[HSF] Restrictions after aortic surgery

[Tea Acuff]

Mitch. tell us more about the operation, esp the posterior SVR with MVR and why you think that he feels better.

tea


----- Original Message ----
From: Mitch Lirtzman <drmitch at cox.net>
To: OpenHeart-L at lists.hsforum.com
Sent: Monday, December 10, 2007 6:49:04 AM
Subject: Re: [HSF] Restrictions after aortic surgery

Nah, I can stand on his sternum...
I just didn't know of any good science to back up further restrictions. 
Very reassured now, thanks. At 09:03 PM 12/9/2007, you wrote:
>In a message dated 12/9/2007 2:35:40 P.M. Eastern Standard Time,
>drmitch at cox.net writes:
>
>Colleagues,
>A few months ago, I posted a case about a 59yo man that  we did asc. aortic
>aneurysm, posterior LVA, and MVR. He's doing  exceptionally well and tells
>me that in looking back, he had no idea how  bad he really felt compared to
>now. He's back to work and in being very  compliant, he hasn't lifted
>anything heavier than 10#. He'd like to lift  up to 50#, and is looking for
>less exertional work. Any opinions regarding  lifting post op restrictions?
>What are you worried about Mitch? Is it the aortic anastamotic line? the
>sternum?How long postoperative is he? Is it temporary hypertension 
>accompanying
>the isometric activity of holding a 50 lb weight against gravity? Having
>searched the literature for information on incision strengths many years  ago
>(don't ask me to find the references) I came to the conclusion that   post op
>weight restrictions were not based on evidence and just told my 
>patients  you can
>do what you like so long as you stop when it hurts. The only 
>incidents  that I
>had were in training:  a big and impatient man gave an almighty  cough in
>front of me and blew his bronchial stump; an obese little man disrupted  his
>guggle to zatch (apologies to James Thurber) midline abdominal 
>incision  with very
>little effort after the skin stitches were removed. But then   examination of
>the edges showed that all the sutures on the left side  encompassed 2 cm of
>tissue and all those on the right hand side 2 to 5 mm. I  never saw 
>anything like
>that happen with incision lines in the heart or great  vessels  I saw a few
>late false aneurysms (all in previously infected  cases). Of course
>osteoporotic sternae can do this early if extra precautions  are not taken 
>in closing,
>but I presume you are talking about patients some  weeks after surgery.
>In a similar vein I did not restrict driving because I was worried that  they
>would hurt themselves but rather because pain might interfere with an
>appropriate response to a dangerous situation and result in an accident 
>which
>normally would have been  avoidable.
>Bob
>
>
>
>
>
>
>
>
>
>**************************************Check out AOL's list of 2007's hottest
>products.
>(http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001)
>_______________________________________________
>OpenHeart-L mailing list
>
>Send postings to:
>  OpenHeart-L at lists.hsforum.com
>
>To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>http://mmp.cjp.com/mailman/listinfo/openheart-l
>
>All messages transmitted by the OpenHeart-L are subject to the policies and
>disclaimers posted at:
>http://www.hsforum.com/listdisclaim
>-----------------------------------------

_______________________________________________
OpenHeart-L mailing list

Send postings to:
OpenHeart-L at lists.hsforum.com

To UNSUBSCRIBE, to CHANGE email address, or to view archives:
http://mmp.cjp.com/mailman/listinfo/openheart-l

All messages transmitted by the OpenHeart-L are subject to the policies and 
disclaimers posted at:
http://www.hsforum.com/listdisclaim
-----------------------------------------