Hello Bryan!
I?ve been worried about you!! You?ve been away for a long time!
It is WONDERFUL of you to be concerned for your friend. Too often the
elderly in this country (US) get neglected. I myself care for two
elderly women ? taking them to the doctor, helping with meds, etc.
You've received some good tips from the commenters already! Here are
some more, some elaborate on the comments, and others are ?fresh?
--Medicine boxes: Something like this, with a different color for
morning, noon and evening. Label them with marker ? Morning, Noon,
Night, for example. There are all kinds- look for one that is simple
for arthritic or feeble hands to open. It?s actually easier for the
elderly with a memory problem to have a separate box, of different
colors, than one large box.:
http://www.forgettingthepill.com/organizers.html
http://www.elderdepot.com/customer/home.php?cat=398
--Slipper Socks with gripper bottoms (no skid)
http://www.landsend.com/is/image/LandsEnd/81450_AE04_M1_RAG009999_M.jpg
http://www.seniorsinc.com/non_skid_slipper_socks.htm
--Seat for the shower:
http://www.allegromedical.com/bathroom_assists/shower_chairs/invacare/careguard_shower_chair_with_back.P214503
--Soap on a rope (If he prefers soap versus liquid shower gel). Get a
bit longer ribbon and tie it to a grab bar (if he has one) or
someplace where he will be able to easily retrieve the soap should he
drop it. (Grab bars are an excellent fall preventer)
http://www.amazon.com/exec/obidos/tg/detail/-/B00021WMUI/sr=1-2/qid=1137206749/ref=pd_bbs_2/002-1719235-3304824?%5Fencoding=UTF8&v=glance
--Grab bars
http://www.ameraproducts.com/store/product.aspx?ItemID=527
http://www.bedbathstore.com/safetyitems.html
--Good gripper bathmat (One that won?t lift up from the tub floor when wet)
http://www.bedbathstore.com/tubmatsafinb.html
--Raised toilet seat
http://www.elderdepot.com/customer/home.php?cat=271
More bathroom tips:
===================
TUBS/SHOWER equipment can be adapted to improve both safety and
independence. Use hand-held shower heads, long handled sponges, simple
tub benches and skid-proof rubber mats. Shower curtains are safer than
shower doors.
TOILETS can be installed with a wide variety of enhancements to
improve safety such as simple grab bars or specially-designed commode
chairs.
PIPES that are exposed should be insulated to prevent burns and
scrapes. This is important if you have toddlers who can squeeze into
small places.
FAUCETS can be converted to a single lever handle. Some even operate
with a sensor eye so you don't need to use your hands at all.
SKID-PROOF RUGS or rubber mats are recommended for the floor in front
of the sink to avoid slipping on wet spots.
In general
==========
Falls in the home are a leading cause of serious injury, especially
among the elderly. Have a doctor check hearing, vision or foot
problems. Many of these problems increase your danger of falling.
STAIRS AND HALLS must be well-lit at all times. Illuminated light
switch plates make it easier to find light switches; they are
inexpensive and easy to install. Use sturdy handrails when walking
down steps; consider installing handrails for hallways. Tack down
loose carpeting everywhere in your home, especially on steps. Consider
removing lose throw rugs from your home because they can easily cause
you to fall.
FURNITURE should be carefully arranged to provide plenty of walking
room. Use chairs with strong backs and sturdy armrests and tables with
four legs (not tripod or pedestal tables).
There is more on this site:
http://www.mageerehab.org/education/article5953.html
and here
http://www.pamf.org/patients/falls.html
Make sure your friend has a thermometer he can easily read, as he
will want to check his temperature for signs of infection. Avoidance
of infection is critical in valve replacement patients. Should he need
any dental procedures, he should be put on antibiotics before the
procedure. (His dentist and doctor will advise him of this).
If he is put on Coumadin/Warfarin , a so-called blood thinner, he
will need to adjust his diet, be sure other medications don?t
interfere, use an electric razor and try to avoid getting scratched or
scraped. Coumadin patients are advised not to use tools or put
themselves in a position where they may suffer a wound. (More on this
further down).
