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pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

  • 1.  pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 11-12-2021 12:15
    I'm so happy to have found a support group where people can express how they feeling pre- and post-heart surgery.

    I am 11 months past my aortic valve replacement.  All went well.  The first 3 months I healed quickly and easily.  I started to do exercise which included swimming after 3 months.  And then I noticed a popping sound in the lower part of my sternum.  Luckily, I had no pain associated with this.  I saw my surgeon and with a cat scan he was sure that my sternum had separated and that I would have to go on post operative protocol (no lifting, driving, etc) for 6 months.  Well six months has passed and I was very religious about following his insturctions, but the clicking/popping has gotten worse.  Very often when I roll over in bed, get up from a prone posiition, I will hear a clicking/popping.  I am also getting much discomfort/ low-end of pain in my chest (separate from sternum) and in the area just under my lower ribs.

    The last time I saw my surgeon, I found him very unhelpful and he suggested that I was fine ( he touched my chest while I breathed and coughed) there was no more need for the basic protocols and I could start to go about my life normally.  And that he thought my pain was a result of anxiety and depression.  I am not by  nature someone with a lot of anxiety, but not knowing  and understanding the state of my sternum has caused anxiety.

    One of my main questions is, is this normal 11 months after surgery.  And are there diagnostic tools that my surgeon can use to assess the state of my sternum and not just rely on feeling my chest when I breathe and cough.

    Thanks for reading this long diatribe.  If you have any experience that might help, please do share.

    Thanks,

    Lorne in Vancouver


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    Lorne Berkovitz
    retired
    Vancouver BC
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  • 2.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-06-2021 14:02
    Hi Lorne.  I am coming up on my six year anniversary. And I understand a little bit about what you're going through. I worked in surgery for most of my career so I understand surgeons. For the most part they look at the body part they're repairing and not the whole person. So I would not expect a lot of interaction and sympathy from the surgeon. However, I did find a great listening ear and a good deal of compassion in my cardiologist. And that's who I truly trust at this point. As far as your sternum goes it will always be tender.  Mine looks like a wad of knotted wires. Almost as if he was in a hurry to finish stitching me up and be on to the next patient. I am quite thin so the defects is unsightly, and sometimes it hurts, I will also say that my ribs have been tender since my surgery, and I have to be very careful about hitting them even on some thing as simple as the console of my car. I'm pretty sure the first time I lost my purse on the floorboard and thought I could easily reach and fetch it, I broke a rib. Ouch. I've also learned or at least i believe that my brain rewired itself during the nine plus hours I was on a ventilator.  I don't think the way I used to. Like you I am prone to depression. So I've learned to do different things and do them sequentially not trying to do multiple things at once. It seems like that's where I get frustrated and depressed that I can't go 90 miles an hour like I used to.  Long story short version my friend have patience with yourself and practice a great deal of self-care. Whatever that looks like to you. I found a different job as healthcare was too much to handle. I'm still running quite a bit, but not at the distance I did. And I always do things very sequentially and this planned out as I can. I know that I am not good with surprises. I hope this helps please filled reach out again happy to connect

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    Melodie Garrobo
    Highlands Ranch CO
    (303) 470-9300
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  • 3.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-07-2021 12:32
    "I've also learned or at least i believe that my brain rewired itself during the nine plus hours I was on a ventilator." 

    This is probably the best description I've heard yet. Same thing happened to me, which is how I ended up here on Mended Hearts. After my open heart surgery, I knew something was different in my mind. I just felt off all the time. Have always been very much a positive mental attitude kind of guy but found myself dealing with a lot of anxiety and depression. Had trouble remembering things. When I found MH and started reading all the stories, it helped a lot knowing I wasn't the only one experiencing this. I've learned to manage how my brain thinks differently now and although I have very little anxiety now, I do still have trouble concentrating at work every day. I feel like a dog when it sees a squirrel. I'll be trying to concentrate on something and then "Squirrel!", my mind is on to something else. It's very frustrating.

    Lorne:  Although my symptoms are slightly different, I can totally relate with your frustration. I'm 2 1/2 years post op and still have pain in my chest. Have had numerous trips to the emergency room with several heart cath procedures, stress tests, chest x-rays, MRIs, etc., and they say they can't find a cause. My primary doctor at the V.A. basically told me I was a 
    hypochondriac because I was constantly complaining of chest pains. Which really pissed me off, by the way, because I'm allergic to any kind of narcotics and have never once asked for any kind of pain pills. The bottom line is that you know your own body and you know when something is wrong. I've come to the realization that most doctors today don't know how to be real doctors. They have a checklist that says these symptoms require this drug or this procedure and anything that doesn't fit those criteria puts them at a complete loss as to what to do. My suggestion is to not give up and keep pushing your doctor to find the answer. If they won't or can't, find another doctor. Hopefully with time your snapping and popping will eventually go away.

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    Brett Temple
    Project Manager
    Sarasota FL
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  • 4.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-07-2021 18:08
    Thank you Brett, Melodie and Rick for your feedback.

    What seems to be a theme in all these three responses is that doctors and surgeons specifically have little empathy and interpersonal skills. Certainly true in my case.

