Mechanical Valve

[pellicle]

@Redone
you may find interesting discussion in this thread from this point on
https://www.valvereplacement.org/th...sudden-death-complications.887348/post-893966

 

[Christyleedh]

Hi Christyleedh,

I am so sorry you've had issues with your mechanical valve, which is something that concerns me. I believe my surgeon is one of the best in the Boston, MA area. I'll find out as I'm two weeks away from the surgery and require a Bicuspid Aortic Valve replacement, Aortic Aneurysm repair and reroute of Anomalous Coronary Artery. Part of me wanted to put the surgery off for another year as I was told 1 - 4 years, but once Drs learned what I did (activity wise) hiking, heavy lifting, etc they said sooner is better. I will be thinking of you and hope they solve the situation you're dealing with. This is definitely not an easy situation for anyone and I feel for you! Thank you so much for sharing your experiences with me! I truly appreciate it!

I appreciate the good thoughts coming my way. With yours being the aortic valve, it’s even less likely to have stroke issues than in the mitral position. You will do great with surgery and be up and moving in no time. I did cardiac rehab with both. I was already an otherwise active and healthy person, but I felt more comfortable pushing myself knowing I was being monitored.

 

[Redone]

indeed ... its now the standard process in the USA to do this ... everyone profits ... sometimes its even good for the patients.

It sure seems so! I'm still leaning toward the On-X Mechanical Valve, but I also want to look at St. Jude. I think profiting from heart surgery is sad. I've heard this from more than the surgeon.



well to be honest it shouldn't be their jobs, patient self management seems to be unheard of in the USA, but then everyting there seems to be profit oriented.

Yes, I agree and isn't every country profit oriented? Even though the patient is handling their own INR I would think the cardiologist would stay on top of your care and the numbers as well am I wrong?



that's sort of out of my area of strengths, but I would rely on the surgeons views. I would suggest that its better to get it done earlier than later ... the old days of "wait till the risk of death is high enough" are pretty stale by now IMO.

Yes, I suppose you're right.

Get it sooner, get it healthier and recover better and sooner IMO. @Astro has something on this ... I'll see if I can fish it out sooner than he replies.

Thank you! Your input is very helpful.

 

[pellicle]

Thank you! Your input is very helpful.

just a heads up ... if you put anything between the starting QUOTE="pellicl...

and the ending QUOTE]

it gets lost ... I saw what you typed because I have a habit of looking (expanding) what was quoted to see (because I see this a lot). What stood out was the words:

Yes, I suppose you're right.

which I knew I didn't write.

I'll address this point:

Yes, I agree and isn't every country profit oriented?

yes and no. In Australia health is public health, we have a private system to but often that just uses the public system. So its fair to say that (and public health is State not National) its only "budget oriented" ... meaning that if something results in more money being spent its generally not favoured unless there is a bloody good case made that the benefits outweigh the costs.

In that way the Health System can pursue best outcomes at a society level and "overall".

Like in the UK where they have (in many if not most) a system of National Health (they don't have States) sponsored Coaguchecks and state sponsored strips for self testing. Why? Because they've crunched the numbers and found "self internal recursive" billing between providers and in and out of system charges of $90 for a test strip which costs $6 if you actually buy it not only costs less (unless you're an economist who still believes GDP is the best measurement of a system) but results in better outcomes because (studies have shown) people who self test and self manage aren't the ones who go "oh, I don't need this drug anymore" and get a leg amputated due to yet another clot.

https://www.valvereplacement.org/th...-compliance-with-an-on-x-aortic-valve.888128/
Its hard to make the case that Australia is a Socialist Country in a really meaningful way. Somethings should be public (fire department comes to mind), some private.

 

[tom in MO]

I have a mechanical valve. If you go mechanical and are active then the risks are more bleeding with injuries. The valve you are thinking of getting requires an INR ~2 which means it will take 2 times longer for your blood to coagulate when you fall or take a header into a boulder. For other surgeries in your future, it will take 2 times as longer for any internal or external bleeding to stop. If you suffer from arthritis, the NSAIDs used to treat it are generally not allowed due to their propensity to cause stomach bleeds.

