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Date of last update: 10/20/2017.

Forum Name: Valvular Heart Diseases

Question: Heart murmur is very loud now!

 deano89 - Tue Sep 16, 2008 8:44 am

Hi had a heart murmur diagnosed when i was 21 ,had this all checked out at a specialist hospital ecg,echo, xray and the finally a consultant who diagnosed an innocent mvp. i am now 45 been to the doctors because i was feeing tired and had poundings in my chest when in bed , he checked my blood pressure which was high 159/90 he then llstened to my chest and said the murmur was very loud but not to worry but he did seem very surprised at the loudness and checked back through my notes quickly!! he refered me back to hospital i see a junior doctor my blood pressure was sky high 206/? i had blood tests ecg and eyes checked and blood cultures and thjunior doctor said the murmur sounded typical of what she listened to in training i was then sent home ,and had follow up as an outpatient , i have so far had a 24 hour tape ecg and seen a specialist today for my results he said the ecg showed and insignifacant palpitaytion cant remember the correct term (think it was something like vetrical...also blood pressure was 160/ 83 and he then listened to my murmur and then got a registrar to listen and said it was to loud for a normal mitral valve prolapse there was a lot of eye contact going on between the registrar and the one i went to see .i have now got to have an echo. what does this all mean? could my high blood pressure cause the murmur to be louder or is the mvp causing high blood pressure as always i think of all the questions after i have left the specialist can it still be innocent murmur or has something changed . i have also got to see my gp for control of blood pressure this all started back in june this year thanks for any advice
 John Kenyon, CNA - Fri Oct 03, 2008 9:56 pm

User avatar Hello -

Well your blood pressure does need to be managed, but the MVP isn't causing it. The elevated BP could, however, be making the murmur (usually a "click" sound with MVP) sound more prominent. This is usually a contentious matter anyway, as one doctor may hear a click murmur in a given patient, while another hears nothing and questions the whole diagnosis. MVP can be like that.

Your Holter monitor findings referred no doubt to premature ventricular contractions (PVCs) which occur normally in most people from time to time, and more often in people with MVP, but have no real diagnostic significance of their own.

There are actually two types of MVP. One is the usual "variation of normal", which can range from an intermittent finding to a constant annoyance, but is totally benign. This accounts for perhaps 10 per cent of the general population (some estimates run even higher). There is also MVP due to degenerative disease, whch is fairly unusual, and the progress of this can be easily visualized over time via repeated echocardiograms. This type, which is not usually what is referred to when the term "MVP" is used, sometimes requires eventual valve replacement. The common form of MVP doesn't progress much, if at all, but can change from apparent to non-apparent at different times for reasons that aren't entirely clear.

It would seem the increased volume of the murmur is puzzling one doctor but not another in your case. This happens fairly frequently, and the reason could be the increase in blood pressure, which can make the "click" seem louder sometimes.

Control of elevated blood pressure would be the first order of busniess. If, with that accomplished, the murmur is no longer a concern, then that will probably have been the cause of the change in loudness. If there is no evident progression of the prolapse then the volume of the murmur really shouldn't be a concern.

I hope this helps clarify things somewhat. Please follow up with us as needed.
 deano89 - Mon Oct 06, 2008 3:25 pm

hi John
many thanks for the reply ,its given me a much better understanding .i have been to my doctor for blood pressure and it was 144/75 this time ,so he is just going to monitor it , i have always done wieght training since about 18 but now been doing a lot of cycling ,cross trainer and swimming as well in an effort to get it down naturally. he did say before putting me on medication the readings would have to be consistantly over 150 .
Still havent had the Echo as the referal didnt get sent first time! but should here with in next 4 - 6 weeks
thanks again
 John Kenyon, CNA - Mon Oct 06, 2008 8:56 pm

User avatar Hi Dean -

You're very welcome and I'm glad my response helped clarify things a little. I'm also glad your doctor will follow you before deciding to start medicating. I'll look forward to hearing about the echo results once that gets done.

