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Wednesday, August 5, 2009
Saturday, July 25, 2009
Heart Valve Replacement Surgery - Pacemaker Complications!
When I had my double valve repair surgery nine weeks ago, my cardiac surgeon thought before going into the surgery that I would need heart valve replacement surgery on at least one of the valves, but since my heart problems had been caused by a lead extraction procedure while implanting a new pacemaker and leads, all the parts to the valves were still there; they just needed to be sewn back together and reinforced.
It is always better to repair instead of replace where possible for obvious reasons, not the least of which is your body just goes on about it's business and doesn't have to adjust to something foreign. Also, it you get an artificial valve, taking Coumadin will be a lifetime sentence. However, if you need heart valve replacement, thank God that it is a perfectly viable option.
To get back to my pacemaker complication problem, one of my pacemaker leads had fractured (picture an electrical cord that wears and frays), it needed to be extracted and a new one put implanted in it's place. The fractured pacemaker lead was leaking current into my pectoral muscle and causing it to jump like a bouncing ball. Believe me, my pectoral muscle hadn't had that much excitement in a long time.
Since the fractured pacemaker lead was being extracted anyway, my cardiologist decided to extract the other one and replace my existing pacemaker too. I thought this was fantastic, an overnight stay in the hospital, and I would have two new leads and a new pacemaker to boot. I'd be ready to rock and roll for another ten years or so.
Sadly, my tricuspid valve was severely damaged during the lead extraction procedure, so that's why I ended up with a full-blown open heart surgery.
To get back to my pacemaker complication, it seems that the new pacemaker has slipped out of its pocket or something. The posts and screws are now right under the skin, and get pinched during exercise, and also with any little friction of my bra strap which lays right over the pacer.
Right now, I'm going without a bra until I can show the Doctor what's happened.
This is my third pacemaker, and I know that something weird is happening since neither of my other pacers started migrating or slipping out of the pocket like this. I'm afraid that the screws and connection posts will just work their way through the skin pretty soon. I have an appointment with Dr. Blake, my cardiologist, soon and I'm anxious to hear what she recommends.
I'm just curious, have any of you had this problem?
It is always better to repair instead of replace where possible for obvious reasons, not the least of which is your body just goes on about it's business and doesn't have to adjust to something foreign. Also, it you get an artificial valve, taking Coumadin will be a lifetime sentence. However, if you need heart valve replacement, thank God that it is a perfectly viable option.
To get back to my pacemaker complication problem, one of my pacemaker leads had fractured (picture an electrical cord that wears and frays), it needed to be extracted and a new one put implanted in it's place. The fractured pacemaker lead was leaking current into my pectoral muscle and causing it to jump like a bouncing ball. Believe me, my pectoral muscle hadn't had that much excitement in a long time.
Since the fractured pacemaker lead was being extracted anyway, my cardiologist decided to extract the other one and replace my existing pacemaker too. I thought this was fantastic, an overnight stay in the hospital, and I would have two new leads and a new pacemaker to boot. I'd be ready to rock and roll for another ten years or so.
Sadly, my tricuspid valve was severely damaged during the lead extraction procedure, so that's why I ended up with a full-blown open heart surgery.
To get back to my pacemaker complication, it seems that the new pacemaker has slipped out of its pocket or something. The posts and screws are now right under the skin, and get pinched during exercise, and also with any little friction of my bra strap which lays right over the pacer.
Right now, I'm going without a bra until I can show the Doctor what's happened.
This is my third pacemaker, and I know that something weird is happening since neither of my other pacers started migrating or slipping out of the pocket like this. I'm afraid that the screws and connection posts will just work their way through the skin pretty soon. I have an appointment with Dr. Blake, my cardiologist, soon and I'm anxious to hear what she recommends.
I'm just curious, have any of you had this problem?
Friday, July 24, 2009
Valve Replacement Surgery - Yeh! I'm Off The Lasix!
