Hey everyone!!   I have been doing well and making strides in my recovery every day.   I started cardiac rehab last week and that is a good addition to the walking that I’ve already been doing.   I still have some sternum and rib pain and muscle pain around pacemaker incision.   My INR is still not in target range so that has been an ongoing challenge.  I’ve read that the sound of the mechanical valve is very loud and really bothers some people.  I didn’t really notice it until last week and it is definitely a loud heartbeat sound.  However, some people describe it like a ticking clock sound that other people can hear too - I haven’t experienced that yet.