?After successful aortic valve replacement, patients can expect to
return to their preoperative condition or better. Anticoagulation
("blood thinners") with a drug like Coumadin may be prescribed for 6
weeks to 3 months after surgery for those with biological valves, and
for life for those with mechanical valves. Once the wounds have
healed, most patients should experience few if any restrictions to
activity. A patient will require preventative or prophylactic
antibiotics whenever having dental work, and should always tell a
doctor about their valve surgery before any surgical procedure.?
http://www.sts.org/doc/3620#10
?It will be very important for you to be up and around as soon as
possible. Most patients may be able to sit on the side of the bed the
evening after surgery and sit in a chair the following morning. Your
nurse will assist you with your first walk the same day. Taking deep
breaths and coughing are also important for recovery and prevention of
pneumonia. Coughing and deep breathing help your lungs to remove fluid
that collects as a result of remaining in bed for an extended period
of time. You will be instructed on how to use a breathing device
called an incentive spirometer, which should be used every hour while
you are awake.?
?Please note that prevention of bacterial endocarditis is a key to the
success of the valve repair or replacement. Inform any dentist or
physician who treats you about your history of valve replacement or
repair. They may prescribe antibiotics to prevent an infection from
settling in your heart.?
******* Very Important***** ?In addition, be aware of the signs
and symptoms of bleeding (therapeutic levels of Coumadin would be too
high, thus causing bleeding tendencies): ******pink urine, black
stools, excessive nosebleeds, unusual vaginal or anal bleeding, purple
or red skin discoloration or bleeding gums.***** Report these symptoms
to your cardiologist or the physician covering your anticoagulation
therapy. Moreover, take Coumadin at the same time every day and never
make up for a missed dose. Do not take aspirin or aspirin products,
avoid excessive alcohol intake (it may cause bleeding) and carry an
identification card indicating that you take a blood thinner and have
had a heart valve repair or replacement.
Patients with prosthetic heart valves should also be alert to
signs of prosthesis failure. Often the signs of value failure resemble
the symptoms that occurred prior to the valve surgery and may include
******fatigue, weakness, lightheadedness, shortness of breath while
lying down or during exertion, as well as chest pain (angina).?
*******
http://www.inova.org/inovapublic.srt/heart/treatment_options/cardiac_valve_repair.html
?What should I watch out for?
=============================
Be sure to call your doctor if any of the following symptoms appear:
? Fever
? Warmth, redness, or swelling around the incision
? Drainage from the incision
Will there be scar(s)?
A scar will remain along the chest bone.
When can I expect to return to work and/or normal activities?
Your doctor will advise you to walk or to do other physical
activities, increasing gradually in order to regain your strength and
return to a normal, active lifestyle. Most individuals who have
sedentary jobs can return to work in four to six weeks. Those who
have physically demanding jobs will have to wait longer.
Additionally, your doctor will not want you to drive a car for six
weeks.?
http://www.debakeydepartmentofsurgery.org/home/content.cfm?proc_name=aortic+valve+replacement&content_id=274
?Generally, most patients can leave the hospital 5-6 days following
surgery. It is important to have family members or friends available
to assist you in your first week home. The nursing staff will contact
a home care agency near your home to arrange a home nursing assessment
the day after your discharge. Additional services available through
the home care agencies for patients who meet criteria include physical
therapy, occupational therapy, and the services of a home health aide
or social worker.
Cardiologist
It is important to make an appointment with your cardiologist within
two weeks of discharge. Your cardiologist will monitor your progress
over time and adjust your medications.?
http://www.brighamandwomens.org/patient/cardiac_valve.asp#discharge
?Difficulty sleeping and weakness are both fairly common post
surgery, especially in someone so ill prior to the surgical repair,
again this is more true in older patients (>65 yo). The lack of sleep
surely needs to be addressed by your father's physicians as this could
potentially hinder the progress of his rehabilitation.
There are other sources of protein for protein for your father and yes
this very, very important in his recovery, and I would try these
(milk, soy protein, etc.)first before asking the patient to eat
something he is against.?
http://www.medhelp.org/forums/cardio/archive/1895.html
?Recovery after valve surgery may take a long time, depending on how
healthy you were before the operation. You will have to rest and limit
your activities. Your doctor may want you to begin an exercise program
or to join a cardiac rehabilitation program.
If you have an office job, you can usually go back to work in 4 to 6
weeks. Those who have more physically demanding jobs may need to wait
longer.
Life After Valve Replacement
----------------------------
Patients with a mechanical valve will need to take a blood-thinning
medicine for the rest of their lives. Because these medicines increase
the risk of bleeding within the body, you should always wear a medical
alert bracelet and tell your doctor or dentist that you are taking a
blood-thinning medicine.
