The Other Side of the Glass

At work, my desk is situated so that I can look out into the hall at a door. The door is partly made of glass so I can see what’s on the other side. I’m sure most people would find this distracting because the temptation to peek out at others is something we all do. What’s made this all the more interesting for me is that on the other side of the door is a ward of post-op patients. So every time I start to let my mind wander and look up, I’m reminded of my own time in hospital. And if I really think about it, it hasn’t been very long at all – my operation was in May but it feels a lifetime away.

Things have changed so much and I’m reminded about this every time I see one of the nurses patrolling the neighbouring ward with one of those damn machine-on-wheels saying “blood-pressure and pulse time...”. Even the rattling of the wheels is enough to remind me of those sleepless nights waiting to get disturbed by the nurse! And then there’s the visit from the families. I know I should be giving the patients some privacy, but as they can’t see me, I can’t help but watch as loved ones come over and read the paper beside them or try to cheer them up. The one thing I am glad about however is the fact that I can’t smell that hospital food when it’s brought around to the patients!

Wired

A lot of things have happened since my last post. After looking around for a job since my operation in May, I’ve finally got one. Well technically I have two part-time ones. They’re both Assistant Psychologist posts working with people living with chronic pain. Seems everything’s worked out quite nicely as I nabbed the positions when I’m finally fully fit! I should point out that it took me almost 100 applications to get these jobs, and that including me browsing a jobs website around a week after my surgery in the patient computer room (whilst pumped full of medication which made it extremely hard to read anything at all!).

On the topic of psychology...where have all the psychology bloggers gone?! Seems that everyone’s had to dash off into hiding after one anonymous blogger was outed to her company.

In terms of my heart there are a few things to mention. Sternum wires...god damn them! They leave these in you after sawing your ribcage open and it holds everything together during the recovery. They don’t bother to take it out as it would require another operation. I have a mental image of what my chest x-ray would look like...lots of jagged lines all over the place, tied in knots to hold the bones together. Why do I bring this up? Well I’ve noticed that I can feel them poking out slightly. If I arch my back out in a stretch I can feel a wire poking out uncomfortably. I don’t think it’s anything to worry about, but it sure is annoying!

I went ahead and got the swine flu vaccination. Seems I’ve had a bad reaction to it as it’s sent my heart rate up to a 100 and given me some bad symptoms. I’m hoping these will pass...I worked hard to get my pulse back down to 70! So if you’re a patient and thinking of getting it, just consult your cardiologist. Opinion tends to vary depending on the cardiologist.

Part of my keloid scar has reduced thankfully, but it still looks hideous and sticks out. I’m considering the dreaded injection of steroids which apparently can help. Will decide a bit later on...

I'm Strong to the Finish, when I Eats Me Spinach

Is it just me or are all GPs useless? Cue my rant:

Every time I visit my GP I wonder how the hell he’s managed to keep his job for so long. Instead of looking at you while you speak, he stares at the computer. This is no exaggeration. Recalling my last visit to him, I think the only time he looked at me was to give me my prescription. It’s quite worrying to be honest because he doesn’t exactly inspire confidence in patients so if I had personal problems I would be reluctant to discuss them with him. But saying all that, he’s the perfect doctor compared to his colleague.

I had an appointment with her today about my INR. My blood is clotting too quickly (the level is 1.6) and that’s very dangerous for someone in my position because I’m at a big risk of a stroke as the blood can clot on my mechanical heart valve; and that clot can travel to the brain. Now the usual way doctors and nurses calculate how much medicine I need to take is with a computer. Simple? Not for this specific doctor I saw today. She seemed to think calculating it by a chart would be better than the computer. That made me cautious but I thought, hey, she’s the doctor after all. She then said I should come back tomorrow. TOMORROW?! It’s an emergency considering how low my blood is and she wants me to wait a day? I then told her exactly how to open the program on the computer to calculate the dosage, but she didn’t trust me. In the end I asked for my original doctor to calculate it and ring me back. Which he did. Thank god. He might not look at me but at least he knows what he’s doing! It’s quite scary to think these people are in control of my anti-coagulation levels...

