AVR in March

[KAJ]

In March, I will turn 47. I will have an AVR and repair of an aortic aneurysm sometime that month. Our family doctor diagnosed me with a heart murmur at the age of 8. He said it was only a ?functional murmur.? When I enlisted in the Navy at 19, I had to have a note from the doctor saying the murmur was simply ?functional.? During my 20 year Naval career, it was never an issue.

About four years ago, through a very rapid series of events, it was discovered during a heart cath that I have a bicuspid aortic valve. Since that time, I have had an echo every six months. Last October, my cardiologist said the valve was deteriorating much faster than expected. I was due to have another echo in March. Last month I was admitted to the hospital due to a severe burning sensation in the chest. It turned out to be major heartburn. However, another echo and heart cath showed the valve worsened to the point that surgery now needs to be performed. The gradient went from 39 in October to 46 in January. During the heart cath, I heard the cardiologist say that the two measurements for the valve area were .47 and .64. I immediately asked if that was low. He responded, ?That is very low.? I thought ?oh great.

Reading the posts from others on this site has helped me accept the fact that this has to be done. In addition, it helped me go from a woe-is-me attitude to an attitude of thankfulness that I least I will be able to live. I did not want to be on coumadin for the rest of my life. I was hoping I would be a candidate for the Ross procedure. I have since learned from another surgeon who performs that procedure that is really not an option for me. After having reviewed all the information on this site, being coumadin is easier to accept.

I live in Jacksonville, FL but my cardiologist strongly recommended Dr. Kirland at the University of Alabama Birmingham (UAB). Once he reviews my case, and the insurance company approves the surgery, a date will be set. I am also told that my case is a little more complicated due having a severe pectus that was repaired at the age of 22.

My experience with the pectus surgery (done at a Naval hospital) is another reason why I dread the upcoming surgery. I remember the pain all to well. I was on the ventilator for three days. It was several more days before I was allowed to walk outside of my room. My wife, who is an ICU RN thinks my pain was not managed well (we did not know each other at that time). Anyway, again, I would like to thank all of you for sharing your experiences. You have certainly helped me to see that I am not alone.

Karl

 

[brendamarlene]

Karl,

I also live in Jacksonville, and I am returning to UAB for a reoperation in 2 weeks. Who is your cardiologist in Jacksonville?

Brenda

 

[Ross]

Hi Karl and welcome to the forum

You will be pleasantly surprised at all the changes since your last ordeal. Your out of it for most of the bad time and pain is managed very well. It's not as bad as one might think. My hip replacement far outweighed the pain from OHS.

Browse around and ask questions. We've pretty much all been there and done that!

 

[ALCapshaw2]

Karl,

I am sending you a Private Mail message that should be of interest to you.

'AL' (AVR at UAB)

 

[KAJ]

Brenda,

My cardiologist is Dr. Schrank at Baptist Hospital (downtown). Will Doctor Pacifico being doing your reop? I thought I was going use Dr. Pacifico but Dr. Schrank wants me use Dr. Kirklin because of the pectus.

Karl

Karl,

I also live in Jacksonville, and I am returning to UAB for a reoperation in 2 weeks. Who is your cardiologist in Jacksonville?

Brenda

 

[brendamarlene]

Private Message

Private Message

Karl,

I have sent you a private message

Brenda

 

[gadgetman]

Dr. Kirkland and Dr. McGiffin (mine) work hand in hand at UAB. They are jointly involved in heart transplant. I was told that one will go harvest the donated organ while the other completes the operation at UAB. In their spare time they work in the valve replacements and repairs and anything else dealing with the heart and lung. There can't be a better place that UAB (of course it is the only place I have been). Due to complications before surgery, I spent almost all of my first week flat on my back in ICU but the staff and nurses are fantastic. The CICU is brand new and state of the art. UAB, with the clinics, covers over 12 blocks of downtown Birmingham. There is a hotel that is run by UAB that is on a space available basis for $50.00 a night. It doesn't offer the hands on touches of a major hotel but a place to shower and rest for the family. You can get more information from Dr. Kirkland's staff. They sent us a very informative package about the area and what to expect. We were fortunate (at least my wife was, I had a room HA) that we had relatives that lived just outside Birmingham. Wife and sister-in-law stayed with them when not at the hospital. My wife was my companion during my stay and probably (I'm sure of it) got less sleep than I did.

Sending warm thought and prayers your way on your upcoming walk. Feel free to ask any questions about UAB that might come up.