Even if you are not taking a blood-thinning medicine, you must always
tell your doctor and dentist that you have had valve surgery. If you
are having a surgical or dental procedure, you should take an
antibiotic before the procedure. Bacteria can enter the bloodstream
during these procedures. If bacteria get into a repaired or artificial
valve, it can lead to a serious condition called bacterial
endocarditis. Antibiotics can prevent bacterial endocarditis.
Patients with mechanical valves say they sometimes hear a quiet
clicking sound in their chest. This is just the sound of the new valve
opening and closing, and it is nothing to be worried about. In fact,
it is a sign that the new valve is working the way it should.?
http://www.tmc.edu/thi/vsurg.html
?Another common problem occurs when calcium deposits build-up on a
worn-out valve. This build-up can restrict the valve?s movement,
leaving the valve either unable to open or to close properly.
People experiencing problems with their aortic valve may experience
shortness of breath, dizziness, chest pain, loss of consciousness, or
a combination of these symptoms.
Aortic valves generally cannot be repaired, especially if calcified,
and are almost always replaced, either with an artificial valve or a
biological valve. Many doctors prefer using artificial valves for
their durability, but most use biological valves because of no need
for warfarin anticoagulation.
?After this surgery, patients usually can expect to return to healthy,
and more active lifestyles,? said Cohn. ?Now that the procedure can be
done with minimally invasive techniques, their quality of life
immediately after surgery also improves significantly.?
http://www.or-live.com/BrighamandWomens/1127/
?Life expectancy (LE) and event-free life expectancy (EFLE) for a 65
year old man after implantation with a mechanical valve or a
bioprosthesis were 10.4 and 10.7 years and 7.7 and 8.4 years,
respectively. The lifetime risk of at least one valve related event
for a mechanical valve was 48%, and for a bioprosthesis, 44%. For LE
and EFLE, the age crossover point between the two valve types was 59
and 60 years, respectively.?
http://heart.bmjjournals.com/cgi/content/full/90/10/1172
Coumadin
========
? Never take a double dose of this medication.
? Do not take aspirin or nonsteroidal anti-inflammatory drugs
(NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen
(Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox), and
others while taking Coumadin, except under the direction of your
doctor. These medicines increase the risk of bleeding.
? Avoid sudden changes in your diet. Vitamin K decreases the effects
of Coumadin. Large amounts of vitamin K are found in foods such as
liver, broccoli, brussels sprouts, and green leafy vegetables (e.g.,
spinach, Swiss chard, coriander, collards, cabbage). Do not change the
amount of these foods in your diet without first talking to your
doctor.
? It will be necessary to regularly monitor your therapy with a blood
test called a "PT" or an "INR." These tests help to determine the
amount of Coumadin that you need to take.
? Contact your doctor if you experience any unusual bruises or
heavily bleeding wounds, diarrhea, infection, or fever during
treatment with Coumadin.
Understand that your friend does not have to avoid foods that contain
Vitamin K while on Coumadin, just maintain the amount of such foods.
If he eats green leafy vegetables usually, then he should maintain
that diet. Don?t start or stop eating the food listed above.
http://www.drugs.com/coumadin.html
This page has a chart with Vitamin K content of foods:
http://www.dietitian.com/vitamink.html
?Rationale: Why do I need to pay attention to my diet while I am on Coumadin®?
A. Coumadin works to keep your blood from clotting by decreasing the
availability of vitamin K. Vitamin K helps your blood to clot. These
are opposing actions.
B. Excessive vitamin K intake can interfere with the Coumadin® and
allow your blood to remain susceptible to clots. Likewise, if you eat
too little vitamin K, the excess medication may cause your blood to
become too thin.
C. Your medication will be adjusted to the amount of vitamin K
typically in your diet. If you suddenly increase or decrease the
amount of vitamin K in your diet, your medication will not work
properly.?
Your friend?s doctor will advise him about diet, but now that you know
about it, you can keep a close eye on him!
http://www.whmc.af.mil/coumadin/coumdiet.htm
?Q2:"Is life on coumadin really that bad?"
Depends on who you talk to. Being on coumadin requires that you have
regular INR checks -- Blood draw from arm or finger stick. Most people
need to have once per month checks, but some need more frequent. You
also may need to curtail some of your activities, depending on what
you like to do with your spare time.?
http://www.medhelp.org/forums/cardio/messages/34386.html
?It is important that you carry identification stating that you are
using this medicine. If you have any questions about what kind of
identification to carry, check with your health care professional.