In terms of why my INR is so low...I'm not sure. It's been stable for the last month or so, and the only thing I can think of is that I had spinach two days ago. Apparantly it's high in Vitamin K, which interacts with my medicine and causes the blood to clot quicker...Damn...I better be more careful from now on. I also learnt that if your heart beats very rapidly then there is a risk of a clot forming. This little piece of information has torn apart my plans for sky diving next year. God damn it...what a rubbish day.

Healin' Tape

As you’ve probably noticed I haven’t been updating my blog as regularly as I used to. One of the main reasons for that was because, heart-related, there wasn’t much to say. The aim of the blog had always been to provide a site where future patients could come and see what the experience would be like before their own surgery. And I felt if I deviated off that track and wrote about other things...well that wouldn’t be good! But I am aware that a blog that gets updated rarely would not get read...so give me some feed back people! Is it just heart related stuff that you’re after or other topics too?

Getting back on track, I consider myself pretty healthy now. In fact, fully recovered. It’s strange because my family and friends always ask how I am and it’s getting quite irritating now. Although I shouldn’t be annoyed because they mean well! I think it’s always harder on them because they had to witness what I went through and it always looks worse to them. That’s not to say it was a walk in the park! So now I’m doing a lot of running, weights, and even bought an exercise bike. I know, I’m turning in to a fitness freak.

The only sign of my surgery is the scar. It’s still quite unsightly because it’s raised a rather large (keloid scar). My GP offered my the option of injecting the scar with a steroid which can help...but the stories I’ve heard of how painful that is made me refuse. So instead he offered me something called Haelan Tape. Keep that in mind if you have a keloid scar yourself! I’m sure you don’t need me to tell you how annoying those things are and Haelan Tape actually works. It’s like Sellotape that you place on the scar and throughout the day it will release some form of steroid on to the scar to reduce the size. I’ve been using it for about 2-3 weeks and the size of the scar has reduced dramatically. I would post a picture but I don’t think you’d like to see that! Hopefully it will go away eventually.

I’m still taking Warfarin (obviously, otherwise I’d be dead!)and my anticoagulation level is pretty much stable (if you don’t know what I’m talking about shame on you! Have a read of some of my older posts to do with INR/anticoagulation/Warfarin). I know have to see the nurse every two months or so, which is great compared to the 3 times a week when my INR was unstable after the operation.

Temptation

Today was the first time I was confronted with beer since my operation. I went out and a few people had some pints...and I have to say I was giving a few glances to those glasses. It was like something out of an M&S commercial (to my non-English readers, M&S have some amazing food advert videos that leave you wanting to lick the television screen). Those glasses had drops of water forming because of how cold the drink was...and the head of the drink was perfect...and the colour. God I sound like such a freak! Being on Warfarin doesn’t mean you’re entirely banned from alcohol, but you do have to be careful. It interacts with the medication and can make your blood clot quicker/slower, depending on the individual. And right now as my anti-coagulation level isn’t stable, i’d rather not start alcohol yet. Part of me (the sensible part) is just saying to not bother with drink. I used to drink to get drunk...but I don’t know now...we’ll see!

Now on another topic, I’m aware I have two types of readers: people interested in aortic valve replacement, and then a few psychology readers. Now to not alienate either side...I’m going to attempt to bring them together. Let’s go: I have a job interview for an Assistant Psychologist which just seems perfect for me. Part of it involves giving psychoeducational talks to cardiac rehabilitation patients. The other part is involved with chronic pain (something I have good experience in already). It’s like the job was written just for me! I really feel I could make a difference and work with passion in the cardiac rehabilitation part of the job. I would have a really good understanding of what patients are going through...the ups and the downs, the physical aspect...and I think clients would appreciate what I had to say because I have gone through the process myself.

On another note, I’ve started to do more activities. Namely football in the garden with my younger brother. I used to get really tired doing this prior to the operation (and even fainted once – the warning sign to have my operation), but now I’ve noticed a slight increase in my ability. Well that, or I’m just seeing an improvement when it’s not there. I’m sure there is one...I mean my valve has doubled in size to what is considered normal, so it means I’m getting plenty more blood around my body. Only time will tell I guess!

Resting Heart Rates

So, interview over with. My ticker coped quite well mainly because I wasn’t too stressed out. There weren’t any questions that really stumped me so all was good. I thought that would be the worst kind of situation for me to be in after major heart surgery, but it appears I was wrong. The next day I found out I had 2 more interviews...one of them involving a presentation. Now I’ve always found these stressful! Being up there forced to talk about something will definitely make me go red, and get my heart pumping. But I know, I should really stop complaining! I’m back on my feet doing exercise so a little presentation won’t really do too much harm!

