It makes a clicking sound

[JedC]

I underwent AVR on September 29th. I'm the proud new owner of an On-x aortic valve. Boy is it a noisy little thing. Any thoughts?

 

[pellicle]

Boy is it a noisy little thing. Any thoughts?

welcome to the club

the first few weeks of avr after a mechanical are I believe harder than the later years. Myself I have an ATS and while it doesn't "click" by any stretch of the imagination it is like a softened kick drum.

I still recall a discussion with a specialist (on a different matter) with him saying "well they sure put a diesel into you didn't they"

Now mostly it is only apparent to me when I think about it or at particular times. Amusingly I can hear it more prominently when I put audio "over the ear" cans (headphones) on, noise cancellation makes zero difference highlighting that its coming from inside (conducted through the vascular system and other harder materials far more than outside.

I have just come up from the shed where I was painting and to be honest I was only aware of it significantly when I read this to reply. I'm just over 10 years on this valve.

Here's a tip: the more you get worked up and anxious and angry about it the worse it will be for you. So I recommend make friends with your new part(ner) and you'll get used to it.

Some things make it worse for me (drinking) so I avoid more than moderate drinking now days. That's not really a bad thing.

Anyway, Happy New year and I hope it settles into the background soon (even though the awareness never totally goes away).

Best Wishes

 

[JedC]

Hey, thanks for the supportive thoughts. Looking forward to getting used to it and becoming one with it.

 

[pellicle]

becoming one with it.

this reminds me of the Buddist joke

Guy goes into a Buddhist hamburger joint and looks at the menu, eventually says to the guy "can you make me one with everything?"

The cook looks at him flatly for a moment and says "sure, that'll be 20 bucks"

The cook makes him the burger and the guy hands over a 50 and the cook just puts it in the till and goes back to working on other things. The guy complains and says, "hey, where's my change buddy!"

The cook looks at him and says "well you should know, change comes from within"

[/rimshot]

btw, remember these?

 

[almost_hectic]

My On-X was much louder right after surgery. I don’t know why that is. I can say though it’s quieted down a LOT since then. Now whether or not I hear it depends on how much other sound is happening around me. One interesting thing I learned several months after surgery I had a CT scan and was told that tissue had grown around that area. Maybe that’s why it’s quieter

 

[Humboldtgrrl]

this reminds me of the Buddist joke

Guy goes into a Buddhist hamburger joint and looks at the menu, eventually says to the guy "can you make me one with everything?"

The cook looks at him flatly for a moment and says "sure, that'll be 20 bucks"

The cook makes him the burger and the guy hands over a 50 and the cook just puts it in the till and goes back to working on other things. The guy complains and says, "hey, where's my change buddy!"

The cook looks at him and says "well you should know, change comes from within"

[/rimshot]

btw, remember these?
View attachment 888328

Great Buddhist Joke (am sharing with my sangha). It actually has at least a second layer joke, which is the make me "One-with-Everything" level. Tends to take at least one lifetime for that to evolve, lol

 

[Estrazz]

I had a Bental procedure in November 18th and I agree. Mine sure is a noisy bugger and really got to me on more than one occasion. I am starting to accept it more. I pretty much seem to always hear it but it doesn’t bother me as much already.

 

[GSP]

I had my on-x put in 4 months ago and I could swear it’s not getting any quieter. I also had my ascending aorta and root replaced so that might help conduct the noise a bit. I notice it a lot, as does my wife, but it doesn’t annoy either of us in the slightest. It’s as if our brains have just accepted this is the cost of admission.

 

[Chuck C]

I had a St. Jude mechanical valve put in 9 months ago. It was louder for the first couple of months, but has quieted down substantially. At this point, I usually don't hear it at all. For example, it is very quiet right now and I'm trying to listen for it but can't hear it at all. However, if I take a deep breath, I can hear it for a few beats. I expect this is because the expanded lungs act as a drum of sorts. I can also hear it if I put on headphones or put earplugs in. I'm about to go hike a local mountain and I will certainly hear it some as my heart starts to beat harder with exertion.

Hang in there. As the months pass it should not be nearly as noticeable.

 

[AZATADINE]

Well, I have a tissue valve since Nov 4th and it obviously doesn't click but by God, trying to get to sleep at night can be a challenge sometimes as well due to the thumping I hear/feel through my ears against the pillow.

 

[pellicle]

@JedC
I'd say that this was to some extent exactly what I also experienced.
(underline mine)

Mine sure is a noisy bugger and really got to me on more than one occasion. I am starting to accept it more. I pretty much seem to always hear it but it doesn’t bother me as much already.

but its a matter of mind over matter. At its nub its an interesting question of psychology. I personally believe every human has the capacity for coping with change. However I see that some people appear to choose to not cope. Such changes are often forced upon us; for instance our cosy home lives can be interrupted by the unexpected appearance of noisy things which scream when they want attention and don't sleep properly for the first year or so. People often say "I can't wait for things to get back to normal" ... well that never really happens does it ;-)

 

[Astro]

There may be a couple reasons why new mechanical valves are so noisy at first but get better with time:

1) Before the valve replacement, your heart thickens or expands to pump harder to compensate for your tight and/or leaky valve. When the valve is replaced, initially your heart continues to push blood with this extra force so is quite noisy. Over the next few weeks, your heart remodels. It no longer needs to push blood with so much force so the noise production decreases.

2) The psychological compensation as outlined by Pellicle.

For my first month with a new mechanical valve, I quite liked sleeping in a room with a fairly noisy clock.

