Mended Hearts Open Forum

Hi folks, I haven't been here in awhile. I had OHS last May to repair an atrial septal aneurysm and an ASD.  I'm doing very well and have been back to work and exercise for a while and I'm feeling pretty strong and healthy.
My main problem is my weight.  Prior to surgery I had been losing weight on my own through cutting carbs and increasing exercise.  I had lost about 35# but had not reached my goal weight.  The weight loss accelerated from January through May due to a lot of health problems and hospitalizations, including one for pancreatitis.  There were a lot of times I was NPO, a lot of times I didn't eat bc I didn't feel well, etc. Of course for a little while immediately after the surgery my weight was up bc of fluid retention, but that eventually came back off and I continued to lose more weight in a very effortless way, eventually being down about 50#. I reached the lowest point maybe 2 - 3 mths after surgery, last summer.
Fast forward to now.  My weight keeps going up and up.  I'm now up about 10 - 15# up from my low post-surgery weight. Sometimes I'll have those 2# overnight weight gains, for which I'll take Lasix, but I feel like I'm cheating bc I'm not seeing signs of fluid retention like swelling/edema (maybe very mild edema). So I feel like I want to blame it on fluid and get that quick-fix weight loss, but maybe I shouldn't bc maybe it's not fluid, but just my old weight "finding me" again.  And I know I wasn't exercising as much bc of winter, and who knows, maybe I wasn't being as careful about what I was eating as I thought I was.  But the other day?  I ate fruit, non-fat yogurt, and some mixed nuts (not salted) during the day and had a salad for dinner.  The next morning I was up 2#. I had also taken half hour walks pretty much every day that week. That's got to be fluid, right?  Anyone else have this problem?  It's very frustrating.

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Anne Birdsong
Occupational Therapist
Rural
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Anne ~ to be clear, a 3 pound weight gain within one week is not possible unless it is due to fluid overload... take it from me, you don't always exhibit physical signs you are retaining fluid except excess weihht gain in a short period. I think about salt and gain ten pounds. It's just  fact of life for those with congestive heart failure (CHF for thos averse to acronyms). Little signs I note are feeling full when I haven't eaten, stiff knees, increased shortness of breath without seeing my gorgeous wife, sluggishness  and I guess thats it.

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Warren
TucsonAZ
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Thanks.  Yeah, I know the gold standard is 2# gain overnight or 5# in a week.  I have that with relative frequency (probably a few times a month), but bc I don't see other symptoms, I always second-guess and figure I wasn't careful enough in my diet or something.  But there are times when I know I did everything by the books with exercise and eating right, and still have the gain, so I guess it's just my heart not clearing fluids. I have not been diagnosed with CHF, but I do have a right ventricular wall motion abnormality, so I think I'm heading in that direction.

Thanks,
Anne

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Anne Birdsong
Occupational Therapist
Rural
------------------------------

Original Message:
Sent: 03-16-2021 19:21
From: Ralph Warren
Subject: Weight Gain

Anne ~ to be clear, a 3 pound weight gain within one week is not possible unless it is due to fluid overload... take it from me, you don't always exhibit physical signs you are retaining fluid except excess weihht gain in a short period. I think about salt and gain ten pounds. It's just  fact of life for those with congestive heart failure (CHF for thos averse to acronyms). Little signs I note are feeling full when I haven't eaten, stiff knees, increased shortness of breath without seeing my gorgeous wife, sluggishness  and I guess thats it.

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Warren
TucsonAZ
------------------------------

I really gotta stop replying in the middle of the night I go walking in my sleep...oops. yeah you got it. I meant to say a 3 pound gain overnight. And I get you, the weight gain (fluid overload) with no obvious trigger mechanism is hard to grasp. Kind of like shortness of breath when a pulse oximeter says O2 saturation is normal. Doesn't seem logical but its just the oxygen isn't getting pumped out to the organs and they scream for breath. 

