i'm back oink oink

[sylviayasgur]

hi rich!
so glad to hear all went well and that you are on your way to recovery.
wishing you a continued smooth one and a fresh start in this new year.
all the best, sylvia

 

[showhost]

Some insight into "minimally invasive"

Some insight into "minimally invasive"

Hi Y'all...

Great to be part of the loop now. Prior to surgery I was just a "fly on the wall" listening in and gathering info from other people's experiences and didn't really have anything to add or ask (as so many of my questions were being answered).

Ram... as I to my choice to go "cross-country" for my surgery, I began doing research on my options as soon as my natural valve started to really fail and I began having bad symptoms. I had been monitoring the valve for 15 years and when things got bad my cardiologist here in L.A. said it was time for replacement. He wanted me to have it done here in L.A. (USC, UCLA or Cedars-Sinai) but my research convinced me I wanted to go minimally invasive. I quickly discovered the top three places for this procedure were NYU, Cleveland Clinic, and Brigham Women's in Boston. Surprisingly, Los Angeles is NOT a place where minimally invasive has caught on.

I visited each facility the month before and interviewed all potential surgeons (exept Cosgrove who is booked so solidly in surgery each day he doesn't meet with patients beforehand). This "unavailability" factor alone narrowed it down to either Boston or NYU. Ribakove was so engaging, confident and amazingly willing to address ALL my questions and provide any info I needed to make an infoirmed decision (he spent over two hours with me) that that just cinched it. Lawrence Cohn at Boston was very brief and showed far less warmth and genuine empathy toward a person about to make a monumental health decision. I felt more like "new business for the hospital" than a person he wanted to care for and provide a new lease on life.

The big factor in making my choice was that there are TWO distinct types of minimally-invasive surgical approaches: a "mini-sternotomy" (Cleveland & Brigham) and an offshoot of the old "port-access" procedure (NYU) where the sternum is not cut but the heart is approached from between the ribs. There are decidedly two different camps here and a "war" seems to be being waged between them (mostly from the side of the mini-sternotomy camp).

Cosgrove is certainly a brilliant surgeon but he also loves the limelight and basks in his glory as a "pioneer" in the field of minimally invasive heart surgery. It is my opinion that he and other prominent leaders in this new technique don't want any competition and would like to see other approaches quashed so as not to divert attention (and business) from them. I liken it to the war between the two home-video formats being marketed to the public in the late 70's -- VHS and Beta. Both offered the public an amazing new product and were a groundbreaking development in entertainment, but Beta was empirically superior to VHS. It became a marketing war between the two formats and Beta (owned by Sony) played it's cards wrong and was eclipsed by VHS.

Sadly, one can also find politics, egos, and greed in even the noblest of professions and I found evidence of it in my research in this area.

With that, I hope this answers your question Ram, and gives some "food for thought" to others reading these posts who are contemplating their options for upcoming heart surgery.

Curious if Rich has read any of these posts since his last message. If so, Rich I assume you are only just home from the hospital? Are you a resident of NY? Why did you opt for NYU vs. Cleveland, Boston or others.?

Larry (aka Showhost)

 

[richie rich]

hey larry

i just got in. walked 40 minutes today. not sure how far. i will distanced it with my wife later in the car. i feel really good. not great but real good considering i am only 9 days post op. at this time last week i was having a real bad nitemare at NYU last saturday afternoon. the morphine really messed me up.

i live in long island, ny. i felt that there was no need to travel around the country. i am lucky cause i live in NY which has some excellent hospitals and surgeons. i had my choice of a surgeon on LI who performs over 150 VALVE jobs a year doing the "old " method, a surgeon in NYC who has done over 350 ross procedures ( dr. stelzer) the most on the east coast if not the country after the retiirements of Ross and Adkins in OKlahoma and I was close to NYU, a hospital that is into new technology. with a docotr who is in the cutting hedge of minimal invasive. I never met Ribacove. I went with Colvin because they told me he is the man to do it. Period. I admit he may be a great surgeon but I think his bedside manners are way off.

