Question from BillB

[BillB]

Having completed a 2nd Opinion with Dr. Thomas Gleason (Dr. Patrick McCarthy's referral), I suppose I am now officially a resident in the pre-surgery waiting room. My wife and I spent Tuesday morning with him, and were both very impressed with him. He reviewed my records, and viewed the DVD of my most recent Echo's and CT Scan. He recommends that's I have surgery in the next 6-12 months. It's amazing that as rattled as I have been lately because of this problem, I felt a nice quiet resolve after the consultation. I guess the realization that this needs to be done... has finally sunk in. WOW! I'm still probably about 5-6 months out, but we talked at length (lotsa of samples) about valve selection and the dacron aortic graph. As I have read here countless times, he wants me to make an informed valve decision. I was always leaning toward the St. Judes mechanical, but I could not help but think that he thought the stentless porcine might be the valve of choice for my situation (he never said it, but both Donna and I got the same impresson). His said the porcine valve has the best "hemodynamics" that is most like that of humans. He also said that I could very well expect 12-15 years (maybe) more from one. Anyway....Here's my Question. As I've previously posted, I'm currently (aside from the avr/stuff) in really good health and I feel terrific...But... in the last 4 years I have 2 bouts with diverticulitus...(one requiring an overnight hospital stay, and a recent minor bout). I've developed a real appreciation for salads, veggies and high fibre food. I recently read on a website that coumadin is not good for people with diverticulitus. Do any members have any insight as to the upside/downside effects of coumadin and diverticulitus?? My research into valve selection is in the primitive stage right now, and I know that if I choose to go tissue, there are no guarantees that coumadin will not be required. I also realize that (Good Lord willing), I'll require another surgery. In conclusion, because of the diverticulitus I'm kind thinking "PIG". Maybe this is a question for AL?? Any thoughts...Comments??? As always, thanks for reading.

 

[Kate]

Hi Bill!
Unfortunately, I have only anecdotal information about diverticulitis and coumadin - an older man in my cardiac rehab program has had problems with this combination (two visits to the emergency room for internal bleeding). However, this is only one person so hopefully Al or someone else will be able to shed light on whether this is a common problem or not.

I looked at your public profile to try to figure out how old you are (since that plays a big part in the mech / bio discussion) and noticed that you describe yourself as self-employed. One thing you may want to consider when making your decision is insurability. If you are having to insure yourself, you may want to go mechanical as getting coverage with a second operation looming may be more difficult. I'm not sure about this, but it's something to think about.

I have a bovine valve myself and am generally happy with it (as happy as one can be considering the alternatives ) However, I really believe there is no "right" answer - you just have to learn as much as you can and make the choice that fits best within your particular situation. Take care, Kate

 

[BillB]

Thanks Kate..I'm very soon-to-be 56. Thanks for the input. I never once considered the insurance aspect. I now need to find the correct valve with an expectancy to carry me into my medicare years AND is somehow compatible with the the possible interaction to diverticulitus! Again Thanks.

 

[Guest]

Bill,

I am not able to answer any of your questions; however, "hello" from a fellow Illinoisian and welcome to the Waiting Room. While I'm not a member of the Waiting Room, I know it is filled with great ammenities and has a bunch of wonderful people .

Thoughts/prayers coming your way as you look into your options and make a decision....


Cort, "Mr MC" / "Mr Road Trip", 32swm/pig valve/pacemaker
MC:family.IL.guide.future = http://www.chevyasylum.com/cort/
chdQB = http://www.chevyasylum.com/cort/quilt.html
"We got mountains to climb" ... Rod Stewart ... 'Broken Arrow'

 

[tobagotwo]

Intestinal bleeding and Coumadin are not good bedfellows. I would Google it. "Coumadin AND diverticulitis" got a first page that read "Results 1 - 10 of about 30,500 for 'Coumadin AND diverticulitis'". Popular subject.

If the surgeon is considering a Freestyle stentless valve, 15+ years at your age is a reasonable expectation. The Freestyle is a current-generation valve processed with non-damaging preservation techniques and anti-calcification treatments. It's been around for quite a while, and had a good track record even before the new preparation methods.

If the root is to remain and not be replaced, consider asking the surgeon if it would help to surgically stabilize it, to prevent it from possibly enlarging or distorting later on. I mention this because of the Dacron aortic graft you are receiving, because aortic root abnormalcies more often develop in those with other connective tissue problems. If the root misbehaved after the surgery, it could compromise the valve's functioning and be cause for an unplanned extra OHS, whether you go mechanical or tissue.

Best wishes,

 

[RCB]

Oh Boy!

Oh Boy!

Bill,
You really need to Ask Al this question. I had one attack of diverticulitus
5 years ago and never did any of the two GI specialist say warfarin was a problem. It is caused by pressure on the colon which cause it to bulge in to little pouchs that can become infected. The pressure comes about if the stool becomes impacted due to low fiber diets, low water intake, or lack of exercise to name a few. In my case, I blame it on intake of Norpace which I used to control my AF. When you have any of these factors envolved and you have a hardened stool, pushing when you are trying to void can cause
these pouchs to form.

Remember warfarin will not cause you to bleed, it just makes bleeding last
longer. You should have made changes to your diet that will make you void more often and your stool should always be soft. That is good advice for everyone!

If you keep on having attacks, it would be important to have this matter addressed whatever type of valve you decide on!

 

[tobagotwo]

A note: I just reviewed some of the Google findings, and although they claimed to include Coumadin (it was highlighted), many of them did not include Coumadin in the articles that discussed diverticulitis. I didn't intend to send you on a wild goose chase, and I apologize for posting a glib and unresearched reply.

