Thursday, 17 September 2009

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.

Saturday, 12 September 2009

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.

Sunday, 2 August 2009

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!

Saturday, 25 July 2009

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!

Saturday, 18 July 2009

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!

Sunday, 12 July 2009

Please Let Me Jump Out of a Plane After Life Threatening Surgery...

So I was curious to see what the main reason was for visitors stumbling upon this blog (other than being a regular reader). To my surprise...nearly every person who finds this from Google is wanting information on swine flu and aortic valve replacement. Now I’m not here to mock anyone but I did find how one person found this site funny: “Will having a pig valve give me swine flu?” That did put a smile to my face but I felt it was important to say that you will not get swine flu like that! If you catch it, it will be from another person. You have nothing to worry about having a pig valve if you choose that route.

The rest of the people seemed to want information on swine flu and valve replacement in general. Now I don’t have the answers concerning the risk to valve replacement patients yet, but I am seeing my cardiologist tomorrow and plan to ask him this question and will put the answers on here for anyone curious.

My appointment tomorrow is the usual follow up to check how my sternum and scar are healing, and to see how my heart is. I thought it was a good idea to make a list of questions I wanted to ask:

• Will I be able to do sky diving?
• Is the yellow gross puss normal (I only have a tiny bit left on the scar)
• Will I be able to fly a plane? No, seriously. (I want to get a license for that!)
• When can I start running? (I’ve only been doing brisk walking now)
• When can I do weights?

I don’t plan to ask when I can go back to work. I already know that I can, but plan to visit my GP and give a sob story of how the supermarket I work for makes me pull heavy cages and life heavy things. Hopefully I can get a month extra off! Oh...by the way, don’t call me a cashier! Whenever someone asks what my career is I casually say Research Assistant (and conveniently miss out the voluntary part!)

As an update of where I’m at 8 weeks post-op...I feel no pain really apart from when I wake upin the morning. Even then, this is usually minimal. Sneezing can still make me feel like a bomb has just gone off in my chest but apart from that, it’s okay! I’m also walking very briskly now (at a speed of 6km an hour). I tend to walk about 3km a day – gets you very sweaty after all that work. I feel like I can if I wanted to but want to wait to see what the doctor says first tomorrow. I think I’m recovering quite quickly but that might be down to my young age. I can’t wait to test myself on the treadmill to see if there’s an improvement in my stamina like I was promise! Oh, and before I forget, my pulse tends to rest around 90bmp. I’m not happy about that, but have noticed if I do regular exercise it will come down. If not, then it goes back up. Need to ask the cardiologist about that.

Sunday, 5 July 2009

Kindness, Samaritans, and All that Type of Jazz

Going through a major operation makes you realise how kind people can be. From the time in hospital people who you might not have thought gave a damn about you will turn up to give you support. Now I’m not complaining about this at all – it really is wonderful to know people care and it certainly has changed the way a view different people and made me appreciate distant family members more. And out of hospital I’ve received cards from so many people I don’t even know. For example, my mum’s work colleagues got together to write out a very nice card and give some gift vouchers. Now the cynic in me just thinks they’re doing that because they have to, but no. It doesn’t stop there. Some of her colleagues have actually gone on (religious) fasts when I was in hospital as a kind of prayer for me to get better. Now that really is touching – people you don’t even know doing that for you. I used to think people like this were few and far between but this experience has shown me there really are lots of nice people out there. God, I sound like a tree-hugging hippie full of love now!

Apparently my friend said that people at the place I volunteer at have been asking about me too. The next time I go there I need to make sure to say hello to everyone I pass because I don’t want to offend these people who I don’t know, but know me. Is that a bad thing? I really don’t know how they know me because I’m sure I’ve not met them – maybe I’m one of those terrible people who forget people. Oh damn, that has to change if that’s the case!

Also, in an entirely unrelated bit of information, I’ve applied to volunteer at the Samaritans. And no I’m not seeing the world in a new light now before you start rolling your eyes! I actually think it will be a good perspective to help people who have/are going through things a lot worse than me. And hey, it should help me develop as a person and maybe get one of those elusive Assistant Psychologist jobs!
 
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