Doctor has given me a timeframe for the first time for surgery but it appears I have fallen into severe range..please see echos below and my post

[Unicusp]

amazing on tee

Hello. Keep in mind that the TEE is a "procedure" and may be expensive since you are a cash customer. I had one done years ago when the Cardiologist needed to confirm my valve (uni or bi) but the surgeon never requested one. The surgeon preferred a cardio echo. I agree with others. Get it done sooner than later. The valve calcification and stenosis can accelerate and you could start to have cardiac syncope which is dangerous and leads to other injuries. All depends upon when it happens and what you are doing. It happened to me right after exercise and led to an ER visit with facial sutures. Not fun. I'm your age and also agree with others that you should go with the mechanical valve and be done with this issue for the rest of your life. There are no side effects with Warfarin, and it's very inexpensive. I doubt that you will want to go thru this again. And a comment on your cost. With the newer high deductible insurance plans here in the US, we are paying in deductible close to what your mentioning as your total cost. My current plan has a $17k deductible. Yes, it's crazy. And, I just got a bill the other day from my surgery (in Feb 2021) that I owe another $4k. Good luck and get 'er done!

 

[newarrior]

Hello. Keep in mind that the TEE is a "procedure" and may be expensive since you are a cash customer. I had one done years ago when the Cardiologist needed to confirm my valve (uni or bi) but the surgeon never requested one. The surgeon preferred a cardio echo. I agree with others. Get it done sooner than later. The valve calcification and stenosis can accelerate and you could start to have cardiac syncope which is dangerous and leads to other injuries. All depends upon when it happens and what you are doing. It happened to me right after exercise and led to an ER visit with facial sutures. Not fun. I'm your age and also agree with others that you should go with the mechanical valve and be done with this issue for the rest of your life. There are no side effects with Warfarin, and it's very inexpensive. I doubt that you will want to go thru this again. And a comment on your cost. With the newer high deductible insurance plans here in the US, we are paying in deductible close to what your mentioning as your total cost. My current plan has a $17k deductible. Yes, it's crazy. And, I just got a bill the other day from my surgery (in Feb 2021) that I owe another $4k. Good luck and get 'er done!

Thanks..My concern in regards to mechanical is blood thinners and ticking...My MD did not think TEE or a treadmill test was warranted..Yes I am worried about get this done sooner rather than later for health reasons and because I in a job hunt..I do have free insurance in Cali via Medi-cal but the cost of getting it done in the USA is close to a government hospital in Thailand (in USA I have no to take care of me so I would have to pay for post op help, food, transportation, Airb Bnb, airfare etc etc as I have no family, car, home, infrastructure in the USA

 

[newarrior]

My thought is when the tissue valve goes out do a TAVR in my 70's

 

[newarrior]

TEE bottom line, and without using too many words is this, the closer they get to your heart for the ECHO is much better and see much more things. this is the TEE, the other is on the outside, the TEE is thru the mouth, and into the inside of ya body, and to get much closer for a much better look at ya heart, and to see what is going on, C what I mean?

Totally understood and thank you

 

[newarrior]

The TEE is much more accurate because it is looking from inside your chest and can get better angles. Twice now they’ve thought I was severe but the TEE reversed it and I’ve been surgery free for more than a decade after this first “scare.” Even if it was confirmed I would need surgery, the surgeon would want the TEE to get a good look at what they’re getting into before operating.

Thank you and understood

 

[newarrior]

U

Mr Pearl, in your post #3
By a typo you stated you were 6 years old ( unless you now decide to edit your mistake )

I think you owe Caroline an apology.

@groundhogday

Understood and thank you

 

[newarrior]

U

Understood and thank you

PS--I have Asberger's/some form of Autism and some ADHD and I voice type into my phone and don't check my editing

 

[newarrior]

God

I had mine replaced when my valve area hit 1.0 cm^2.....it dropped from around 1.3 cm^2 to 1.0 cm^2 over a period of a year or thereabouts despite being pretty stable for years prior to t

 

[newarrior]

God that is scary--thanks..I am at .78 on one test and 1.00 on another

 

[newarrior]

Tj

You should consider Germany or the UK for your surgery. The surgery in Germany costs around 25k Euro and in the UK around 29k pounds. These are quotes for the best doctors and best hospitals in these countries respectively. With the USD so strong at the moment, perhaps it is worth trying?

