Clint's Journal

Two weeks ago I had my surgery. Unbelievable. I haven't used the prescribed Norco in days, and haven't even had a Tylenol in the last 24 hours! My neck and back aren't as tight, and that's been great. My sleep hasn't been as good the last two nights, and I think that's due to not taking any pain meds. Incision and drain holes look pretty fantastic. Onward!

Today's the day! I'm at a 1.9, as of 5am, so they believe I'll be at a 2 INR by the afternoon. So the morning is filled with education sessions about Coumadin, ATU, sternal precautions, and other things. My neck and hand IV were removed right before discharge, and we were on our way. We swung by Walgreens to get my prescriptions and we got settled in at home. Oh what a relief to be home!

I'm told "maybe tomorrow," for discharge. I'm starting to feel like I'm wasting a room. Food, walks, wipe-down baths, and meds are all going A-OK. They're just waiting on my INR to come up, from the Coumadin dosing. I'm sitting at a 1.5, and they want to see 2 or higher. Just hurry-up-and-wait mode. In better news, I got my final drain out. Woohoo!

5:30am - I awoke to one of the monitors starting to beep. Before I could figure out what it was, one of the nurses asked if I was OK. Confused, I said, "yeah, I think so." At that point, more nurses came in and the monitor started beeping more urgently. It wasn't until then that I noticed my heart was racing and I was starting to sweat. They called the cardiologist in and he said, "you're going to feel terrible for a few seconds." He loaded up a syringe of saline and a syringe of adenosine and plunged them into the IV in my neck. At the same time, nurses were putting AED pads on me, "just in case." I felt a weird wave of discomfort sweep over me. I closed my eyes and let out a sigh. The cardiologist glanced at the heart rate screen and said I was back to normal. Sure enough, I began to feel better instantly. I was told that my heart rate was nearly 140 when the first nurse came in, and it reached 210bpm toward the end. The adenosine temporarily stopped my heart, so that it could resume a normal beat. This was another SVT (SupraVentricular Tachycardia) event. The first on I'd had was what initially brought me into the Cardiologist to discover I had the bicuspid aortic valve in the first place. These can happen after surgery, as the heart gets very irritated. These are typically benign, and don't usually need treatment...they typically resolve themselves within 20-40 minutes. However, I was so soon post-op that they wanted to get it stopped immediately, so there wasn't any damage caused by the increase in rate and blood pressure. Ultimately, I was told to just pop another beta blocker if the bpm stays under 140. If it goes above, then going to the ER is prudent...just to make sure things are under control. Getting an ablation is an option, but I don't get them anywhere near frequently enough to consider it. Instead, the upped my beta blocker, which helps prevent them in the future. I also learned about Vagal Maneuvers that can help stop an SVT episode. After all of that hoopla, it was back to normal. I continued to eat (even finishing my Lunch AND Supper!) and walk, as usual. The surgeon revealed that since I also got the aortic root replaced, all of the suture knots were on the outside of the heart and aorta. If it's just the valve being replaced, the suture knots are sometimes on the inside of the aorta. The knots are a big part of the clotting issue, so I was relieved to hear that there are no knots interfering with my bloodflow.

Today I got 2 of my drain tubes and my pacer wires out! The stung just a little bit coming out, but didn't hurt at all. Now oh my gosh I can breathe deeply again! When meeting with the surgeon before surgery, he said that the worst pain is the drain tubes poking you on the inside. The incision pain would be hardly noticeable. Boy was he right! Life improved 100% after that stuff came out. During my afternoon nap, I slept so much more soundly. I looked at the drain tubes after they were pulled and those were inside me by at least 10-12 inches! I did another 3 walks, increasing the distance each time. There was less fatigue after them now, too. I'm still ordering 3 meals per day. Not finishing them yet, though.

