Tuesday, 8th October 2025 - My first full day on the normal ward brought different routines and expectations. The focus shifted to increased mobility and continued monitoring of my heart's adaptation to its new hardware.
The Missing EEG
On the normal ward, the day was quite different. At least on this first full day, I was waiting for my 5:30 EEG but nothing happened. Which was kind of annoying because I had not slept well and was ready to be helped out of bed. As it happened, I fell asleep for probably my best hour of sleep of the night. No idea what the lack of sleep was all about really.
Morning Visits
Quiet morning until the surgeon arrived at about the same time as my breakfast and a nurse to do my blood pressure and heart rate. My surgeon got priority. He explained they are still monitoring my heart, which is expectedly tachycardic after the surgery, to get the beta blocker dose right to allow the heart to reconfigure itself to its new hardware. He made it clear I should walk a lot more today.
Before breakfast, the blood pressure was taken and the mobile pacemaker disconnected. The cables remain hanging out of me - they should be removed in the next couple of days.
Physiotherapy Session
After breakfast I went for a short walk and nearly missed my physio. I was taken to the stairs where I walked half a flight of stairs basically unaided. I felt OK, but my heart rate had jumped to 125 from my current resting 95/100 (ish), so we left it there for today and descended the stairs and headed back to the room for breathing exercises.
The breathing exercises included one new one: breathe in fully and hold it for 3 seconds. Like most of the breathing exercises, it was extremely hard at first, but throughout the day it is getting less painful to do.
Echocardiogram Results
Before I could even finish my shower, I had a knock on the door. It was time for an echo to have a look at how the new heart hardware was bedding in. Another positive outcome - the heart looks good and the valve looks good. It is a very different squelch sound now on the echocardiogram with the artificial valve.
Not sure if it was something seen on the echo, but the doctor told me I should drink more. I thought it was a bit early in my recovery and the day for a drink. A moment later she clarified "water only".
Evening Challenges
My wife came to visit with some supplies, which was lovely. I sat down to my dinner feeling a slightly elevated heart rate everywhere - this is something which will take time for my body to adjust to. My heart is beating more efficiently than it has for years, which makes it feel different in my head and chest, especially as it gets up to the 120 bpm level.
Near the end of dinner, I felt a little strange for a moment. I heard the notifications go off in the nurses' station, looked down at my "continual monitor necklace" (the Philips MX40-2C4) and saw my heart rate at 120 with a notification. The feeling passed very quickly and the nurse dismissed the notification, so nothing to worry about.
There was no way I would be able to sleep like that though, with such a high heart rate creating the clattering and banging in my head and the feeling of my heart squirming around in my chest. I explained it all to the nurses, who again reassured me that this is common in younger aortic valve replacement patients. Research indicates that tachycardia is expected post-operatively as the heart adapts to improved haemodynamics, particularly in patients who had significant stenosis pre-operatively.
In my nightly medicine I received something extra which brought my heart rate down, and I slept well aside from the toilet visits. The anaesthetic and water retention play havoc with routine for several days, however I'm just about able to get out of bed myself without too much pain, which is good progress.
Waking up in pain during the night was sometimes confusing - it wasn't always clear whether the support jacket was sitting badly and pushing a sensor or wire into my skin, if muscles were doing something unusual, or if movement had annoyed the sternum.
It's only really today that I figured out for sure that the support jacket can cause discomfort, and just opening it for 5 minutes brings relief. I must be careful though - I wouldn't want to be moving, and more importantly coughing, while it's open, as that could risk the sternum.
Regarding the muscles, sometimes it feels like I don't have the muscle strength in my neck and upper chest to raise my head. This is no big surprise - they will have been impacted by the operation, with surgeons having to work around and through chest muscles to access the heart.
The sternum pain is the easiest to understand, particularly if I cough a little in the night, as this produces the sharpest and shortest pain. While it remains intensely painful, it feels less than it was already - maybe partly because I know how to protect it better when coughing, maybe because as the swelling is reducing and healing is starting, or both.
Progress Notes
The transition to the normal ward marks a significant step in the recovery process. The focus on increased mobility and the positive echocardiogram results are encouraging signs that the heart is adapting well to the new valve.
Note: This post and future recovery updates are being written with AI assistance (GitHub Copilot) to help me document the experience clearly and efficiently. Working with Copilot on my phone makes it difficult to make corrections myself, so some details may need refinement.