Danny

 

[KAJ]

Danny,

Thank you for the information! My wife and I very much appreciate all of the prayers. Yesterday, we spoke to Dr. Kirklin. He took the time to explain everything to us. He strongly recommended a homograft. I did not know that was an option for me. I decided to go for it. Surgery is scheduled for March 1st. However, I have been batteling a sinus infection for the past several days. Antibotics barely phased it Yesterday my primary doctor prescribed another decongestent. If I am not over this a week before surgery, it will be rescheduled. I am ready to have the surgery so I hope this infection goes away very soon. I am sure I will have more questions but am too tired to think of any right now.

My wife, my parents, my twin brother and my sister-inlaw will be with me most of the time.

Thank again!
Take Care,
Karl

Dr. Kirkland and Dr. McGiffin (mine) work hand in hand at UAB. They are jointly involved in heart transplant. I was told that one will go harvest the donated organ while the other completes the operation at UAB. In their spare time they work in the valve replacements and repairs and anything else dealing with the heart and lung. There can't be a better place that UAB (of course it is the only place I have been). Due to complications before surgery, I spent almost all of my first week flat on my back in ICU but the staff and nurses are fantastic. The CICU is brand new and state of the art. UAB, with the clinics, covers over 12 blocks of downtown Birmingham. There is a hotel that is run by UAB that is on a space available basis for $50.00 a night. It doesn't offer the hands on touches of a major hotel but a place to shower and rest for the family. You can get more information from Dr. Kirkland's staff. They sent us a very informative package about the area and what to expect. We were fortunate (at least my wife was, I had a room HA) that we had relatives that lived just outside Birmingham. Wife and sister-in-law stayed with them when not at the hospital. My wife was my companion during my stay and probably (I'm sure of it) got less sleep than I did.

Sending warm thought and prayers your way on your upcoming walk. Feel free to ask any questions about UAB that might come up.

Danny

 

[Bionic Man]

sounds like me

sounds like me

Your story sounds extremely similar to mine. I had a murmur which was later discovered to be a bicuspid valve. After a quick worsening of heart and valve function... long story short I'm 35 and am now part mechanical.

I anticipated a bad sugery and lots of pain and a bad ventilator experience. None of it came true. Things turned out to be not so bad. The moment I woke up in ICU, I coudn't see but could hear voices of my loved ones talking to me. I felt wonderful! I had so much energy and vitality despite the fact that I was so drugged up I couldn't move.

As soon as I could lift my head slightly they took the ventilator out and from there life got better. My second day had me worried as my heart was doing little strange beats (totally normal after surgery) but everything was fine.

Each day I got feeling better. The morphine initially was fine but then they put me on lortab and that was awsome. I had really very little pain and am now 4 weeks past surgery with no pain and I can walk any distance without any difficulty unlike before surgery.

Feels good to be fixed up.

Hope you have a good experience too.

David C

 

[KAJ]

David,

Thank you for sharing your story with me. After I tell my wife about stories similar to yours, she gives loving "I told you so." In addition, since I do not know what feeling normal is anymore, I am ready to experience having more energy than before. I am now at the point that I am ready to get this over with. Being part mechanical, I assume you are on blood thinners. If so, how is that part going?

Thanks again for the words of encouragement. I hope your recovery continues to go very smoothly!

Take Care,
Karl

Your story sounds extremely similar to mine. I had a murmur which was later discovered to be a bicuspid valve. After a quick worsening of heart and valve function... long story short I'm 35 and am now part mechanical.

I anticipated a bad sugery and lots of pain and a bad ventilator experience. None of it came true. Things turned out to be not so bad. The moment I woke up in ICU, I coudn't see but could hear voices of my loved ones talking to me. I felt wonderful! I had so much energy and vitality despite the fact that I was so drugged up I couldn't move.

As soon as I could lift my head slightly they took the ventilator out and from there life got better. My second day had me worried as my heart was doing little strange beats (totally normal after surgery) but everything was fine.

Each day I got feeling better. The morphine initially was fine but then they put me on lortab and that was awsome. I had really very little pain and am now 4 weeks past surgery with no pain and I can walk any distance without any difficulty unlike before surgery.

Feels good to be fixed up.

Hope you have a good experience too.

David C

 

[danielgilboa]

Hi Karl,

Welcome to the club...

My story goes quite similar to yours. I also came to a point when I realized I need to go for surgery and quite soon. This was about 2 months before the big day. Then I went somewhat shy of the fact I needed heart surgery I found it dificult to share with people, from family thuogh friends and to work colleagues. At some point my atitude changed (a big thanx to my wife) and i begun speaking about it more freely, telling friends, and sharing detials with them. I am so happy I opened up on time because the amount of support I got from closer to greater circles absolutely improvde my capability of coping with the before and after periods. I can remember the strong feeling on the morning of surgery, already under medication, of the many many people who are with me now and during the next few hours, hoping, thinking, waiting and praying for my well being. Hadn't I opened up and shared with them on time, I wouldn't have had their support.

