Playing after surgery - any personal experience?

[sloan]

I just came home from a heart catheterization (left, right, trans-valve - all the bells and whistles - but in by 6am and home by 6pm) and now have holes in my femoral artery and vein that need care and tending.

Doc says "no pressure for at least a week". Anyone out there with personal experience on how long I should lay out, and any hints on ramping back up again?

And then, of course, all of this is preparatory to an aortic valve replacement (my best guess will be December - the next month-sized hole in my professional schedule, but a busy time for the amateur tubist). Big time rib-cracking, open heart slice and dice ("nurse! hand me that SkilSaw!"). Same questions: how long to plan on being away, and how to come back safely.

[rocksanddirt]

well....hard to say on the recent stuff.

when my dad had bypass surgery he didn't feel recovered for about 4 months. He was up and able to do most things within a week or so, but just had no endurance for a couple of months. gradually built back up.

so, not really an answer, but maybe a hint?

[Dean E]

. . . . Doc says "no pressure for at least a week". Anyone out there with personal experience on how long I should lay out, and any hints on ramping back up again? . . . .

I would highly recommend looking for ways to get into walking, Yoga, breathing, swimming, biking, etc. How do you feel working those healthy activities into your lifestyle?

[DLThomas]

Nothing like you have ahead of you (just an appendectomy and a partial parathyroidectomy for me in recent years) but while recently looking for information about embouchure overuse I found this:

http://www.sciandmed.com/mppa/" target="_blank" target="_blank

a journal devoted to medical problems of performing artists. Perhaps it will provide you (or lead you to other sources for) the information that might help in your situation.

Dave "believing music is good for spiritual and physical healing" Thomas

[Rick Denney]

You are an amateur tuba player. Surely your playing can tolerate a break of a couple of weeks, no?

My doctor said no tuba playing for two weeks after my gall-bladder removal, because of pressure which might open the larger of the four insertion points (actually, that was the extraction point), and because of lifting the instrument. So, I played radio and spent my recovery time on other hobbies. My tuba playing isn't any worse now than it was before--various demands have caused two-week layoffs many times.

My wife interpreted the rule as no tuba playing until the two-week follow-up visit, but I started playing the tuba again after two actual weeks. When the surgical tape came off (after ten days or so), I could tell much better how well the incisions had healed.

What does your doctor wife have to say? My wife is not a doctor, but that didn't stop her expressing an opinion...

Rick "...and enforcing it" Denney

[cjk]

I agree with Rick's wife.

I would do whatever the doctors recommend plus some. An extra week (or even month or months) so without a tuba is definitely better than a life without a heart.

If doctors are going to be opening me up, how long to wait before playing the tuba will be one of the last things on my mind.


All the best,

Christian Klein

[sloan]

You are an amateur tuba player. Surely your playing can tolerate a break of a couple of weeks, no?

My playing always sounds as if I had just returned from a month off...

My wife interpreted the rule as no tuba playing until the two-week follow-up visit, but I started playing the tuba again after two actual weeks. When the surgical tape came off (after ten days or so), I could tell much better how well the incisions had healed.

What does your doctor wife have to say? My wife is not a doctor, but that didn't stop her expressing an opinion...

My wife is a Professor of Ophthalmology, but she's a mere Ph.D. in Anatomy. They don't let her touch human tissue until the donor no longer has any use for it.

Which, as you point out, does not prevent her from voicing (...and enforcing) an opinion.

Looks like I'll be taking a very long break. I see my surgeon on 30 May, and best bet is that they apply the SkilSaw in mid-June. My goal is to be able to *attend* the 4 July concert, and be back standing in front of a classroom by 15 August.

By then, I'll have lost so much practice time that I may well switch to Eb as my main instrument (and if not...that YBB-621S will come in handy for awhile; carrying the 2341 may be out of the question for 6 months).

[sloan]

If doctors are going to be opening me up, how long to wait before playing the tuba will be one of the last things on my mind.

True enough - but it's the only thing that's on-topic here...

[billeuph]

Ken-

My experience was quite different from what you face, but I learned a lesson or two from it. In 2003, I had nearly half of my lower lip removed due to skin cancer. Plastic surgery following the tumor removal left the face cosmetically intact, more or less, but playing any wind instrument was out of the question for at least 3 months. After that, the next 6 months were comical. I wouldn't have been able to play in a middle school band. There just wasn't any buzz. The lip was stiff and inflexible.

Life goes on. I began falling back on other activities that my tuba playing had pushed out of the way, like long distance road bicycling. And our dog was walked a lot more often than before. Eventually, a couple of years after surgery, I was able to play well enough to get by. It's been 5 years now, and my playing still isn't back to what it was before surgery, but it's good enough to enjoy doing it again.

A few months without playing isn't the end of the world for us amateurs. Find some other things that you used to like doing and go back to them for a while. Above all, be patient. We play only because we enjoy it, so if you don't enjoy it due to discomfort or frustration, but the horn aside for a while. Take a walk. Get a bicycle. And be thankful that you don't have to make a living by playing.

And I ALWAYS use sunscreen on my lips now!

