Hey buddy, check out this new valve.

[Jorcsa]

Hello all,

I was pleased to find this forum. One never knows when and how we may become part of a brand new group. I'm just glad to be part of any group, you know.

Five years ago I was diagnosed with "mild" aortic stenosis when I was 53. This past summer I was checked again at 58 and deemed "moderate". My cardiologist sent me to a heart surgeon for a consultation. He suggested I schedule the surgery within the next two years. After processing the reality and deciding to get proactive with the inevitable, I scheduled the surgery for early January 2005. The pre-op heart cath revealed my condition had moved from "moderate" to "severe" in six months, so my timing was none too soon.

January 10, 2005 was my the date of my surgury. I chose a mechanical valve (St. Jude model 25AJ-501 with lifetime Coumadin) because i did not want to go through this anguish again, as I probably would have had I chosen a tissue valve (10-15 years shelf life).

I was in CICU overnight, and moved to a private room for five more nights. I have been recovering now almost four weeks. I am walking two miles daily.

Although I am still sore all over Sholder blades especially), and the incision and breastbone are sometimes uncomfortable, I suffer no excruciating pain. I have had four Coumadin checks, and am basically "balanced."

Sleeping is difficult right now, but having a long-running slight sleep disorder, it was difficult before the surgery anyway. I was dismissed by my surgeon last week and referred back to my cardiologist for further decisions. I started driving a few days ago. I will probably return to work in a few more weeks, part-time at first, and then full time.

I'm glad it's over, and feel blessed that I am progressing so well. It has not been that frightening, only a bit uncomfortable. I am just grateful the technology and surgical knowledge has made all this possible.

Good luck to all of you.

Joe

PS. This may be a goofy question, but does anyone know how the severity of valve replacement surgery compared with bypass surgery? My brother-in-law had a single bypass operation last week, and he keeps telling me how much more serious my opertion was. Any thoughts on his remarks?

 

[Rich]

Congratulations Joe and welcome to this great site.
I had mine done when I was 58 also and it's been great.
We had some discussion a while back about the severity of the surgeries.
My guess is to repalce a valve they have to open up your heart, whereas with by-pass they don't, someone correct me if I'm wrong about that.
They are both open heart surgeries however so I couldn't minimize either one.
Rich

 

[perkicar]

Welcome!

Welcome!

January 10, 2005 was my the date of my surgury. I chose a mechanical valve (St. Jude model 25AJ-501 with lifetime Coumadin) because i did not want to go through this anguish again, as I probably would have had I chosen a tissue valve (10-15 years shelf life).

I was in CICU overnight, and moved to a private room for five more nights. I have been recovering now almost four weeks. I am walking two miles daily.

Although I am still sore all over Sholder blades especially), and the incision and breastbone are sometimes uncomfortable, I suffer no excruciating pain. I have had four Coumadin checks, and am basically "balanced."

Glad to hear from you and about your recovery. I see the surgeon next week and am stressing about when he'll want me to go under the knife. Every time I read about the potential complications it makes me a little more nervous, but considering the most serious complication (death) if I didn't have it done (not right away, but eventually, more than likely), it's worth the risk. Where did you have your surgery?
Carolyn

 

[Jorcsa]

Thanks Rich

Thanks Rich

Congratulations Joe and welcome to this great site.
I had mine done when I was 58 also and it's been great.
We had some discussion a while back about the severity of the surgeries.
My guess is to repalce a valve they have to open up your heart, whereas with by-pass they don't, someone correct me if I'm wrong about that.
They are both open heart surgeries however so I couldn't minimize either one.
Rich

It's very comforting to have knowledgeable people like you and those on this forum who can relate to this valve replacement phenomenon. Most of the folks I've discussed this with say, "I just can't imagine this type of procedure" and go off saying "Gee, I'm sure glad I'm not faced with this". Obviously you're doing well with your AVR. Best to you and thanks for your reply.

Joe

 

[Jorcsa]

Wishing you the best

Wishing you the best

Glad to hear from you and about your recovery. I see the surgeon next week and am stressing about when he'll want me to go under the knife. Every time I read about the potential complications it makes me a little more nervous, but considering the most serious complication (death) if I didn't have it done (not right away, but eventually, more than likely), it's worth the risk. Where did you have your surgery?
Carolyn

Carolyn,

I know you are anxious about your eventual surgery. I had about six months to process, and I think it helped. I wanted to wait until the first of this year, after the holidays. When I started asking my surgeon details of the procedure he said, "You really don't want to know about that. Just trust me to get you through this. Also, I recommend you don't research too deeply on the net. You'll scare yourself half to death."

