Recovering in ‘stages’ after aortic valve replacement

“Life can be good again,” says Ruth, a critical care nurse who learned about the far-reaching impact of heart surgery, first-hand.

Ruth started out running around the park with her daughter and her friends when they were young, and from there kept on exercising in one form or another. The first indication that something was wrong with her heart was when she was living in Manly (Australia) and running up North Head became more challenging.

“I started to get really really puffed and couldn’t understand why my chest was getting really tight.”

She’d known since her 40s that she had an “aortic murmur” – an issue picked up by her GP during a routine check-up. It possibly stemmed from childhood, she says.

“Nobody really knows whether I had rheumatic fever or not. I remember as a kid having lots and lots of really bad sore throats but we were tough little kids and we were healthy kids, and I used to jump out of my bedroom window and run out with the other kids up the farm and play in the creeks with these dreadful dreadful sore throats. But I wasn’t going to miss out, you know.”

Though normally optimistic, Ruth struggled with depression following the second surgery and “had to fight against it”.

As well as knowing her aortic valve was slightly compromised, ECG tests over the years showed some calcification in her arteries. Taking statins and watching her cholesterol kept that under control while Ruth got on with life, continuing to run, travel and work in parts of New Zealand, and the world, as a critical care nurse.

On returning home to Taranaki however, she learnt that her aortic valve had started to close and that she’d need an aortic valve replacement. At first, Ruth was on the fence about having surgery: “Should I get this done or shouldn’t I? Because apart from when I was pushing myself in exercise, I felt pretty good.”

But taking into account the accompanying occlusion in her coronary arteries, she decided it was time. In 2013, she went to Waikato Hospital and had an aortic valve replacement and had a single bypass to that artery.

Breezed through surgery

Surgery for Ruth was straightforward – “I breezed through it. I felt fine. I was home within five days of surgery.”

The night she arrived home, however, she had “the most horrific pain” in her sternum so she ended up going back to Taranaki Base Hospital to get on top of the pain. “And then I came home and I was alright. I was back at work in five weeks...”

Her background in nursing had its positives and negatives, she says. “My background was in ICU (Intensive Care Unit) and when I was in Australia I worked in the cardiac ICU so we got lots of patients that had bypass surgery. Part of my training had been to go into theatre and observe a full bypass so I knew exactly what was going to happen, I wasn’t frightened of it.

“I’ve got to be honest and say as a strong, believing Christian, I know that my faith in God and dependence on Him got me through. That sort of held me there and gave me a peace – I just kind of knew. And I had a great anaesthetist and the staff were great. It was fine. I got through that really well and came home.”

Ruth returned to work and starting building up her fitness again, but by the height of summer she was starting to feel off.

“I went to my GP two or three times and said I was really feeling very unwell and I couldn’t put my finger on what it was. I was starting to feel really very tired and lethargic, I was cold a lot. Nobody could pick it up.

“One day I was sitting at work in late February and I was shivering. And it was a boiling hot day and I had a jacket on, so I just packed up and went up to hospital.

“They did bloods and everything else and it came back that I had a staph epidermis (infection) in my blood. So I ended up back in hospital with sub-acute bacterial endocarditis. Three weeks of IV antibiotics and back into theatre again for another valve operation.”

Ruth doesn’t know where she picked up the infection. “But it was the staph epidermis so it was off somebody’s skin. It could have happened anywhere along the pathway, I mean it’s no blame, it’s just one of those things.” She was frustrated to be back in hospital though and determined to get back to regular life.

This time around it took Ruth six or seven weeks to get back to work. “The second (cardiac operation) was much more difficult to come through.”

The emotional toll

Though normally optimistic, Ruth struggled with depression following the second surgery and “had to fight against it”.

“Because my darling (husband) is deceased, my Ian is dead, I missed him dreadfully. So even though I’ve got the most wonderful family and friends and a great supportive church... in the middle of the night when you’re feeling hopeless, you still have to find a way through yourself.

“I didn’t feel like going out half the time, I felt tired and didn’t really want to do it.” But Ruth was of the mind she would not give in, and says her faith helped in that tremendously.

“I think recovery from anything, a lot of it lies in your own desire to get better and to get up on your feet. You don’t have to push yourself that hard…. you have to have an attitude that you’re going to overcome this – that you’re going to get through. It’s kind of about how you think.

“My doctor suggested at one stage that I did go on antidepressants because I felt quite down and quite weepy and I said, ‘No I’ll get through it.’ And I did.”

Ruth made herself fresh juices from her garden and would go for good walks to feel better. “In the summer months it’s beautiful so I got out on the beach, and I did a lot with my family and I did a lot with my friends. And one day I was fine, it was all gone.”

Be prepared for the stages of recovery

Ruth knew from her own nursing training that was she was experiencing was “part and parcel” of the journey. “And I decided I wasn’t going to let it throw me, I was going to try and accept it and just get through it.”

“The funny thing is that in some way, I know this sounds crazy, but you feel like you’ve lost something, you feel like part of you is gone. I know that there’s a prosthetic valve in my heart now, and it’s kind of like I know that it has its lifespan limitation. But I think ‘just get on and live each day and enjoy it’. I could get hit by a bus and it’d have nothing to do with my heart!”

She thinks patients do get a comprehensive explanation of what might happen with surgery and beyond, but “none of it really takes until you actually walk through it yourself”.

“You can explain and describe something to someone about the potential of what could happen, but it doesn’t mean anything until you’re in it...”

For anyone struggling with recovery, she’d advise them to get support from people that have come through it and are living their life to the fullest now. “That’s what they need to see. They need to see that this is a journey that you can make now, wonderfully.

“A lot of their recovery is in their own hands. They can do these things but there are stages you go through, and if they can be accepting of those stages, knowing that they can come through them and they will come through them, then life can be good again.”

 

Shared January 2017

Please note: the views and opinions of the storyteller and related comments may not necessarily reflect those of the Heart Foundation NZ.

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2 Comments

  • Dave 20 June 2018

    I just had a bicuspid aortic valve replaced. I am one week past that. I was i great shape and great health. But this will clearly take 4-8 weeeks time..

  • Liz 30 September 2017

    Thank you Ruth
    From another registered nurse with heart valve defect from ?rheumatic fever now pondering valve surgery your story is very helpful.