Bill Anderson

[sloan]

Some recovery may depend on how they zipped you up. Did they hand sew you up or did they machine sew you closed? (no, I'm not kidding. I know Dr. Sloan isn't a teddy bear, at least not physically...) In and out in 12 hours, I'm betting the latter. Hand sewing requires more time with a weight sitting on you in a fun spot. So, a week will probably do it, BUT if you are exerting more pressure from any activity you will instantly feel it right at that entry incision.

Take care of yourself!

12 hours in and out was for the cardiac catheterization. No stitching required. They insert IV-like sheaths (in my case, in both the femoral artery and vein) - snake wires (under X-ray guidance) to the heart - and then use the guidewires to bring catheters to the heart to sense pressure and flow and to inject radio-opaque dye so that the TWIN stereo X-ray machines can take 3D movies of the heart in action. Then, you lie flat on your back for 6 hours while the punctures heal.

The "stitching up" part comes next month, after they apply the SkilSaw to my sternum, disonnect my aorta, and slap in a replacement valve (piston or rotor?, silver or lacquer?).

[TubaRay]

without a tuba is definitely better than a life without a heart.

And what an interesting life that would be.

[GC]

Sloan,

I'm having an heart cath Wednesday. You've filled in a few details I've wondered about. Thanks.

It'll give me a good excuse not to carry a 25J up and down two flights of stairs . . .

[WoodSheddin]

12 hours in and out was for the cardiac catheterization. No stitching required. They insert IV-like sheaths (in my case, in both the femoral artery and vein) - snake wires (under X-ray guidance) to the heart - and then use the guidewires to bring catheters to the heart to sense pressure and flow and to inject radio-opaque dye so that the TWIN stereo X-ray machines can take 3D movies of the heart in action. Then, you lie flat on your back for 6 hours while the punctures heal.

The "stitching up" part comes next month, after they apply the SkilSaw to my sternum, disonnect my aorta, and slap in a replacement valve (piston or rotor?, silver or lacquer?).

The cath is used to measure the pressures and flow rates at various points in the heart. The cath is much more accurate than the echocardiogram. These pressure and flow rate numbers are used to map out better exactly what and where the corrections will take place. The cath part ain't a big deal.

The heart surgery is obviously a much bigger deal. Once the new valve is in place, apart from the discomfort from the actual surgery recuperation, the benefits should be pretty quick. The first day sorta sucks with the drain tube in place and you kinda look like hell. Once the tube comes out you should start to be a bit less drugged up and start the process of feeling better.

I ain't no doctor, but I would think you might wanna stay off that horn for a few weeks and try not to pig out too much.

Did the doctor give you an estimated life for the new valve? 20years maybe?

[MikeMason]

Sean,surely you're too young to have had this done? You sound pretty knowledgeable...Just curious...

[WoodSheddin]

Sean,surely you're too young to have had this done? You sound pretty knowledgeable...Just curious...

I know someone who had work done on his aorta.

[Mike Ferries]

Dear Sir
Having had lumbar spine and inguinal hernia surgeries, AND being an anesthesiologist, my advice is to put the horn aside. Aortic valve surgery is nothing to mess with, and neither are the puncture sites in your groin. The horn and the music will still be there when you have recovered. God speed.

[sloan]

Did the doctor give you an estimated life for the new valve? 20years maybe?

Haven't talked to the surgeon, yet - but I've been reading his papers (I'm a dangerous patient).

From my reading, 20 years might be a tad optimistic. 15 seems to be the middle-of-the-road estimate.

I'll lay 8-5 that we go with a cryogenic allograft (human). At my age it's only *marginally* statistically less likely to require replacement in my lifetime than a xenograft (pig or cow) but I'd rather do it again in 15 years than put in a mechanical valve (pretty much guaranteed for life...ah, there's the rub!) and take warfarin for those 15 years. I'd miss out on all those dark green leafy vegetables. Also, that's the choice that this guy has been pushing (and pioneering) in his papers for the past 15 years. It *might* be that I'm just old enough to make a pig valve slightly preferable (I'm guessing, but I think fresh pig might be slightly preferable to frozen human - again, considering my age). I have an uncle who had a pig valve put in 28 years ago and replaced it with a cow valve 15 years later. He would have been about my age (perhaps a tad younger) - but he would have had slightly different options then. In particular, I don't think allografts were (commonly?) available then. Hmmm, he's probably due for another one (apparently, age alone is not a problem for this procedure, although other conditions that come with age might be).

I talk to the surgeon on 30 May (would have been 23 May, but I'm out of town and it isn't *that* much of an emergency) and I'm guessing surgery will be mid-June.

Rest assured that I'll take all instructions on post-op behavior to heart - I posted here to see if there were any special considerations. My docs have not been particularly knowledgable about tuba playing and a natural tendency (which I have to fight) is to say "he really doesn't understand" (actually, he probably DOES).

The one time that tuba playing has mattered to me so far was when I was an unwilling guest of the ICU with double pneumonia and sepsis. I (am told that I) was fighting the respirator until my wife told them I played the tuba and they cranked it up a notch (something like 1/3) - and then I was happy.

[RyanSchultz]

Best wishes for a speedy recovery!