I am on coumadin for 10 months now. Not a big deal. It took me a couple of months to stabilize my INR levels and now it is more or less OK. I don't look after my vitamin K diet too seriously but I am careful about cutting myself. The only concern I have is if I am ever injured.

You will be better after surgery than you have been for a long time. You should be able to get back to normal life and enjoy it much better.

 

[KAJ]

Daniel,

Thank you for taking the time to share with me. Almost a month has gone by since I found I need surgery. As you can relate to, it is very nerve wracking time, and still is now but no where near as bad. I can honestly say that there is no doubt in my mind that the thoughts and prayers of others have made a significant improvement in my attutiude and outlook. This past Thursday my wife and I had conference call with the surgeon. He took the time to thoroughly explain everything. However, He did surprise us. When my wife asked him what procedure he was planning to use on me, he stated he was going to use a homograft. I did not think that was even a possibility with me. I went ahead and told him go ahead. My surgery is currently scheduled for March 1st. Unfortunately my sinus infection may dictate if I have it then or not. My primary doctor put me on some kind of new 5 day antibiotic. It did not do too much good for me. Thursday he changed the decongestant. So far, I have noticed little improvement. If it does not clear up by somtime next week, the surgery will be rescheduled. I certainly hope it does not have to happen. I now ready to get this over with so I can start to experience the improvements you and others have described.

Again, thank you very much for the words of encouragement!

Take Care,
Karl

Hi Karl,

Welcome to the club...

My story goes quite similar to yours. I also came to a point when I realized I need to go for surgery and quite soon. This was about 2 months before the big day. Then I went somewhat shy of the fact I needed heart surgery I found it dificult to share with people, from family thuogh friends and to work colleagues. At some point my atitude changed (a big thanx to my wife) and i begun speaking about it more freely, telling friends, and sharing detials with them. I am so happy I opened up on time because the amount of support I got from closer to greater circles absolutely improvde my capability of coping with the before and after periods. I can remember the strong feeling on the morning of surgery, already under medication, of the many many people who are with me now and during the next few hours, hoping, thinking, waiting and praying for my well being. Hadn't I opened up and shared with them on time, I wouldn't have had their support.

I am on coumadin for 10 months now. Not a big deal. It took me a couple of months to stabilize my INR levels and now it is more or less OK. I don't look after my vitamin K diet too seriously but I am careful about cutting myself. The only concern I have is if I am ever injured.

You will be better after surgery than you have been for a long time. You should be able to get back to normal life and enjoy it much better.

 

[KAJ]

Time To Change Primary Doctors

Time To Change Primary Doctors

Hello Everyone,

I am currently on a business trip and still have this nasty sinus infection. My ears are still plugged and I have been running a constanst fever (I check it at least 3 times a day.) My wife called the doctor's office yesterday morming to schedule another appointment for me with the P.A. for this Thursday. ( I do not at all care for the primary doctor.) The appointment was made. However, in the afternoon, the office called to say the doctor cancelled my appointment. He said I was taking up an accute care spot . Needless to say my wife had an absolute fit and told the receptionist there was no way we were going let that appointment be cancelled. My wife and agreed that when this is over, we are going to change primary doctors. I cannot see me completely recovering from this week in 2 weeks. More than likely I will ask my surgery to be delayed until the middle of March.

Will keep you posted.

Karl

 

[Karlynn]

Karl, most of us here have run across those doctors that make us wonder why they are in the practice of medicine. I think it's probably because we have much more exposure to the medical field through our continued needs. Your response to get another doctor was right. I used to give doctors several chances to prove themselves. Now they get one and if they fail, I'm outathere.

I hope you feel better soon. It's not easy, but try to not let the stress get you. It could prolong the bug you have.

 

[Tom F.]

Hey shipmate ! I am former Navy as well, but reserves. There was another fellow, Jim Jacobsen, whose story is posted on this site, who was retired Navy. Now I will tell you the same that Jim told me pre-surgery, it will not be anywhere as bad as you think it will be. The only time I had any pain at all, and I mean the ONLY time, was 8 weeks post op when I began exercising a little harder and my muscles got sore. No pain at all immediately post op, even in the hospital. For the record I had an ascending aortic aneurysm, which was replaced with dacron, and my own valve waas repaired.

You will be fine, really !

 

[KAJ]

Pam,

Thanks for the suggestions! I do have a recliner. I imagine that soon I will be spending more time in it than I ever thought possible.

