Advice please on my Aortic valve

[johnny c]

Hello
I am 51 years young and my congenital, bicuspid, aortic valve needs replacing. I have gone from mild/moderate to very severely leaking in the last year and will be going for the op in the next few weeks. I am now getting tired very easily....

I am a wine merchant so i like a drink. I am not an alcoholic and do not drink everyday but i do like to polish off a bottle a couple of times a week and perhaps 6 pints at the football once a month.
I do not really want to change my lifestyle but i understand that i am going to have to to some extent. I also do not fancy the big op twice so i am edging towards an artificial valve.
i also like to run and have been very fit for my age.

Question 1 To those of you who have an artificial valve and drink alcohol.... Any information that you feel will be useful please?
Question 2 Recommendations to what make / sort of artificial valve i should ask for?
Question 3 Will i be able to run a-fast b-long distance?

I thank you in advance for your help

Johnny

 

[Warrick]

Hi Johnny, if you use the search feature on the forum you will find many post regarding alcohol and warfarin. Plenty of drinkers here

I'm not a big drinker by any means but I never let it get in the way of a beer or two ( I have used it as an "excuse" for not drinking at a work thing when I just felt like a water).
Some people find alcohol affects them alot INR wise and others don't, when I first started on warfarin I noticed 3 beers raised it but now I think that may have been coincidence and it's never anything I bother about.
My father who also has a mechanical valve and is on warfarin use to regularly get absolutely smashed when I was a kid and it never affected his INR at all.

I have a mechanical valve, it will last forever and unless I need another op for something else is a one stop shop.
Warfarin has been easy to manage for me,
it seems many managed by a clinic are happy with it but there are also many self testers and managers here who use the available portable self testers such as coaguchek..

If you havea tissue valve you will most likely not need warfarin unless you end up with afib from the op, but you clearly will need it replaced anywhere from only lasting a few years to 15 years +

Physically you should be as good as you were prior to your valve leaking and again if you search the forums you will find many here who do a multitude of sporting activities including marathons.
All the best.

 

[johnny c]

Warrick- Thank you for taking the time to answer my questions.

 

[pellicle]

Hi

I am 51 years young and my congenital, bicuspid, aortic valve needs replacing. I have gone from mild/moderate to very severely leaking in the last year and will be going for the op in the next few weeks. I am now getting tired very easily....

sure indication of needing a new valve

I am a wine merchant so i like a drink. I am not an alcoholic and do not drink everyday but i do like to polish off a bottle a couple of times a week and perhaps 6 pints at the football once a month.

I enjoy reds and beer ... most nights I'll have a beer while cooking dinner (or before it) and a glass or red with / after.

I do not really want to change my lifestyle but i understand that i am going to have to to some extent.

so far I haven't ...

i also like to run and have been very fit for my age.

I'd rate myself as "ok" and perhaps for my age in the lower levels of fit. I enjoy cross country skiing (when I'm in Finland) and used to enjoy cycling, but don't really cycle to work anymore (complex but lets just say "I don't go to work anymore")

Question 1 To those of you who have an artificial valve and drink alcohol.... Any information that you feel will be useful please?

answered, now my question is this: what do you mean by artificial valve? There are three types of valve replacements

1. bioprosthetic
2. mechanical
3. homograft

I've had the last two

I had a homograft when I was 28 which lasted till I was 48 when I got a mechanical.

Question 2 Recommendations to what make / sort of artificial valve i should ask for?

firstly, what ever you feel like. At your age I'd tend towards a mechanical, but you'll need to be a confident person able to tell medical people what you want ... if you aren't then you'll be better off with a bioprosthetic. Which have use-by dates and you'll need a reop.

Question 3 Will i be able to run a-fast b-long distance?

totally

Grab a drink and have a good slow long read of this blog post of mine:

http://cjeastwd.blogspot.com/2014/01/heart-valve-information-for-choices.html

Then, get another drink and have a careful and thoughtful listen to this:



Lastly, if you want, contact me by email and I'm happy to chew the fat

Hotmail ... (and at pellicle of course)

Best Wishes

 

[dick0236]

Question 1 To those of you who have an artificial valve and drink alcohol.... Any information that you feel will be useful please?
Question 2 Recommendations to what make / sort of artificial valve i should ask for?
Question 3 Will i be able to run a-fast b-long distance?

