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Guest

Hi!

I'm 41, congenital BAV diagnosed age 4, have had yearly echos my entire life. I've researched the "state of the art" of OHS and valve options every few years the last decade, as my numbers creep into range. Now my AS is severe, my ascending aortic aneurysm is 4.7cm, and surgery is near.

I would love to have just one OHS and be done with it, if luck permits. Thanks to the members of this forum, I know I'd be able to self-manage warfarin and my INR if I went mechanical.

The issue is the clicking noise of the mechanical valve. I am someone who, when renting a new apartment, asks six+ noise related questions of the landlord (neighbor noise, road noise, landscaping noise, construction noise, water pipe noise etc.) My work requires silence at a desk (no music, no white noise), and my greatest pleasure is reading in silence.

I would have access to white noise at night, to help get to sleep, but that's about it.

I've experimented by strapping a cheap watch with a strong tick to my wrist. I don't hear it when walking outdoors, or showering, or watching tv, or at restaurants or the cinema.

I also know that for *most* people, "the brain eventually filters it out", and "the ticking can be a comfort", and "your real problem is when it stops ticking". I appreciate these things, and hope they would apply to me.

But during this decision phase, and based on my life experience with ticking noises, I must assume that none of these mental frames will help, and that I will be one of the few who are persistently and deeply disturbed by mech valve noise.

The only thing I can think of which might help in this scenario, is if I could muffle the valve enough to work and read in peace. So I have a few questions in this vein below:

1. Scale of 0 to 10, with Zero being pin-drop silence, and Ten being someone talking to you in a "normal" human voice (which I assume is louder than the valve), what number would you assign to your valve clicking?

2. Is your valve noise comparable to the strong tick of a cheap watch? Or softer, or louder? What number would you assign a cheap watch, on the above scale?

3. Would a small pillow strapped to your chest completely muffle your valve? A rolled up sweater, in a pinch? Or is there a large bone/body conduction element to the noise?

4. How good is your hearing?

5. Do you have a graft repair/replacement of a section of your aorta?

6. How much "natural muffling" do you have? Are you thin, stout, lots of muscle/fat on your chest? Is your heart in a "normal" place? (I ask because mine apparently sits a bit lower than average, and wonder what this means for my own accoustics!)

7. Are you still bothered by the noise, years later? Is the need for silence to work/read I meantion above familiar? If so, how do you manage?

Again, thank you all so much, for this, and for all the knowledge, wisdom, and support I've had, even as a lurker, from this forum.
 
Guest;n868084 said:
Hi!

I've experimented by strapping a cheap watch with a strong tick to my wrist. I don't hear it when walking outdoors, or showering, or watching tv, or at restaurants or the cinema.

I also know that for *most* people, "the brain eventually filters it out", and "the ticking can be a comfort", and "your real problem is when it stops ticking". I appreciate these things, and hope they would apply to me.

m.

If you don't hear the watch under the circumstances above, you would probably get used to the valve noise, if any, after a period of time. My valve noise experience is not a lot of help since my valve is a "ping pong ball" bouncing around in a metal sleeve and you might expect it to be very noisy.....but nobody can hear it, even if they stand next to me.......and I don't think I ever hear it altho sometimes, in a quiet room, I become aware of the valve......not sure if it is noise or the movement of the ball inside the cage.......or just a heart beat.

I also think your comment "the brain eventually filters it out" is true. Three or four months ago I was diagnosed with permanent a-fib(irregular heart beat) and early on the irregular beat drove me crazy, especially in bed at nite. Now I rarely notice it. In discussing this with my cardio he said that most people get used to the irregularity fairly quickly.
 
I think it goes like this
If you want to get used to it you will
If you Don't then you won't.

It's not like a watch in my view as it's totally internal and totally related to you.

We all started as baby's in our mothers womb, hearing her heart. I've never heard anyone discuss some baby's being born hating it. We have found puppies like a clock in with them when very young and separated from their mother.

So I really do believe that the most significant aspect is your attitude.
If you work yourself up over things and get over anxious about stuff then this might be one too.

If you want to do something you can.
 
