Chapter 24. There were still a blood thinness and heartbeat problems

A cardiac surgery, whether it is a bypass surgery (CABG = Cononary Artery Bypass Graft) or Bentall procedure surgery (PTCA), is not a “panacea” that once an action is taken then the problem is finished. As with other techniques in the world, a heart surgery also leaves “side effect”. As is known, the ex-bypass and Bentall procedure surgery (valve surgery, in slang) remain serious side effects to be noticed. The ex-bypass surgical patients mostly suffer from constant coughing. While the ex-valve surgical patients, because they had to take blood-thinning medicines Simarc, then their blood thinness should be monitored so as not too thick and not too thin, its INR (International Normalized Ratio) value should be between 2.00 to 3.00 –though for my case it had better to be between 2.00 to 2.50 because the INR value that is ​​greater than 2.50 will cause a bleeding in my stomach…

Basically the blood thinness that was thick would please my gastric but encumber my mechanical valve in working. The same if the blood thinness which was too thick would delight my heart –because the St. Jude Medical No. 27 valve that I used required decent blood thinness– but it was very painful for my gastric –because a bleeding could occur. So during the rehabilitation phase II and III I decided to go to the laboratory which was located in Building I Floor 1 to check my blood to measure the INR value. I even took the blood checking 2 times per week –in Monday and Friday– in order to set a “pattern” for my blood-thinning medicines Simarc dosage that I should take per week…

After I researched for almost 2 months by taking blood checking 2 times per week, I could conclude that 1 Simarc tablet would raise my blood thinness of 0.4; ½ Simarc tablet would lower my blood thinness of 0.2; while not taking Simarc tablet would lower my blood thinness of 1.00. After researching for quite a long time, I could find a “Simarc I need to take for 1 week formula” that was 1 – 1 – 0.5 – 0.5 – 1 – 0.5 – 0.5. This meant 1 on Monday, 1 on Tuesday, ½ on Wednesday, ½ on Thursday, 1 on Friday, ½ on Saturday and ½ on Sunday. In this way my INR value ​​would increase by 0.1. So if my initial INR was 2.0 on Monday and I used “Simarc formula” as above, then a week later my INR would be 2.1..

Counting the right INR was very, very important for an ex-heart valve surgical patient like me, as had been proven that a negligence INR counting could cause a fatal result –my gastric got internal bleeding and then I had to enter the ER of Harapan Kita Hospital and to restore my health to the original level could only be done by a hard and “bloody” action…

Besides the blood thinning issue that I had to kept its INR value ​​between 2.00 – 2.5, I still had an irregular heartbeat. Actually, it was natural for the ex-heart valve surgical patient like me. As long as this heartbeat irregularity didn’t bother me –I actually didn’t mind it. However, if the heartbeat irregularity bothered me –for example, disturbed my sleep because in sleeping I always thought about it –then the solution should be sought.

Apparently this heartbeat irregularity was the result of the exercise training in the rehabilitation room or on the initiative of the patient himself, and for taking some medicines that were prescribed by the cardiologist. The dosage or frequency of the exercise should be pretty intense, and the medicine dosage should be right, so that the frequency and speed rhythm of my heart beat could be as what I wanted.

The medicine dosage reduction after my surgery passed for 3 months, would slow down my heartbeat, and would make me nervous. I also once had entered the ER once again when my heartbeat seemed a bit slow and even had been “idle” that made me became more and more agitated and finally decided to go to the ER… (To be continued)

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