Johnny

#1. For about 20 years post surgery I was a heavy drinker (beer and bourbon) without apparent effect on clotting time. Much of that time was before the INR system and I had a very stable PT (clotting time under the pre-INR system). Life style and INR can be managed......good or bad.....just be consistent. FWIW. my warfarin dosing has decrease since I quit drinking.....but that could be due to my age and inactivity.

#2. Obviously I would recommend my valve except it was taken out of production in 2007 (after nearly 50 years on the market). The St. Jude valve has been around a long time and the Onyx seems to have a good reputation (although I think the lowered INR range is more a marketing ploy than a real benefit).

#3 There are quite a few on this forum that run, bike, climb mountains etc......I am not one of them although I used to water sky and knew my way around a "skil saw"........and still golf (if that counts:coolhank.

 

[pellicle]

Dick,

#1. For about 20 years post surgery I was a heavy drinker (beer and bourbon) without apparent effect on clotting time. Much of that time was before the INR system and I had a very stable PT (clotting time under the pre-INR system). Life style and INR can be managed......good or bad.....just be consistent. FWIW. my warfarin dosing has decrease since I quit drinking.....but that could be due to my age and inactivity.

always a pleasure learning more about you sir.

I've not had a burbon in a while (Jack D and Bookers being my prefs) but I'll have a single malt tonight and salute you.

PS: I never drink spirits mixed (that would be an insult to the makers) and I only have at most 2 nips of fine spirits. Wine or beer is my plastering drink of preference. (well except on my 30th ... I started on Guinnes, moved between champagne and whatever I was handed ... we all know where that party ended ...

Best Wishes

 

[dick0236]

Dick,

... we all know where that party ended ...

Best Wishes

I was a young man in the '60s and enjoyed indulging in the good (or goofy) things in life. It didn't help that my heart surgeon prescribed a beer a day for me while I was post-op in the hospital. He did it because there were few diuretics available in those days and beer is a pretty good diuretic. My young mind took that to mean "if one beer is good.....then 8-10 would be much better"........bad idea!

There should be little problem with having a couple shots or beers or glasses of wine from time to time.........but if you "binge drink", then "abstain", then "binge drink", then "abstain".......you will probably have INR problems. Everything in moderation is a good way to approach using alcohol . The problem with alcohol is that by the time we realized we've had too much is AFTER we've had too much. Now I'll step down from my "soapbox" and sit down in the corner.

 

[pellicle]

I was a young man ...

my 30th was a while back too ... not as far as your's granted.

but I was only gonna salute you with one nip mate (I'm of Irish descent and far too stingy with the good stuf)

;-)

 

[Superman]

Question 1 To those of you who have an artificial valve and drink alcohol.... Any information that you feel will be useful please?
Question 2 Recommendations to what make / sort of artificial valve i should ask for?
Question 3 Will i be able to run a-fast b-long distance?

I thank you in advance for your help

Johnny

Hi Johnny,

At 51, it can be a bit tougher of a call between tissue and mechanical. As things are today, you’re looking at minimum one or two re-ops with tissue. Your surgeon will say, “...advances in TAVR...” But there are no guarantees there. That said, I’m a testament to no guarantees against re-op with mechanical either. I had my valve replaced with a St Jude when I was 17. Then I had an aneurysm when I was 36. I opted for St. Jude again. I’m 45 now, and banking on that lifetime guarantee. I’d rather not have another.

Regarding alcohol, I’m a casual drinker. I drink seldom, but have put a few away at a time with no noticeable changes to my INR. By seldom, I mean I may go weeks or months between drinks. Primarily driven by frugality (with 5 kids, alcohol is an expensive hobby), and lack of time (did I mention 5 kids?).

Can you run fast now, and long distance? You’ll definitely have recovery time, but in theory, your cardio should see some improvement provided you put the work in post op. It’s an easy trap to fall into to get a little sedentary during recovery. You can’t go nuts right away, but you do need to work at recovery.

Wish SE you well as you make your decision. I’ve seen it frequently mentioned here that regardless of what you choose, it’s better than one you have now!