I had a stroke and repetitive noises drive me insane... I was so worried about my mechanical valve but it is quiet. Even if you lay your head on my chest you don't hear it ticking. Had my surgery 3/9/16
 
I stopped wearing a watch in 1997, and deliberately avoid mechanical clocks in my house as the ticking annoys me, so I thought the noise of the valve would be irritating. However, I hardly notice it. Whether this is because my brain has tuned it out, or because it really is quiet, I am not sure. People over about the age of 50 cannot hear it if we are in a quiet room, but younger people can, but it really must be dead quiet for that. (I had my valve almost exactly 2 years ago).

And I agree with Pellicle - it is inside you, and no amount of padding will stop you hearing it if you are minded to hear it.

On your scale of 1 to 10 about how much do I hear it, I would say "2" if I am listening for it, otherwise "1", or "0" if I am actively doing something. I do have a bit too much natural padding, but I am not sure that would make a difference, and my hearing is ok for distinct noises but I struggle to make out a conversation in a noisy background such as a pub (especially if it is my round next ... ;-)
 
I amalmost 5 weeks post op. As all the others have stated valve noise is a non-issue for me. I honestly would not be even able to tell you if it makes a naoise at all. The fear ( which I had BTW also) that it is like a watch ticking was unfounded. I think it also has to do with the fact that this is the sound of your heart beating means it is not a noise. It is absolutely in synch with your body.

Again - let me assure you that this is a non-issue based on my experience, I have read the same from every other recipient of a mechanical valve and I am not aware of anybody that felt the need to replace a mechanical valve because of noise. I did read though about valve receipients that worried about the inevitable next surgery required for a biological valve. I know that this is a different topic but feel that your consideration of a mechanical valve at your age makes sense.
 
Hi


I answered earlier on my phone (which is a PITA) so I'll toss in data for the specific questions now as well...

Guest;n868084 said:
1. Scale of 0 to 10, with Zero being pin-drop silence, and Ten being someone talking to you in a "normal" human voice (which I assume is louder than the valve), what number would you assign to your valve clicking?

well I can't hear it 'ticking' instead I hear an almost perfect lub lub lub as often used on movies and it is not though my ears, but conducted through my body. Hearing protection stuff (earmuffs or plugs) simply make it 'clearer' by excluding external sounds


2. Is your valve noise comparable to the strong tick of a cheap watch? Or softer, or louder? What number would you assign a cheap watch, on the above scale?

nothing like it at all (described above)

3. Would a small pillow strapped to your chest completely muffle your valve? A rolled up sweater, in a pinch? Or is there a large bone/body conduction element to the noise?

no, reason described above

4. How good is your hearing?

good ... I used to be a sound engineer and still do recordings for personal hobby


5. Do you have a graft repair/replacement of a section of your aorta?

yes ...


6. How much "natural muffling" do you have? Are you thin, stout, lots of muscle/fat on your chest? Is your heart in a "normal" place? (I ask because mine apparently sits a bit lower than average, and wonder what this means for my own accoustics!)

about 5Kg over ideal ... but to me unless you are built like santa clause this will not make an iota of difference. There is seldom fat on the sternum.

7. Are you still bothered by the noise, years later? Is the need for silence to work/read I meantion above familiar? If so, how do you manage?

it is actually convenient. I can take my heart rate just sitting looking at a clock and can tell immediately if I'm getting wound up by things as my HR elevates and I'm instantly aware of it. Sort of like a biofeedback mechanism as a bonus.

I believe that the amount of scar tissue influences the sound as much as a graft does ... it increases internal conduction. I've had 2 previous (in total 3) OHS's so I've got my fair share of scar tissue.

Best Wishes
 
Hello.

1. Scale of 0 to 10, with Zero being pin-drop silence, and Ten being someone talking to you in a "normal" human voice (which I assume is louder than the valve), what number would you assign to your valve clicking?
- Probably around a 3. I hardly even notice it anymore, but it's there. I find it comforting now. My son and wife can hear it through my chest with their ears right above it, and in the middle of the night my wife can hear it laying in bed.

2. Is your valve noise comparable to the strong tick of a cheap watch? Or softer, or louder? What number would you assign a cheap watch, on the above scale?
- haven't worn a wrist watch in years, sorry.