The surgeon or cardiologist who pushes tissue or mechanical is unusual unless there is a specific medical reason. Most of us, myself included, were told that it was up to us to choose. You might want to ask them what is the medical reason why one valve type is better for you. "Being active" is not the right answer.

 

[Lynn]

Redone, I sympathize with how you are feeling. I found the decision between tissue and mechanical to be one of the most difficult I have ever had to make. Like you and many others I was initially leaning tissue and was very concerned with taking warfarin. I am 58 so I could have gone either way and I thought my mind was settled on tissue. My surgeon, however, was very adamant that if I went tissue I would be facing another surgery at some point in my life and was strongly advocating mechanical which sent me crashing back to the drawing board and completely confused as to which way to go.

The surgeons case was that even if I did get 20 years from a tissue valve (which he felt was unlikely) I would be facing a redo of some kind in my life-at an advanced age. My deliberations went like this: If I did get 20 years and TAVR was a possibility and a was able to squeeze another few years out of that it could work out. If my tissue valve failed after 7, 10 or 12 or even 15 years (which is a real possibility) I would face another surgery as TAVR could not be relied upon to get me through-even if I was a candidate.

The other side of the coin is of course anti coagulants for the rest of my life. As others have said, this board helped a great deal in my ability to overcome my reluctance to warfarin. I think without reading people’s real life experiences on this board I would have been to afraid to chance the warfarin and gone tissue despite my surgeon and cardiologists recommendations.

In the end I went On-x because that is the mechanical valve my surgeon uses most often. Am I happy with my choice? Yes I am. I feel great (surgery April 1) warfarin really is no big deal. I home test and I eat what I want. My hair hasn’t fallen out (knock wood) and I don’t bleed very much if I cut myself. I don’t feel the mechanical valve or the warfarin limit any of my activities.

Whatever choice you make, I am sure everything will work out for you. Really, both choices are great options. We are so lucky to have these choices and to live in a time when medical science can give us a new lease of life. Good luck.

 

[Redone]

I have a mechanical valve. If you go mechanical and are active then the risks are more bleeding with injuries. The valve you are thinking of getting requires an INR ~2 which means it will take 2 times longer for your blood to coagulate when you fall or take a header into a boulder. For other surgeries in your future, it will take 2 times as longer for any internal or external bleeding to stop. If you suffer from arthritis, the NSAIDs used to treat it are generally not allowed due to their propensity to cause stomach bleeds.

The surgeon or cardiologist who pushes tissue or mechanical is unusual unless there is a specific medical reason. Most of us, myself included, were told that it was up to us to choose. You might want to ask them what is the medical reason why one valve type is better for you. "Being active" is not the right answer.

Being active is not why the surgeon suggested mechanical and he did because he asked me, would you like to know what I would do? Of course I said, yes! I have been dreading this surgery for the last 5 months and I dread it still. Yes, I realize I'll die if I don't have surgery, but I hope to NEVER do it again if possible. I realize the impact of blood thinners, but my surgeon said tissue valve recipient's also can end up on these even if they didn't plan to be on them.

 

[Redone]

Redone, I sympathize with how you are feeling. I found the decision between tissue and mechanical to be one of the most difficult I have ever had to make. Like you and many others I was initially leaning tissue and was very concerned with taking warfarin. I am 58 so I could have gone either way and I thought my mind was settled on tissue. My surgeon, however, was very adamant that if I went tissue I would be facing another surgery at some point in my life and was strongly advocating mechanical which sent me crashing back to the drawing board and completely confused as to which way to go.

The surgeons case was that even if I did get 20 years from a tissue valve (which he felt was unlikely) I would be facing a redo of some kind in my life-at an advanced age. My deliberations went like this: If I did get 20 years and TAVR was a possibility and a was able to squeeze another few years out of that it could work out. If my tissue valve failed after 7, 10 or 12 or even 15 years (which is a real possibility) I would face another surgery as TAVR could not be relied upon to get me through-even if I was a candidate.