Of course, the best doctor and hospital in Thailand could be excellent and on the same level as the one in the UK or Germany. I am not an expert on this. But I can say that the UK has some world leading hospitals in this area and probably some of the best surgeons in all of Europe.

PM me if you want some UK/Germany doctor and hospital recommendations.

Thank you and appreciated

 

[newarrior]

Here is another thought …

As you get older and the AS becomes more severe, your heart has to work harder to get the same amount of blood out of that small opening. The heart is a muscle - and since it is working harder, it’ll thicken and get bigger. That’s not a good thing.

So, since you know that you will absolutely have to get it done, and IF you’re going with a mechanical valve that will last for the rest of your life, then what’s the point in waiting? Do it at a point when you’re in good health AND before the heart thickens up.

Delaying will put you at risk. Delaying might mean that you have to have emergency surgery. Delaying could mean that you have to do it when you’re not in good health.

This is based on a mechanical valve choice. For me, I honestly wouldn’t even consider a tissue valve if you’re under 60yr old … especially if you’re active. JMHO.

Thanks again sir..Many good points well taken

 

[newarrior]

I am superactive on the cusp of hitting 60 etc etc.. Will bring this up to MD

 

[newarrior]

thanks again sir..I have one MD I trust but trying to get price down do seeking many doctors and getting many echoes here as well as working on what valve to get

 

[user 16827]

@newarrior

Hey Dave, are you aware TAVR is valve type specific.

Not everyone can have this procedure once / or if your bio valve has SVD.


You need clarification on your specific situation & valve choice.

Remember we are dealing with facts here and not blind optimism.

I would urge you to seek clarification & start to move forward.

Given Your constant concern over costs & unexpected bills then don't forget:
You will need to make financial provision for your ( probable) redo too given your age : sub 60 and by your own admission; very active.

It may be prudent to get your Lp(a) tested if you opt Bio

 

[newarrior]

I've had my lip of protein tested I am moving forward but remember I'm in a foreign country doesn't cover pre-existing conditions so I got to pay cash for everything cardiac I'm trying to find somewhere that's cheap but reliable. I'm far too young for Tavr and can't afford it. I've gone to five hospitals so far. I'm going to go to more this week. You're aware that I'm living in Thailand correct? I'm an american? I don't have any insurance that covers pre-existing? So I've got to pay for all my surgery just to make sure you understand that insurance here doesn't cover pre-existing conditions. I'm on private Thailand insurance. I'm 59 years old I'm going to get a tissue valve but I'm trying to shop around for the cheapest place cuz I don't have much money.. a lot of the places I'm going to are Thailand government hospitals and you can't just rush them to do surgery you've got a lot of bureaucracy

 

[newarrior]

I'm aware of a second surgical redo probably in my seventies at that point I'll probably do valve in valve

 

[newarrior]

By the time I do the second surgery perhaps I'll be back in America I may still move back to America at the 11th hour and do the surgery there.

 

[pellicle]

I'm far too young for Tavr

don't be like that ... we've had members get TAVR as their first valve replacement who were under 50.

Strangely we don't seem to hear much from them anymore ...

 

[user 16827]

I'm aware of a second surgical redo probably in my seventies at that point I'll probably do valve in valve

You may not be a candidate.
This information you seem to either not fully understand or you're ignoring it.

 

[BGold]

@newarrior

Hey Dave, are you aware TAVR is valve type specific.

Not everyone can have this procedure once / or if your bio valve has SVD.


You need clarification on your specific situation & valve choice.

Remember we are dealing with facts here and not blind optimism.

I would urge you to seek clarification & start to move forward.

Given Your constant concern over costs & unexpected bills then don't forget:
You will need to make financial provision for your ( probable) redo too given your age : sub 60 and by your own admission; very active.

It may be prudent to get your Lp(a) tested if you opt Bio

I would like to confirm SVD is Small Vessel Disease?