Decision for 22 year old UK male

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ajay,at 22 mech would be the obvious choice as with a tissue you would need re ops,but have a good talk with cardio and surgeon,i know people who are young and still gone for tissue,who knows where heart surgery will be in 15 20 yrs time,we may be still where we are now? or it may be a day job? who knows,theres no guanantees with any,whatever you pick willbe the right choice for you,good luck
 
i've got a new meat valve, so am only on acitrom (warfarin) for three months.
it's really no big deal, i'm running, cycling, working on the bike, shaving, even cutting
those tiny pills into quarters with a double-edged razor blade. have had some
small cuts, bleeding stopped normally. only time i noticed was when i had a blood
draw, inr was 4.2, couple drops came out when the needle was removed, that's all.

taking the drug and living with it would not be a problem for me. what would be a
problem is trying to maintain a schedule. apparently you're supposed to take your
pills at about the same time every day. well, my days are pretty random. without
setting an alarm, i'd be all over the map. i don't want to deal with testing....i like
to go on cycle tours for months at a time in the middle of nowhere (i.e. inner
mongolia), and test machines aren't quite that portable yet.

and ross says to dose your diet. but i have none, or at least nothing that could be
called balanced. i don't want to have to think about it.

i may regret the decision in ten or fifteen years when i go through this again.
maybe then i'll go plastic.
 
I'm 27 now. I have an ON-X valve and while I do hope the trial is a success and I won't have to take warfarin anymore, it's really not a big deal. It took me about 9 months to get comfortable with it and learn about different foods and portions and how they affect my INR. I'm more active now than I ever was before. I work out or play sports about 5 days out of the week. Unless you REALLY enjoy an activity that is a big no-no while on warfarin, I'd just go for a mechanical valve.
 
I'm 27 now. I have an ON-X valve and while I do hope the trial is a success and I won't have to take warfarin anymore, it's really not a big deal. It took me about 9 months to get comfortable with it and learn about different foods and portions and how they affect my INR. I'm more active now than I ever was before. I work out or play sports about 5 days out of the week. Unless you REALLY enjoy an activity that is a big no-no while on warfarin, I'd just go for a mechanical valve.

I do hope you've learned to dose the diet you eat and not diet the dose your on! Food is very minor thing when it comes to INR management. You shoud be eating everything you want to, as you normally would have, had you not been on Coumadin. The problem comes up when you suddenly eat a huge portion of something that you normally don't do. I hope to God your not relying on Vit K charts and a Coumadin cookbook, cause that stuff don't work. It'll just drive a person insane.
 
I adjust my warfarin dosage according to what I'm eating, not the other way around. The only chart I look at is Lodwick's, but thankfully I rarely ever have to.
 
Hi Ajay.

Lotti here in the UK too. I had my surgery done at Glenfield in Leicester at 37. I was shown a valve "catalogue" it was like being in argos!. I could have a porcine or any of a selection of mechanicals. Each one was shown to me and described, with it's pros and cons. I decided porcine knowing that I would have to do re-surgery 15 - 20 years down the line. This was the right choice for me at the time, but I have to say that if I knew then what I know now I would have gone mechanical.
Go with your gut feeling when it comes to your decision and ask your cardio, not just a surgeon. Cardios here in the UK have a much better view of living with replacement valves, than surgeons who's main view is putting them in. I did not get the time or opportunity of talking to my cardio before surgery so just had my surgeons comments to go on. He said tissue. Your only other option here in the UK is to refuse to make the decsision and then the surgeon will put in whatever is best at the actual time of surgery. They won't like it but will do it.

All the best with your decision and surgery. A good month to have it in as the weather will at least be warm enough for you to take gentle walks. Mine was in a freezing February and having to wrap up in loads of layers to keep warm was not fun.

Take care

Lotti
 
Ajay:

Good luck with your decision.
That is a very personal choice, because it does affect you for a long time, i.e., if you choose tissue, you will definitely be facing a re-op down the road, and being only 22, that will come sooner than someone older, for example, in their 50s or older. If you choose mechanical, you will be on warfarin, which isn't an evil thing but does take some understanding on how things affect it. (With any intellect, it's a no-brainer.)

taking the drug and living with it would not be a problem for me. what would be a
problem is trying to maintain a schedule. apparently you're supposed to take your
pills at about the same time every day. well, my days are pretty random. without
setting an alarm, i'd be all over the map. i don't want to deal with testing....i like
to go on cycle tours for months at a time in the middle of nowhere (i.e. inner
mongolia), and test machines aren't quite that portable yet.

and ross says to dose your diet. but i have none, or at least nothing that could be
called balanced. i don't want to have to think about it.

i may regret the decision in ten or fifteen years when i go through this again.
maybe then i'll go plastic.

Whoa! No one ever told me I had to take my warfarin the same time very single day. Coumadin cops are going to come after me!!!
I take my warfarin in the morning, but it's not the same time every single day. Sometimes it's 3 hours past my normal time. No big deal.
Test machines are quite portable, although they are a little larger than glucometers. But they are still quite small. Guess that depends on your interpretation of "portability" and "small."
 
