscle. This brought back more feeling. Shirts and bed sheets really irritate my skin. Day 12 Walked 2 miles in the morning, and 1 mile in the evening. Spent all day walking and shopping in Wal-mart and Lowes. Two sets of 30 reps 5lb curls. Calf raises. Continued doing light stretching to my pectoral, latissimus and teres. Messaged pec and lats to bring back nerves. The more feeling I got back in my pec, the more irritated my skin was. Shirts and bed sheets irritate my skin to no end. DAY 13 Walked 2 miles in the morning. Two sets of 30 reps 5lb curls. Calf raises Day 14 Walked 3 miles in the morning, and 1 mile in the evening. Two Sets of 30 5lb curls. Calf raises.

I would have to say that the surgery wasn\'t very painful. Most of the pain that I had was in my upper right back. I assume this was from my ribs being spread. Day 3 after surgery was the most painful day. The incisions never really gave me much pain. I was off of pain medication the day after I returned home from the hospital. (5th day after surgery) Buy week 3 I was off of all medication except 1 asprin a day. Day 2 and 3, wires were removed from my heart and drainage tube was removed. The electric wires felt strange as they were plucked off of my heart but not painful at all. The drainage tube removal was painful because it basically has to be yanked out of you. But in 15 minutes it is a huge relief to have it out of you. The tube goes in your right armpit, across to your heart area. Since the tube touches your lungs, it causes a lot of breathing pain and upper chest/back muscle irritation.