The other side of the coin is of course anti coagulants for the rest of my life. As others have said, this board helped a great deal in my ability to overcome my reluctance to warfarin. I think without reading people’s real life experiences on this board I would have been to afraid to chance the warfarin and gone tissue despite my surgeon and cardiologists recommendations.

In the end I went On-x because that is the mechanical valve my surgeon uses most often. Am I happy with my choice? Yes I am. I feel great (surgery April 1) warfarin really is no big deal. I home test and I eat what I want. My hair hasn’t fallen out (knock wood) and I don’t bleed very much if I cut myself. I don’t feel the mechanical valve or the warfarin limit any of my activities.

Whatever choice you make, I am sure everything will work out for you. Really, both choices are great options. We are so lucky to have these choices and to live in a time when medical science can give us a new lease of life. Good luck.

Hi Lynn,

This is so encouraging and I can't thank you enough! I plan on going with the On-X although I do have questions as to what option the surgeon prefers. I just don't want to do this surgery again if I can avoid it. Unfortunately, I don't have a desk job, but work as a personal trainer, which requires me to demonstrate various exercises and form on each. I am grateful for great hospitals and Drs in my area! Finding out 5 months ago I had severe valvular Stenosis was a huge blow. Regardless of how much this bothers me I do have a lot of faith and a great support system. My surgery is scheduled for 11/29 and I do get more terrified as I approach the date. Thank you again for your encouraging response!

 

[Redone]

just a heads up ... if you put anything between the starting QUOTE="pellicl...

and the ending QUOTE]

it gets lost ... I saw what you typed because I have a habit of looking (expanding) what was quoted to see (because I see this a lot). What stood out was the words:

Yes, I suppose you're right.

which I knew I didn't write.

I'll address this point:


yes and no. In Australia health is public health, we have a private system to but often that just uses the public system. So its fair to say that (and public health is State not National) its only "budget oriented" ... meaning that if something results in more money being spent its generally not favoured unless there is a bloody good case made that the benefits outweigh the costs.

In that way the Health System can pursue best outcomes at a society level and "overall".

Like in the UK where they have (in many if not most) a system of National Health (they don't have States) sponsored Coaguchecks and state sponsored strips for self testing. Why? Because they've crunched the numbers and found "self internal recursive" billing between providers and in and out of system charges of $90 for a test strip which costs $6 if you actually buy it not only costs less (unless you're an economist who still believes GDP is the best measurement of a system) but results in better outcomes because (studies have shown) people who self test and self manage aren't the ones who go "oh, I don't need this drug anymore" and get a leg amputated due to yet another clot.

https://www.valvereplacement.org/th...-compliance-with-an-on-x-aortic-valve.888128/
Its hard to make the case that Australia is a Socialist Country in a really meaningful way. Somethings should be public (fire department comes to mind), some private.

Thanks for your feedback! I'm not used to these forums, but I'll get there since I truly appreciate everyone's feedback!

 

[pellicle]

Hi

Of course I said, yes! I have been dreading this surgery for the last 5 months and I dread it still

I believe you need to address that, as it says something about your underlying perceptions.

I have never dreaded any surgery (or anything much since my usual floggings from the school principle at the Catholic Christian Brothers school).

Its inconvenient and its a bump in the road, but if you haven't started to suffer symptoms, or yet lost your health and had to fight hard to get it back then you may not see this as being a the most wonderful opportunity you have had or will likely ever have.

Having had to fight for my health and regaining my health and fitness about 3 times in my adult life I dread the loss of it more than the second chance to keep it.

This surgery gives gifts well beyond the gift of a return to live before that failed part tried to kill you (slowly and unplesantly), it gives the possibility to reflect, to consider and to experience something truly outside of anything you've ever done.

Make the most of it, dig into some philosophy.