What wise advice!! I saved myself plenty of sleepless nights.

I followed his lead, and only started backing into the info after the surgery.
Now I can enjoy the forum and other sites without fear playing a large role in my reading.

My cardilogist referred me to Dr. David McGiffin, one of the top three heart surgeons at the University of Alabama Medical Center in Birmingham, AL.
I can't say enough about the professionalism, the caring and the healing environment there. My doctor is outstanding, and the attending nurses were
angels all.

May you find peace in your heart and mind as I have.

Joe

 

[Ross]

It's very comforting to have knowledgeable people like you and those on this forum who can relate to this valve replacement phenomenon. Most of the folks I've discussed this with say, "I just can't imagine this type of procedure" and go off saying "Gee, I'm sure glad I'm not faced with this". Obviously you're doing well with your AVR. Best to you and thanks for your reply.

Joe

Unless they've been through it, none of them get it. They may think they have a clue, but are truly clueless.

 

[epstns]

Hi Joe,

Looks like you may be writing the book for several of us. I, too, was diagnosed with moderate AS while in my mid 50's. I'm now 57 and my condition has progressed from moderate to "moderate to severe" at the last echo. No real symptoms, just not as much energy as in the past. In discussion with my cardio, his opinion is that surgery is 2 to 4 years out. I did a lot of reading when first diagnosed. Once I found that the condition is treatable, I really haven't delved deeply into the actual surgery. I have read and discussed the "patient experience" of friends here, and that has helped me to accept the fact that my turn will come, and that I will work it through and then get on with life.

Welcome, and glad you're doing so well. Stories like yours make it easier for those of us in The Waiting Room to control our anxieties.

 

[Karlynn]

Welcome! One of the most helpful things you'll find with this group is the knowledge on Coumadin (warfarin). There are a lot of misconceptions about the drug, and not all doctors know how to manage it - even thought they think they might.

With an aortic valve the customary target range for your INR is usually 2.0 - 3.0 unless you have any special considerations. Most of us like to keep our INR more towards the high end of our range, just for comfort's sake. Don't worry about the dosage amount. It is what is needs to be to keep you in range. There are no "normal" dosages. It may take a while to get your INR steady. Unless you are like me, who hasn't been steady much for the last 13 years. Our wonderful member Al Lodwick has a site you will find invalvuable www.warfarinfo.com I highly recommend going there and giving it a read.

I'm glad you found us so soon after surgery. It's good medicine to know you aren't alone in the experience.

 

[gadgetman]

Good to see you are progressing so wonderfully. I have a follow-up with Dr McGiffin Feb 15 after open heart surgery Jan 21. I had three by-passes done at the same time as they repaired my valve. The most difficult addition with by-pass are the sites on your leg where they took the veins. I'm still getting strange feelings with my left leg as things wake up. I'm starting to experience the discomfort between my shoulder blades. Guess my body didn't appreciate all that spreading.

Good luck to you on your return to work and remember to take things easy for a while.

Danny

 

[catwoman]

This may be a goofy question, but does anyone know how the severity of valve replacement surgery compared with bypass surgery? My brother-in-law had a single bypass operation last week, and he keeps telling me how much more serious my opertion was. Any thoughts on his remarks?

VR surgery is more invasive.
Bypass surgery can be done with a beating heart; so can VR, but that's still pretty much in the experimental stages from what I've read.
Bypass surgery does not involve cutting into the interior of the heart, as does VR. Often, a previously undetected septal defect is discovered during the VR (mine was), so sometimes an additional procedure is done.

Of course, VR doesn't involve harvesting veins/arteries from your legs, chest for replacing the blocked arteries.

Both procedures entail risks; both are life-savers.

 

[Jim]

Hey buddy, Nice Valve!

Hey buddy, Nice Valve!

Joe, thanks for joining the group and sharing your experiences. Good question about the risk comparison between bypass vs. valve replacement. I often wondered this myself.

Marsha did bring up some good points about bypass. Bypass is often referred to open heart surgery but valve replacement actually involves opening the heart. While there is no harvesting of veins, I could have sworn I saw they temporarily removed some of the veins feeding into the heart when they performed an AVR on a recent webcast of an actual AVR. Correct me if I'm wrong.

