PFO closure and recovery information

I had my PFO (Patent Foraman Ovale) closure on Friday (Dec 15th 2006). A PFO is an opening in the heart, which doesn't close completely after birth. The opening, 0.5cm, was allowing unfiltered blood and clots to travel to my eyes and brain, resulting in serious symptoms of haemorrhaging and mini-strokes for many of my 26 years. The PFO was finally identified in July 2006 and I was whisked on to the surgical waiting list to have it corrected. I was also given aspirin and plavax to take daily to help thin the blood, and all of my symptoms of paralysis, slurred speech, numbness, tingling, weakness, headaches and blurred vision vanished. Hallelujah!

The surgical team attempted to do the procedure on the 8th but an unexpected allergic reaction to the antibiotic Vancomycin caused me to break out in a rash all over my neck. This apparently is called "red neck syndrome" and is a known side effect of this antibiotic. Hives developed in an itchy, red welt mess all over my back and my tongue and lips swelled like the results of a bad cosmetic lip enhancement. I threw myself on to an offered stretcher and promptly passed out. I was quickly given phenergan and something else equally doze-worthy plus oxygen, resulting in a long, drug induced sleep. I can't do anything simply - it isn't my style.

The doctor kept me in, much to my annoyance, for the whole weekend, releasing me on the Monday with strict orders to return at the end of the week. Frustration that the surgery wasn't over consumed me on the Saturday but I soon reminded myself that everything happens for a reason and maybe my body wasn't ready to undergo the procedure on the 8th. Or maybe something more unfortunate than a simple anaphylactic reaction would have happened and I decided I should be thankful for the reprieve.

The 15th arrived in a rush and I found myself back in cardiac investigations of the Prince Charles Hospital. The staff remembered me, courtesy of my troublemaking the week before, and I was given expensive, non-allergenic antibiotics with no problems. Trying to get a decent vein in my arm to insert a canular is a challenge but the doctor didn't do too badly - it only took him two attempts instead of the usual three.

The surgeon came to get me and I was forced to walk as quickly as my little legs could carry me, dressed in my massively oversized Jacaranda purple gown, down the hallway. He gripped the IV stand in his heavily insured hands, and threatened to accidently pull the drip out of my arm if I didn't practically run to keep up. He deposited me in the theatre and disappeared. The theatre nurses indicated that I was to clamber up on to the surgical table, where I lay, nervous anticipation engulfing me. I swallowed the lump that threatened to form in my throat. I had refused the sleeping tablet, anticipating a decent sedative once in the theatre. Big mistake! Note to self: accept all drugs offered when expected to stay awake during an op!

Oh my Goodness, what a horrid experience.

My groin, which had been previously Brazilianed but an enthusiastic nursing student, and legs, were washed down with ice cold, beetroot coloured alcohol (and not the good type). A surgical cloth was placed over my body and the surgeon's assistant arrived to cut open my legs. Local anaesthetic injected into both sides of my groin didn't do much to hide the pulling, pushing, pressure of sutures and insertions of tubes and wires. The drug they had put into the IV to help me relax didn't arrive until half way through the procedure due to a blocked canular. After much ooohing, aaaaahing, ouching and tears from me, the unenthusiastic patient, they finally realised something wasn't quite right. They flushed the canular, reattached the drip line and Hello! there we go. The good juice.

A mesh cocktail umbrella styled device was threaded up through the groin to the chest. It was pushed through the hole and popped open, then pulled back through and popped open on the other side, producing a shield to prevent fluids from travelling through. Pretty amazing! An xray and an echocardiogram was performed to ensure that it is in the right position. Two to three weeks post-op endothelial cells grow over the device, sealing it.

Recovery. The lovely nurse who looked after me applied lots of pressure to the groins to help stop the bleeding, and there was quite a lot of that happening! She alternated between using hand pressure, pressure bandages and a device that was strapped around my waist. I had to lie flat without moving my legs for five hours. That was hard on my back and knees but the time didn't go too slowly. At 9pm i was allowed out of bed, and was sent back up to the ward. Overall, the worst part was the procedure itself.

I wasn't allowed to drive for a few days and I can't do much exercise for another month. I usually go to the gym once a fortnight and to hydrotherapy weekly so that is out until after my next cardiology appointment. Routine dental care is out for six months (what an excellent excuse to avoid the dentist!!). I also experienced bruising, tenderness, bleeding and pea sized lumps around the incision areas, fluttering in my chest for the first 24 hours, shortness of breath for the first three or four days, and the feeling that something was "stuck" in my chest. Imagine having a big bit of phlegm in your chest that you want to cough up. Now replace phelgm with chicken bone! Yuck. Once my brain realised that, "oh! that is supposed to be there!" the feeling went away. A week on, I still feel a little tired, extremely tender and bruised in my groin area still and some mild palpatations but I'm sure all that will improve soon. I go to the cardiologist for a check up and another echo mid-January, 3mths post op, 6 mths post op and then annually for a little while.

Update: It is three weeks later and everything is going well. I had a check up on Friday and the device is looking stable. The lump in the right groin was ultrasounded but it is fine and should go away eventually by itself. I went to a music festival yesterday and today and felt the benefits for the first time - more energy and no puffing... even after walking quickly up a hill. I'm feeling more confident in myself too!



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