I have lost good friends due to cancer, I'm on the way to losing another one. Take heart in this surgery, for its highly successful and really, compared to rounds of Chemo this is a cake walk.

some of my own philosophical ruminations

https://cjeastwd.blogspot.com/2015/09/denial-or-delusion.html
Best Wishes for a smooth recovery

 

[Redone]

Hi

I believe you need to address that, as it says something about your underlying perceptions.

I have never dreaded any surgery (or anything much since my usual floggings from the school principle at the Catholic Christian Brothers school).

Its inconvenient and its a bump in the road, but if you haven't started to suffer symptoms, or yet lost your health and had to fight hard to get it back then you may not see this as being a the most wonderful opportunity you have had or will likely ever have.

Having had to fight for my health and regaining my health and fitness about 3 times in my adult life I dread the loss of it more than the second chance to keep it.

This surgery gives gifts well beyond the gift of a return to live before that failed part tried to kill you (slowly and unplesantly), it gives the possibility to reflect, to consider and to experience something truly outside of anything you've ever done.

Make the most of it, dig into some philosophy.

View attachment 888217

I have lost good friends due to cancer, I'm on the way to losing another one. Take heart in this surgery, for its highly successful and really, compared to rounds of Chemo this is a cake walk.

some of my own philosophical ruminations

https://cjeastwd.blogspot.com/2015/09/denial-or-delusion.html
Best Wishes for a smooth recovery

I think it's great you didn't dread any surgery, but I'm afraid from what I've read most people would dread this surgery. From someone who feels their life was just high jacked (keep in mind I'm asymptomatic) and my profession involves me being active all day every day this has been as upsetting as losing my first child after a 17 hour delivery. I've had many medical obstacles and do have a lot of faith, which to me is paramount above all else. It still doesn't take the dread away from all I feel I'm losing while recovering from this procedure. Everyone's feelings are real to them. I might not have had a flogging, but I've had a cancer scare, spinal Stenosis, two hips that need replacing at some point, breast implants that are a problematic factor regarding this surgery. So yes I am absolutely dreading it and nothing will change that.

 

[dick0236]

Hi Lynn. At 54 the logical choice would be a mechanical valve if you want to minimize your future risk of additional surgery. Current anticoagulation therapy with Warfarin is NOT a big deal. Take a pill, routinely test, don't binge on food or drink.......and do not totally exclude any food you enjoy from your diet. Last but not least don't run with scissors

 

[Redone]

Hi Lynn. At 54 the logical choice would be a mechanical valve if you want to minimize your future risk of additional surgery. Current anticoagulation therapy with Warfarin is NOT a big deal. Take a pill, routinely test, don't binge on food or drink.......and do not totally exclude any food you enjoy from your diet. Last but not least don't run with scissors

 

[Redone]

Hi Dick,

I think you're right and I am going to go with the mechanical valve. From what I've read and I've tried to read as much as possible it isn't a big deal taking blood thinners. I don't like taking pills, but I also don't think I'm going to enjoy having my Sternum split in two either so hoping this is the last surgery for me! I was encouraged by a member who has had a mechanical valve for 53 years now. I promise not to run with scissors!

 

[Superman]

I think it's great you didn't dread any surgery, but I'm afraid from what I've read most people would dread this surgery. From someone who feels their life was just high jacked (keep in mind I'm asymptomatic) and my profession involves me being active all day every day this has been as upsetting as losing my first child after a 17 hour delivery. I've had many medical obstacles and do have a lot of faith, which to me is paramount above all else. It still doesn't take the dread away from all I feel I'm losing while recovering from this procedure. Everyone's feelings are real to them. I might not have had a flogging, but I've had a cancer scare, spinal Stenosis, two hips that need replacing at some point, breast implants that are a problematic factor regarding this surgery. So yes I am absolutely dreading it and nothing will change that.

I can’t speak for pellicle, but myself, I can’t relate as I grew up with knowing I had a heart defect. My surgery was the light at the end of the tunnel. It meant an end to a lot of the restrictions I had grown up with.

50 plus years of “normal”, then to face open heart surgery? I get the anxiety. I didn’t feel the same way - but I understand why you do. For me at 17, it was a relief to finally be getting it over with.