I don't know what the risk is for bypass but I would believe it would have to be below 1% given the average for any valve replacement is below 2%. It would also be interesting to know a comparison between the length of surgery time would be for these two procedures.

Jim

 

[Jorcsa]

Ignorance is a blessing in this case

Ignorance is a blessing in this case

Unless they've been through it, none of them get it. They may think they have a clue, but are truly clueless.

For their own sake, Ross, I'm sure we're all glad they are naive about the particulars. I can't think of anyone else I would wish this on, except, of course, someone who needs a replacement.

Thanks for your reply.

Joe

 

[Jorcsa]

Hang in there Steve

Hang in there Steve

Hi Joe,

Looks like you may be writing the book for several of us. I, too, was diagnosed with moderate AS while in my mid 50's. I'm now 57 and my condition has progressed from moderate to "moderate to severe" at the last echo. No real symptoms, just not as much energy as in the past. In discussion with my cardio, his opinion is that surgery is 2 to 4 years out. I did a lot of reading when first diagnosed. Once I found that the condition is treatable, I really haven't delved deeply into the actual surgery. I have read and discussed the "patient experience" of friends here, and that has helped me to accept the fact that my turn will come, and that I will work it through and then get on with life.

Welcome, and glad you're doing so well. Stories like yours make it easier for those of us in The Waiting Room to control our anxieties.

Well Steve, it sound like when your turn comes around, you'll be informed and ready. You'll be a better patient, and recover sooner. Up until two years ago, I was an aerobics fanatic, going to class at least three times a week. Then I skipped a meeting here and there. Then I dropped down to one a week. I never noticed any real symptoms either, but the excuses for not attending kept increasing.

Now I walk my two miles every day at the same recreation center, looking down on the aerobics folks from my third floor walking track, and wonder if I'll ever be back on that floor again. It's way too early at a month to tell. I am hoping though that I get some increased energy out of this 100 K investment.


I appreciate your reply.

Joe

 

[Jorcsa]

I'm tossing the vitamin K

I'm tossing the vitamin K

Welcome! One of the most helpful things you'll find with this group is the knowledge on Coumadin (warfarin). There are a lot of misconceptions about the drug, and not all doctors know how to manage it - even thought they think they might.

With an aortic valve the customary target range for your INR is usually 2.0 - 3.0 unless you have any special considerations. Most of us like to keep our INR more towards the high end of our range, just for comfort's sake. Don't worry about the dosage amount. It is what is needs to be to keep you in range. There are no "normal" dosages. It may take a while to get your INR steady. Unless you are like me, who hasn't been steady much for the last 13 years. Our wonderful member Al Lodwick has a site you will find invalvuable www.warfarinfo.com I highly recommend going there and giving it a read.

I'm glad you found us so soon after surgery. It's good medicine to know you aren't alone in the experience.

Karlynn,

This Coumadin thing is different. I never thought I'd have to balk at the salad bar, or look twice at that tempting bowl of turnip greens (can you tell I'm from Alabama?) Must steer clear of heavy does of vitamin K, right? Drats, I sure miss my daily breakfast of kale and seaweed pancakes with mayonaise topping.

I've had four weekly INR's, and all have been in range with the exception of the first. I guess I'd better get chummy with Mr. C, since it looks like we'll go the distance together.

I enjoyed your reply.

Joe

 

[Jorcsa]

Another McGiffin guy...cool !!!

Another McGiffin guy...cool !!!

Good to see you are progressing so wonderfully. I have a follow-up with Dr McGiffin Feb 15 after open heart surgery Jan 21. I had three by-passes done at the same time as they repaired my valve. The most difficult addition with by-pass are the sites on your leg where they took the veins. I'm still getting strange feelings with my left leg as things wake up. I'm starting to experience the discomfort between my shoulder blades. Guess my body didn't appreciate all that spreading.

Good luck to you on your return to work and remember to take things easy for a while.

Danny

Hiya Danny,

I sure didn't expect to run into another "Dr. MacG" patient here. Were you referred or did you request him? I hope your follow-up goes as well as mine, when he summarily dismissed me, and said "Walk, walk, walk...or you'll be back." I see no future in a rerun, do you?

I lucked out on the bypasses, all clear, thank God. I've heard the leg thing is no picnic. Funny you mentioned the shoulder blades, here it is a month tomorrow, and I think the shoulders sometimes cause the most discomfort. I think our bodies are saying to us, "Don't do stuff like spreading your arms and ribcage for over four hours."