3. Would a small pillow strapped to your chest completely muffle your valve? A rolled up sweater, in a pinch? Or is there a large bone/body conduction element to the noise?
- as I believe someone said above, this wouldn't help. Something I have noticed is, to me, it feels like the sound is audible in my mouth if that makes sense. Ever had pop rocks that fizz, and bubble in your mouth? When I first came out of surgery that's what a likened the sound too. Not as intense though.

4. How good is your hearing?
- very good. I'm 31.

5. Do you have a graft repair/replacement of a section of your aorta?
Nope

6. How much "natural muffling" do you have? Are you thin, stout, lots of muscle/fat on your chest? Is your heart in a "normal" place? (I ask because mine apparently sits a bit lower than average, and wonder what this means for my own accoustics!)
Maybe a few KG above 'ideal' however this won't matter.

7. Are you still bothered by the noise, years later? Is the need for silence to work/read I meantion above familiar? If so, how do you manage?
- 4 months later I'm use to it. I hardly even think of it and, as above, I find the sound comforting (I'd worry more if I couldn't hear it). I guess, each to their own, but for me,

I hope this helps. As most people have said, you get use to it or it's not even an issue to begin with. I work a desk job that involves a lot of computer work, writing, researching etc and it doesn't put me off at all.
 
1. Scale of 0 to 10, with Zero being pin-drop silence, and Ten being someone talking to you in a "normal" human voice (which I assume is louder than the valve), what number would you assign to your valve clicking? 2-3

2. Is your valve noise comparable to the strong tick of a cheap watch? Or softer, or louder? What number would you assign a cheap watch, on the above scale? Comparable to watch, if I had swallowed the watch. An external watch would be 1-2.

3. Would a small pillow strapped to your chest completely muffle your valve? A rolled up sweater, in a pinch? Or is there a large bone/body conduction element to the noise? The noise is mostly internal.

4. How good is your hearing? No issues afaik

5. Do you have a graft repair/replacement of a section of your aorta? yes

6. How much "natural muffling" do you have? Are you thin, stout, lots of muscle/fat on your chest? Is your heart in a "normal" place? (I ask because mine apparently sits a bit lower than average, and wonder what this means for my own accoustics!) by BMI I'm on the upper ranges of normal weight. Heart is normal afaik

7. Are you still bothered by the noise, years later? Is the need for silence to work/read I meantion above familiar? If so, how do you manage? Sounds bothers me, specially trying to sleep but doesn't drive me crazy. I don't mind it during many daily activities.

Extra info: I'm 35 years old. This is relevant as hearing gets worse with age, specially for higher frequencies such as clicking sounds. Another note: I have a St jude regent; this is relevant as different mech valves are reported to have different noise levels. Also I'm 6 weeks post op.

Beyond the questionnaire, from my research it's a bit of a crapshoot. The valves make different levels of noise for different people, and the reasons are not well understood. Beyond the objective noise levels, the noise bothers some people more than others. It drives some people insane, others are comforted, others don't mind. The good news is that the odds are in your favor; according to one study (should be easy to find if you google for papers on valve noise) I read, by the two year mark most people (I think more than 95%) don't feel the valve noise affects their quality of life. Personally I was worried, and the noise definitely irritated me after I got out. At the six week mark, I'm mostly ok with it and expect to get more used to it in the future. Of course, there's a chance you could be in the 5% that really don't like it, if you're unlucky. On the other hand, if you get a tissue valve there's a near 100% chance you'll have to get operated again in your lifetime, which you said you'd also like to avoid.
 
I'm week eight post-op. Yes, I can hear it. Sometimes I think it's getting quieter as time goes on. Most audible when I'm lying down.
Some people can hear it, others can't.
3-4/10 for me. Sounds like a cheap watch.
No aortic conduit. Good hearing.
More a reminder of what I've just been through, rather than an annoyance per se.
 
1. Scale of 0 to 10, with Zero being pin-drop silence, and Ten being someone talking to you in a "normal" human voice (which I assume is louder than the valve), what number would you assign to your valve clicking?