    My 1 year anniversary of surgery (valve replacement) was December 1st. I am happy to say that my heart is working really well now. I walk hills and climb steps without any heart-related chest pain or discomfort that I did before the operation.

    But 1 year after my sternum and ribs still give me grief It’s not that bad that I can’t carry on with most of my day to day activities, but I am still afraid to put any serious pressure on my chest. When I have, It takes a few days to get over it. And usually at night and first thing in the morning when I get out of bed, I hear click, click click in the top part of my sternum near the collar bone.

    The surgeon has suggested that having my wires removed might help. ButI suspect that this skeletal pain is just something I’m just going to have to learn to live with and hope in time that it improves. The good news is I am much less anxious when I hear the clicking noise of I feel discomfort in my sternum and rib-cage.

    Thanks so much for sharing your experience.

    Lorne




  • 5.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-07-2021 22:16
    Climbing hills.  Oh how I envy you!  Good to hear.  The clicking would drive me nuts.  Wish I had something relevant for you other than "ask the correct questions".   Did you also tell your surgeon/docs about the pain below your ribs?  Best, Rick





  • 6.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-08-2021 06:41
    Folks,

    I had open heart surgery 4 years ago for a quintuple bypass, and never experienced experienced any clicking around my sternum, although, to this day, I cannot lie on my chest without feeling a sharp pain around my solar plexus.  Doc doesn't find anything wrong and I'm not the least concerned about it anymore although it's sad to know that boxing, wrestling and martial arts probably would be a bad idea for me at this point.  But I'm 71 anyway, learned that my wrestling days were over when I was 37 and my friend's high school kid kicked my butt because I was to slow to execute my superior knowledge and training.  I'm still an active gym rat, though, going on 60 years as a strength athlete, at a somewhat reduced level more because of aging than my heart surgery.  And it's all okay because I'n still alive and able to be here for my family.  What a gift!

    I do want to add that nobody should accept the idea that doctor's are by nature callous to patient emotional needs.  They are human beings as varied as us all.  If you don't like what you're getting or not getting from your doctor, find another.

    Finally, yes your brain rewires but it's not just because of the surgery or time on a ventilator, and I was in a ventilator for 2 weeks post-surgery after contracting ventilator caused pneumonia! Our brains are constantly rewiring.  What we regard as "we" is constantly changing, including not only our bodies as we age but also our minds.  There is a continuum of what we call memory that gives us the illusion of an unchanging sense of "me" but a lot of that memory is selective and warped by our subjectivity.  Anyway, embrace the change or rewiring.  It's called growth.  And, Brett, I like your squirrel and dog metaphor.  I know that I'm just like my old dog, recently passed, in every way that's important.

    All the best,

    Ira

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    Ira Reid
    Hoboken NJ
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  • 7.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-08-2021 19:00
    Great and positive insight Ira 😀

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    Melodie Garrobo
    Highlands Ranch
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  • 8.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-09-2021 06:05
    Thanks, Melodie!  I generally feel like Ebenezer Scrooge when he awakens on Christmas Day after his adventures with the ghosts the night before.

    Ira

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    Ira Reid
    Hoboken NJ
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  • 9.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-14-2021 12:13
    Dear Melody and Lorne
    Your messages are so on target about dealing with postop "inperfections" in our bodies.  
    I am 9 years post op from Open heart surgery and complications.  For yhe mist part, i am fortunate to not have the symptoms that you are experiencing.   ( i think my thinking process is lessened but no one  else notices : or they blame it on  age.  
    This is my take on this New Reality: without the surgery I wouldn't be alive to have helped care of my elderly parents and others  nor had the pleasure of meeting 3 more grandchildren ( there were 3 at the time of my surgery) .  My husband and I have made many new friends thru our Mended Hearts group in Plano Texas .  
    Survival has some complications, however please appreciate each day as an opportunity to enjoy life, make fruends, do good deeds.  (maybe volunteering to visit patients).  EVERY surgery has potential for  long term residual complications. Yet the alternative is not being alive

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    Marilyn Rosenhouse
    Dallas Tx
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  • 10.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-07-2021 10:13
    >> is this normal 11 months after surgery <<

    Lorne, it's certainly not my normal, seven months out.  Just after surgery, in the hospital, the nurses praised my incision.  It was sort of weird, each successive nurse raved about my closure.  Then they asked the name of my surgeon, and their responses were something along the lines of "he's the best!".  For the next three months, I was extremely careful about remaining "in the tube", and have a pencil-point thin scar with no issues.  I was told to watch for and report any "clunking" to my surgeon's office, but there was none.

    >> he thought my pain was a result of anxiety and depression <<

    Yikes!  I'd be extremely upset.  Popping/clunking is popping/clunking!  You deserve better care, or at least more reassuring guidance.  Rick


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    Rick H.
    CA
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  • 11.  RE: pain, clicking and anxiety 9months after aortic valve replacement and sternotomy

    Posted 12-08-2021 10:29
     >> I was extremely careful about remaining "in the tube", and have a pencil-point thin scar with no issues. <<

    Rick -- I am wondering what you meant by the above. I had a single CABG last March with a nice battle wound to prove it. I am hoping I didn't miss something I was supposed to do. My scar is definitely not pencil-point thin.




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    Evelyn Quast
    Maple Grove MN
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