I struggle with fluid daily and take 80mg Furosemide. when its flaring I increase my Lasix that day to drain the swamp. Make sure you ask your Dr before doing that


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Warren
TucsonAZ
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Original Message:
Sent: 03-17-2021 10:07
From: Anne Birdsong
Subject: Weight Gain

Thanks.  Yeah, I know the gold standard is 2# gain overnight or 5# in a week.  I have that with relative frequency (probably a few times a month), but bc I don't see other symptoms, I always second-guess and figure I wasn't careful enough in my diet or something.  But there are times when I know I did everything by the books with exercise and eating right, and still have the gain, so I guess it's just my heart not clearing fluids. I have not been diagnosed with CHF, but I do have a right ventricular wall motion abnormality, so I think I'm heading in that direction.

Thanks,
Anne

------------------------------
Anne Birdsong
Occupational Therapist
Rural
------------------------------


Original Message:
Sent: 03-16-2021 19:21
From: Ralph Warren
Subject: Weight Gain

Anne ~ to be clear, a 3 pound weight gain within one week is not possible unless it is due to fluid overload... take it from me, you don't always exhibit physical signs you are retaining fluid except excess weihht gain in a short period. I think about salt and gain ten pounds. It's just  fact of life for those with congestive heart failure (CHF for thos averse to acronyms). Little signs I note are feeling full when I haven't eaten, stiff knees, increased shortness of breath without seeing my gorgeous wife, sluggishness  and I guess thats it.

------------------------------
Warren
TucsonAZ

Hi Ralph

Have you asked your doctor what a safe dose of Lasix is for most people, and how much fluid  do you lose when you increase? Struggling with the same and hearing slight wheezing during those times.Thanks!

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Lisa Johnson
Registered nurse
CA
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Original Message:
Sent: 03-17-2021 12:18
From: Ralph Warren
Subject: Weight Gain

I really gotta stop replying in the middle of the night I go walking in my sleep...oops. yeah you got it. I meant to say a 3 pound gain overnight. And I get you, the weight gain (fluid overload) with no obvious trigger mechanism is hard to grasp. Kind of like shortness of breath when a pulse oximeter says O2 saturation is normal. Doesn't seem logical but its just the oxygen isn't getting pumped out to the organs and they scream for breath.

I struggle with fluid daily and take 80mg Furosemide. when its flaring I increase my Lasix that day to drain the swamp. Make sure you ask your Dr before doing that


------------------------------
Warren
TucsonAZ
------------------------------


Original Message:
Sent: 03-17-2021 10:07
From: Anne Birdsong
Subject: Weight Gain

Thanks.  Yeah, I know the gold standard is 2# gain overnight or 5# in a week.  I have that with relative frequency (probably a few times a month), but bc I don't see other symptoms, I always second-guess and figure I wasn't careful enough in my diet or something.  But there are times when I know I did everything by the books with exercise and eating right, and still have the gain, so I guess it's just my heart not clearing fluids. I have not been diagnosed with CHF, but I do have a right ventricular wall motion abnormality, so I think I'm heading in that direction.

Thanks,
Anne

------------------------------
Anne Birdsong
Occupational Therapist
Rural


Original Message:
Sent: 03-16-2021 19:21
From: Ralph Warren
Subject: Weight Gain

Anne ~ to be clear, a 3 pound weight gain within one week is not possible unless it is due to fluid overload... take it from me, you don't always exhibit physical signs you are retaining fluid except excess weihht gain in a short period. I think about salt and gain ten pounds. It's just  fact of life for those with congestive heart failure (CHF for thos averse to acronyms). Little signs I note are feeling full when I haven't eaten, stiff knees, increased shortness of breath without seeing my gorgeous wife, sluggishness  and I guess thats it.

------------------------------
Warren
TucsonAZ

Hi Anne,

I've had a similar experience. When I left inpatient rehab (6 weeks post OHS), I was about 25 pounds lighter than my pre-surgery weight.  Over the next 6 months or so, I effortlessly dropped another 15 pounds.  I then remained stable at the low weight for a while.  I used to joke to people that if they want to lose weight, I highly recommend OHS.