For some reason, getting off the Lasix (a common diuretic used after valve replacement surgery), has been extremely difficult for me. My cardiologist, Dr. Blake, has gradually reduced the dosages, but that last small dose was the hardest to eliminate.
I would try to skip a day of the small dose, and the next morning, fluid would pool around my knees. I was beginning to think that I would be on this particular diuretic forever, but after skipping my dose yesterday, no fluid had accumulated around my knees this morning. I am so happy to subtract one more drug from my daily medicine taking routine.
I'm still taking a small dose of another type of diuretic (Spironolactone, a potassium saving diuretic), but with any luck, it won't be for long.
When you first leave the hospital after your heart valve surgery, it seems you have a dozen different medications to take, but gradually, one by one, the dosages get cut and then they are completely eliminated.
You feel somewhat liberated, and strangely enough, there is a certain sense of accomplishment every time you get to discard one of those medicine bottles. Each medicine bottle that you get to throw away can be counted as a milestone in your recovery process.
I believe that one of the most beneficial things that you can do for your recovery is to stick with your rehabilitation program. Exercise is a form of medicine too, at least that's what the sign says over at New Heart, my rehabilitation facility.
Cardio exercise gradually makes your heart stronger and able to pump efficiently. When your heart pumps efficiently, it can automatically keep the fluid from accumulating in your body.
Lets see now, it's been nine weeks since my open heart dual valve repair surgery, and on the days I'm not at rehab, I work a full day on our Internet business. It feels really good to be back in the saddle again. Right now, I'm learning new things every single day.
I do still get tired, but not even half as tired as I was getting before the surgery, but back then I could not have hit a lick at a snake.
After only nine weeks, life is good again. We've found a bird block that the quail just love. I'll bet we have at least ten quail families that feed here now. It's a pleasant morning ritual to watch the different quail families come to the block and feed.
Connie and Rod, our friends who live up the mountain have had to quit feeding their quail because they now have three hawks hunting on their property.
Today is rehab day, and grocery day. Yes, I can do them both on the same day. At rehab, I'm working out a little on the weight machines, as well as doing 60 minutes of cardio exercise. I've made some friends there, and it's wonderful to see their progress too. Sometimes, I'm amazed at how fast heart patients begin to improve.
I would try to skip a day of the small dose, and the next morning, fluid would pool around my knees. I was beginning to think that I would be on this particular diuretic forever, but after skipping my dose yesterday, no fluid had accumulated around my knees this morning. I am so happy to subtract one more drug from my daily medicine taking routine.
I'm still taking a small dose of another type of diuretic (Spironolactone, a potassium saving diuretic), but with any luck, it won't be for long.
When you first leave the hospital after your heart valve surgery, it seems you have a dozen different medications to take, but gradually, one by one, the dosages get cut and then they are completely eliminated.
You feel somewhat liberated, and strangely enough, there is a certain sense of accomplishment every time you get to discard one of those medicine bottles. Each medicine bottle that you get to throw away can be counted as a milestone in your recovery process.
I believe that one of the most beneficial things that you can do for your recovery is to stick with your rehabilitation program. Exercise is a form of medicine too, at least that's what the sign says over at New Heart, my rehabilitation facility.
Cardio exercise gradually makes your heart stronger and able to pump efficiently. When your heart pumps efficiently, it can automatically keep the fluid from accumulating in your body.
Lets see now, it's been nine weeks since my open heart dual valve repair surgery, and on the days I'm not at rehab, I work a full day on our Internet business. It feels really good to be back in the saddle again. Right now, I'm learning new things every single day.
I do still get tired, but not even half as tired as I was getting before the surgery, but back then I could not have hit a lick at a snake.
After only nine weeks, life is good again. We've found a bird block that the quail just love. I'll bet we have at least ten quail families that feed here now. It's a pleasant morning ritual to watch the different quail families come to the block and feed.
