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Dodger Fan

Well-known member
Joined
May 6, 2015
Messages
118
Location
Temecula, CA , USA
Hi. My name is Cainan. I am a 38 year old male living in Southern California. I am married to my best friend and have 2 boys (8 and 10 years old).
When I was 20 years I old was working at the Nike Factory Store. I was rewarded for good performance with an opportunity to work at a temporary store at the U.S. Open Tennis Tournament in New York. It was a 28 day trip. I had never been on a plane before or been away from home for so long.
My mom recommended that I have a physical before I left. I went to a doctor I had never been to before. He was the first doctor to hear my murmur. The doctor said that it was probably nothing to worry about. He recommended that I have an echo when I returned from my trip.
I procrastinated and had an echo when I was 21 years old. The echo revealed that I had a BAV. The cardiologist said that I would need to have surgery and that the regurgitation was likely made worse because I had just run 2 marathons. I was devastated. I was pretty sure that I would soon be dead. Every time I went running I thought I was having a heart attack.
I had just moved to San Diego. I found a great doctor (he is still my GP 17 years later). He referred me to a cardiologist who recently retired a couple of years ago. I was now under the impression that I would not be having surgery until I was in my 50s or 60s. My only restrictions were skydiving and power lifting.
I was then scheduled to have echos biannually. I would always know that it was time for my echo because I would start having chest pains and other symptoms until my stress test and echo proved I was okay.
I was not introduced to the term stenosis until 5 or 6 years ago when I was applying for life insurance. I brought my GP a form to fill out. My GP wrote that I had a BAV with mild stenosis and insufficiency. The insurance company rejected me. I did not look into stenosis or insufficiency because I felt fine and was still at least 20 years from surgery.
Fast forward to last year. I was told that my stenosis had gone from mild to moderate and that I would need to start having echos yearly. I still didn’t feel compelled to research for the same reasons. Although, I did start feeling a fluttering heartbeat during high intensity running.
On 4/29/15 I had a treadmill stress test. I went for 13 ½ minutes and hit 160 BPM with no problems. I had one or two doubled up heart beats. I was told that I had excellent exercise capacity. The next morning I had my echo. My GP called me that afternoon. I was getting ready to go to a work related awards dinner. He told me that my stenosis had gone from moderate to moderate/severe in 1 year. He said that the aortic valve area had gone from 1.4 cm to 1.1 cm. He told me to take it easy. When I asked for clarification he said don’t train for any Ironmans or marathons (I had actually considered training for an Ironman). I asked about the 2 half marathons I was registered for ($200 each, both at Disneyland). He told me that I would need to ask the cardiologist. My GP wanted to keep my running to 10k or less. The news put a damper on the awards ceremony. This was the first real restriction put on me that I cared about. I hate lifting weights and had no desire to jump out of a plane but these were going to be my 10th and 11th half marathons.
I called the cardiologist the next morning. I spoke to his nurse. She basically told me to stay hydrated, don’t run in the heat, and keep my runs under 10k until my cardiologist had a chance to listen to my heart. We scheduled an appointment for 6/19. I then began to stress and obsess about aortic stenosis. I started reading these forums, watching videos, and reading other information. I read about the risk of sudden death, the life expectancy at 2, 5, and 10 years, and about surgery taking place later than it should have due to cardiologists being too conservative. I started to have chest pain, dizziness, shortness of breath, and fatigue. I was extremely stressed out. I was afraid I was going to die before 6/19 so I called my cardiologist yesterday and they squeezed me in for today.
It was only the second or third time I had seen him since his predecessor retired. He really took his time and explained everything to me. He made it very clear that at 1.1 cm he doesn’t expect me to have symptoms. He listened to my heart. He discussed my excellent stress test with me. He told me that I am at low risk for sudden death at the moment and that he does not recommend surgery at this time. He assured me that he will not let me wait until it’s too late to have surgery. He spent almost an hour talking to me and I really appreciated it. I will now start having echos every 6 months. So between now and November I will plan on not having OHS.
I am glad this forum exists. It is nice to have a group of people to go to that know what I am going through. Nice to meet you all.
 
Quick question: Based on what I wrote above, do you think it would be prudent or silly to have a surgery consult despite my cardiologists recommendation?
 
Hi and welcome

I think what you should do is get a second opinion ... seems your observations don't match the opinion.
 
Hi, Dodger Fan, and welcome to The Waiting Room, the virtual room where many folks await their own turns at valve surgery. I personally spent almost 10 years in the waiting room, and know much of how you feel. My valve followed a progression a lot like yours. A doctor, whom I was seeing for something not heart-related, asked me "How long have you had that murmur?" And the roller coaster began. I was a good bit older than you (around 51 or 52 at diagnosis), but I was a recreational runner. No marathons, just a good morning run, 7 days a week. I also lifted weights and did a lot of other activity. I, too, had no symptoms, even though my valve area measured as low as 1.0 sq cm.

