bicuspidrek
Member
Today is exactly two weeks since I've had my valve replacement procedure. Spent quite a bit of time mentally processing this entire thing and I figured sharing it here will be of greater value versus simply existing within my own mental chamber.
35 year old Singaporean, asymptomatic, bicuspid aortic valve.
Discovery & Diagnosis - MAY-AUGUST 2022
As a Singaporean male, I have to fulfill national duty by serving 2 years of full-time military service. Following this, I will need to serve about 10 years of service (about 1-2weeks/year). If you turn 35 and are still serving your national service, you have to attend a check up. It was during this check up that I got picked up for my bicuspid heart valve.
I recall playing football the night before the check up and not getting very great sleep. I also recall overcaffeinating and squeezing in a cigarette before the check up. All of these did not make for a grand BP reading and I was flagged. They gave me an EKG and the Medical Officer picked up on an anomaly.
I was referred to National Heart Centre Singapore and by July 2022, it was clear that I had an issue with my heart.
In August 2022, I found a cardiologist from National University Heart Centre, Singapore and an echocardiogram later, it was confirmed that I had a bicuspid aortic valve. I was completely asymptomatic, thankfully. The regurgitation was moderate-severe and there was "left ventricular hypertrophy; eccentric".
My cardiologist's advice was for me to stop high-impact sports (soccer) at the time, and we were to take a wait-and-see approach. I stopped soccer, and picked up some leisurely cycling, quit cigarettes (more than a decade long habit, at a pack over 2-3 days) and was generally healthy, active.
We agreed to monitor this, and he set the next appointment for January 2023.
My wife and I had taken the period from August till January to sort of process (and perhaps compartmentalize/rationalize) the diagnosis and our next steps. We spoke about it on and off and had a general consensus as to where we were going with this.
Do this with someone who means something to you, it really helps take the edge off things.
Pre-Surgery - JAN 2023
My cardiologist squeezed me in before the Lunar New Year period. I recall him looking at my scan and still being pretty optimistic about it.
Wife and myself had mentally set aside a Apr/May 2023 procedure date "cos we wanted to do a short trip together first".
My cardiologist was very supportive, but he mentioned that "there's this surgeon who's in town right now" and maybe you could meet him first and see. He set the meeting up for the day after.
As I waited to meet my surgeon, I remember being pissed off having spent such an amount of time in hospital so early in the year. Stepping through the doors, there was a very different aura to my surgeon. Prof Theodoros Kofidis is a very confident man, and having a confident surgeon really helps you make the tough decisions.
He asked when I had initally wanted to do the surgery, and I mentioned April/May and he counter proposed, "What if I told you we could get it done in February, and by April/May, you and your wife can be on that trip?"
Had a discussion with the wife and we decided to go with it. One of the biggest factors was that Prof Kofidis had mentioned that there was a good chance my heart could shrink down to normal size. He is also a leading expert in the minimally invasive procedure.
The date of surgery was 3 weeks from that day of the meeting, with almost a week-long worth of public holidays (CNY). I did not think it would happen, but crazily it did.
I was obviously visiting the hospital a great deal in the 3 weeks leading to surgery. MRI, meeting with hospital finance team, dental, meeting with anaesthetists etc.
They gave me a hibiscrub body wash with instructions to start using it couple of days before I was admitted.
Surgery - FEB 2023
Was asked to come in the evening before the surgery. Checked in, and it was relatively fuss-free. Wife made sure I was settled in, bought a couple of snacks for me and left. We already had been advised by the nurses that she didn't have to be around during the procedure - they'd called her to inform her once it was over.
I took my shower, and was asked to fast from midnight onwards. I clarified if water was fine, and they replied, "sips are fine". Slept rather peacefully all things considered and before I knew it, it was time for my final shower before they pushed me into the OT.
I recall being pushed into a prep area where they stuck lots of monitors on me. I was given a central line on my left arm at a waiting area. I had a lot of worries - do they put in the catheter while I was conscious (answer: no), will the neck injection hurt (answer: no) etc.
I was pushed into the OR and in fact my last memory of the entire thing was just a neck injection. I don't even recall being asked to count backwards or to hold my breath. The time was approximately 0700hrs in the morning.
Post Surgery - FEB 2023
Day 0
If not for this forum, I'd have freaked out by the amount of tubes in me. I recall waking up around 1400-1500hrs and had fitful sleep at ICU. They removed the breathing tube at 1800hrs. My wife was there. Nurses were talking to me. My wife left at 2000hrs after visiting hours.
2200hrs they removed another tube and allowed me to sip on water. It was unpleasant but I expected worse. I had painkillers at 0000hrs and they wore off at 0200hrs. I stared at the clock and listened to every sound (there's plenty) in the ICU. I felt my pressure in my heart and lungs. I felt miserable.
It was 0500hrs when the nurse hurriedly gave me some painkillers. It made me burp and gasp, but she was rushing off. She hurriedly gave me a spitoon. I survived. I recall dozing off finally and waking up at 0640hrs, listening to a resuscitation process. I dozed back to sleep.