Karl

Karl:

My husband had AVR and root replacement in October for an emergency aortic aneurysm and, while we didn't have a month before the surgery but only four days, in those four days, he really had the same fears you have. But, as everyone has posted, it wasn't nearly as bad as he thought. Management of pain meds is a key because you do not want to feel a sneeze without them! And taking out the chest tubes - definitely ask for meds before that!

Mike had a lot of muscle pain during his recovery, but when you think about what they do to your body, it's understandable. He just played 18 holes of golf the last week in January - not bad considering he had OHS in October.

Great suggestion that I got from this site and used - get a recliner for your recovery at home. Some patients, including my husband, could not lie flat for quite a few weeks and the recliner was simply more comfortable to rest in. Pillows, pillows and more pillows is another great thing to have.

And...whatever you do, don't try to open or shut a car door - trust me! For that matter, the refrigerator door will make you scream the first few days also!

You also asked in a previous posted about anticoagulants - you make some changes, but you manage the medication around your life, not your life around the medication. I guess the hardest part for my husband is remembering to take it.

 

[KAJ]

Surgery Rescheduled

Surgery Rescheduled

Hello Everyone,

My surgery has been rescheduled for the 15th of March. Last Thursday we saw the P.A. She put me on Augmentin. She thought I had developed a stronger strain of infection. I started to feel better (finally) after 3 days on this anitbiotic. I thought it best to reschedule the surgery. The surgeon's office agreed. Only today did I not have any symptoms of the infection. Since my kids are having their standardized testing the week of March 7th, we thought it would be better to schedule the surgery for the 15th. This should also give me time to back to normal.

Two of my 4 kids are now sick so needless to say, I am trying to avoid them. I just hope and pray I do not come down with something else. The delaying only creates greater tension. I am sure some of you have probably been in the same position. Thanks for being here

Karl

 

[perkicar]

good call!

good call!

Hello Everyone,

My surgery has been rescheduled for the 15th of March. Last Thursday we saw the P.A. She put me on Augmentin. She thought I had developed a stronger strain of infection. I started to feel better (finally) after 3 days on this anitbiotic. I thought it best to reschedule the surgery. The surgeon's office agreed. Only today did I not have any symptoms of the infection. Since my kids are having their standardized testing the week of March 7th, we thought it would be better to schedule the surgery for the 15th. This should also give me time to back to normal.

Two of my 4 kids are now sick so needless to say, I am trying to avoid them. I just hope and pray I do not come down with something else. The delaying only creates greater tension. I am sure some of you have probably been in the same position. Thanks for being here

Karl

Sounds like a good call on the doc's part. This will give you time to get rid of the bug and get the kids settled and through their tests. Just stay healthy, stay away from crowds if you can (all those germs you know ). Keep us posted!

 

[tommy]

Karl,

My son has a pectus bar in his chest right now. Techniques have changed since 1982. His bar was slid in from the side. It reshapes the sternum and ribs much like an orthodontist reshapes your teeth, but with no adjustments. The bar comes out this spring. It's called the "Nuss" procedure. They like to do this on young people when their bones are soft. Sorry that it wasn't invented in 1982.

I understand that the old procedure for pectus repair was to break the bones and rebuild your chest. If so, that is absolutely brutal, brutal, brutal. (No need to tell you!) It's no surprise to me that you had incredible pain. You deserve a medal for enduring that. Yikes! Your AVR will not be a cake walk, but should be much simpler to heal with less pain. The previous PR may complicate it a little, but I doubt it.

Sorry to see that you had to reschedule. Hope you have a great outcome.

 

[KAJ]

Tom,

Thanks for info! I have often wondered if the procedure for pectus repair had changed over the years. To my knowledge, not one doctor ever mentioned to my parents that it should be corrected. It was not until I was 22 that a Navy surgeon (who had done pectus surgeries before) in civilian hospitals, suggested it really needed to be corrected. If you don't mind answering, how old is your son? I hope and pray that it turns out all right for him.

Karl

Karl,

My son has a pectus bar in his chest right now. Techniques have changed since 1982. His bar was slid in from the side. It reshapes the sternum and ribs much like an orthodontist reshapes your teeth, but with no adjustments. The bar comes out this spring. It's called the "Nuss" procedure. They like to do this on young people when their bones are soft. Sorry that it wasn't invented in 1982.

I understand that the old procedure for pectus repair was to break the bones and rebuild your chest. If so, that is absolutely brutal, brutal, brutal. (No need to tell you!) It's no surprise to me that you had incredible pain. You deserve a medal for enduring that. Yikes! Your AVR will not be a cake walk, but should be much simpler to heal with less pain. The previous PR may complicate it a little, but I doubt it.

Sorry to see that you had to reschedule. Hope you have a great outcome.