A pre-surgery question people might have:
"Will my new valve be really noisy when exercising?"
My answer: yes it is more noisy but I am unaware of it because my heavier breathing from exercising drowns it out. I am rarely aware of it after exercising and no-one else has ever commented on it.

 

[chebag]

On bad nights, my On-X is a reminder of how fragile I am. On good nights, I remember just how lucky I am to have it. I'm four months out from my replacement, and the good nights far outweigh the bad. It doesn't keep me up and I usually don't think about it.

As pellicle said, a matter of perspective.

If you're struggling to adjust to having your own personal tell-tale heart, a therapist is always a great option. Has been a huge help to me. Coping with trauma is not just about can-do attitude and self-esteem but also about having the external supports to get you through a tough time. Which is a good reason to come to a forum like this one.

 

[pellicle]

I had my on-x put in 4 months ago and I could swear it’s not getting any quieter

While this may not seem helpful, but maybe it won't. Mine shakes me less than it did in the first year, but I'm 10 years in now with this valve. I believe one needs to think in these time scales, because (all things being equal) this part(ner) lasts a lifetime ;-)

PS: I was 48 when my valve was put in, it would be very unlikely for an active 48 yo to get 20 years out of a bioprosthetic, which would mean reoperation time at around 68. That would also be my 4th surgery and you can be sure that wouldn't end as well as my third did.

To my mind the "get past the hump" - "ten years seems unthinkable" is an indication of either your age or your state of shock.

Best Wishes

 

[pellicle]

to adjust to having your own personal tell-tale heart, a therapist is always a great option.

interestingly as a kid I learned about biofeedback and wished I could have one to help my meditation by hearing my heart beat.

Well, as my wife always said: be careful what you wish for ;-)

TBH I'm happy to have it as it really informs me about when I am stressed and am in denial.

 

[Superman]

My first surgery was just a St Jude valve in 1990. It ticked. It was enough where I was asked about my loud watch during a test in college. I remember it getting quieter over time, but hearing it really depended on what I was doing and ambient noise around me. Overall it was just an ever present clock. No big deal.

Then in 2009 I had a Bentall Procedure. I swear that Dacron aorta was an echo chamber. Took a while for living tissue to develop around it and muffle the sound. I think it’s still louder than my original replacement, but definitely quieter over time. It’s been 12 years now since the Bentall. Doesn’t really bother me at all, but I am aware of it.

I did lose a job over it though. Can’t be a good tooth fairy if the kids can hear you ticking.

 

[Chuck C]

It does seem that the vast majority are not bothered at all by the clicking, but clearly there are a few who are. I'm not talking about the first few months, because the sound does decrease, probably from psychological reasons and some physical adaptive reasons.

I think that some self-evaluation for your personality type might be in order before making the choice. On other threads we have discussed the issue of evaluating whether you are the type to be consistently compliant with taking medication- very important for mechanical valvers on warfarin. But, also perhaps it would also be wise to give some consideration to how you might psychologically handle it if you can hear a faint clicking sound from time to time and if that would bother you.

To elaborate on my point. When I was making my decision, it really helped me to read the stories of the many members here on warfarin. The vast majority indicated that the clicking was a non-issue for them, some even viewed it as a positive. To me, that was good enough. I did not worry about it and since getting my surgery, it has never been something that bothers me. On the other hand, there is someone I know who is not yet facing surgery- probably still a few years away. They have not made their valve choice yet, but they are very worried about the clicking sound already in the event they choose mechanical. He has asked so many times about whether the clicking sound bothers me that I am losing count. No matter how many times I tell him that it is a non-issue for me, he keeps bringing it up and asking again. For him, I'm beginning to think that perhaps he should go tissue, because he seems to be certain that the clicking will drive him crazy. I believe it could very well become a self-fulfilling prophecy. He is almost at the age where valve choice enters the gray area, in which the guidelines suggest that either tissue or mechanical is a reasonable choice, so perhaps he should go tissue given his level of anxiety that he is already experiencing about it.

I'm not sure the best litmus test for this. Having a lot of anxiety about hearing the clicking even before surgery might be one litmus test. Perhaps another is whether a fan on at night keeps you awake or if the sound eventually just blends in as white background noise for you.

 

[KLS39]

I had surgery to replace my aortic valve with a mechanical one 10 months ago. I still hear a thump especially if I am sitting at my desk or driving my car. If I am distracted, working out or there is a lot going on around me, I am not really aware of it. It does thump when I first get into bed but after a short while I don't hear it. I have on a few occasions heard the clicking sound. That was strange.

 

[pellicle]

Interestingly I don't seem to hear mine when walking, which leads me to share this wonderful philosophical view (of which sadly I have not experienced since 2016):

During long cross-country wanders, you do glimpse that freedom of pure renunciation. When you walk for a long time, there comes a moment when you no longer know how many hours have passed, or how many more will be needed to get there; you feel on your shoulders the weight of the bare necessities, you tell yourself that’s quite enough – that really nothing more is needed to keep body and soul together – and you feel you could carry on like this for days, for centuries. You can hardly remember where you are going or why; that is as meaningless as your history, or what the time is. And you feel free, because whenever you remember the former signs of your commitments in hell – name, age, profession, CV – it all seems absolutely derisory, minuscule, insubstantial.​

 

[almost_hectic]

It ticked. It was enough where I was asked about my loud watch during a test in college.

LOL I’ve had almost the exact same experience more than once when I started just s few months after my surgery. None of my coworkers knew anything about my surgery. Leaning over someone’s computer once to explain something, they said, “wow, your watch is loud!” It took me a second to even understand… Then I replied, “that’s not my watch ticking, that’s my heart.” My coworker was in shock and didn’t know how to comprehend what I said! LOL