I remained asymptomatic for nearly my entire time waiting. It was only during the last 6-9 months before surgery that I felt any real symptom - and that was only a noticeable increase in my mile times. Granted, I was by then in my early 60's, but my mile times went from around 7:00 to almost 10:00 over the course of the last 6 months or so. My valve area had, by then, decreased to around 0.8 sq cm. I guess my experience proves the advice we often give around here: "The worse a valve gets, the faster it gets worse."

My point in all this is to tell you that many of us are diagnosed and given quite a bit of notice before we are even close to needing surgery. During the waiting time, many of us are able to go about our lives with little or no changes, other than the periodic exams and echo's. Don't panic. Discuss your lifestyle with your cardio. He may (or may not) temper the restrictions on your running, depending upon what he sees and hears in your interview, exam and echo. These docs are pretty good at figuring out when each of us is, in fact, ready for surgery, and if we are intelligent patients, they can help us to maximize our life experiences until that time.
 
Thanks for the replies. This is a really cool forum. I am now monitoring my blood pressure at home on my cardio's orders. I'm not really happy with my systolic. I am averaging 131. I am going to work on dropping it below 120. I will most likely be running both half marathons but at an 11:30 pace which should be super easy for me. After that I will not be running over 10k until after my surgery. For some reason I hate running 10ks so I will be running mostly 5ks. I have also been instructed to be better at staying hydrated. I admit, I am terrible at it. The cardios reasoning for limiting my distance was due to dehydration that occurs during longer endurance runs. I am pretty sure that based on my tests, my past history of psychosomatic symptoms caused by anxiety, and my history of dehydration, that my cardio believes these are the cause of my symptoms. If I am not feeling better in a couple of days, I will consider a second opinion.

I guess since I learned I would need surgery 17 years ago, I have been in the waiting room that long and didn't know it.

espnts - as a veteran runner I would agree that such a rapid slow down over such a short time frame would concern me as well. I asked the cardio about the .3 cm sq decrease in 1 year. The echos were done by 2 different techs. It was his opinion that the decrease was legitimate. I asked if the degradation tends to snowball at a certain point. He wouldn't answer. He told me that everyone was different. He also wouldn't give me a ballpark estimate on when he would recommend surgery. He told me that he wouldn't recommend surgery at this point based on just the valve measurement when all of the other measurements and tests were good. He didn't think the risk of heart attack, stroke, bleeding, etc. was worth it at this time.

I read that stenosis increases approximatley .1 cm sq per year on average. Mine increased .3 cm sq last year. I believe I read that they often recommend surgery at .08 cm sq even if asymptomatic. I also read that larger people may get the recommendation sooner. I am 6'2" and weigh 220 lbs. Based on these numbers I estimate that I will be green lit for surgery within the next 1-3 years.

I have a consultation scheduled with Dr. Ali Khoynezhad at Cedars Sinai in Los Angeles on 5/29 but I am considering rescheduling it until after my kids get out of school for the summer or after my next echo in November.

Thanks for chatting.
 
Hi and welcome! I had AVR in 2005 due to aortic stenosis from a bicuspid aortic valve. A cardiologist missed the call 23 years earlier when I was 8 months pregnant and having nonstop pvc's. I didn't receive an accurate diagnosis until 2001. Four years passed before replacement was necessary, and I stayed very active up until the last six months. If I had it to do over, I would have spent much less time worrying about when I would need surgery and more time enjoying the time that I had. I'm glad you've found the forum and look forward to your future posts. Mary
 
I had my echo yesterday. I don't know the numbers but my cardio scheduled a CT scan and recommended that I meet a surgeon. They are going to mail me the report from the echo. I am waiting for approval from the insurance for the CT scan. I expect to have the scan and meet the surgeon within the next month. My guess is I'll have a new valve within the next couple of months.
 
When it gets towards the time, stenosis can progress rather quickly. Mine did. One year they said your fine, nothing to worry about for a long long time. The following year it was more like whoa this isn't good. The worst part was my cardio at the time said my surgery would likely be within a year or two. I didn't like him or his opinion. I actually didn't even believe him, so I found a new cardio. He redid the echo and said yes you will need surgery soon, but not in a year or two. He said it was much more serious than that and surgery was going to be in a month or two and the process of making arrangements began immediately. That began in April, now I'm three months out from surgery. My surgeon actually said I was a walking time bomb and I was rather lucky that I made it to surgery when I did, as I was in pretty bad shape. Had I known then what I know now. I would have been eager to have surgery much sooner if I could. Being healthy now feels great!
 
Oh I almost forgot to say welcome to the forum. You'll find this is a great place with great people! Try not to worry yourself too much. This type of surgery is major yes, but it has been perfected to an extreme level and you can expect to do very very well!
 
Hi Dodger - welcome to the forum ! The murmur from my BAV was first heard when I was 25, but not much was done until my early 50s when they decided I should start having yearly echos as the gradient had reached moderate levels. This carried on until I was 60 when everything reached severe and I had surgery. I never, ever had any symptoms though ! I was doing quite heavy weight lifting and lots of walking just the day before surgery as I felt so well. Stressed yes but not physically off at all. Best of all for when you meet the surgeon !
 
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