HCM CARE tips - What do you wish you had known after surgery?

Posted by Ron Petrovich @ronaldpetrovich, Jun 16, 2018

A high-voltage song from the band ACDC rocks my headset, jolts my brain, legs, arms, and attitude. Deep below the bone-crunching guitar of “It’s A Long Way to the Top (If You Wanna Rock ‘N’ Roll)”, an accompanying hard-driving riff powers something bigger; it goes thump, thump, thump, thump, thump. I’m winded, gasp for air, and my face turns red. When I press my fingers against my sweaty neck, I count 125 thumps a minute and relish every breath.

I’m running sprints and have only been able to listen to my heart beat like this since open-heart surgery at Mayo Clinic. I was diagnosed with hypertrophic cardiomyopathy (my story) a few years ago, a condition that inhibits blood flow because the heart muscle is too thick. I tried medicine, but decided that a procedure to remove a part of that muscle, a septal myectomy, was my best option. Immediately after surgery, a new sound with a steady rhythm and powerful cadence played through my body; this music to my ears was my new and improved heartbeat, which continues today, nearly three years later.

Over this time, I have seen a lot of similar questions about HCM surgery on social media sites like Connect. After my positive experience, I wanted to share some HCM CARE tips to help patients and families prepare for surgery:

Help - Prior to surgery; get help at home and at work. Line up a caregiver, friend, or family member for two weeks after surgery. My wife was amazing and without her, I believe I would have suffered setbacks. If you work and have a leave of absence policy, make arrangements as early as possible and try to detach from work during your recovery. In my case, that helped me recover physically and mentally.

Clean - Follow wound prep instructions precisely before and after surgery. Prepare as many laundered clean towels and wash cloths as you can before leaving for the hospital, if possible, at least 20. These need to be clean every day when you get home, so load up. In my case it was also recommended to use liquid, not bar soap.

Meals - Try to buy or prepare two weeks of frozen dinners and lunches. You might not feel like bending over after you return home. This also offers the opportunity eat healthy.

Chair - If you have a seat to recline in, great. I didn’t, and that would be one of my top recommendations. If you can afford to buy a chair or rent one of those seats that props you up, please consider that. The first few weeks after surgery, I felt like a turtle trying to roll upright after tipping over.

Area restaurants and hotels - I live in Rochester, Minnesota and work at Mayo Clinic in Communications, so this experience was easier for me, but a lot of people ask for a list of hotels and restaurants.

Rehab - Studies show that people who participate in rehab have an improved long-term outcome. When I came home, my wife would take me to the mall and I would shuffle from store to store until I built up enough stamina to work out. This report from our Mayo Clinic News Network on my cardiac rehab from about two years ago shows the benefits. Also, if it is offered to you, I recommend massages by an occupational therapist who can work the muscles that have been traumatized. I began this in the hospital and believe it helped me.

Exhale and inhale - My biggest surprise was low lung capacity. Even though my daughters tried to make me laugh in the hospital, I could barely make a squeaking sound. I used a spirometer (not quite like the one in the picture but a smaller version) to learn how to exhale and inhale after being placed on the heart-lung machine during surgery. The goal or incentive of the spirometer is to open the air sacs in your lungs, making it easier to breathe deeply and keep your lungs clear. It is believed that proper usage may speed up your recovery time while reducing your risk of developing pneumonia or other breathing problems.

Additionally, no matter how many pictures and videos as you see before your surgery, it’s still surprising to see wires and tubes coming out of your chest.

Everyone’s experience is unique, so always please keep that in mind. I would go through it again in a heartbeat (pun intended) and as I have said often, the team at Mayo exceeded all of my expectations.

The intense pain following surgery subsided after the first few days and today, I feel decades younger. I have high exercise tolerance and on most days, my overall energy level is very good. However, I occasionally experience bouts of low energy, and when that happens, I try to lay low and sleep. Atypically, my appetite is less than it was prior to surgery and my food tastes have changed. That’s good in that I lost a healthy amount of weight, but bad because I don’t enjoy my wife’s fantastic cooking like I used to. While my heart is doing well, I have experienced frequent back pain over the past few years. I have gone through physical therapy and am told my core is strong, but I continue to address this challenge.

Social media was an invaluable resource to learn about HCM and preparing to make a decision about surgery. In addition to Mayo Connect and Mayo’s other information about HCM surgery, another great resource for this journey is the blog, HCM Beat, hosted by fellow patient, @cynaburst.

I felt prepared because I read posts and blogs from other patients, conducted a lot of research, and felt informed going into this. I do wish that I would have connected with more patients to learn about the post-operative challenges after going home. My surgery was a great success and I hope this post can help make your experience even better.

For those of you who have had surgery, what tips would you add ?

Interested in more discussions like this? Go to the Hypertrophic Cardiomyopathy (HCM) Support Group.