Thank you all for the replies and welcomes again; it's definitely good to hear from so many people and their different opinions. I think at this point I'm leaning more towards the mechanical valve option, though I'm still wary of the warfarin as anyone would be! I'm going to discuss it with my surgeon and see what they say. I also want to see if I get a choice on the mechanical valve as two people who have posted from the UK have said different things - I guess it depends on the hospital you go to!

I feel so young compared to you oldies :p Joking joking of course!
 
Hi Ajay, My son doesn't post, but he'll be 21 in April and has had a few heart surgeries. He has a bovine valve, but that is because his is his pulm valve and they usually don't recomend mech valves there. Anyway even tho Justin doesn't posts if you ever have questions or want to talk to someone around your age, just email me and I'll pass them on
his page is in my sig
 
Your young and this is a tremdous decision to have to make at your age. You probably have heard us old foggies or fossils saying how things break down in the body as you age. Well I can tell you it's very true. If you can minimize the cutting and surgeries and all that it entails, good and bad, your better off. We'll respect whatever choice you make. The only bad choice is to make no choice at all.
 
Ajay,
Looks like you got a ton of support and solid advice already. I hope the normalcy of everyone's activities really stood out to you. What you're dealing with will certainly be difficult. No one here would deny that, but it's just another step. You'll come out strong and able to do what you want in life. I can't speak to the reality of a mechanical valve (had a Ross procedure), but everyone on her seems to go about their days wonderfully. All the best.
 
I repeat again, taking coumadin is not a problem. If you cut yourself, you will not bleed to death anymore than someone else who doesn't take coumadin.

If you fall on your head, you may have the same problem as someone who does not take coumadin.

If you need an operation, the sugeons will know how to accommodate the coumadin.

If you miss one dose, you will not die. If you take the dose at different times of the day, you will not die.

As long as you take the dose every day and have blood tests as required, you can eat whatever you want . The blood tests will tell if you need an adjustment of the doseage because of a change in diet.


I have been on coumadin for 20 years, and over these years I have read about developments about drugs to replace coumadin which will not be effected by diet. I have read about making the valve replacemtnt simpler. Don't count on any of these, because often they never meet the expectations.

If you need a new valve now, I would choose the valve using the information that is proven now and not expecting a big change in the future.
 
Once again thanks for all the advice. It's definitely put things in perspective and know that warfarin won't be as bad as I first thought! More than likely I am going to choose the mechanical valve I think. I'm actually looking forward to hearing the 'clicking' of the valve!
 
Hi and welcome:
My personal opinion is go with the mechanical valve. I don't really get why a Dr. would make the coumadin issue such a negative thing. However, if you are really active in sports you may want to factor that into the equation: there is risk involved taking coumadin and being involved in contact sports and/or skiing, ice skating etc. The Calif. governor, Arnold S., for example, had a tissue valve in the late 90's due to his active lifestyle, plus he was a downhill skier. When his tissue valve needs replacing, as it likely will, he may choose a mechanical valve for his "senior" years.
We wish you all the best in considering your options.
Sue
St. Jude Mechanical valve 1993 (age 52)
 
My vote is for mechanical. I was 19 when I had my Ross procedure and I hoped it would last forever. While I was still in the hospital from that surgery I had an echo and was told my aortic valve was leaking and I would need another surgery in about 8 years. Well I can tell you 8 years comes really fast and having that time frame counting down in the back of my head constantly made my 20's not as fun as it should have been. Now with 2 children and a husband to think about my second surgery was very hard emotionally.
My 2nd surgery was 8 hours long, a lot of which was getting thru scar tissue. Now I have my lovely on-x valve and coumadin is so easy thus far. I have no regrets in getting a mechanical valve. I actually pondered the idea of getting another tissue valve for my second surgery but with the help of this site I chose mechanical and I am so glad I did. I couldn't lay in that hospital bed recovering and thinking "I will be going thru this again in x amount of years." Been there, done that, and it sucks!
 
Welcome

Welcome

Once again thanks for all the advice. It's definitely put things in perspective and know that warfarin won't be as bad as I first thought! More than likely I am going to choose the mechanical valve I think. I'm actually looking forward to hearing the 'clicking' of the valve!


Just want to say Hi and welcome, the clicking can be quite comforting !!!

good luck on your decision

cheers

Jan ( Liverpool )
 
Ajay, Welcome! Just another supporter on ACT. I have gone skiing, bike riding, kayaking, and done some fairly extreme sailing. I am more conservative now, but when I was younger... Don't try sailing a Hobie 16 in 30 knot winds unless you really know what you are doing! I have had a few (4) bleeding incidents, but none due to injuries in my adventures. I think Woodbutcher has the right idea, don't stop doing the things you love, just do them as safely as you can. Brian
 
Ajay,

Good luck with your choice and valve replacement. I've got a few years on you, I had my bicuspid replaced when I was sixty.

I'm part of the On-X trial, and have been on Plavix / low dose aspirin for the last 19 months, and have had no apparent side effects.

Like the old Timex commercial says,

"Just keeps on ticking!"

Although to be honest, I don't notice any discernable "ticking", just a much sharper "beat".
 
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