Take care and keep up the good work.
 deano89 - Mon Oct 20, 2008 1:54 pm

Hi John
just had echo today and been advised that i have moderate to sever reguritation ,the technician doing the echo said it was difficult to tell for certain because it was going around the outside (not to sure what he meant by that )but that it was his view it was probably most likely sever because my lung pressure is a bit high as well , but i would need a down the throat food pipe echo to no for certain,he also added my heart looked healthy but was dynamic and pumping hard
i asked him what is likely to happen now and he said i would need sugery and they would likely opt to repair the valve ,this has filled me full of fear and its only just sinking in ,i did ask how soon i would need surgey but he didnt answer and said i would need go to the clinic for more details. also one thing i have noticed i urinate more frequently and up approx 3 - 5 times nightly but i have a dry mouth and sweat quite easily
i need to ask because i am petrified of surgery and outcome !
p.s what are the timescales for ops and how long could i go on without surgery

i have just been swimming for 1 1/2 hours today which i do once a week if i can .
on other days i do 1/2 hour weights in the morning and 35 mins on a cross trainer in the afternoon nearly every day should still be doing this?
 John Kenyon, CNA - Mon Oct 20, 2008 3:44 pm

User avatar Hi Dean -

You've turned out to be one of the relative few who wind up with progression of the problem to the point where it requires surgical repair. It's pretty unusual, given how common the problem is overall. Still, this does happen once in a while. Since there have been a lot of mitral valve repairs and replacements done over the years, largely due to damage from rheumatic fever, they've gotten awfully good at it. While there are risks associated with any form of surgery to any part of the body, they are classifiable based on how "radical" the surgery is. Replacing and/or repairing the mitral valve is, as a rule, fairly routine anymore, and the recovery time is generally fairly quick, although there can be some lag in the return to a normal energy level. The replacement valves are virtually indestructable, so that's a plus if it needs to be replaced.

The "down the food pipe" echo is called a transesophageal echo or TEE for short. It's a really good way of getting an excellent view of most of the internal structures of the heart, and makes the surgery all the more precise. The actual test is barely annoying for most people, just takes most of your day because of mild sedation (which makes you pretty much unaware anything's going on). Recovery from the test is quick, and you're able to go about your business afterward, although you'll probably need someone to drive you home. This will give a great picture of where everything is and what all is going on in there.

The anxiety that comes with the prospect of almost any kind of surgery is pretty universal, so don't feel strange about that. It's understandable and almost everyone feels it to some degree. The doctor should be able to reassure you greatly about the low risks associated with it, and the importance of having it done. For a number of reasons, some of them psychological, others practical, I'd suggest you move forward with all deliberate speed, so this can be quickly put behind you and your problems resolved once and for all.

The surgery can take anywhere from two to six hours (there's no set timing for it, and a lot just depends on the anatomy of any given patient) and recovery time usually takes about a day for full clarity. Grogginess and sometimes soreness are the main complaints in the hours to days following, and you should be up and home inside five days on average, but will have to take your time getting back to activities as usual, although there's usually nothing remarkably unpleasant (other than site soreness, which, again, varies a lot from patient to patient). Many times now this surgery can be done using minimally invasive techniques, which reduces the discomfort and need for pain meds, and allows for a quicker recovery time.

Based on the comment that the regurge is occuring "around the outside" may mean the leak is in the annulus (the ring to which the leaflets are attached) and if that's the case, this could actually make the repair simpler. It all depends.

Regarding the exercise program, you seem to tolerate it well, but only your doctor can tell you for sure whether or not you should curtail it, since he knows the precise details of your individual case. You should ask very specifically about this, because it's always nice if one can continue to exercise up til shortly before surgery. If not, hopefully you can learn to just take it easy for a little while. You seem to be in excellent shape otherwise, and so should have a pretty smooth recovery.

While I'm not happy you were dealt this hand, at least now you know what's happening, and even though it is unusual for MVP, it's still a pretty common type of surgery which keeps improving. I hope I've been able to reassure you and answer some of your questions -- although the swimming and lifting one really does need to be directed to your personal doctor -- and I look forward to hearing more from you regarding the TEE and everything else that happens from here on out. Best of luck to you, and please continue to bring your questions here as needed or at least keep us updated.
 deano89 - Mon Oct 20, 2008 4:36 pm