Connie and Rod, our friends who live up the mountain have had to quit feeding their quail because they now have three hawks hunting on their property.
Today is rehab day, and grocery day. Yes, I can do them both on the same day. At rehab, I'm working out a little on the weight machines, as well as doing 60 minutes of cardio exercise. I've made some friends there, and it's wonderful to see their progress too. Sometimes, I'm amazed at how fast heart patients begin to improve.
Tuesday, July 14, 2009
Valve Replacement Surgery - Meds Create Havoc!
It's been exactly two months since my valve repair surgery, and Dr. Blake, my cardiologist, is trying bring my body down off of some of the medicines. She cut my Carvedilol (a medicine given for congestive heart failure, high blood pressure and other indications) in half.
In my case, Dr. Blake prescribed the Carvedilol to make my heart beat harder. Now that my heart is healing, she felt that it was time to cut back on it. My blood pressure has been gradually trending down (80 to 88 over 41 to 52) for a couple of weeks, indicating that I no longer needed such a high dose.
After taking the new reduced dosage, my blood pressure has been bouncing around all over the place, it even got to 131/86, but now it seems to have settled into the 90+ over 50+ range when I'm at rest and 100+ over 80+ when I'm up and about. This was about my normal before the open heart surgery.
My atrial fibrillation is now well controlled by my new fancy pacemaker, and even if the Maze Procedure does not work for me, I should be able to get off all heart medications within a short time. I'm on no anti-arrhythmia drugs for the first time in over 13 years. The anti-arrhythmia drugs have serious long-range side effects, so I'm happy to be off them.
One question that I'll have for Dr. Blake the next time I see her will be, what is now different about my heart or the new pacemaker that allows me to be off the powerful anti-arrhythmia medicines.
My rehab sessions are going very well, I'm doing 60 minutes of cardiovascular exercising plus some weight training three times a week. I'm gradually increasing the resistance levels or the rpms or the speed depending on which exercise machine I'm on. My legs and arms are both looking a bit better from their previous atrophied condition.
I'm now able to work a full day either on the Internet Projects and around the house or on the Internet Projects and going to my rehab workouts. This really feels good to me, to be able to not only take care of myself, but to actually start contributing my help to our Internet Projects. I never dreamed that in only two months post open heart surgery I'd be this far along.
There are times when I still do feel vulnerable, but not as I did the first days and weeks after my open heart valve repair surgery.
Bo and Bentli, my beautiful canine companions, just might be getting their normal morning walks in the not too distant future. They will be happy to be walking down to the dog park where they can run and rip and roar again, and I'll be simply ecstatic to be able to take them.
I could take Bo, the little Shi Tzu, now, however, Bentli is a 70lb. Boxer. She is capable of dragging me all over these beautiful Sandia Mountain foothills if she were to spot a rabbit or some other animal of interest. No, dog walking, will have to wait just a little longer. Gives us all something to look forward to.
In my case, Dr. Blake prescribed the Carvedilol to make my heart beat harder. Now that my heart is healing, she felt that it was time to cut back on it. My blood pressure has been gradually trending down (80 to 88 over 41 to 52) for a couple of weeks, indicating that I no longer needed such a high dose.
After taking the new reduced dosage, my blood pressure has been bouncing around all over the place, it even got to 131/86, but now it seems to have settled into the 90+ over 50+ range when I'm at rest and 100+ over 80+ when I'm up and about. This was about my normal before the open heart surgery.
My atrial fibrillation is now well controlled by my new fancy pacemaker, and even if the Maze Procedure does not work for me, I should be able to get off all heart medications within a short time. I'm on no anti-arrhythmia drugs for the first time in over 13 years. The anti-arrhythmia drugs have serious long-range side effects, so I'm happy to be off them.
One question that I'll have for Dr. Blake the next time I see her will be, what is now different about my heart or the new pacemaker that allows me to be off the powerful anti-arrhythmia medicines.
