Met with a surgeon - step two on my way to a decision.

[Alerion]

Hello all,

Well after my cardiac cath (a boring walk in the park, btw) and an echo and some consulting with my cardiologist, I decided to go meet with a guy here in MA (Dr. Tom Carr, Charlton Memorial Hospital in Fall River, MA).

His rep in this area is outstanding and I can't find a word against him on the web. My concern is that he's at a relatively small hospital with a quite recent (2002) but Hi-tech cardiac facility.He's got great cred and has been doing valves at a rate of ~200/ year since his stint as an Army surgeon in the late '80s. .

And he was great - Waaayyy better than my PCP, who says things like "your 10 minute appointment is over in nine minutes" while tapping his watch and looking at me over his glasses (He hates sick people).
Dr Carr took a LOT of time to talk with Heidi and me. He read and answered the list of questions I grabbed off this forum (thnx Jason) and was willing to chew the fat about anything - mutual interests; his family; my family etc. I like him personally, so I think I might just go with him.

I felt a weird ambivalence after talking with him, though.

The reason for that, I think, is that after studying so much in the last couple of weeks and especially after reading so much on this forum, it was kinda anti-climactic. He didn't tell me anything I wasn't prepared for (Hurrah!) other than good news. The good news is that I don't need any by-pass surgery. My arteries are, apparently, muy macho and healthy in all respects. Every doc who has checked out the cath results has expressed jealousy (venous envy) so all I need is an aortic valve replacement.

Btw, "all I need is an aortic valve replacement" is not a phrase I ever thought I would be relieved to write.

He did tell me some things I'd like you guys to comment on if you'd care to.

He told me that with the Carpentier-Edwards bovine valve (His personal favorite) I would have a 30 to 40% chance of re-op in less than 20 years. That's a 60 to 70% chance of NOT needing one in less than 20 years, right? If that's the case, I am attracted to that idea. Are there a lot of folks out there with this valve who are happy with it? Any bad stories or stats?

He also said re-op with a mechanical valve (should I decide on the bovine) should pose no problem. He was very confident about that.

He also told me that he doesn't use the On-x (rats!).
He has in the past, but doesn't like the way he has to implant it and he's not totally convinced it's much better than his first choice, which is the St. Jude - a valve he has been using and assessing for 20 some odd years. I absolutely refuse to take any manufacturers literature seriously-That's one source of info I don't trust - but a surgeon who shows a marked preference is persuasive..

He did say that he knows a lot of surgeons who do use and prefer the On-x and would be happy to contact them on my behalf quickly to set up a consult. I've read a lot about the St. Jude valves - standards in the industry - so I'm thinking hard about those two choices. He told us not to wait very long since my valve is very occluded with 104 gradient - I'm GOING TO DECIDE this week. Period.

Oh, and apparently I also need my teeth cleaned before the procedure!
I assured this guy that I brush and floss religiously, but he was having none of it. If he tells me I need Hi lites in my hair or a pedicure, I'll find another surgeon. Barring that, I like the guy and trust him as much as I do any other stranger with a bunch of diplomas on his wall.

I could very easily strike out for B&W in Boston if I want, but a friend of mine just came back from there with a horrible experience with long-term consequences. Another person I know of went there and can't shut up about how great it was. I guess anecdotes are not the best way to judge a hospital. Anyone who has some real dirt on Charlton or Dr. Carr, though, please dish it this way. I am on a short deadline for this!

I haven't been on this forum much lately because of work, but I am home now and trying to stay current. I truly appreciate the help and support you all are so generous with. Because of it, I am well-informed and feeling pretty cocky!

Thanks everyone.

 

[Bridgette]

If you like this surgeon, feel comfortable with him and with the information he's given you, and have researched his credentials thoroughly, then go with him for your operation.....that's what I'd do anyway.
I think there can be such a thing as "shopping around" too much if you know what I mean - like you could visit 5 or 6 surgeons and be in a spin trying to decide which one

You sound as though you are happy with where you're at, so I wish you all the best. Keep us posted.

Bridgette

PS: It is essential that you get a dental clearance before your surgery - no clearance, no surgery....

 

[Alerion]

Bacterial infection from your mouth can seriously ruin your day, ruin the operation and possibly prove fatal.

 

[ponytaila1a]

Yep, I was surprised when told of the cleaning....I also must have a "full head" xray done by my dentist and a letter from him stating I have a "clean mouth". No comments please! The girl who does the cleaning told me that her husband was having a stress test last summer and she anticipated a by-pass. She "suggested" to him that he had not been in for a cleaning in a while and brought him in one evening before the test and cleaned his teeth. He did not realize this was done before surgery....but she knew the importance of it. She says the mouth is the "germiest" place in/on the body! Now I am constantly brushing, flossing and waterpicing!