Hi John
many thanks for your reply as my stomach has been in knots ,it doesnt help when i had a dream/nightmare when i was around 9-10 i was in a room with loads of chairs which i was jumping over , after being told i needed a heart transplant!!
in the dream i asked how long the longest person had survived and got the answer ten years i woke in a cold sweat asked my parents and this is appeared to be accurate i was shaken for along time over this,it was the most real dream ever and it has always remained with me and i think thats why i sensed this slight change, i didnt get diagnosed with a heart murmur till i was 21 ,i always had an awful feeling i wasnt going to see passed 45 which i am now till jan 8th !! thats why i am petrified,
i really appreciate your responses because you explain everything in depth and clearly
i notice this has been veiwed by 34859 people all probably taking on board the fact that whats happening to me is rare ,
is this genetic as i had to call an ambulance for my 19 year old daughter 6 mths ago she was having breathing difficulties ,palpitations ,tightness in her throat ,at hospital i told them i had MVP and asthma but they checked her over and put it down to asthma and panic attack she is very much like i was as a child very skinny long fingered , long arms which appears to be a body type associated with mvp she is also a drama queen flying off the handle quickly and gets very emotional also she has had a few dizzy spells
she is now having blood test for thiroid & cell count
thanks again i will sleep a bit easier now and will keep you updated
 deano89 - Tue Oct 21, 2008 1:48 pm

Hi John
i have been to the clinic today,saw the registrar who has gone through everything ,he said the heart hasnt enlarged one chamber was slighty bigger but no significance probably due to regurgitation and it had probably been happening for years. my BP was 135/70 and my lung pressure was slightly high and there was no a fibralation shown on the holter which was good,i am going to have the throat echo in the next few weeks which will determine exactly what the leakage is ,he did say he would most likely be recommending sugery purely because the outcome is better before the heart suffers any damage and he beileves the leak is sever, it looks like any surgery will be early next year after my 46 birthday! which will make me slightly more at ease !, he told me it would be Frank Wells who does there repairs at papworth hospital i have looked him up and he trained in london and america ... rank_Wells
seems like i would be in very good hands. he also said i would have an angiogram to check for any artery problems and any probs would be done at the same time
i asked how the operation is likely to be done and he said they split the rib cage to get access to the heart which did sound quite brutal and painfull!
but i am getting a bit more used to the idea now still worried but the more info the better
i feel i am getting my head around it all now.i did ask about exercise and he said to continue as normal unless i experience breathlessness in which case i was to contact my Doctor ,the only problem i have is i am asthmatic as well so not quite sure when its not asthma related
he also added if i hadnt kept fit i may have been at this position much earlier in life

i will update when i have my next echo which he has put in as urgent
thanks for your in depth advice in this uncertain time it has been much appreciated
 John Kenyon, CNA - Thu Oct 23, 2008 9:57 pm

User avatar Hi Dean,

I'll try to reply to both these posts, at least the most pressing parts. First, the dream you had, which was traumatic for you, but also was oddly premonitory. That has had to cause you a lot of discomfort over the intervening years. I won't attempt to analyze why that happened, but it certainly does add a layer of complexity to everything else that's happening now.

Regarding genetics and your daughter, you do describe her as sounding like someone who may have Marfan's syndrome, which is hereditary, and you say she resembles you, build-wise, when you were younger. Long fingers, longer-than-normal long bones (arms, legs), and a number of other characteristics, are possible markers for this disorder, which almost always causes the subject to have MVP and frequently to have partial detachment of the mitral valve's annulus, which is what it sounds like you may have, and which is repairable surgically. Sometimes this can be done between the ribs on the left side of the chest and sometimes it requires cutting the sternum and spreading the ribs that way. (I've experienced the latter personally, and while it is uncomfortable for a while, it heals really well and usually fairly quickly). At any rate, you probably should have your daughter evaluated for Marfan's as if she has it she'll be able to know what to watch out for, and that puts everyone ahead of the game, whether the problem is with structures of the heart or loose joints or retinal detachment (all things that can happen with Marfan's).

I've read up on Frank Wells, and I must say you seem to have found yourself a very accomplished surgeon. That's a very happy thing in itself. It seems he is especially good with valvular repairs, which is just what you're looking for.

If you should experience breathlessness related to failure of the mitral valve apparatus, you'd very likley be able to tell it is different from asthma. Hard to explain or describe, but it's apparently a markedly different sort of sensation.

Finally, yes, your fitness level has no doubt made you an excellent candidate for this repair, which should also speed your recovery ahead of more sedentary people.