My rehab sessions are going very well, I'm doing 60 minutes of cardiovascular exercising plus some weight training three times a week. I'm gradually increasing the resistance levels or the rpms or the speed depending on which exercise machine I'm on. My legs and arms are both looking a bit better from their previous atrophied condition.
I'm now able to work a full day either on the Internet Projects and around the house or on the Internet Projects and going to my rehab workouts. This really feels good to me, to be able to not only take care of myself, but to actually start contributing my help to our Internet Projects. I never dreamed that in only two months post open heart surgery I'd be this far along.
There are times when I still do feel vulnerable, but not as I did the first days and weeks after my open heart valve repair surgery.
Bo and Bentli, my beautiful canine companions, just might be getting their normal morning walks in the not too distant future. They will be happy to be walking down to the dog park where they can run and rip and roar again, and I'll be simply ecstatic to be able to take them.
I could take Bo, the little Shi Tzu, now, however, Bentli is a 70lb. Boxer. She is capable of dragging me all over these beautiful Sandia Mountain foothills if she were to spot a rabbit or some other animal of interest. No, dog walking, will have to wait just a little longer. Gives us all something to look forward to.
Friday, July 10, 2009
Valve Replacement Surgery - Happiness Is Running Errands!
Before my open heart surgery, I detested running errands, but now that I'm getting stronger and feeling better I'm extremely grateful to be well enough to go to the grocery & drug store. I've been going to the pharmacy for a few weeks, but this is only the second time I've tackled a big two-week grocery shopping excursion.
I now consider errands as opportunities for outings. Believe it or not, I actually enjoy getting out and seeing other people. There is always an adventure around the corner if you will focus on the moment at hand. I use my outings as opportunities to make the other shoppers smile. You never know what a smile or a kind word will mean to another human being.
We really don't appreciate all the everyday activities that our marvelous bodies perform for us countless times every day unless we lose the ability to do our regular daily routines, do we?
In three more days, it will be two whole months since my heart valve repair surgery. I can remember when it was all that I could do to walk to the end of my driveway and now I'm doing 60 minutes of cardiovascular exercise three times per week. Good for me, right!
The point is, don't get discouraged during those early weeks of recovery. If you are like I was, although progress seemed slow, it was progress nevertheless. And, there is a compounding cumulative effect too, the more you do, the more you are able to do.
My sternum area is still pretty sore, but it takes longer for bones to heal than it does for tissue, so I'm not worried about it. I'm not supposed to lift over 10 pounds, but who carries a scale with them all the time. The telltale knot at the top of my sternum which gives away any open heart surgery is almost gone (the surgeon said it would be 3 months). My scar is healing and is almost invisible at the top now.
All-in-all, I'm perking along pretty well these days. Grocery shopping this morning and rehab this afternoon. WOW! It's still hard to believe that I can do both in one day.
I now consider errands as opportunities for outings. Believe it or not, I actually enjoy getting out and seeing other people. There is always an adventure around the corner if you will focus on the moment at hand. I use my outings as opportunities to make the other shoppers smile. You never know what a smile or a kind word will mean to another human being.
We really don't appreciate all the everyday activities that our marvelous bodies perform for us countless times every day unless we lose the ability to do our regular daily routines, do we?
In three more days, it will be two whole months since my heart valve repair surgery. I can remember when it was all that I could do to walk to the end of my driveway and now I'm doing 60 minutes of cardiovascular exercise three times per week. Good for me, right!
The point is, don't get discouraged during those early weeks of recovery. If you are like I was, although progress seemed slow, it was progress nevertheless. And, there is a compounding cumulative effect too, the more you do, the more you are able to do.
My sternum area is still pretty sore, but it takes longer for bones to heal than it does for tissue, so I'm not worried about it. I'm not supposed to lift over 10 pounds, but who carries a scale with them all the time. The telltale knot at the top of my sternum which gives away any open heart surgery is almost gone (the surgeon said it would be 3 months). My scar is healing and is almost invisible at the top now.