 

[kfay]

Cleaning and and taking care of any problems with your teeth is a must before surgery. Alot of us were told No dental work of any kind for 6 months after surgery.

I'm glad you found a surgeon that you like. That makes a big difference. Keep putting one foot in front of the other and get in there and get it taken care of.

Kim

 

[escargome]

Sorry, but I don't have anything to dish about your surgeons. However, I want to wish you the very best. Sounds like you are just about ready to jump into a final decision. That is a good thing. Once you decide, don't look back... Just remember that whichever valve you take, you are getting a whole new lease on life. I'm almost 8 months post-op and I must admit I am feeling great! Unbeknownest to me I was feeling yukky prior to my surgery Go figure...

 

[TFBruce]

Though the Ross Procedure is not real popular on this site, you may want to, at the very least, do some research on this surgery, just to explore ALL options. I am not sure how old you are, but depending on your surgeon it may be a good option for you.

 

[Bina]

My surgeon is the chief of surgery at his hospital, and when I met him, I just liked him and felt a bit more secure.
He had nice hands , the requisite diplomas and creds, and a "no bull sh-t" attitude.

 

[Alerion]

Bruce - Yes, i absolutely checked out the Ross. It's very attractive but it's a bit scary. How are you getting along with it?

Bina - OMG! I forgot to check out my guy's hands!
I liked the guy and he had a no BS attitude too. He pulled no punches when reciting the litany of possible outcomes and was candid as hell when I asked him questions.
Oh.. I just remembered - the guy had some really big nose hairs. They tame those puppies right...tape or a mask or something? I don't want a re-op for "nose hair removal". That would blow (har!)

 

[LeakyValve]

Cleaning and and taking care of any problems with your teeth is a must before surgery. Alot of us were told No dental work of any kind for 6 months after surgery.

I'm glad you found a surgeon that you like. That makes a big difference. Keep putting one foot in front of the other and get in there and get it taken care of.

Kim

Kim -

Thank you. Now I'll check with my cardiologist about a dental visit I have scheduled for next month.

I was told the same thing pre-surgery. No dental clearance? No surgery! No soup for you! I must admit, I hadn't been to the dentist in over 15 years and I had MUCH more trepidation about the dental work than I did about the OHS!!! ;-)

Don't put off the dental work...get it done as soon as possible. Apparently, most dentists are well aware of the urgency of getting this done pre-surgery.

Mike

 

[LeakyValve]

"And he was great - Waaayyy better than my PCP, who says things like "your 10 minute appointment is over in nine minutes" while tapping his watch and looking at me over his glasses (He hates sick people)."

Sounds like Greg House, MD is your PCP? ;-)

As for the hospitals, the key in my humble opinion, is to find the surgeon who provides you with the most comfort and who performs your specific surgery the most. The downside of the larger facilities (e.g., Cleveland Clinic, Mass General, Johns Hopkins) is that they are factories. And while they have volume, the follow up care isn't always the best.

The way I looked at it when I did consults with surgeons was that I thought, "This person will literally have my heart in their hands." Ask lots and lots of questions, no matter how bizarre you might think.

If travel is an option for you, there is a great Aortic guy here in the DC area, Dr. Alan Speir at INOVA Fairfax (IHVI). Check him and his practice out at www.cvtsa.com.

Best of luck!

Mike

 

[Lionheart]

As for the hospitals, the key in my humble opinion, is to find the surgeon who provides you with the most comfort and who performs your specific surgery the most. The downside of the larger facilities (e.g., Cleveland Clinic, Mass General, Johns Hopkins) is that they are factories. And while they have volume, the follow up care isn't always the best.Mike

Sorry Mike buddy, but I disagree with your second statement.
I traveled a long distance to go to Cleveland Clinic and all the staff was extremely professional while also caring. They all treated me like an individual and my care was exceptional. My entire experience was positive. I also found that I was able to contact and get quick advice from my CC surgeon (insert well-known name here) for advice by email much quicker than I could contact my local cardio. I understand that returning to CC on a regular basis is problematic, but unless there are complications there is no need to return. As far as my surgeon, my cardio, and I are concerned all we have to monitor now is my new valve's function every two years and my BP annually, these are things that can be done locally.

My local cardio also mentioned CC being a "valve factory" and I think that was to keep my business at the local shop. After I thought about it I came to the conclusion that for me CC was the valve Mecca.

Take care,
John