Eventually, I told my cardiologist that a potential long term care insurer was complaining that I was dehydrated which also might have been raising my blood glucose levels and the cardiologist responded by saying "let's get you off the lasix; you don't need that anymore and that will improve your readings."  Well, the doc was right about the improved blood readings, but I also started to gain weight.  By the way, I told my financial advisors who had recommended the long term care policy that the insurers were imbeciles for worrying about my blood readings and potential heart risk when they really should be worrying about my Alzheimer's risk given my father's health history and the fact that mine has mirrored my father's history almost to the day.  I said that if those fools aren't worried about paying me for years until I die at 92 from Alzheimer's complications, then they probably are in the wrong business.

Anyway, I'm now close to 25 pounds heavier than when I left the hospital.  I'm estimating that about half of that weight is new muscle (I'm back at the gym after a one year Covid layoff and, amazingly, at the age of 70, I'm lifting heavier weights now after a year of calisthenics and isometrics, than I was last year) but I definitely also gained a layer of fat that I need to drop asap.

So, the philosophical question I need to answer is whether I lose the unwanted pounds, live longer and die of Alzheimer's in 20 years. or die sooner, skip the Alzheimer's and save my family a lot of money and stress.  It's a tough question to answer because, if it wasn't for the cost of care issue, it might be very interesting for a zen buddhist like me, who has spent the last 40 years learning that the self is an illusion, to experience the loss of self that occurs through Alzheimer's.  There might even be a book I could write about it if I finished it in the early stages.  Sort of like one of my heroes, Ulysses S. Grant, racing against time to complete his memoirs before dying of throat cancer.


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Ira Reid
Hoboken NJ
------------------------------

Original Message:
Sent: 3/17/2021 10:47:00 AM
From: Ira Reid
Subject: RE: Weight Gain

Hi Anne,

I've had a similar experience. When I left inpatient rehab (6 weeks post OHS), I was about 25 pounds lighter than my pre-surgery weight.  Over the next 6 months or so, I effortlessly dropped another 15 pounds.  I then remained stable at the low weight for a while.  I used to joke to people that if they want to lose weight, I highly recommend OHS.

Eventually, I told my cardiologist that a potential long term care insurer was complaining that I was dehydrated which also might have been raising my blood glucose levels and the cardiologist responded by saying "let's get you off the lasix; you don't need that anymore and that will improve your readings."  Well, the doc was right about the improved blood readings, but I also started to gain weight.  By the way, I told my financial advisors who had recommended the long term care policy that the insurers were imbeciles for worrying about my blood readings and potential heart risk when they really should be worrying about my Alzheimer's risk given my father's health history and the fact that mine has mirrored my father's history almost to the day.  I said that if those fools aren't worried about paying me for years until I die at 92 from Alzheimer's complications, then they probably are in the wrong business.

Anyway, I'm now close to 25 pounds heavier than when I left the hospital.  I'm estimating that about half of that weight is new muscle (I'm back at the gym after a one year Covid layoff and, amazingly, at the age of 70, I'm lifting heavier weights now after a year of calisthenics and isometrics, than I was last year) but I definitely also gained a layer of fat that I need to drop asap.

So, the philosophical question I need to answer is whether I lose the unwanted pounds, live longer and die of Alzheimer's in 20 years. or die sooner, skip the Alzheimer's and save my family a lot of money and stress.  It's a tough question to answer because, if it wasn't for the cost of care issue, it might be very interesting for a zen buddhist like me, who has spent the last 40 years learning that the self is an illusion, to experience the loss of self that occurs through Alzheimer's.  There might even be a book I could write about it if I finished it in the early stages.  Sort of like one of my heroes, Ulysses S. Grant, racing against time to complete his memoirs before dying of throat cancer.


------------------------------
Ira Reid
Hoboken NJ
------------------------------

It's great to hear from you, Mary, and I'm happy that you got your Covid vaccine.  I had just a sore shoulder for a day after my first vaccine, but developed a fever for about 18 hours the day after my second vaccine.  Tylenol easily knocked it out and then I was fine.