I'll be thinking about your speedy recovery Danny. Thanks for taking your time to reply to me. Tell DR. M "hello".

Joe

 

[Jorcsa]

You answered my question.

You answered my question.

VR surgery is more invasive.
Bypass surgery can be done with a beating heart; so can VR, but that's still pretty much in the experimental stages from what I've read.
Bypass surgery does not involve cutting into the interior of the heart, as does VR. Often, a previously undetected septal defect is discovered during the VR (mine was), so sometimes an additional procedure is done.

Of course, VR doesn't involve harvesting veins/arteries from your legs, chest for replacing the blocked arteries.

Both procedures entail risks; both are life-savers.

Very informative Marsha. I think you summarized the comparisons quite well.
I'm not trying to "one-up" my brother-in-law who had the bypass surgery, I just honestly had no idea.

Thank you very much.

Joe

P.S. I've talked to my cat Jake about my Coumadin in relation to his razor sharp claws. I think we have resolved my concern, and we can mutually exist.
As well as human and feline can exist anyway!

 

[Jorcsa]

Great points you raise, Jim

Great points you raise, Jim

Joe, thanks for joining the group and sharing your experiences. Good question about the risk comparison between bypass vs. valve replacement. I often wondered this myself.

Marsha did bring up some good points about bypass. Bypass is often referred to open heart surgery but valve replacement actually involves opening the heart. While there is no harvesting of veins, I could have sworn I saw they temporarily removed some of the veins feeding into the heart when they performed an AVR on a recent webcast of an actual AVR. Correct me if I'm wrong.

I don't know what the risk is for bypass but I would believe it would have to be below 1% given the average for any valve replacement is below 2%. It would also be interesting to know a comparison between the length of surgery time would be for these two procedures.

Jim

Hopefully some informed member can enlighten us. As for the time comparison, my recent valve surgery lasted a little over four hours, and my brother-in-law's bypass surgery (one bypass), performed by the same doctor, was barely two hours in duration. This may not be valid, just two actual operations I'm very familiar with.

Take care, and thanks.

Joe

 

[PapaHappyStar]

, I could have sworn I saw they temporarily removed some of the veins feeding into the heart when they performed an AVR on a recent webcast of an actual AVR. Correct me if I'm wrong.

Hi -- The two coronaries are removed and reimplanted when they do a replacement of the aortic root -- most aortic valve procedures are sub coronary, i.e. the excision is below the point at which the coronaries branch off from the aorta.

 

[Ross]

Karlynn,

This Coumadin thing is different. I never thought I'd have to balk at the salad bar, or look twice at that tempting bowl of turnip greens (can you tell I'm from Alabama?) Must steer clear of heavy does of vitamin K, right? Drats, I sure miss my daily breakfast of kale and seaweed pancakes with mayonaise topping.

I've had four weekly INR's, and all have been in range with the exception of the first. I guess I'd better get chummy with Mr. C, since it looks like we'll go the distance together.

I enjoyed your reply.

Joe

Totally and utterly FALSE!!!

A daily seaweed, Kale and mayo diet may be a bit over the edge, but a couple times a week and adjustment should be fine.

You are falling victim to people that are spreading terror to Coumadin patients. Eat what you want to eat and adjust your Coumadin around that diet. Be consistent in the amounts of Vit K that you take in. Do not deprive yourself of things your love and that are also good for you. I suggest you go to Mr Lodwicks site and study up on Coumadin. You'll feel better, most likely know more about the drug then those people telling you cannot have greens and feel better about the whole situation.

Go look at www.warfarinfo.com

 

[geebee]

Joe,
Welcome to the site. It is a fun place to hang out.

I think OHS refers to any operation where the heart is exposed. However, in VR surgery the heart is actually opened so it adds a little definition to OHS.

As far as diet & coumadin: I have been on coumadin for 24 years. I have not changed my diet other than watching my calories (a personal side effect of getting older ). I eat seaweed (read sushi), love spinach salads and eat a lot of green vegies. However, I do all that on a regular basis (more than once/week) so my dosage has been adjusted to fit my diet.

I have thought of coumadin as a friend who keeps me from having a stroke and not as an enemy trying to sqeeze the blood from my body. A bit bizarre of an analogy but one that works for me.

I am happy for you that recovery has been fairly "easy" (yeah - right!) and it sounds like you will be back to regular "stuff" soon. Congratulations.
Look forward to more updates.