While you are taking this medicine, it is very important that you
avoid sports and activities that may cause you to be injured. Report
to your doctor any falls, blows to the body or head, or other
injuries, since serious internal bleeding may occur without your
knowing about it.
Be careful to avoid cutting yourself. This includes taking special
care in brushing your teeth and in shaving. Use a soft toothbrush and
floss gently. Also, it is best to use an electric shaver rather than a
blade.
Drinking too much alcohol may change the way this anticoagulant
affects your body. You should not drink regularly on a daily basis or
take more than 1 or 2 drinks at any time. If you have any questions
about this, check with your doctor.?
Unusual bleeding may mean that your body is getting more medicine than
it needs. Check with your doctor immediately if any of the following
signs of bleeding or overdose occur:
? Bleeding from gums when brushing teeth
? blood in urine
? nosebleeds
? pinpoint red spots on skin
? unusual bleeding or bruising
? unusually heavy bleeding or oozing from cuts or wounds
? unusually heavy or unexpected menstrual bleeding.
? Signs and symptoms of bleeding inside the body dose-related
Abdominal or stomach pain or swelling
? back pain or backaches
? black, tarry stools
? bleeding in eye
? blood in stools
? blood in vomit or vomit that looks like coffee grounds
? blood in urine
? blurred vision
? chest pain
? confusion
? constipation
? coughing up blood
? diarrhea (sudden and severe)
? dizziness or fainting
? headache (continuing or severe)
? joint pain, stiffness, or swelling
? loss of appetite
? nausea and vomiting (severe)
? nervousness
? numbness or tingling of hands, feet, or face
? paralysis
? shortness of breath, weakness (sudden)
Also, check with your doctor as soon as possible if any of the
following side effects occur:
Less common
? Cough or hoarseness
? fever or chills
? lower back or side pain
? painful or difficult urination
? skin rash, hives, or itching
? Rare Blisters or itching on skin
? blue or purple toes
? dark urine
? pain in toes
? painful red sores on skin especially on thighs, breasts, penis, or buttocks
? sores, ulcers, or white spots in mouth or throat
? sudden increase or decrease in amount of urine
? swelling of face, feet, and/or lower legs
? trouble in breathing
? yellow eyes or skin
http://www.fvleiden.org/publications/coumadin.htm
An emergency alert system is a fabulous idea, if your friend can
afford it. Perhaps some senior organizations can help with the cost.
If not, you could schedule different friends/family members to call
him twice a day, to be sure he is alright. Many communities in the US
have a Meals on Wheels service that delivers meals to senior citizens-
you may find the same thing available in your area.
Remember, your friend will need to eat a healthy diet and drink
plenty of healthy liquids to make a speedy recovery. The blood
pressure monitor is thoughtful, but only useful if he suffers from
elevated blood pressure! Aortic valve replacement and high blood
pressure do not necessarily go hand in hand.
Instead of a cell phone, how about a portable phone (cordless),
that has a base that plugs into the regular phone jack, but the phone
is wireless and can be placed near your friend at all times. (Ride in
a robe pocket, perhaps) during the day. Cheaper too. Program his phone
to emergency services if it is not already programmed.
http://www.amazon.com/gp/browse.html/002-1719235-3304824?node=172614
If you are into cooking, you could prepare meals and freeze them
for him to reheat in a microwave. I do this with my ladies. I cook a
pot roast for example, with carrots and potatoes. When cool, I divvy
it up into plastic containers. The ladies take one out in the morning
to thaw enough to place into a glass bowl to heat in the microwave.
They are very appreciative of this, and they get a nutritious homemade
meal.
If he was able to go upstairs prior to surgery, his doctor will
give him the go ahead to climb stairs again and return to normal
activity. The surgery is supposed to make life easier, not turn one
into an invalid, even an 80 year old man, unless he has other
ailments. Encourage him to quit smoking, if he is a smoker.
I?ll bet what your friend will enjoy most, will be visits from you!
Take a short walk outdoors with him. Don?t forget to hug him, tough
his arm, and pat him on the back (gently). The healing power of touch
is often overlooked. I hope this has helped you out! I?m so glad to
see your return!
Sincerely, Crabcakes
Search Terms
=============
socks + grippers + men's
Medicine organizers
Raised toilet seats
Grab bars
gripper sole socks + men's
infection + post aortic valve replacement
diet + Coumadin
post + aortic valve + replacement
recovering + aortic valve + surgery |