DAY 01
The catheter was next to come off. I thought it would hurt (it didn't). Learnt how to use amazing urinals in bed. By then I was already on the fast track to recovery. They allowed me with soft foods so very bland porridge and small cut food. I had to stay another night at HDU as I was draining quite a bit of blood through the 2 tubes.
DAY 02
Big day. Therapist came in and kicked me out of bed. Showed me how I had to stretch to minimize potential formation of scar tissue and gave me everyone's favorite Incentive Spriometer (2500 Voldyne). Wife thankfully prepared porridge- hospital food was really bad! Took a walk around the ward and had a dizzy spell. Had a couple friends visit today as they had a check-up. Got transferred me to a general ward later in the day. Pressure/pounding was still present, but definitely improved. Slept more compared to when in ICU, but fitfully. Thanks pump alarms.
DAYS 03, 04, 05, 06
Day 3 - Spent some time walking around, not much. Wife accompanied me, working from the hospital. Spent quite a bit of time in bed and just recovering, napping.
Day 4 - Saw a number of visitors, owing it to being a Saturday. Parents visited, ate very well. Was running a slight fever by evening time. They took out my pacer and one drainage tube this day. The expectation of it to hurt helped.
Day 5 - Walked a lot. Also had 700ml of drainage fluid discharged. Tube had to be kept another day as a result.
Day 6 - They got sick of my drainage tube and removed it. Again, the expectation of it to hurt helped. I was very concerned about pleural effusion and being short of breath and raised it up. They seemed unparticularly concerned. "Do deep breathing, use your spirgometer". Yep.
DISCHARGE
I was so ready to get out of hospital and was a bit annoyed I had to wait longer for some doctor's memos. Took a taxi back and disliked the experience very much - we had a very aggressive rider (braking, accelerating, weaving through traffic). The first thing that struck me upon returning home was... how warm it was. I had grown accustomed to air conditioning. This took a while to recalibrate.
CLOSING THOUGHTS
Recovery is tough but having a positive mentality most certainly helps. I remember the first night I was in ICU, I had a couple of miserable thoughts - why did I do this when I was asymptomatic, now I feel every heartbeat/intake of breath. Accept this. It happens. Let the thoughts come, gently cast them out because it gets better.
Coughing, sneezing, burping was scary but it gets better. Showering is an inconvenience, but it gets better. It gets better. I motivate myself by knowing that today is better than yesterday.
I will update this thread as I go along and learn new things about my new valve. I have had some issues with INR and with the ACC. Will update here once I get a handle on things.
Fire away if you have questions!
35 year old Singaporean, asymptomatic, bicuspid aortic valve.
Discovery & Diagnosis - MAY-AUGUST 2022
As a Singaporean male, I have to fulfill national duty by serving 2 years of full-time military service. Following this, I will need to serve about 10 years of service (about 1-2weeks/year). If you turn 35 and are still serving your national service, you have to attend a check up. It was during this check up that I got picked up for my bicuspid heart valve.
I recall playing football the night before the check up and not getting very great sleep. I also recall overcaffeinating and squeezing in a cigarette before the check up. All of these did not make for a grand BP reading and I was flagged. They gave me an EKG and the Medical Officer picked up on an anomaly.
I was referred to National Heart Centre Singapore and by July 2022, it was clear that I had an issue with my heart.
In August 2022, I found a cardiologist from National University Heart Centre, Singapore and an echocardiogram later, it was confirmed that I had a bicuspid aortic valve. I was completely asymptomatic, thankfully. The regurgitation was moderate-severe and there was "left ventricular hypertrophy; eccentric".
My cardiologist's advice was for me to stop high-impact sports (soccer) at the time, and we were to take a wait-and-see approach. I stopped soccer, and picked up some leisurely cycling, quit cigarettes (more than a decade long habit, at a pack over 2-3 days) and was generally healthy, active.
We agreed to monitor this, and he set the next appointment for January 2023.
My wife and I had taken the period from August till January to sort of process (and perhaps compartmentalize/rationalize) the diagnosis and our next steps. We spoke about it on and off and had a general consensus as to where we were going with this.
Do this with someone who means something to you, it really helps take the edge off things.
Pre-Surgery - JAN 2023
My cardiologist squeezed me in before the Lunar New Year period. I recall him looking at my scan and still being pretty optimistic about it.
Wife and myself had mentally set aside a Apr/May 2023 procedure date "cos we wanted to do a short trip together first".
My cardiologist was very supportive, but he mentioned that "there's this surgeon who's in town right now" and maybe you could meet him first and see. He set the meeting up for the day after.
As I waited to meet my surgeon, I remember being pissed off having spent such an amount of time in hospital so early in the year. Stepping through the doors, there was a very different aura to my surgeon. Prof Theodoros Kofidis is a very confident man, and having a confident surgeon really helps you make the tough decisions.
He asked when I had initally wanted to do the surgery, and I mentioned April/May and he counter proposed, "What if I told you we could get it done in February, and by April/May, you and your wife can be on that trip?"