All-in-all, I'm perking along pretty well these days. Grocery shopping this morning and rehab this afternoon. WOW! It's still hard to believe that I can do both in one day.
Thursday, July 9, 2009
Valve Replacement Surgery - Too Much, Too Soon!
For the first time since my open heart surgery, I woke up with two knees that looked like water balloons. Boy, was I ever surprised and a little scared. This means that my heart is not yet healed enough to prevent fluid retention.
Dr. Blake cut back drastically on my diuretics and I guess it was just too much of a reduction at one time. It seems that I'm one of those people that needs to reduce diuretics gradually.
I talked to Dr. Blake's nurse about my water balloons, and she said to try taking the Furosemide (a powerful diuretic) every other day instead of once a day. I'm to continue with the Spironolactone (a milder, potassium saving diuretic) as before.
A question that is bothering me is, what do heart patients do when they are not at all familiar with various medications or their own heart conditions. Most heart patients are older, and many of them do not know how to use the Internet to gather pertinent information. Often, I fear, they do not recognize telltale signals that could be life threatening.
While I was at New Heart Rehabilitation doing my rehab exercises a couple of days ago, I heard the dietician trying to explain to a recent heart attack patient the difference between his heart rate and his glucose level. My God! He thought they were the same thing. How does this man manage all the instructions and medicines? My guess is that he doesn't.
I've been fortunate in that I've been closely monitored, almost on a weekly basis, ever since my open heart surgery. I know for a fact that many heart surgery patients do not get seen nearly that frequently.
Our newest saltwater fish, a gorgous powder blue tang, died last night. Kathy and Judy gave her to us when they were here; we are so very sad. It looked like it had a little Ich, but that shouldn't have killed it. Maybe the change from its natural habitat to our tank was just too much for it.
Dr. Blake cut back drastically on my diuretics and I guess it was just too much of a reduction at one time. It seems that I'm one of those people that needs to reduce diuretics gradually.
I talked to Dr. Blake's nurse about my water balloons, and she said to try taking the Furosemide (a powerful diuretic) every other day instead of once a day. I'm to continue with the Spironolactone (a milder, potassium saving diuretic) as before.
A question that is bothering me is, what do heart patients do when they are not at all familiar with various medications or their own heart conditions. Most heart patients are older, and many of them do not know how to use the Internet to gather pertinent information. Often, I fear, they do not recognize telltale signals that could be life threatening.
While I was at New Heart Rehabilitation doing my rehab exercises a couple of days ago, I heard the dietician trying to explain to a recent heart attack patient the difference between his heart rate and his glucose level. My God! He thought they were the same thing. How does this man manage all the instructions and medicines? My guess is that he doesn't.
I've been fortunate in that I've been closely monitored, almost on a weekly basis, ever since my open heart surgery. I know for a fact that many heart surgery patients do not get seen nearly that frequently.
Our newest saltwater fish, a gorgous powder blue tang, died last night. Kathy and Judy gave her to us when they were here; we are so very sad. It looked like it had a little Ich, but that shouldn't have killed it. Maybe the change from its natural habitat to our tank was just too much for it.
Wednesday, July 8, 2009
Valve Replacement Surgery - 7 Week Follow Up With Cardiologist
It's been seven weeks since my open heart valve repair surgery. Today, I saw Dr. Blake, my cardiologist, for another follow-up appointment. She was very happy with my improvement since she last saw me only a couple of weeks ago.
The fluid in my right lung has finally disappeared, and she felt it was time to decrease the diuretics and also my heart medicine. She cut them both back to almost half what I've been taking. I'm elated to start getting off some of the meds., particularly the diuretics.
