Has another year really passed?

[epstns]

Well, I'm back from my annual "major check up." I see my cardio twice a year -- once for an echo and complete evaluation, the other time at mid-year just for an office consult to see if I've noted any changes. This year the report is. . . SAME AS LAST YEAR! In other words, all major measurements are consistent with last year's measures. All critical dimensions within normal parameters, EF about 70%, valve opening around same as last time (just over 1 sq cm), no new problems noted!

In other words, I can keep on keepin' on -- at least for the immediate future. We're watching and waiting, keeping a close watch on the heart dimensions and performance, but as long as it is stable I can continue to wait for AVR until the valve is "ripe." What that means to me is that I will be just a bit older when I have the valve replaced, and just might be at the age when I can have a real choice of tissue or mechanical valve. (At 58, I guess I'm in the "grey" zone for more than one reason. Beside the obvious hair color, the docs tend to recommend tissue valves for patients in their 60's and older, but continue to recommend mechanincal valves for younger patients.)

I know I've been pretty quiet for the last month or so, but looking back I realize that as I get closer to each year's major evaluation I seem to become just a bit more anxious. I know that at some point I'll be told it is time to see some surgeons, but I keep hoping to hold off just a little bit longer.

Now to see what freshening up we need in that waiting room. . .

 

[Ann L]

Hi Steve, I'm new around here and it's nice to meet you. I'd like to ask how long you've been in the waiting room now? It's been 7 years since I was told that I'd need AVR. You said something that I hadn't realized... about age being a determining factor in what kind of valve is used. I figure there may not be anything written in stone but did your doctor tell you what age is a good cut off point for mechanical valves?

 

[LUVMyBirman]

Great to hear it Steve! Happy you are in still the "waiting room"

Congrats

 

[Wise]

Congratulations Steve. That's great news. I hope I'm in the same boat indefinitely.

Wise

 

[Karlynn]

Steve - we are very happy that you remain the official greeter of our waiting room!!!

 

[Nan]

Hi Steve, that is great news. Maybe by the time (if ever!) you need the AVR they'll be doing it by catheter and no OHS! Wouldn't that be great?

 

[epstns]

To all, thanks for the wishes! I, too, hope to be able to stay in The Waiting Room until I'm good and ready to move on. . .

AnnL -- First, let me be very clear -- I am not a medical professional. I'm just the owner of a diseased heart. As I understand it, the surgeons' recommendations are based on several factors. One being the typical life span of a tissue replacement valve versus a mechanical. The tissue valves for which there are long-term studies show (I think) expected usable life spans in the range of 15-20 years. Some last more, some less. (Some of the newest designs claim longer life, but there are not yet any long-term study results as the valves are too new.) Mechanicals rarely wear out or break -- those that must be replaced are usually replaced due to a failure of the underlying tissue, failure of sutures or clot formation. The thought is that if a person in their 30's or 40's has a tissue valve implanted, they are fairly certain to require at least one re-operation, which surgeons and many patients prefer to avoid. Also, younger patients tend to calcify their replacement valves at a higher rate, so if stenosis is present the choice of mechanical replacement becomes more likely. But, if the patient is beyond "that certain age" - even with stenosis present, the likelihood becomes that a tissue replacement valve will last their expected life span. The last time I discussed the age factor with my cardio, he opined that at that time most doc's were using age 60 as the earliest age at which a tissue valve might become a viable choice for a patient with aortic stenosis, barring other pressing factors (such as life style choices that make coumadin anti-coagulation too risky).

In my case, as long as my quality of life remains at an acceptable level, and as long as my cardio feels it is a medically sound choice, I'd prefer to delay surgery for some years yet. I'd like to have the choice of tissue or mech, and maybe if I can wait long enough, even have the choice of valve implantation via catheter.

So, I've been here in The Waiting Room officially for about 3 and 1/2 years. Given that I have aortic stenosis, which begins development much earlier but may wait until patients are in their 50's to present symptoms, I would have to admit that I've probably had this "heart condition" for many years without knowing about it. We are far better off being aware and wary than being surprised. . .