Continuing my medications and breathing exercises. Those are getting a little easier. The surgeon was in and said that the Coumadin would start today...and it did. I got another wipe-down bath, haha. Even though it's not a true shower, it feels great to get a little cleaner. I took my first walk without a walker! I did so well that I was told to refuse the walker from here on out. I had my first BM, so that was great. Checked off another box needed for discharge. haha. My dog, Alannah was cleared for a quick visit. It was so awesome to see her. Although, she wasn't a big fan of all the tubes, smells, and noises. On my second and third walks of the day, I completed a full lap of the hall. Awesome progress, though I still got a bit worn out by them. I had three meals today. I couldn't finish all of any of them (and my taste is still a bit off), but eating solid food felt good. They changed my dressings. Everything still looks great with my incisions, IVs, and drains.

My chest dressing got removed. My diet got advanced today, so I started eating more solid foods. I Got my first walk in! It was only 60 feet or so, but it was exciting (and a bit scary) to get moving again. 12:00p - My catheter came out. Although it never bothered me one bit, I was pretty happy to be rid of it. Hooray! 1:00p - I took my second walk. I did a half-lap of the hall, which was awesome. It was REALLY hard, but I made it. I actually walked right from my ICU room to my new Step-Down room! My morphine button was taken away today, after the second walk. I hadn't used it a whole lot, which I was really happy about. 3:20p - I ate some fruit and chicken salad. My appetite is super low and nothing really tastes good. 8:20p - I urinated for the first time, on my own. It's the little things! haha. 9:30p - My surgical pain was almost non-existent. My real challenge was shoulder, neck, and back tightness. I simply could not get comfortable. So I was offered some benadryl to help knock me out for the night. That seemed to help.

I'm still in my ICU room. 6:15a - They turned the breathing machine off. I still have the tube in, but they're seeing how well I breathe on my own. They add Albumin and Protonix for blood volume and ulcer prevention. 7:15a - I've been breathing on my own for an hour, so they draw some blood to make sure my oxygen level is good. 7:35a - Oxygen level looked good, so they took out the breathing tube. Yay! They gave me nose oxygen as a back-up, and I got my Morphine button. They also started Percocet in pill-form, as the Morphine was only going to be with me for a day or so. 7:40a - First breathing exercise. In addition to using the Incentive Spirometer, there was another device I had to blow hard into (like blowing out birthday candles) and also make a good cough. Ouch! These exercises continued every 4 - 6 hours around the clock. They were painful at first, and each exercise got easier and easier. 7:45a - The nurses shift me in bed. They had to lay me flat briefly. That REALLY HURT my chest! 7:50a - I got my first ice chips, which was GLORIOUS, given how dry and nasty the breathing tube had made my mouth. 10:15a - My arterial and heart line monitors were pulled out (one from my wrist, and the other from the line in my neck). 10:45a - I got to sit in a chair for the first time. This felt great, as it took the weight off my chest. 12:35p - My Heparin got started, so they could start thinning my blood (for the mechanical valve). 1:00p - I got some jello, which was wonderful. Although, swallowing was painful at first. There was no rush to start walking, given the extra time that the breathing tube was in. They were happy that I asked to sit in the chair and left it at that, especially because I enjoyed sitting in it for so long. My only frustration was how I was HOT then COLD. That continued throughout my stay. I'd have blankets on, then I'd sweat, then I'd tear them off, and then I'd freeze. Ugh. They also started doing wipe-down baths and changing my dressings every day or two.

