Here we go with the week 4 edition of the Tundra_Man heart surgery newsletter. This week's events brought the first little setback since I had my aortic valve replaced 28 days ago.
I've been attending cardiac rehab classes three times per week. They have me over in the corner where I can't annoy the other patients in my class. I briskly walk on a treadmill for 20 minutes and then run on an elliptical machine for another 20 minutes. I figured that as long as I'm attending the classes I might as well try and get some benefit from them, so I tend to push myself pretty hard during these sessions and finish the class drenched in sweat. The nurses usually have to tell me to pull the intensity back a little bit, but overall they're pretty happy that I'm taking the rehab seriously and am challenging myself. Apparently they don't see that very often.
So after last Friday's rehab session I finished the cool-down exercises and then went and got in line to get my final blood pressure reading and have my heart monitor removed. When it was my turn, the nurse was unable to get a blood pressure reading or a pulse, and then noticed on the monitor that my heart had gone into atrial fibrillation. About the time she asked if I was feeling OK, I more or less passed out. Thankfully I was able to stumble into a chair before I hit the floor. The next thing I knew they had wheeled me down to my cardiologist's office and had me hooked up to an EKG machine. After roughly an hour my heart had returned to normal rhythm and my blood pressure had returned to a reading that was low, but within acceptable limits. They sent me home with instructions to take it easy for a couple of days and to call them if it happened again.
By Monday I had no recurrence, so I returned to cardiac rehab classes. Once again I pushed myself a bit, but being a little gun shy from the previous experience I didn't work as aggressively as normal. Everything was fine during the workout, but again after I was completely done my blood pressure crashed and I got light headed again. Luckily this time my heart rhythm stayed consistent and I didn't pass out. And like last time, after a few minutes of rest my blood pressure returned to the low side of normal and everything was good again. At least this time the nurses were able to handle things in the rehab area and I didn't wind up in the cardiologist's exam room again.
To make a long story short(er), the doctor thinks they may have gotten a little too heavy with the dosage of my blood pressure medication. They want to keep my blood pressure as low as they can without it causing me any issues, but obviously it's causing me some issues after intense exercise. They cut the dosage of one of the meds in half. I'm supposed to give it a week, and if I'm still crashing after my rehab sessions then they're going to cut the dosage of the other medicine in half as well. The good news is they feel they have a good explanation for what might be happening.
Along with the blood pressure roller coaster, I've also had a slight increase in pain. This appears to be unrelated to the other incidents, and the doctor suspects that I did something last week to aggravate the muscles that had been stitched back together. I've been pretty careful to follow doctor's orders about lifting too much, so it's quite possible that I did it while I was sleeping while trying to reposition myself in my chair to get comfortable. The doctor didn't seem concerned that I'd done any real damage, he just thinks I'll be a little sore for a while. The pain isn't bad enough that I've needed to take anything stronger than Tylenol, which I've pretty much stopped taking anyway. The pain went from feeling like a mild sunburn on my chest to feeling like a medium sunburn, so it's annoying but tolerable. Oh, and for those keeping score at home the sneeze count is up to 12.
Speaking of pain medication (and I was,) now that I'll be on blood thinners the rest of my life I've been given three options for pain management: Tylenol, Tylenol or Tylenol. Other over the counter pain medications like Ibuprofen or Advil conflict with my anti-coagulation medicine so they are off limits for me. Unfortunately, Tylenol never has been an effective medication for me. So now if I get a headache or other minor pains I'm going to have to take the "grin and bear it" approach.
Some good news is I had my follow-up appointment with the surgeon and it went great. They removed my only remaining stitches where my chest tube had been placed while I was in the hospital. He said that my incisions looked like they were healing very well and show no signs of infection. He pressed on my sternum and said that there was no flex (which is a really good thing.) He was happy with the progress I have made, and said that the only restrictions I currently have are to still not lift more than 10 pounds (five pounds per arm) and don't do anything that obviously hurts. He said that I am healing well enough that when I hit six weeks from my surgery date he feels comfortable with me going "hog wild" (his words, not mine) and doing anything I feel like doing. Unless I encounter unexpected complications, or run into him at Menards, that was probably the last time I will ever see the surgeon.
My self directed therapy sessions have slowed slightly partially due to the blood pressure issues, and partially due to the terrible weather we've been having the last few days. I've gotten out and walked some, but not as much as in previous weeks. I did managed to walk eight miles last Wednesday, so that was a new post-surgery record for me. Since my discharge from the hospital I've walked a total of 83 miles.
Another piece of good news is I had two blood thickness checks in a row that were within the desired range, so I've been moved to weekly coagulation appointments. If I can get two weekly appointments in a row within range then I'll get to go every two weeks. However, if I have two consecutive appointments out of range then I go back to twice weekly. In a way it feels like a children's board game that also involves getting poked with a needle. The hope is to eventually get to monthly appointments and avoid getting stuck in the molasses swamp.
So that's all the news this week from Lake Wobegon. Actually, it's the news from Lake Tundra that forms in the low spot behind my garage every time we get a heavy rain. Thanks for reading and hopefully I've now cured your insomnia.