 

[Superman]

Hi Dick,

I think you're right and I am going to go with the mechanical valve. From what I've read and I've tried to read as much as possible it isn't a big deal taking blood thinners. I don't like taking pills, but I also don't think I'm going to enjoy having my Sternum split in two either so hoping this is the last surgery for me! I was encouraged by a member who has had a mechanical valve for 53 years now. I promise not to run with scissors!

Hey, @dick0236, do you know anyone who’s had a mechanical valve that long? Or even longer?

 

[Redone]

I can’t speak for pellicle, but myself, I can’t relate as I grew up with knowing I had a heart defect. My surgery was the light at the end of the tunnel. It meant an end to a lot of the restrictions I had grown up with.

50 plus years of “normal”, then to face open heart surgery? I get the anxiety. I didn’t feel the same way - but I understand why you do. For me at 17, it was a relief to finally be getting it over with.

I appreciate what you're saying. I've known about the Bicuspid Aortic Valve since my early twenties. I honestly didn't worry about it all these years and instead got Echocardiograms when my general practitioner recommended. Perhaps my outlook will change, but I have been enjoying life climbing mountains, competing in figure competitions, training clients and strength training for years and I have many concerns as to how recovery will go. I've read horror stories of people who have pain, clicking etc from their Sternum and other issues. Yes, the procedure is a blessing for sure especially if it allow you to live a normal life eventually.

 

[pellicle]

but I'm afraid from what I've read most people would dread this surgery.

my mum used to say to me as a kid "if most people jumped off a bridge does that mean you should".

I believe that its not what happens but what I choose to make of it that shapes my feelings. Of course there are first reactions, but then you can work though that.

I came to the decision years ago that what didn't bother me in my childhood, should not bother me now.

I have tried all my life to have the view that I should not need to twist reality to be happy, and to me the first step of that was this:

Some people (not me) have a faith in God ... if they truly have that faith then they should be able to accept that what God has put before them is what God wants. Why dread that?

Happiness is a choice, being in dread does not seem like a choice that leads to being happy or clam.

this has been as upsetting as losing my first child after a 17 hour delivery.

I can't speak to that, but I can say that when my wife suddenly died on a trip home due to an unknown cancer in her brain and then that bleeding on the flight I was pretty wracked. When I left Australia she was alive (but in intensive care) when I got to mid way I was told she had died. The remaining 13 hours of flight was hard and long. I have taken a long time to come to terms with that (and it saddens me still). However (if you look on my blog) you can see the steps I took towards becoming "better not bitter"

Make friends with this surgery and you'll see its not your enemy.

Best Wishes.

 

[pellicle]

Perhaps my outlook will change, but I have been enjoying life climbing mountains, competing in figure competitions, training clients and strength training for years and I have many concerns as to how recovery will go.

and based on almost every story here there is no reason to not expect that to continue.

I got back to XC Skiing ... you can get back to whatever you want too.

Just like this woman did.
https://www.newsweek.com/my-turn-climbing-everest-bionic-heart-99749
Life is not easy, but facing it is all we can do, Søren Kierkegaard (a Christian philosopher and theologian) views Dread as the outcome of fear of facing what you need to face.

I don't know why were are here on this place, but my view is that my personal goal is to become stronger, more caring and wiser.

Best Wishes.

 

[pellicle]

From what I've read and I've tried to read as much as possible it isn't a big deal taking blood thinners

I know there are people here who can help you manage AntiCoagulation Therapy ... its even easier if you cut out the clinics and do it yourself.

I can’t speak for pellicle, but myself, I can’t relate as I grew up with knowing I had a heart defect.

as you know, (so for the benfit of Redone I'll say) I was diagnosed at about 5 and had my first sugery at 10.

This is what I was meaning (@Redone ) when I said " I came to the decision years ago that what didn't bother me in my childhood, should not bother me now."

For when I was having my surgery when I was 28 (then my second) there was a reaction of "**** just got real again" and I spent time reflecting on it.

We all start as something, its up to us to become something better.

Best Wishes