3

2. Is your valve noise comparable to the strong tick of a cheap watch? Or softer, or louder? What number would you assign a cheap watch, on the above scale?

​Comparable / 3

3. Would a small pillow strapped to your chest completely muffle your valve? A rolled up sweater, in a pinch? Or is there a large bone/body conduction element to the noise?

It would not help.

4. How good is your hearing?

Normal

5. Do you have a graft repair/replacement of a section of your aorta?

No

6. How much "natural muffling" do you have? Are you thin, stout, lots of muscle/fat on your chest? Is your heart in a "normal" place? (I ask because mine apparently sits a bit lower than average, and wonder what this means for my own accoustics!)

​6'2" / 240lbs (overweight)

7. Are you still bothered by the noise, years later? Is the need for silence to work/read I meantion above familiar? If so, how do you manage?

Going on 8 months since surgery. The sound only bothered me for a few days after surgery, if I tried to lay flat. Laying flat is painful at that stage and the ticking and the throbbing seemed to be related. Now I don't notice it most of the time. I do notice it when I think about it. Friends, family, and healthcare people have heard it in quiet rooms. It does not bother me at all. I can check my pulse by counting the ticks.

My wife rates it a 2 and says that she doesn't hear it as much any more.
 
PS My On-X is the biggest size. The bigger the size, the louder the valve.
I'm 'deep' chested, meaning I have my fair share of padding, although I'm trying to lose weight (9kg over a bmi of 25)
 
1. 8-10 out 10, hear it over the tv and radio, people talking to me, when I'm driving, only time I don't hear it is in the shower
2. Never owned an expensive watch so can't say maybe 2 , more like 2 coins tapping together
3. No hear it up my neck, so it sounds like the sound is from my head not my chest.
4. Good
5. No graft or repair of artery
6.Not alot of muffling
7. Bit bothered every now and then but getting better, doesn't keep me awake like it did at first
 
Warrick;n868118 said:
1. 8-10 out 10, hear it over the tv and radio, people talking to me, when I'm driving, only time I don't hear it is in the shower
2. Never owned an expensive watch so can't say maybe 2 , more like 2 coins tapping together
3. No hear it up my neck, so it sounds like the sound is from my head not my chest.
4. Good
5. No graft or repair of artery
6.Not alot of muffling
7. Bit bothered every now and then but getting better, doesn't keep me awake like it did at first

I can certainly empathise. I've heard of this getting some people down.
For me the clicking is a reminder of the negative experiences.
If it was a noisy watch, it wouldn't be an issue.
Is it possible it seems this loud because you've been preoccupied with it? Is it loud to other people, as well?
It's a bit like when I got the coaguchek before the operation. I played around with it and got an INR of 1, and I thought 'this will probably never happen again.'
In the ICU, I was glad I didn't hear anything. I noticed it on Day 3. Sometimes, I struggle to hear it.
I've noticed when I hear it, it's more likely others can hear it as well.

I wear a t-shirt under my shirt and it does dampen the clicking. When it's cold and I wear another layer, it's even quieter. This contradicts what other people are saying.
 
Agian;n868120 said:
. This contradicts what other people are saying.

Our at least suggests your situation is different.
I suspect there are variances and all reports may represent different experiences than contradictions
 
I think I hear it more as coming from my chest than others, only louder (because I'm closer). That's why I can dampen it with padding. Other people hear it more as resonating up their body, so padding doesn't work. That's how I hear it when I'm lying down. It's much louder, but doesn't stop me from sleeping. I prefer to sleep with ear plugs, which makes it even louder.

I'm self-conscious of other people hearing it. My son stood next to me listened for a while, muttered 'click-master' and walked away, laughing. Kids can hear it more than adults, and it varies between people. I've asked. Some hear it clearly, others can't at all, despite trying.

It only bothers me because it's a reminder, like the scar. The fact that I have the scar itself is not an issue, the issue is why I have it.
 
Funny reading this- I was showing a house over the weekend. While upstairs in the bedroom it was really quiet and the owner was in their reading. When leaving the house with my client- the owner greeted us at the door and he said "that's a nice watch you have- it's really loud eh"
I said thanks and made me way lol
 
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