COfireftr
Active member
Hello all. I was a lurker on the site about 10 years ago. Never did take the plunge and actually register. It was best for me to step away and live life without extra worry as it appeared I would be in the waiting room for quite a while. I kind of was. Well...I'm back! Things are progressing and I'm getting ever so much closer to surgery. Looks like I'm here to stay for a while. Here is my original introduction as a guest in 2007...
Went to my annual physical for work which is usually just quick 10 minute formality for my job as a Firefighter/Paramedic. The doctor heard a murmur and what he thought were carotid bruits. He encouraged me to follow up with a cardiologist. I was sent for an echo and appointment with the cardiologist. I assumed it was all going to be a waste of time and money as I had always been healthy; and besides, wouldn't they have noticed something on a past physical if there was really something going on? My echo revealed a bicuspid aortic valve with moderate to severe aortic insufficiency. Luckily there is no stenosis yet and other values such as LV internal diameter are within normal limits including an EF of 65-75%. After comparing some of the numbers to normal values I have found on the internet, it looks to me like I am in the upper ranges of normal though. My cardiologist didn't spend a lot of time with me and didn't seem too concerned though didn't deny the fact that AVR was inevitable. I think he could tell I was very nervous so he didn't want to make a big deal out of the situation as it is a very common defect and sudden death probably won't happen tomorrow. There was never an EKG run so out of curiosity I ran one on myself at work and I'm showing many signs of LV hypertrophy which concerned me a little. I'm sure the echo is much more sensitive so it is nothing to worry about but I will be bringing my EKG strip in with me to my next appointment. I'm sure he must have some concern though as he set me up for a follow up at two months. He never really gave me an indication of how long I could go on my current valve. I am having trouble figuring out if I am mildly symptomatic. I've experienced a couple of episodes of "lightheadedness" and shortness of breath while lifting heavy people and lifting weights in the gym. I can't figure out if it's all in my head. I think the doctor thinks it is all in my head as my EF is still more than normal. Part of me wishes I could just go in and get it replaced so I could move on with my life. The waiting game really messes with your head. I know deciding when surgery is appropriate isn't black and white but I'm the type of person that wants to make a plan and it's hard to do when you don't know if it could happen within a year or 20 years.
I am a little freaked out. I'm 30 y/o with two young daughters and a wife. I love my job and fear I won't be able to do it after surgery (especially if I am required to be on Coumadin for life). I know that there are several options for surgery that wouldn't require anticoagulation though I also fear being back under the knife in 10 years. I just really appreciate the site. You are all an incredibly strong and supportive group of people! I've learned a lot by just browsing around the site the last couple of weeks. Thanks for allowing me to be a part of it.
Fast forward back to 2016....Since that first post a lot of great things have happened and I've lived well. I ran a marathon, several half marathons, too many shorter races to count, have been promoted twice at work to my current position as Captain, completed a Bachelor's degree, watched my little girls become middle and high schoolers, maintained a great marriage. I could go on and on. But...things have been progressing slowly with the valve over the last couple of years and its time to get serious about my options. My cardio thinks I have 6-24 months(ish). He did have me meet with a surgeon the other day so I can consider my options. Things could get tricky with work situation and potential Coumadin. I know other firefighters have faced the same challenge. My specialists have no problem with me going back to work and my command staff and City are also very supportive. The challenge will come when I have to face our contracted "doc in the box" Occupational Med group. I will be scouring the site and beyond for good literature that shows just how manageable anti coagulation therapy is these days and how ridiculous it is that people react the way they do. The surgeon is ready to cut now, as he thinks I meet the criteria with some LV hypertrophy, almost severe regurgitation, and possible very very subtle symptoms. He is recommending the OnX with the newly approved low INR levels (1.5-2). He told me he felt it would be "criminal" to put a tissue valve in me at age 39. He thinks I would only get a good 4-5 years out of it due to my age, activity level, and job. I agree mechanical is probably the best option for me, especially at the lower INR, but if I am unable to return to work I will seek out other options. I wouldn't hesitate to seek out a Ross surgeon or take my chances with the tissue valve. Us Firefighters are kind of crazy like that. The job is very important and potential re-op might just be worth it though not desired!