It sounds like all the bases have been covered, at least pending the TEE. I hope you'll have time to let us know how that turns out. Best of luck to you. We'll be standing by for further updates.
 deano89 - Sun Oct 26, 2008 4:29 pm

Hi John
just wondering about something that was mentioned after echo about the lung pressure slightly high ! what is it and what are the implications of "slightly "
 John Kenyon, CNA - Mon Oct 27, 2008 9:07 pm

User avatar Hi Dean -

"Slightly", in this case, means just that, and the implication is only that there is a remote possibility of early pulmonary hypertension, which can be quite serious if it develops fully. As a result, you will need to be rechecked for this over time, and if it doesn't show up in future visits, it is probably just an artifact of the test, or it would have been persued far more vigorously. Unfortunately, everything has to be noted that is not exactly according to the book (that is to say, "normal"). It's very likely nothing significant. A recheck later on would prove this to be so. Not to worry.
 deano89 - Tue Dec 16, 2008 6:26 am

Hi John
thought i would update , just got back from the local hospital where i have had my my "put you in as urgent TEE " 8 week wait almost! chose not to have the sedation just the throat spray ,what a truly uncomfortable experience specailly when they push it down further!
the result was mitral valve posterier leaflet is the problem severe regurgitation, think the Doc described it as fragmented .on the screen it look like a solid leaflet one side and sort of bity the other .She also said hopefully it can be repaired but it did pose a bit of challenge more than normal ,wouldnt really know for sure until the surgeon was in there, so i have been refered to the surgeon now for the repair so will be waiting anxiously for the letter ,also went to my local GP as wasnt coping well She has put me on diazapan 2mg 3 times aday but they don't really do anything been on these for about 3 weeks
Also got my daughter checked for Marfans and THe Doc said she was not at risk from that and couldnt here any murmurs so that was all good but she was suffering panic attacks.
will keep this updated as things occur thanks for all your input and advice
p.s as i am writing this i have got the sore throat from hell !!
 John Kenyon, CNA - Tue Dec 16, 2008 5:49 pm

User avatar Hi Dean,

Well that was an intersting if uncomfortable procedure, or at least the finding was. I won't try and predict or second-guess or anything. This sort of torn or flail mitral leaflet isn't uncommon, and some are amendable to repair while others wind up having to be replaced. It's surgery either way, and so long as there's a working valve afterward, not much else should seem different one way or the other, subjectively, except that you shoud begin to feel better afterward.

That's awful about the sore throat. It happens sometimes. Other times the patient will act like they're unaware anything was down there. It should settle down shortly though. As for the diazepam, not my favorite, but I'm not a doctor, let alone the doctor in the case, so I'll just say it's probably better than nothing.

Great news about your daughter not having Marfan's, but it's a shame about the panic attacks. Hopefully she'll get the right kind of help with that and will learn to manage them to the point where the cease being a problem.

We'll be looking forward to updates from you. Hang in there. Help is on the way.
 deano89 - Tue Feb 10, 2009 10:40 am

Hi John
hope you had good christmas and new year.
bit of an update just got back form the cardio ( the wheels of the Britsih NHS turn very slowly!) ,i saw the consultants registrar what he has told me today was, the results of the TEE showed the left ventrical measuremant is still normal for someone of my size ,the leak is bad but as i am not showing symptoms the heart seems to be functioning ok except for the reading of lung pressure from previous echo he said i have mild PH beileve the the reading he quoted was 41mg of mercury
but they couldnt get a reading from the TEE for lung pressure.!
he appeared now to be a bit undecided on surgery but still feels its the best option because of the lung pressure reading, so hes now sending me for an Angiogram ,then a consult with the surgeon, he also brought in the consultant who said the repair was still an option , but i could possibly go another 5 years without symptoms .He also said that surgery was probably the best option saying they used to wait but now the thinking is to get in early while your younger and good health ,the registrar siad the surgeon would probably quote me at 1-2% risk with surgery . 5 years seems good to me at the moment i don't like making decisions i know its best to have it done now so long as i am not in the 2%!! as at least at the moment i am alive would of rather he said surgery was an only option like the last time i saw him!!
Best wishes Dean
will keep this updated as things progress many thanks again for all your input its really appreciated.
 John Kenyon, CNA - Wed Feb 11, 2009 12:30 pm

User avatar Hi Dean,

The holidays were great, thanks. Hope they were for you as well.

I'll keep this brief: the most positive thing about having repair done sooner than later is that there is less opportunity for damage to be done over time. Since you remain asymptomatic there is likely none being done at present (at least not grossly), and it gives you time to mull this over. However, the sooner it is done (and this won't repair itself or remain stable indefinitely) the sooner you can set it aside as a future worry and the less damage can possibly be done (such as development of a weakened left ventricle, the one thing you really don't want). So use the extra time to ponder it, and I only hope you won't wait until you're looking at a timeline rather than a strictly elective procedure. The latter is a lot safer and better over the long haul. At the same time, I don't know of many people who, feeling fine, would volunteer to go under the knife, so I'm glad you have this buffer period to give it some thought.