Maybe tinkering with the search would produce more useful results.

Best wishes

 

[RCB]

Google search

Google search

A note: I just reviewed some of the Google findings, and although they claimed to include Coumadin (it was highlighted), many of them did not include Coumadin in the articles that discussed diverticulitis. I didn't intend to send you on a wild goose chase, and I apologize for posting a glib and unresearched reply.

Maybe tinkering with the search would produce more useful results.

Best wishes

I don't mean to distract for this impotant subject, but Tobagotwo brings up(yet again) another important point. One has to becareful of Google searchs.

For fun I did a search for "RCB and Stupid" got 10,800 hits one was strange
one with the words "Bulua Sex"- I was afraid to open it!!
Here are some other ones:
"Tobagotwo and Stupid" 692 hits mostly about VR.com
"Tobago Two and Stupid" 172,000 hits mostly about his favorite vacation spot.
When I put his medications in and death, the results were- well we don't need to go there, no sence scaring people.

The lesson is as Bob H. says he " .... didn't intend to send you on a wild goose....."
BillB we have all been on many of those and can learn from Bob H. that one must careful of any kind of a search.

 

[PJmomrunner]

Well, RCB, I know you're right about the google searches, but I had already done mine when I came back to post!

I searched for diverticulitus medical treatment to see if I could turn up what medications might be precribed and I found this seemingly thorough explanation of the condition, including the possible meds used: http://www.medicinenet.com/diverticulosis/page3.htm.

I then ran those medications through: www.drugdigest.org/DD/Interaction/ChooseDrugs

What I came up with was that of the four drugs mentioned for treatment of diverticular pain ((Librax), dicyclomine (Bentyl), Donnatal, and hyoscyamine (Levsin)) only Donnatal is noted to have an interaction with Coumadin. Of the antibiotics of choice for treatment of any related infection (ciprofloxacin (Cipro), metronidazole (Flagyl), cephalexin (Keflex), and doxycycline (Vibramycin)), only Keflex is reputed NOT to react with Coumadin; the others DO react to varying degrees.

Bill, Metamucil is your friend.

 

[BillB]

I just did a Google Search for "Really Super People" and there was only one result ..... www.valvereplacement.com. Geez...where else in this big wonderful world can one discuss such "diverse matters" with 1400+ strangers?

Thanks..."Benefiber" BillB

 

[Mary]

I just did a Google Search for "Really Super People" and there was only one result ..... www.valvereplacement.com. Geez...where else in this big wonderful world can one discuss such "diverse matters" with 1400+ strangers?

Thanks..."Benefiber" BillB

Welcome to the site, Bill!

 

[RCB]

Well, RCB, I know you're right about the google searches, but I had already done mine when I came back to post!

I searched for diverticulitus medical treatment to see if I could turn up what medications might be precribed and I found this seemingly thorough explanation of the condition, including the possible meds used: http://www.medicinenet.com/diverticulosis/page3.htm.

I then ran those medications through: www.drugdigest.org/DD/Interaction/ChooseDrugs

What I came up with was that of the four drugs mentioned for treatment of diverticular pain ((Librax), dicyclomine (Bentyl), Donnatal, and hyoscyamine (Levsin)) only Donnatal is noted to have an interaction with Coumadin. Of the antibiotics of choice for treatment of any related infection (ciprofloxacin (Cipro), metronidazole (Flagyl), cephalexin (Keflex), and doxycycline (Vibramycin)), only Keflex is reputed NOT to react with Coumadin; the others DO react to varying degrees.

Bill, Metamucil is your friend.

PJ,
I was treated with ciprofloxacin and metronidazole, warfarin was stopped and INR checked every 12 hr. to see how the the meds. cocktail
affected PT. The dr. kept me in range and had to get a INR reading 3 days
after I left hospital. My card. took it from there, adjusted the dose once.
As I have said before "you don't need a doctor who can't handle the simple stuff, because when it get tough- they fold." One week later, back to 25% higher dose due (I think) to change in diet, where it has stayed pretty much for the last four years. Orange Citrucel, two heaping teaspoon in a 12 glass of water before lunch and dinner. Didn't like it at first, but now look forward to it. Now, I am in and out of the little boy's room very fast, with no time to read anything- I love it.

By the way, my GI doctor thinks the warning about some seeds being dangerous is a myth. That is great, because I eat popcorn and all kinds
of nuts on a regular basis-no problem in four years. Good Luck BillB

 

[tobagotwo]

However, the paragraphs about the Freestyle and about root stabilization are not from a freelance Google search, and I stand by them as my researched opinions.

My apology was intended to throw out the bathwater, not the baby...

Best wishes,

 

[RCB]

Sorry Bob

Sorry Bob

However, the paragraphs about the Freestyle and about root stabilization are not from a freelance Google search, and I stand by them as my researched opinions.

My apology was intended to throw out the bathwater, not the baby...

Best wishes,

That is exactly how I understood you to mean and my comment was only on Google searchs. I'm sorry if you thought I implied anything else, because
I certainly did not. If anybody else made the same inference, my apologizes,
too!

 

[gadgetman]

BillB,

Can't answer any of your questions but welcome aboard. Good luck on your quest for answers.

May God Bless,

Danny

 

[Georgia]

My dad nearly died from a ruptured colon from diverticulitis. It was rather nightmarish. I didn't have the luxury of making a choice on valves. However, if I were in your position, I'd certainly give heavy weight to the diverticulitis issue in my decision.

Best of luck.