Anyway, this has gone long enough. Sorry for the long post! Thank you for providing such a great community. The first thing I did after my last cardio appointment was come here and start reading. Its so great to know the support and true experience is here. I look forward to interacting with you all! It's so great to see so many familiar names and lots of new ones, too.
Eric
Went to my annual physical for work which is usually just quick 10 minute formality for my job as a Firefighter/Paramedic. The doctor heard a murmur and what he thought were carotid bruits. He encouraged me to follow up with a cardiologist. I was sent for an echo and appointment with the cardiologist. I assumed it was all going to be a waste of time and money as I had always been healthy; and besides, wouldn't they have noticed something on a past physical if there was really something going on? My echo revealed a bicuspid aortic valve with moderate to severe aortic insufficiency. Luckily there is no stenosis yet and other values such as LV internal diameter are within normal limits including an EF of 65-75%. After comparing some of the numbers to normal values I have found on the internet, it looks to me like I am in the upper ranges of normal though. My cardiologist didn't spend a lot of time with me and didn't seem too concerned though didn't deny the fact that AVR was inevitable. I think he could tell I was very nervous so he didn't want to make a big deal out of the situation as it is a very common defect and sudden death probably won't happen tomorrow. There was never an EKG run so out of curiosity I ran one on myself at work and I'm showing many signs of LV hypertrophy which concerned me a little. I'm sure the echo is much more sensitive so it is nothing to worry about but I will be bringing my EKG strip in with me to my next appointment. I'm sure he must have some concern though as he set me up for a follow up at two months. He never really gave me an indication of how long I could go on my current valve. I am having trouble figuring out if I am mildly symptomatic. I've experienced a couple of episodes of "lightheadedness" and shortness of breath while lifting heavy people and lifting weights in the gym. I can't figure out if it's all in my head. I think the doctor thinks it is all in my head as my EF is still more than normal. Part of me wishes I could just go in and get it replaced so I could move on with my life. The waiting game really messes with your head. I know deciding when surgery is appropriate isn't black and white but I'm the type of person that wants to make a plan and it's hard to do when you don't know if it could happen within a year or 20 years.
I am a little freaked out. I'm 30 y/o with two young daughters and a wife. I love my job and fear I won't be able to do it after surgery (especially if I am required to be on Coumadin for life). I know that there are several options for surgery that wouldn't require anticoagulation though I also fear being back under the knife in 10 years. I just really appreciate the site. You are all an incredibly strong and supportive group of people! I've learned a lot by just browsing around the site the last couple of weeks. Thanks for allowing me to be a part of it.
Fast forward back to 2016....Since that first post a lot of great things have happened and I've lived well. I ran a marathon, several half marathons, too many shorter races to count, have been promoted twice at work to my current position as Captain, completed a Bachelor's degree, watched my little girls become middle and high schoolers, maintained a great marriage. I could go on and on. But...things have been progressing slowly with the valve over the last couple of years and its time to get serious about my options. My cardio thinks I have 6-24 months(ish). He did have me meet with a surgeon the other day so I can consider my options. Things could get tricky with work situation and potential Coumadin. I know other firefighters have faced the same challenge. My specialists have no problem with me going back to work and my command staff and City are also very supportive. The challenge will come when I have to face our contracted "doc in the box" Occupational Med group. I will be scouring the site and beyond for good literature that shows just how manageable anti coagulation therapy is these days and how ridiculous it is that people react the way they do. The surgeon is ready to cut now, as he thinks I meet the criteria with some LV hypertrophy, almost severe regurgitation, and possible very very subtle symptoms. He is recommending the OnX with the newly approved low INR levels (1.5-2). He told me he felt it would be "criminal" to put a tissue valve in me at age 39. He thinks I would only get a good 4-5 years out of it due to my age, activity level, and job. I agree mechanical is probably the best option for me, especially at the lower INR, but if I am unable to return to work I will seek out other options. I wouldn't hesitate to seek out a Ross surgeon or take my chances with the tissue valve. Us Firefighters are kind of crazy like that. The job is very important and potential re-op might just be worth it though not desired!
Anyway, this has gone long enough. Sorry for the long post! Thank you for providing such a great community. The first thing I did after my last cardio appointment was come here and start reading. Its so great to know the support and true experience is here. I look forward to interacting with you all! It's so great to see so many familiar names and lots of new ones, too.
Eric