That wasn't all that brief, was it?

Stay in touch and keep us updated. Good to hear from you.
 deano89 - Wed Feb 11, 2009 1:44 pm

Hi John
thanks for your quick response, The consultant said i could possibly go another 5 years but that surgery was the best option and i did agree i still want the surgery done so i am still on that route ,the cardio has signed me off from him and i will now have an angiogram i beleive in the next 4-6 weeks then meet the surgeon to discuss the surgery once they have all the results .the only thing thats changed is he said hes not treating me as urgent ! ,which is sort of a relief but also a worry because i am concerned as you say its only going to get worse . so not sure of the time scale now its not urgent! and wether i am at risk of complications from this delay or wether i have time on my side to go at the non urgent slower pace all a bit confused really.
i think he based the decision on not being treated as urgent on the fact that i am not short of breath and the TEE results showed the left ventrical as okish for my size, and that i don't really have symptoms but i did explian i have asthma which could confuse the shortness of breath, and do get up for toilet 2-3 times a night .but i have always had a weak bladder! from an early age . every time i have visted a doctor i have always said i feel tired all the time going back years and years ,. so as i explianed to him i don't feel in touch with my bodies feedback at the moment to say wether i have symptoms or not becuase i am emotionally drained.
the other thing that concerns me now is will the PH become problem or will this right itself after surgery? sorry its a bit of a ramble !
thanks again
 deano89 - Wed Mar 04, 2009 5:15 pm

Hi john
just an update , had left right heart cath today got good results .pulmonary pressure was normal and no clogged or blocked arteries but there was a 3 hour delay and doc did say that cause i was dry from not drinking for so long that could make the pulmonary pressure slighty lower but did add was still all good and normal and my last presures we borderline Mild PH on the echo!
so now been referred to Frank Wells Surgeons clinic for a consultation which i should get in the next 4-6 weeks max
so will update when i hear
best wishes
 John Kenyon, CNA - Fri Mar 06, 2009 11:42 am

User avatar Hi Dean,

Great to hear from you and thanks for passing along some really good news! Hopefully the next consult will also yield really positive information. Stay in touch.
 deano89 - Tue May 12, 2009 4:58 pm

Hi John
just to update ,i met with FranK Wells discussed my mitral valve surgery and hes confident it can be repaired i discussed what the TEE doctor said about it being more complex , he replied i know what she means but it is still repairable.
before hand i was dreading discussing the mortality rates etc but i felt really at ease and he had a really nice calm manner. he said that because i was in good shape and looked after myself although there is a risk its minimal think for 1st time procedures under 65 its less than 1%,i asked if he could do my surgery personnaly and he said yes which was a big relief ,we then discussed timing he said that nothing was going to change in the next 3-4 months so we will look at september/october and i was more than happy with that as i wanted the summer to get things done
best wishes
P.S. will update when i hear anymore
 John Kenyon, CNA - Sat May 16, 2009 9:45 am

User avatar Hi Dean --
This is all extremely encouraging news, especially if Dr. Wells will be doing the surgery himself. The mortality rate he quotes is about that for any general anesthesia surgery at minimum in the general population, so that's almost as good as getting a tooth pulled!

We'll be looking forward to further updates. Thanks for this. It's really encouraging and a lot of readers here will benefit from your sharing all this.
 deano89 - Fri Sep 11, 2009 3:00 am

Hi John
did try to post a week or so back but maybe it didnt go through ,
just to update i now have a surgery date for the 6th october admission will be on the 5th, also Papworth hispital do a pre op consult which i will attend on the 22nd oct this is for an xray and blood test ,after that there will be a nurse show a small group of us facing surgery round the hospital and give a talk and answer questions to try to take some of the anxiety out of the surgery and hospital experience.
i am still doing light weights 2-3 times a week and using a cross trainer 45 mins most days i keep my heart rate under 126,my only slight concern is my asthma and the fact this time of year i get mucus in the back of my throat which i am starting to get now first thing in the morning .also what are your views on exercise near the op time should i tail it off and rest more?
this is a real emotional rollercoaster . thanks for your help and advice its really appreciated

here is a link to the op carried out live on uk TV chan 4 from Papworth Hospital for anyone interested there are videos on the timeline pages ... ical1.html
 LisaT - Sun Sep 20, 2009 5:17 pm

Hi Dean,

I am one of those folks that just clicked on your post to see what was happening with you. I am glad that you are having the surgery soon. I have a dog with this condition. In dogs (probably humans too), it's a myxomatous degeneration of the mitral valve, or Myxomatous Mitral Valve Disease. She also has a ruptured tendinae that flails. All I can say is that she was fine and nearly asymptomatic for a long time, but once that thing ruptured, the murmur became louder, and the disease started to progress at a fast rate.