 

[geebee]

Steve,

Hope things never get bad enough for surgery or surgery is so very simple by the time you need it that a root canal would be worse.

Congrats on the good news.

 

[Phyllis]

Congratulations, Steve. Hope you remain in the waiting room for a long time and continue to grace us with your posts.

 

[bvdr]

Steve, I too hope that you get to stay healthy and in the waiting room for many many years. Glad to hear your check-up was again positive. I know what you mean about a rising anxiety level as major check-ups approach. I have an upcoming cardiac/ph check-up and I have gone the entire gamut from thinking "my symptoms are all imaginary" to "I'm probably on my last leg". In reality, I'm probably somewhere in between .

I'm thinking it might be time for another roll call in the waiting room. You've had so many in and out lately that I've not been able to keep up. I'm glad you have stayed put!

 

[Guest]

Steve,

EXCELLENT NEWS! Congratulations! So good to know that things seem to be well for you!

As for that Waiting Room, my goodness, it needs a lot of freshening up. I don't think the dusting or sweeping has been done in days. And, those dishes waiting to be washed ... oh my goodness. The beds haven't been made in a while.

BUT...rest assured, that huge garage is in tip top shape ... as are all of the cars (especially the Monte Carlos) that reside there .

he he eh



Cort, "Mr MC" / "Mr Road Trip", 32swm/pig valve/pacemaker
MC:family.IL.guide.future = http://www.chevyasylum.com/cort/
chdQB = http://www.chevyasylum.com/cort/quilt.html
"Get the word out" ... Collective Soul ... 'Feeling Better Now'

 

[EVELYN]

Hey Steve.....What great news!!! looks like you'd better order some new magazine subscriptions for that waiting room....they must be getting old after 3.5 years!!!

I wish you many more years in there.....feeling fine and fit.

Tyce had his surgery at age 59. Our surgeon, Dr. James Taylor, of St. Francis, LI., gave him the choice, but strongly recommended the mechanical because people are living longer and he didn't think the recovery rate of surgery was as good at 75 as it is at 59.......Tyce absolutely agreed and has never looked back since.

Be well and healthy for another year at the very least.

Evelyn

 

[Mary]

Steve,

EXCELLENT NEWS! Congratulations! So good to know that things seem to be well for you!

As for that Waiting Room, my goodness, it needs a lot of freshening up. I don't think the dusting or sweeping has been done in days. And, those dishes waiting to be washed ... oh my goodness. The beds haven't been made in a while.

BUT...rest assured, that huge garage is in tip top shape ... as are all of the cars (especially the Monte Carlos) that reside there .

he he eh



Cort, "Mr MC" / "Mr Road Trip", 32swm/pig valve/pacemaker
MC:family.IL.guide.future = http://www.chevyasylum.com/cort/
chdQB = http://www.chevyasylum.com/cort/quilt.html
"Get the word out" ... Collective Soul ... 'Feeling Better Now'

Cort,
I left the waiting room in tip top shape!

Steve,
The waiting room can be a great place to reside. It's great news that you can occupy it awhile longer!

 

[Ann L]

Hi Steve - that is wonderful news. Your comments gave me a much clearer understanding on why folks are deciding which valve to use. I pretty much guessed it was a longevity issue but wasn't aware that 60 was a target age. Since I'll be 50 this summer and have been waiting for 7 years now, I would be surprised if I can wait another 10 years ... but heck, ya never know! As a follow up to my thread, I have found a new cardio doc and have an appt for this coming Monday. I've got it on good authority that this one takes his patient's symptoms seriously.

Official greeter in the waiting room huh? Sounds like you're the right guy. especially with all that attention to details. It's a most welcoming place!!!

 

[Guest]

Mary,

If you left the Waiting Room in tip-top shape, why did Evelyn find subscriptions that are over 3 years old?

*shakes head*

You just don't know sometimes .

He he he he

(all in good FUN, of course )