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Old 07-31-2007, 06:29 AM   #1
Jennie@ifish
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Default Open heart surgery/hiccups

I just have to ask! I don't know how many of you have had open heart surgery-- but ever since, I get hickups and have trouble swallowing, ever since.

Is this normal?

When I asked my doc, he said he thought it was due to the fact that I had to have the breathing tube in for so long that it damaged that area.

They tried to take it out, but I didn't breathe right, so they had to put it back in for a couple days longer. (Is that right, Pete? I forget!)

So... anyone else have this problem?

Jen

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Old 07-31-2007, 06:43 AM   #2
Jaws
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Default Re: Open heart surgery/hickups

It does sound like an esoughophous(sp) problem. Maybe swollen and you are swallowing air. Do You have acid reflux/heart burn? Does doing a certain thing set it off?
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Old 07-31-2007, 06:46 AM   #3
craigcw
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Default Re: Open heart surgery/hickups

Hey Jennie,

As an anesthesiologist I can tell you that difficulty swallowing is not from a breathing tube being in place for a long period of time. The breathing tube, if placed correctly, will never go down the esophagus. If someone with less skill attempts intubation (placement of the endotracheal tube) they might struggle and put the tube down the esophagus or cause some trauma to the back of the throat which would be temporary and not cause any long term damage. However, for your particular surgery (-ies) you would have had a nasogastric tube for prolonged periods which may have been changed several times over the course of your ICU admission. This "feeding" tube would have been up your nose and down into your stomach and that could have caused some erosion of the esophagus and thereby long-term damage to your esophagus. Also, prolonged intubations will cause a great deal of acid build up in your stomach and many people will have problems with gastric ulcers and esophageal erosion; again, this could also be a factor in your difficulty swallowing symptoms.
As for the hiccups, that one I am not sure how to explain. I'll have to do some research on that.
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Old 07-31-2007, 07:03 AM   #4
Jennie@ifish
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Default Re: Open heart surgery/hickups

Interesting... No, no trouble with heart burn. I don't even know what heart burn might feel like.

I have had ulcers in the past, though. I take protonix for that. Even though I haven't had them in a while, they make me keep on it, because mine were bleeding ulcers and they are worried about that while I'm on coumadin. (Forever on coumadin!)

Jen
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Old 07-31-2007, 07:04 AM   #5
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Default Re: Open heart surgery/hickups

and the hickups seem to be caused by the not swallowing problem. I swallow something and it gets kinda stuck. If I don't drink water or liquid right away to get it all the way down, the hickups start. (hiccups?) What's the correct spelling?
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Old 07-31-2007, 07:19 AM   #6
craigcw
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Default Re: Open heart surgery/hiccups

Here's kind of long answer from the Mayo Clinic:


A hiccup is an unintentional contraction of your diaphragm the muscle that separates your chest from your abdomen and plays an important role in breathing. This contraction makes your vocal cords close very briefly, which produces the sound of a hiccup.
Acute or transient hiccups
Although there's often no clear cause for a bout of hiccups, some factors that can trigger acute or transient hiccups include:

Eating spicy food. Spicy food may cause irritation to the nerves that control normal contractions of your diaphragm.
Eating a large meal, drinking carbonated beverages or swallowing air. These can cause your stomach to expand (distend), which pushes up your diaphragm, making hiccups more likely.
Drinking alcohol. Alcohol can relax your diaphragm and vocal cords, making it easier for other factors to trigger hiccups.
Sudden temperature changes. A quick change in temperature, either inside or outside your body, such as drinking hot liquids and then cold liquids or your shower water switching suddenly from hot to cold, can set off hiccups.
Tobacco use. Tobacco use may irritate the nerves that controls the diaphragm (phrenic nerves), causing hiccups.
Sudden excitement or emotional stress. Although it's not clear why stress or sudden excitement causes hiccups, it may be due to the effect being startled has on one of the nerves involved in the hiccup reflex (vagus nerves).
Persistent and intractable hiccups
Rarely, hiccups may be the result of an underlying medical condition. When this is the case, the hiccups usually last longer than 48 hours. More than 100 causes of persistent and intractable hiccups have been identified. They are generally grouped into the following categories:

Nerve damage or irritation. Damage or irritation of one of your vagus nerves or phrenic nerves is the most common cause of persistent or intractable hiccups.
The vagus nerve serves as a communication pathway between your brain and organs, such as your heart, lungs and intestines. There's one vagus nerve on each side of your body. These nerves run from your brainstem through your neck and down to your chest and abdomen. The phrenic nerve controls movement of your diaphragm. There's one phrenic nerve on each side of your body. The phrenic nerves run from your brainstem through your neck and down to your diaphragm.
Examples of conditions that may damage or irritate these nerves include a foreign body (often a hair) in your ear, a tumor, cyst or goiter in your neck or chest, gastroesophageal reflux, or an abscess on your diaphragm.
Central nervous system disorders. A tumor or infection in your central nervous system, or damage to your central nervous system as a result of trauma, can release your body's normal control of the hiccup reflex.
Metabolic disorders. Metabolic disorders that may cause hiccups include a condition that interferes with the ability of your kidneys to keep wastes from building to toxic levels (uremia) and a condition that results in less than the normal levels of carbon dioxide in your blood (hypocapnia).
Surgery. General anesthesia and complications following surgery can cause intractable hiccups.
Mental or emotional triggers. Anxiety, stress and excitement have been associated with some cases of persistent or intractable hiccups.
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Old 08-24-2013, 10:22 AM   #7
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Default Re: Open heart surgery/hiccups

Interesting!
How many years has it been, and finally they are figuring it out. When you're on the heart and lung machine, often times the brain is showered with micro emboli, causing a form of brain injury. So, swallowing difficulties can be a form of brain injury causing dysphagia.

I found this, too.

Quote:
Problems with swallowing occur in 3-4% of patients who have had heart surgery. Quite often no specific cause is found. Patients with diabetes, heart failure, or poor kidney function before their surgery are more likely to develop this problem.

Subtle neurologic problems are surprisingly common after heart surgery, this is thought to have something to do with the use of the heart-lung (bypass) machine. So problems swallowing (“dysphagia”) may actually result from a minor brain injury that does not show up on MRI. Having a breathing tube (endotracheal tube) in place for a long time after the surgery may also contribute.

It is important to recognize swallowing problems early because patients who cannot swallow properly are prone to aspiration, that is the passage of food content into the lungs. This leads to pneumonia which can be very serious or even fatal.

The appropriate treatment is speech therapy and the insertion of a feeding tube. Most patients will recover their ability to swallow but it may take as long as 6 months.
I have choked seriously, where I really thought I was going to die, and I have had pneumonia three times since my surgery. Great.

The real problem with my choking, is that I can't have the Heimlich method, as I have an aortic aneurysm about right there. One squeeze and pop! I'm dead.

It's interesting how fast they find out about these things. Fast, but not fast enough.
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Old 08-24-2013, 09:36 PM   #8
Bob57
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Default Re: Open heart surgery/hiccups

Wow that is interesting, I always blamed my swallowing issues to the dang breathing tube and other tubes they crammed down my throat. Never thought about it might be due to the pump. I know that my memory was not as good after the pump which they told me was entirely possible.
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