The surgery is not done for dogs (at least not cost effective, and not very successfully at this point). She is not yet in congestive heart failure, but will be eventually, if the valve does not bust before that. Perhaps in humans there is a longer time frame for more symptoms to show, because we age more slowly.

Good that you are getting this taken care of, best of luck with your surgery!!
 deano89 - Thu Sep 24, 2009 12:33 pm

Hi John
just to follow on from my last update on the 11th sept ,went to papworth for pre op visit on 22nd, had blood test, xray , talks with a nurse and pharmisist about medications ,i was told if its repaired i will be on warfarin for 6 weeks post op , also they showed a dvd of what to expect on your hospital stay from day one to discharge
so its count down to the 5th oct admission day and the op will be either first or second on the 6th oct wont know till the night before ,
will update when i can best wishes Dean
 deano89 - Wed Sep 30, 2009 9:06 am

just an udate
i have just had a call to say my date for surgery has been moved to the 22nd oct .some one more urgent needs the slot on the 6th ,
will have to go in at 10am on the 21st so they can retake bloods as my original pre-op was on 22nd sept so they will need to be redone.
the waiting is hard but i fully understand the hospital has to treat the more urgent first just pleased i have time to wait still the only symptom i am experiencing is tiredness but thats probably in part the anxiety of the wait
so the count down begins again! .
 deano89 - Thu Oct 29, 2009 5:56 pm

Hi John
Hears an update on my surgery
Went in Wednesday for 11 am they took the bloods but didn’t have a bed free so gave me a voucher to go get some lunch, came back at 3 to my home for the next 8 and a bit days I can understand when people say about as strange calmness when you enter the hospital it was almost like I was someone else my wife and children left at 8 pm quite emotional goodbyes
My wife came up on the Thursday morning about 7.15am I had slept pretty good considering, they shaved my chest and fore arms say shaved they could have plucked the two hairs quicker! At 8.30 they gave me the pre med at 9.15 they came for me and wheeled me down for surgery my wife came with me to the entrance it was hard
I see the Surgeon Frank wells we chatted for a few seconds then he patted the back of my hand and said you’ll be just fine the anesthetist then said think of somewhere nice and I was gone!
At about 7pm I heard voices saying Dad ,Dean, mr b wake up , I woke up in ICU and proclaimed im still alive ,and said I hadn’t seen any white lights or had any out of body experiences rambling quite a bit! Think my kids found it quite amusing!
Mr Wells rang my wife personally at about 3 to say the surgery was successful and he had repaired the valve and it was a nice tidy job but more complex than expected
Mr Wells visited me on Saturday and told me it was more complex than first thought and I was made slightly differently (not quite sure how yet) also said the leaflet was torn and he stitched it back together, so got a few questions for 6 week check up also think I have a C shaped ring round the valve not a closed one. I thanked him for everything, the whole hospital was brilliant, very patient focused
Cant remember exact days now. but first thing to go was the auto morphine and catheter ,then I had drain tubes out think that was day 2 , take a deep breath and hold and out came drain tube one, then another deep breath and drain tube two was gone .very strange sensation , they had to pinch the holes while they tied the stitches ,the pacing wires were removed day 4 and one snagged but she gave it another hard pull and it gave up its hold I know how a fish on a hook feels now, the nurse showed me the thin outer plastic sheeth covering the pacing wire had a split, that is what caused it to snag and had a bit of me attached ! I was up and walking day 2 but only to the toilet all the pain was managed very well with a combinatination of paracetamol and tramadol
Also given breathing exercises to do.
Day three I was up and about for short walks , day four did the stairs and was told if my inr was ok I could go home but my inr remained at 1.5 ,today Mr Wells done his rounds and said this was only prophylactic treatment and could be managed in the community and I could go home
So here I am with my mitral valve repaired walking quite well and considering everthing I feel really good, my kids have bought a leather reclining chair and its great and intend to have a lot of use in the next few days, rest, eat ,walk, its good to be alive!
will be on warfarin for the next 12 weeks

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