The weight issue is strange, because I couldn't seem to gain a pound for the first year or year and a half post surgery and then, all of a sudden, the pounds just started coming back.  I'm not really eating much differently than before either I don't think, although sitting around all day due to Covid doesn't help, despite the fact that I still work out and take daily walks. I think that limiting activities outdoors really has an impact even if you don't think of those activities as formal exercise.  Going out shopping still burns calories for example.

All the best, and Happy Spring!

Ira

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Ira Reid
Hoboken NJ
------------------------------

Original Message:
Sent: 03-18-2021 07:56
From: mary hedtke
Subject: Weight Gain

Hello Ira and Group

Have been off my feed for a few weeks now, early 

spring blues and received my covid vaccine 2 weeks ago

that took me down a notch.

And of course, even eating broth and rice during the

whole week after I received the vaccine only dropped my weight on the scale by about an eighth of a pound.

I started walking last week, our weather is finally beautiful

and I keep my eye on pulse, Blood oxygen levels and 

blood pressure, but now since I quit smoking just before

the OHS, the scale is no longer my friend.

I also never was on medication before OHS and am now on Metropolol and Crestor and have read studies that those

medications may play into not being able to lose weight.

I did ask my cardiologist and he said he hates it when 

people read Google because then they pick up symptoms

they would not have if they stayed off the internet.

PS...I see a new Cardiologist in April.

Just wanted to say Hello and Thank you All for posting

The struggle with weight is real and it is helpful to be able

to share this struggle

Mary

Original Message:
Sent: 3/17/2021 10:47:00 AM
From: Ira Reid
Subject: RE: Weight Gain

Hi Anne,

I've had a similar experience. When I left inpatient rehab (6 weeks post OHS), I was about 25 pounds lighter than my pre-surgery weight.  Over the next 6 months or so, I effortlessly dropped another 15 pounds.  I then remained stable at the low weight for a while.  I used to joke to people that if they want to lose weight, I highly recommend OHS.

Eventually, I told my cardiologist that a potential long term care insurer was complaining that I was dehydrated which also might have been raising my blood glucose levels and the cardiologist responded by saying "let's get you off the lasix; you don't need that anymore and that will improve your readings."  Well, the doc was right about the improved blood readings, but I also started to gain weight.  By the way, I told my financial advisors who had recommended the long term care policy that the insurers were imbeciles for worrying about my blood readings and potential heart risk when they really should be worrying about my Alzheimer's risk given my father's health history and the fact that mine has mirrored my father's history almost to the day.  I said that if those fools aren't worried about paying me for years until I die at 92 from Alzheimer's complications, then they probably are in the wrong business.

Anyway, I'm now close to 25 pounds heavier than when I left the hospital.  I'm estimating that about half of that weight is new muscle (I'm back at the gym after a one year Covid layoff and, amazingly, at the age of 70, I'm lifting heavier weights now after a year of calisthenics and isometrics, than I was last year) but I definitely also gained a layer of fat that I need to drop asap.

So, the philosophical question I need to answer is whether I lose the unwanted pounds, live longer and die of Alzheimer's in 20 years. or die sooner, skip the Alzheimer's and save my family a lot of money and stress.  It's a tough question to answer because, if it wasn't for the cost of care issue, it might be very interesting for a zen buddhist like me, who has spent the last 40 years learning that the self is an illusion, to experience the loss of self that occurs through Alzheimer's.  There might even be a book I could write about it if I finished it in the early stages.  Sort of like one of my heroes, Ulysses S. Grant, racing against time to complete his memoirs before dying of throat cancer.


------------------------------
Ira Reid
Hoboken NJ
------------------------------

Dear Anne
You are obviously very knowledgeable and diligent about your nutrition, exercise, and weight issues. What does your doctor say? How about a dietian’s suggestions?
Maybe your goal weight is too low for your needs?

Marilyn B. Rosenhouse
Mobile: (214)850-0655