The minimal invasive surgery is the way of the futute for now. I have my scar above my right nipple and breast and it is about 5 inches long. many docs don't believe in the minimal invasive for one simple reason: its cutting edge and they don't want to take the time to learn it when they have already nailed down the full sterno.

picking NYU oveer Boston or Celevland was easy. I live 1 nout from NYC. GO JETS
larry i will like to talk to you about your shoulder pains because that is the only problem i am having. they told me that some people get itand some don't. i am a big guy with broad shoulders and a big chest. at NYUa the nurses and docs all had different reasons as to why i had the pain. I couldn't move for 3 days (morphine & shoulder pain). they all claim it is from the surgery put have diff. opinions. I honestly don't think they know why it happens. i have to see Colvin on the 15th and i will ask him then

i actually drove this morning in the library parking lot waiting for my wife to come out. it was actually easier then i thought it would be. these little pluses definitely make the minimal invasive #1 on my list.

Rich

 

[showhost]

Rich...

Wow... you're really doing well. I remember being released from Tisch on the 6th day after surgery and on the next day I was walking through Greenwich Village with friends having breakfast!

Boy, I can empathise -- the morphine was hell on me too. I complained and they switched me to something called Toredol (sp?). Worked fantastic with no side effects. Now I just take the T3 if I have one of my pain episodes previously described.

I neglected to mention that my shoulder pain is just the first symptom of a larger event. When I feel the shoulder pain it advances after an hour or so into a lot of painful "pressure" in my chest and neck area in the front of my body. This is accompanied with tingling in fingers and arm-aching. When it first happened it hit HARD and I went to the emergency room at a hospital in L.A. where they admitted me and ran tests on me and observed me for three days. I thought I was either having a heart attack or my valve had ruptured. As I said earlier, they did a CAT scan, EKGs, echocrdiogram and determined that the valve was sound and working fine.

Naturally, I was also in touch with Ribakove on the phone and he said if the valve was proving to be sound then I was okay and that it was likely just part of the healing process. He conjectured that I might have some pericarditis (inflammation of the sack around the heart) and that possibly an anti-inflammatory might help but he was only guessing without being able to see me. Basically my care is in the charge of my cardiologist here in L.A.

Question: is your shoulder pain accompanied by similar chest pain? Also, should you want to talk privately, you can send me a private message or your phone number and we can chat.

Best...

Larry

 

[mamsram]

larry

Thanks for all the info and the quick response. I really appreciate it. I think richie was fortunate to be so close to his surgeon. I was thinking about Dr. cohen, myself, also heard (read) that he had valve replacement surgery. he chose a carpentier-edwards valve.( I think he is 67 yrs. old). this was a recent occurance. (I wonder, did he have minimally invasive surgery??)
Its great that you two guys having the newest form of valve surgery at the same place and same time-frame. comparing notes shoud be a lot of help and comfort.

I wish both you guys well and again THANKS

 

[showhost]

Ram...

Yes, Cohn (correct spelling) had minimally invasive haert surgery about 2-3 years ago if I remember correctly. He is an avid proponent of this procedure remember.

I asked him about his surgery and he has the exact same valve as I do (the CE Pericardial) and Dr. Cosgrove was his surgeon. He said with a grin, "I had my surgery performed by the second greatest heart surgeon in the world".

All the best to you on whomever and wherever you choose for your own procedure.

Larry

 

[Granbonny]

Larry

Larry

Are you a host of a T.V. show?..Just being my noisy self Larry? Are you Larry Hagman?...Anyways..good to have you on board. I had that shoulder pain a few days ago. Gail had inquired about it..and an hour later. I had it. Blamed her and she responded back with an apology...Mine happen when I took my right arm and reach for something on my far left while seated at computer. Ouch.. Like a knife but only lasted a min. I am 9 months post-op..Bonnie