Had First Cardio. Appt. Today

[DLH]

Well I had my first cardio. appt. after my echo a few weeks ago. So far everything is happening as expected from what I have read on this site and others. My cardio. is the same doctor who read my echo and he also had one from 12/2002 that I forgot that I had. This showed that my regurge has gotten worse and that the ventricle size has increased along with wall thickening taking place. We discussed my list and it sounds as if I will need repair or replacement, the question is when. Since I am not symptomatic he said I could continue riding my bike. As for tests he did not feel a stress test would show anything since I am able to ride 100+ miles a week, but he does want a TEE and it is scheduled for next Wed. the 24th and a follw up consult to discuss the results and the next steps on Mon. the 29th. We did not discuss valves much, but the coumadin, mechanical, tissue, age, activity issue did come up briefly and it sounds like a lot of thought will need to go into that if it comes to that. Did not discuss type of surgery yet. All in all I went in figuring that I would be scheduled for a TEE or Cath. from everything that I have learned this is what I expected and based on the progression between the 2 echos I figure I will be having surgery before too long.

DLH

 

[Ross]

Certainly sounds like your on your way. If things are enlarging, they'll determine how bad and then decide. One thing is for certain, you don't want to be waiting if it's in the upper limits of normal.

Kick back and relax till you get the results. Nothing else you can do at this point.

 

[tobagotwo]

For some reason, cyclists tend to run these out to the limits without too much in the way of symptoms - or they have a bent to not acknowledge their symptoms even to themselves.

If your heart is heading out of normal limits, don't wait for much in the way of symptoms. That seems to be a catch for some cardiologists, who view the symptoms as a "sign from God" that surgery is finally appropriate. It is your heart that needs to recover and shrink back to normal. If it gets too enlarged or damaged, the damage becomes permanent, despite surgery or symptoms.

I'm not suggesting you run out and get an operation tomorrow. I'm saying to keep your eye on the ball - your heart - and don't let symptoms, which many people unknowingly suppress, rule the future of your health.

Best wishes,

 

[ALCapshaw2]

It's time to go SURGEON SHOPPING.

Many cardiologists seem to think that all you need to do for enlargement is to treat it with medication (usually an ACE inhibitor) and 'wait for things to get worse'.

The problem with that philosophy is that eventually, the enlargement becomes PERMANENT, i.e. NOT REVERSIBLE. SURGEONS are well aware of this fact and prefer to operate BEFORE permanent damage is done. One of our members from Texas (I don't remember his name at present) developed significant enlargement in 6 WEEKS. He was a well conditioned (mountain?) biker.

Start thinking about what type of valve you prefer and then find a Surgeon with lots of EXPERIENCE with that valve choice. Let the SURGEON make the call on WHEN to have surgery. I've read too many stories here on VR.com where valves literally disintegrated in the surgeon's hands yet their 'test numbers' did not appear to be all that bad.

Regarding symptoms, SOME patients never develop symptoms, or at least are not aware of symptoms, until AFTER surgery when they suddenly realize they have more energy and more stamina than before. This is especially true for conditioned athletes.

As one of our astute members (an RN / Valve Patient) stated: "When you have a condition that can ONLY be repaired surgically, get a SURGICAL opinion".

Success rates for first time patients under age 60 are extremely high (99%) when performed by experienced surgeons so IMHO, the risk of damage from waiting far exceeds the surgical risk. Just for reference, I consider myself to be one who got to surgery "just in time". As Bob H coined, "The Worse it gets, the FASTER it gets WORSE".

'AL Capshaw'

 

[DLH]

So far I have a good feel about my cardiologist, I had my list and he pretty much covered all of my points without me even pulling it out. They have been good at working me in fairly quickly considering he was booked solid for 2 months and they got me in within 2 weeks and my TEE will be next week with a consult a few days later. He is aware that I am the type that if something is wrong and could get worse I want to take care of it sooner rather than later and I felt he was on this same line of thinking. I will know more for certain after the TEE.

In response to tobagotwo, I think cyclist hearts may adapt and compensate better than the average person because of their fitness level and maybe that is why we do not have symtoms. According to my Doc if I were having symptoms I would not be able to ride any where close to 100+ miles a week at an average speed of 20mph. However, my echo shows a lot of the signs indicating the need for surgery.

Al, if it is true about not being aware that I had symptoms until after my surgery and then suddenly having more energy and stamina than before surgery. My wife may not want me to have the surgery as I am very active cycling, softball, just about any sport I love to compete and to be active. I get bored just sitting around for any extended time.

In the meantime I think I will go for a ride tonight to relieve some of the stress from thinking about this for the past few weeks. I will feel better once a definate plan is in place instead of the wait and worry routine.

DLH