Had a discussion with the wife and we decided to go with it. One of the biggest factors was that Prof Kofidis had mentioned that there was a good chance my heart could shrink down to normal size. He is also a leading expert in the minimally invasive procedure.
The date of surgery was 3 weeks from that day of the meeting, with almost a week-long worth of public holidays (CNY). I did not think it would happen, but crazily it did.
I was obviously visiting the hospital a great deal in the 3 weeks leading to surgery. MRI, meeting with hospital finance team, dental, meeting with anaesthetists etc.
They gave me a hibiscrub body wash with instructions to start using it couple of days before I was admitted.
Surgery - FEB 2023
Was asked to come in the evening before the surgery. Checked in, and it was relatively fuss-free. Wife made sure I was settled in, bought a couple of snacks for me and left. We already had been advised by the nurses that she didn't have to be around during the procedure - they'd called her to inform her once it was over.
I took my shower, and was asked to fast from midnight onwards. I clarified if water was fine, and they replied, "sips are fine". Slept rather peacefully all things considered and before I knew it, it was time for my final shower before they pushed me into the OT.
I recall being pushed into a prep area where they stuck lots of monitors on me. I was given a central line on my left arm at a waiting area. I had a lot of worries - do they put in the catheter while I was conscious (answer: no), will the neck injection hurt (answer: no) etc.
I was pushed into the OR and in fact my last memory of the entire thing was just a neck injection. I don't even recall being asked to count backwards or to hold my breath. The time was approximately 0700hrs in the morning.
Post Surgery - FEB 2023
Day 0
If not for this forum, I'd have freaked out by the amount of tubes in me. I recall waking up around 1400-1500hrs and had fitful sleep at ICU. They removed the breathing tube at 1800hrs. My wife was there. Nurses were talking to me. My wife left at 2000hrs after visiting hours.
2200hrs they removed another tube and allowed me to sip on water. It was unpleasant but I expected worse. I had painkillers at 0000hrs and they wore off at 0200hrs. I stared at the clock and listened to every sound (there's plenty) in the ICU. I felt my pressure in my heart and lungs. I felt miserable.
It was 0500hrs when the nurse hurriedly gave me some painkillers. It made me burp and gasp, but she was rushing off. She hurriedly gave me a spitoon. I survived. I recall dozing off finally and waking up at 0640hrs, listening to a resuscitation process. I dozed back to sleep.
DAY 01
The catheter was next to come off. I thought it would hurt (it didn't). Learnt how to use amazing urinals in bed. By then I was already on the fast track to recovery. They allowed me with soft foods so very bland porridge and small cut food. I had to stay another night at HDU as I was draining quite a bit of blood through the 2 tubes.
DAY 02
Big day. Therapist came in and kicked me out of bed. Showed me how I had to stretch to minimize potential formation of scar tissue and gave me everyone's favorite Incentive Spriometer (2500 Voldyne). Wife thankfully prepared porridge- hospital food was really bad! Took a walk around the ward and had a dizzy spell. Had a couple friends visit today as they had a check-up. Got transferred me to a general ward later in the day. Pressure/pounding was still present, but definitely improved. Slept more compared to when in ICU, but fitfully. Thanks pump alarms.
DAYS 03, 04, 05, 06
Day 3 - Spent some time walking around, not much. Wife accompanied me, working from the hospital. Spent quite a bit of time in bed and just recovering, napping.
Day 4 - Saw a number of visitors, owing it to being a Saturday. Parents visited, ate very well. Was running a slight fever by evening time. They took out my pacer and one drainage tube this day. The expectation of it to hurt helped.
Day 5 - Walked a lot. Also had 700ml of drainage fluid discharged. Tube had to be kept another day as a result.
Day 6 - They got sick of my drainage tube and removed it. Again, the expectation of it to hurt helped. I was very concerned about pleural effusion and being short of breath and raised it up. They seemed unparticularly concerned. "Do deep breathing, use your spirgometer". Yep.
DISCHARGE
I was so ready to get out of hospital and was a bit annoyed I had to wait longer for some doctor's memos. Took a taxi back and disliked the experience very much - we had a very aggressive rider (braking, accelerating, weaving through traffic). The first thing that struck me upon returning home was... how warm it was. I had grown accustomed to air conditioning. This took a while to recalibrate.
CLOSING THOUGHTS
Recovery is tough but having a positive mentality most certainly helps. I remember the first night I was in ICU, I had a couple of miserable thoughts - why did I do this when I was asymptomatic, now I feel every heartbeat/intake of breath. Accept this. It happens. Let the thoughts come, gently cast them out because it gets better.
Coughing, sneezing, burping was scary but it gets better. Showering is an inconvenience, but it gets better. It gets better. I motivate myself by knowing that today is better than yesterday.
I will update this thread as I go along and learn new things about my new valve. I have had some issues with INR and with the ACC. Will update here once I get a handle on things.
Fire away if you have questions!
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