Also, Dr. Blake had her staff do a check on my pacemaker and leads, and she ordered a new EKG. She was trying to determine if the atrial lead was sensing properly. It had not been sensing as it should shortly after my valve repair and Maze Procedure surgery. The Maze Procedure is used to eliminate or greatly reduce A-Fib.
Dr. Levy, the heart surgeon, had re-implanted the lead during the open heart surgery in hopes that my heart muscle would grow around it enough for it to begin to sense and capture correctly. He told Dr. Blake that he didn't think the experiment would work, but that it just might, and if it did, it would eliminate another surgery procedure. Interrogation of the pacemaker device showed that indeed the lead was now functioning just as it should.
This was terrific news to both Dr. Blake an myself as this means she will not have to reopen the pacemaker pocket either to re-implant or replace what was a malfunctioning lead, and it also means no more surgery on my heart hopefully for many years to come. The Medtronic technician adjusted the lead down to 70 from of 80.
While interrogating the pacemaker, a strange phenomenon occurred. My chest muscles in and around the device pocket twitched almost constantly. Neither the in-house nor the Medtronic device technician using various interrogation techniques could figure out what was causing the twitching. They told me to watch it and if it started happening at home to call Dr. Blake.
This muscle twitching is somewhat disconcerting to me because that is what was what alerted me to the original lead fracture back in February. The twitching today was not nearly as severe, but it definitely caught my attention. After all that's happened, I want the new pacemaker and leads to work perfectly.
My INR at last check was 2.9, but today it was only 1.7, necessitating an increase in the coumadin. When it was at 2.9, I bruised easily and bled like no tomorrow with just a little prick on the finger.
I will still be on the coumadin for several months as I am taking part in a research project which requires that I be on this blood thinner for several more months. Coumadin is a hassle as it has to be checked frequently to see if your blood is too thin or thick. Also, if it is too thin, you're subject to abnormal bruising and bleeding.
The fluid in my right lung has finally disappeared, and she felt it was time to decrease the diuretics and also my heart medicine. She cut them both back to almost half what I've been taking. I'm elated to start getting off some of the meds., particularly the diuretics.
Also, Dr. Blake had her staff do a check on my pacemaker and leads, and she ordered a new EKG. She was trying to determine if the atrial lead was sensing properly. It had not been sensing as it should shortly after my valve repair and Maze Procedure surgery. The Maze Procedure is used to eliminate or greatly reduce A-Fib.
Dr. Levy, the heart surgeon, had re-implanted the lead during the open heart surgery in hopes that my heart muscle would grow around it enough for it to begin to sense and capture correctly. He told Dr. Blake that he didn't think the experiment would work, but that it just might, and if it did, it would eliminate another surgery procedure. Interrogation of the pacemaker device showed that indeed the lead was now functioning just as it should.
This was terrific news to both Dr. Blake an myself as this means she will not have to reopen the pacemaker pocket either to re-implant or replace what was a malfunctioning lead, and it also means no more surgery on my heart hopefully for many years to come. The Medtronic technician adjusted the lead down to 70 from of 80.
While interrogating the pacemaker, a strange phenomenon occurred. My chest muscles in and around the device pocket twitched almost constantly. Neither the in-house nor the Medtronic device technician using various interrogation techniques could figure out what was causing the twitching. They told me to watch it and if it started happening at home to call Dr. Blake.
This muscle twitching is somewhat disconcerting to me because that is what was what alerted me to the original lead fracture back in February. The twitching today was not nearly as severe, but it definitely caught my attention. After all that's happened, I want the new pacemaker and leads to work perfectly.
My INR at last check was 2.9, but today it was only 1.7, necessitating an increase in the coumadin. When it was at 2.9, I bruised easily and bled like no tomorrow with just a little prick on the finger.
I will still be on the coumadin for several months as I am taking part in a research project which requires that I be on this blood thinner for several more months. Coumadin is a hassle as it has to be checked frequently to see if your blood is too thin or thick. Also, if it is too thin, you're subject to abnormal bruising and bleeding.
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