After a brief emotional FaceTime call with my mom (she couldn't be with me, as she had bronchitis and pneumonia), we got in the car and drove to the hospital. I checked in at 5:30am and was assigned a room by 5:40am. From there, they started my IV, took some vitals, and I got "the big shave." Adam certainly wasn't lying, in his book. haha. Soon after, we chatted again with the surgeon and the anesthesiologist. Once that was done, they gave me a starter dose of Versed and wheeled me toward the OR by 7am. That all happened very quickly...and that's all I remember from that morning. They started the procedure at 7:55am. By 8:35am, they were starting the graft. I had an On-X Mechanical Aortic Valve & Root procedure...and they used the largest valve available! I was supposed to be done by 2 or 3pm (a 6 - 8 hour surgery). They actually started closing me up at 12:30pm! I later learned that they pad the surgery time to allow for any curveballs. My anatomy had been as expected (from the Angiogram, Echocardiogram, and the CT). Apparently, I had some of the best tissue they'd worked with in a long time, so that helped speed things along, too. I was out of surgery by 1pm. Because I was also getting a Root replacement, the surgeon told us that the breathing tube might be in overnight. The surgeon prefers to have that as a safety net, since the procedure is a bit more involved. Surprisingly, I was recovering well enough that afternoon that they thought I might have gotten the tube out. That was great news, but the surgeon didn't want me "working" to breathe by myself all night. So they left it in overnight. Because of that, they kept me full of Propofol so that I didn't have too many waking moments. I was trying to get creative with hand signals to communicate, but it was tough (asking where my partner was, asking what time it was, etc.). I wasn't a big fan of the tube. I gagged a few times, especially when trying to speak. So here's a Pro Tip: Do not try to talk! I was shivering uncontrollably for a little while, as my fever peaked and the anesthesia first began to wear off. All told, they gave me 2 units of platelets, some Albumin, and 1 unit of blood. They also had a Candy Land kind of map on how my recovery would go.

I'm recovering really well. When I bust out of the hospital (maybe by Thursday!) I'll write a more complete update....complete with post-op pictures, if you're interested.

Hello all. Clint had his Aortic Valve and Root (On-X mechanical) surgery yesterday (2/2). Breathing tube is out and he’s awake and alert. He’s doing fantastic. Today’s the day he begins walking. Thanks for all of your support.

Had my Heart Cath procedure on January 17th. It only took 30 minutes! Everything looked good. No blockages, no surprises. They also confirmed that my aortic valve had a 'severe' leak. I was told that my heart is doing a really good job of accommodating it, and still the cath doctor briefly mentioned moving the surgery date up. Since it's only 2 weeks out though, we'll still plan for that date (February 2nd). In the meantime, I was prescribed Lasix to try for 3 days, just to help relieve any pressure on the heart from fluid buildup. I really haven't noticed any difference on the Lasix. At least it only cost $2.50. haha After the procedure, I was in recovery for 3 hours. They had done a "perclose" suture, so I had to lay flat for an hour, lay at 30 degrees for an hour, then sit/stand/walk for an hour...at least I got some breakfast during that time! My leg was pretty sore, and is feeling better day by day. There's a bit of bruising that has since shown up. I wasn't allowed to drive or go to work for 2 days, since the suture needed time to heal and moving around at work and pressing a gas & brake pedal were going to be too much stress while things healed. Right now, I'm still a tad sore, but I'm able to go back to work, drive, and do most anything except lift more than 10 lbs. That restriction gets lifted this coming week. I've got one more blood test and a pre-op education session this coming week, and that'll be the last steps before surgery.

The surgeon initially said I did not need a cath/angio due to age (44), and after my cardiologist came back from vacation, they spoke and decided that I should have one anyway. So, that means I will get one this coming week and that delayed my surgery by another couple of weeks. Frustrating, but I'm sure it's all for good reason.

That seems to be the name of the game. This journey started in October, officially, and here it is mid-January and we're just about ready to settle on a date. It could be as early as 1/22, or it might not be until March. It all depends on what works best for the surgeon. In the past few months, I've gone through several tests (echocardiogram, stress test, and CT scan). With those results, the surgeon can be fully informed and let us know where we stand. In addition to a bicuspid valve, my aortic root is beginning to bulge. It's not terribly large yet, but we're going to take care of it all in one go. I'll be going with the On-X mechanical valve with root prosthesis. That way, we don't have to worry about the root, going forward. The surgeon said that people with bicuspid valves also tend to have thinner aorta walls, which makes aortic aneurysms more likely. With this one-and-done procedure, we hope to take care of it all in one surgery.