@ronaldpetrovich Congratulations on having the spunk to have this procedure I didn't have this but had open heart surgery so know the protocol ,I'm 23 yrs from my by pass eating right and exercise is the key Congrats again

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The procedure and how you felt after is a good description. I think all the pointers you gave for preparing were great. I am 2 years post-op (septal myectomy) but did not have a good experience because of further surgeries needed. I am now at the point of getting on heart transplant list unfortunately, but still think if I’m lucky enough to receive a new heart, I will be following surgery the same ways I did in past and as you described above.

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@ninimurphy

The procedure and how you felt after is a good description. I think all the pointers you gave for preparing were great. I am 2 years post-op (septal myectomy) but did not have a good experience because of further surgeries needed. I am now at the point of getting on heart transplant list unfortunately, but still think if I’m lucky enough to receive a new heart, I will be following surgery the same ways I did in past and as you described above.

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@ninimurphy I wish you success on you heart transplant let us know how you are doing afterwards and follow Dr,s directions to a tea ☕ take some too

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@lioness

@ronaldpetrovich Congratulations on having the spunk to have this procedure I didn't have this but had open heart surgery so know the protocol ,I'm 23 yrs from my by pass eating right and exercise is the key Congrats again

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Nice to see that you are doing so well. Great to hear. Continued success.

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@ninimurphy

The procedure and how you felt after is a good description. I think all the pointers you gave for preparing were great. I am 2 years post-op (septal myectomy) but did not have a good experience because of further surgeries needed. I am now at the point of getting on heart transplant list unfortunately, but still think if I’m lucky enough to receive a new heart, I will be following surgery the same ways I did in past and as you described above.

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You are in our thoughts. Wishing you success in your next steps. Thanks for the response.

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Thanks for sharing! How long are most people out of work? I recently talked to someone who said that he had to take a year off work after myomectomy. My job doesn’t require lifting but it is stressful at times and that seems to provoke problems. Lately my oxygen levels keep dropping pretty low and I’m assuming a myomectomy is up for discussion at the next visit. I’m 39 and own the business I work in. Longer leave could force me to close, but shorter leave would be stressful. I know I should wait to discuss with my doctor, but since my oxygen is dropping I feel like I need to process this as a possibility before I commit to some things. I will go back to mayo for my follow up soon. Last Mri showed I was 1 mm away from severe hypertrophy, going from non obstructive to obstructive in 1 year. Also, physical activity is really important to me. How long did it take you to be able to exercise at your full capacity?

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@ajohnsonnd

Thanks for sharing! How long are most people out of work? I recently talked to someone who said that he had to take a year off work after myomectomy. My job doesn’t require lifting but it is stressful at times and that seems to provoke problems. Lately my oxygen levels keep dropping pretty low and I’m assuming a myomectomy is up for discussion at the next visit. I’m 39 and own the business I work in. Longer leave could force me to close, but shorter leave would be stressful. I know I should wait to discuss with my doctor, but since my oxygen is dropping I feel like I need to process this as a possibility before I commit to some things. I will go back to mayo for my follow up soon. Last Mri showed I was 1 mm away from severe hypertrophy, going from non obstructive to obstructive in 1 year. Also, physical activity is really important to me. How long did it take you to be able to exercise at your full capacity?

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Like HCM, everyone is different. I find that those that are otherwise healthy, active, and in shape will have a shorter recovery than someone who isn’t. For me, I was a 50 year old gym rat who exercised 1-2 hours a day. I had no complications (in hospital or at home). I went back to work full time at around 7 weeks. Mainly due to boredom. It’s important to rest, sleep, walk and do your breathing exercises. Once Home, I took walks 3 times a day, first just to the mail box, then to my neighbors mail box, then a few houses, a block, several blocks (you get the picture). Careful not to overdo it. There will be days you can do more, and days you will do less. If, after a good day & you’re exhausted the next day, you over did it.
Listen to your body.

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@mbcube

Like HCM, everyone is different. I find that those that are otherwise healthy, active, and in shape will have a shorter recovery than someone who isn’t. For me, I was a 50 year old gym rat who exercised 1-2 hours a day. I had no complications (in hospital or at home). I went back to work full time at around 7 weeks. Mainly due to boredom. It’s important to rest, sleep, walk and do your breathing exercises. Once Home, I took walks 3 times a day, first just to the mail box, then to my neighbors mail box, then a few houses, a block, several blocks (you get the picture). Careful not to overdo it. There will be days you can do more, and days you will do less. If, after a good day & you’re exhausted the next day, you over did it.
Listen to your body.

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Thank you, my husband is 74 and will have surgery on October 4. We live at 4500ft and walk everyday for 3 miles so keeping fit has been first and foremost. The reason he’s having surgery now is he’s on max dose of meds and still have symptoms albeit not severe but there’s nothing else don’t want to wait until he’s really compromised.
Thanks for your input

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