 

[LondonAndy]

Just to add to the consensus on alcohol: I have a St Jude mechanical valve and drink alcohol, generally in moderation and fairly erratically, and these days I notice no difference with my INR. I did think I had a a significant reaction when I had a drink soon after coming out of hospital, which made me very cautious for ages. But then after reading a few similar threads to this one I did some experiments, by using my Coaguchek meter to test my INR before and after a session, and have concluded that alcohol has little or no effect on my INR. I think the early post-op reaction was most likely a coincidence with something else. I personally find having a cold has much more effect!

As far as I can see, it is only contact sports and activities with a risk of injury that might deter me from a mechanical valve. If you might get a cut or severe bruising these are more of an issue to control because of the easier bleeding, so to speak, and whilst the effect of warfarin can be reversed quite quickly in hospital you might need to get there rather quickly. For the rest of us a mechanical valve still has the longest life and lowest risk of going through major surgery again.

 

[LondonAndy]

Another thought on the running, if I may. I ended up with a pacemaker when I had my AVR surgery (a risk that apparently affects 6 - 7% of patients) and so I also follow a pacemaker discussion board similar to this one. I have noticed a surprising number of long distance runners ending up with a pacemaker, presumably because they have over-stressed their heart in some way. Although pacemaker surgery is a walk in the park compared with open heart surgery, having one means having the device replaced every 10 years or so, when the battery gets low, and although personally I have had little issue with mine it is another health thing to have to think about and have annual checkups. So don't over do it!

 

[DachsieMom]

I was 41 when I had my surgery (one week she of 42). My surgeon recommended St Jude mechanical since I was done having children (in fact, I don't even recall discussing other alternatives). I was a runner before, and still now. My speed is the same. Not sure about long distance because I usually only run 3 miles, but I did 6 miles a few weeks ago with no problem. On occasion I get a migraine after vigorous exercise, but I think that's more due to hormones. I chose st Jude because I never wanted another surgery and this was my best chance. I have a valve conduit (valve plus Dacron tube). I rarely drink but that's always been the case. I have a wine maybe once every few months. I home test weekly - warfarin is a non-issue for me.

 

[neil]

hi, at 51 if you choose tissue you will need another op, but having mech doesn't mean you wont either, my tissue is 11 and still going strong plus no warfarin and for some the problems which can occur with it, have a word with your cardio and surgeon, remember no choice is a bad one, good luck

 

[uneeck]

hey johnny c

I am wondering when you were diagnosed with biscupid AV? and what were the mesurments then? I also have biscupid aortic valve (I am almost 31 now - mild/moderate).

I won't answer first 2 questions, but according to 3th one take a look at this guy (he has mechanical aortic valve):

https://www.youtube.com/watch?v=vvd4Pk24_Nk
https://www.youtube.com/watch?v=QWJk8zp6qRk

He runs long distances, he lifts heavy weights, he also run "Runmaggedons" - a bit harder than just running...

So it pretty depends on each person I think, but valve replacement isn't the thing that would cut you off from running or gym

 

[SumoRunner]

I had the Aortic valve replaced in 1991 at age 43. St Jude's Mechanical.

I drink. Seldom enough to get wobbly but once or twice a week. It messes up your clotting time, but that can be managed by knowing to reduce your thinner dosage after a couple drinks.

One of the funnest races I ever did was two years ago, a benefit beer mile for a fellow runner who lost his leg to some odd infection. Chug a beer, run 1/4 mile x 4. Just before the finish, I dropped down and did 25 pushups too, so they handed me another beer.

I ran about 150 races before valve replacement, 200 meter sprints through half-marathon. Then about 350 races in the 27 years post-op, 200 meters through half-marathon. Never ran as fast again since I was getting older. I've done some long distance open water swims and 3 short distance triathlons just in the last couple years. I'm 70 now.

 

[pellicle]

I had the Aortic valve replaced in 1991 at age 43. St Jude's Mechanical.

One of the funnest races I ever did was two years ago, a benefit beer mile for a fellow runner who lost his leg to some odd infection. Chug a beer, run 1/4 mile x 4. Just before the finish, I dropped down and did 25 pushups too, so they handed me another beer.
....I'm 70 now.

I sure hope that the OP is reading this, but even if he isn't that's a great story

Love it

B-)