Rehab? I don’t need no stinkin’ rehab!

Before my operation, my cardiologist had said that she expected to send me to cardiac rehab after I’d healed somewhat. She told me that a stress test was the price of admission, so I showed up at her office yesterday, ready to do battle with the treadmill.

I made it through level 4 (16% grade, 4.2 mph); my heart rate was about 140 at that point. She must have been happy with the results, because she told me that I didn’t need to go to rehab. She also told me that I was free to exercise as hard as I want (subject to the surgeon’s weight constraints, anyway) and that I should keep walking a lot (which will be more difficult now that I’m cleared to drive!).

She’s keeping me on beta blockers because of my circumflex artery, but she doesn’t plan to do anything else unless it becomes symptomatic. And I will be doing another stress echocardiogram next year to see how the artery is doing.

My pain level is pretty low, so she wants me to start weaning myself from acetaminophen, since using it for a long time isn’t good for the liver.

Next steps: a fasting blood test to see how the pravastatin has affected my cholesterol levels, and another checkup in three months.

At this rate, I’m going to need to find something else to blog about soon!

Discharged, with restrictions

I had my 30-day checkup at Dr. Gaudiani’s office today; they were happy with my progress and they don’t see any reason for me to return!

I’m not completely recovered yet, though, so my activities are still restricted for some time to come. Here’s what I have to look forward to.

I can start driving tomorrow, but I need to avoid heavy traffic until mid-March (I guess that translates to “stay off freeways”). And I should be especially careful about bad weather (at least I don’t have to worry about snow here).

I’m allowed to move my arms freely, as long as I don’t hyper-extend myself or reach backwards; in fact, they want me to stretch after my shower. Until today, I wasn’t supposed to raise my arms above my head except to wash my hair, and then I was only supposed to use one arm at a time.

I still can’t lift more than 5 pounds for the rest of this month; then I’ll be limited to 10 pounds till March 15th, and 20 pounds until April 15th. Once tax day comes, I’ll be allowed to bear as much of a burden as I want.

They want me to slowly cut down my pain relievers; I need to stop taking Tramadol before I start driving. As far as Tylenol goes, I should switch my nighttime dose to just before bed; I can stop taking the midday dose when I’m ready, and if that goes well, drop the morning dose. The bedtime dose may continue for quite a while.

They were happy with my walking (both distance and pace), but suggested I be better about bringing water with me.

Golf is not going to happen soon – I can try putting at the beginning of March. A week later, I can chip – if that’s successful (which would be a pleasant change from before the operation), I can hit some balls at the driving range a week later. And if I feel no pain from that, I can try a 9-hole round at the start of April. Bowling and bocce are out for a while, too.

I also need to be very careful and keep the scar from my incision from getting sunburned; if it sees the light of day, I need to cover it with SPF 72 sunscreen.

And the best news: I can stop wearing my HeartHugger and I don’t have to use my incentive spirometer any more, either.

The answer is “yes”

The question, for a frightening amount, is in the “Exercise” category: “Is it possible to overdo exercise during post-surgery recovery?”

I walked something over 8 miles yesterday; the last walk was fairly late and I felt a little achy towards the end, but it was nothing that acetaminophen couldn’t cure. Or so I thought.

I slept pretty well, too – until I woke up at 5:30 with a very sore back. No matter how I moved, I could’t make it feel better, so I finally got up along with Diane at 6am. A hot shower and breakfast helped a lot, too – enough so that I made a pie for the Oneg Shabbat tomorrow. I even remembered to take care of some reimbursement paperwork from IBM, too (we’ll see if they consider golf classes to be “retraining”).

But around 11:30, my back started hurting again. I had to go pick up lunch, but that was a short walk to Safeway (very slow, though). I took a Tramedol with lunch, and felt a little better. But it didn’t last, and the back pains were soon accompanied by an achy chest.

All of my doctors’ offices were closed for lunch, so I couldn’t call right away. When the cardiologist opened, they said it soundled like musculo-skeletal problems and to call my family doctor or visit the ER. I didn’t want to visit the ER, but I had no way to get to the family doctor, so I decided to wait.

But it kept hurting more and more. I had been planning to go out for a long walk with a doctor friend, so I called him – when I described my problem, he suggested calling 9-1-1!

In the meantime, Diane had come back to her office – she said she’d come home and take me where ever I thought would help. And by the time she got home, I was convinced that I needed a trip to the ER.

Off we went. As soon as I got to the triage window, I used those magic words: “chest pains”. Someone was helping me in a minute, and I was given a bed in ER right away.

They strapped me to an EKG – normal. They took X-rays – normal. They gave me pain killers (morphene for sure, possibly other things), which made a big difference – my pain level dropped from 6 (higher than it had been at Sequoia, even right after the operation) to 3. And they took a CT scan – also normal. By this time, I was dozing off, and my pain level was down to a 1 or so.

When all was said and done, the doctor decided that the problems were almost certainly from overdoing my exercise earlier this week. He increased my aspirin prescription to a 325mg pill (up from 81mg) for the next few days, and urged me to take Tramodol if I hurt. And if I don’t feel good on Monday, I need to visit my cardiologist.

This turns out to be a good weekend for doing less, anyway – we’ve got Shabbat services, a play, and the Superbowl. I see lots of sitting-down time – just what the doctor ordered!

Two Week Update

It’s been just over two weeks since I came home after my valve job, and my recovery seems to be moving along fairly well. I did have an episode of atrial fibrillation over the weekend, but my cardiologist adjusted one of my prescriptions, and all seems to be well on that front again.

I’ve been doing a lot of walking; most days, I take three or four long walks which add up to somewhere around six miles, though I walked a bit over 12 miles on Tuesday. Since I still can’t drive, most of the walks have to start and end at my house – that limits the variety substantially.

I’ve been lucky so far, and haven’t had any coughing or sneezing spells – when I do cough or sneeze, it’s an unpleasant experience! And I’ve been slowly reducing my use of pain medication – I’m down to two or three doses of acetaminophen daily.

Sleeping is still a bit of a challenge; it would be nice if I could sleep through the night, because getting in and out of bed is a hassle (I have to be sure not to use my arms).

And I’m bored. I’m beginning to think that it might be time to get serious about my résumé, even though I am officially not allowed to work for another month or so.

Two Minute Warning

One of the projects I intended to take on soon after leaving IBM was to write an iPhone app to keep track of our wine experiences. I haven’t quite gotten to that round tuit yet, but I have learned enough Objective C and Cocoa to write a tool to help with one of the aspects of David Allen’s Getting Things Done) methodology, namely the Two Minute Rule: if you can do a task in two minutes or less, do it now.

If you’re a Mac user and think you’d find a two-minute timer app handy, go visit and give it a try.