I started to some weights as well against the advice of my cardiologist. He told me that when you do weights it can put an added pressure on the heart because of the blood vessels in the arm (you can tell I’m not medical doctor!). He said that based on this, although there was no evidence to support his theory, that it could end up making my aortic root grow slightly larger than the valve. Now if there was evidence for this I would have listened to him... But on a forum I visit dedicated to people who have had valve replacement, there are plenty of people doing weights with their doctors’ knowledge and doing just fine! I think I have to exercise some caution in the things I do but I’m not just going to limit myself off from activities. I’m only 23 after all!

Oh, and thanks for the comments guys, nice to know people are actually reading the blog!

I was browsing the internet and came across this little piece of information. The average heart rate should be around 70-75 for most people. Which is where I seem to be falling at the moment. My aim is to get it right down to the 60s (lower heart rate is better!).

I'm also beginning to check my INR less often. INR is a number that tells you how fast your blood clots. 1 = normal. With someone on anticoagulation (Warfarin), the number rises meaning the blood takes longer to clot. My INR seems fairly stable now and exactly within my target range of 2.5. So at the moment I'm checking it once a week now (initially it was every 2 days!). So that's another weight off my shoulders. In terms of icreased bleeding or bruising...I really haven't noticed a difference. I don't seem to get bruised any easier than I did before I started taking the Warfarin so I'm happy with that too!

Interview, Job Offers and a Racing Heart

I went to see my cardiologist and all seems well. The only issue is that I have developed something called a keloid scar. A keloid scar looks elevated and as it’s been bloated right up, and is very pink. But I can live with that. The cardiologist says that some people are just prone to developing it after surgery and that is should heal on its own. However, a quick search on Google tells me it might not be common for keloids to heal...-gasp- lying doctor! Well either way I’m not too worried because as long as my heart is functioning then the scar can look however it wants!

Now for the big question – swine flu. Rest assured people, swine flu is not more risky for people with valve replacement! However, my GP did say that if I do feel any flu symptoms they will put me straight on the medicine as a precaution. And in terms of normal flu, it now seems that I have to be given a flu jab every winter just like my granddad! I actually don’t mind this either because I hate getting the flu so bring on the jab!

Now another topic. In terms of any dental appointments. For those of you that are new to this topic, it’s common for heart patients to have antibiotics before any type of dental procedure because the nasty stuff in your mouth can go straight to your heart and cause an infection. Now for some reason the guidelines have been changed saying there is no evidence that antibiotics help and your dentist will probably tell you that you don’t need it. Don’t listen to him! There is a lot of criticism about this decision to say antibiotics aren’t needed, and there doesn’t appear to be any clear evidence either way. So until some researchers out there give some hard evidence, just take the extra precaution. Especially if you have a mechanical valve.

I feel like I’m writing a blog for the NHS...so let’s add a personal touch before I bore you all. My heart rate seems to be going down. On leaving hospital it was stuck around 90-100 bpm. What I’ve noticed for myself is that with exercise, the resting heart rate seems to go down. Half an hour on the treadmill every few days or so does the trick. Anyway, right now it’s slipped down to the 80 point (high 70s on a good day!) which is great. The only problem I had was being thrown into a stressful situation – a meeting with a researcher and his team to discuss a project. My heart was racing throughout – partly because this researcher can be very intimidating at times, but also because I was offered a job! He has money to throw at a project I’ve developed, however he wants to take control and turn it in to something else with a different focus. I think it will benefit the clients I see but I’m going to turn down the job (I’m mad I know). And on the job front I also received my first interview!! That also sent my heart racing but I haven’t noticed any problems. My interview is next Tuesday and I just hope I can stay calm and not have anything strange happen – e.g. suddenly get chest pains and get distracted because of my worries!

P.S. For the person who found this blog wanting to know about sex... Yes you can have sex after valve replacement. As soon as you can handle stairs then you can go right ahead...just use your common sense.

P.P.S. Anyone with any questions about the whole surgery experience, feel free to leave a comment and I’ll answer it in my next post if I can!