Question regarding heart failure

[BionicBuddy]

Anne, - one more thing I forgot to say.

You are an incredibly strong woman, (as is the other gal), to go to all of your doctor's appointments alone. Wow. I was floored when I read that. So the lamb metaphor you used does not seem to fit you at all.

Kudos to your Endo for asking for professional collaboration. Here's hoping that collaboration in your health will be optimal!! Good luck tomorrow.

 

[Paleowoman]

Hi Bicuspid Buddy ! I saw the cardiolgist this morning and he too doesn't want my surgery to be performed when he's away on holiday which is over the Christmas and New Year period like most doctors round here. I've now contacted the surgeon's secretary to change the date - she seemed okay with that. I think I will have a good team to look after me post operatively - I'm feeling much more confident. I took hubby with me this morning to the cardiologist but I don't anticipate him coming any more times - I love him, I adore him, he's everything to me, and he'll drive me to and from appointments (I can't drive) and sit and wait in the caféteria if necessary, like when I have a CT angiogram. I'll let him know what he needs to know and I know he'll be by my side when I wake up from surgery and be with me loads while I'm recovering in hospital. He'll be my best nurse when I get home

 

[Rachel]

Yea!!! Great news - way to take care of yourself! Glad you got your med team together that will make a big difference for you during recovery. Also (at least for me) this entire process brought my husband and I closer together - and we already had a strong relationship to begin with.

Keep positive thoughts - seriously it will help you heal faster.

 

[valdab]

Hi Anne
I also have an endocrinologist (Hypothyroidism) - it hadn't occurred to me that she should liaise with the surgeon when my time comes. Do you mind me asking if yours is also a thyroid disorder?
I guess it makes sense - since the menopause I've had a very hard time getting my T4/T3 at reasonable levels and the symptoms I suffer when the levels are awry could easily be mistaken for cardiac issues (breathing problems, palpitations etc).
Also interested to hear that you are having minimally invasive procedure. When I met the surgeon last year he was not amenable to that suggestion at all. Of course, when the time comes, I realise I can and possibly will get a 2nd opinion.

Interestingly, my cardiologist told me that heart surgeons are crying out for OHS work. I think he meant that with all the minimally invasive techniques around now, OHS is not required as often. This came about because I was questioning him on the surgeon's advice not to have surgery at this time (4.6mm aortic root dilation, stable for 3 years, no other issues). He said that the surgeon was certainly not shy to operate but he felt that my time had not yet come.

Good luck with the anxiety - I know so well how it can consume your life.

 

[Paleowoman]

Hi Valdab,


I have diabetes which is why I see an endocrinologist ! You should definitely get your endo involved, particularly for the aftercare.

The minimally invasive surgery is still open heart surgery ! "Minimally invasive" is probably not a very good term as it's just as invasive, but it means that the cut down the sternum to access the heart is shorter than it would be with the other method so healing might be a bit quicker - but both open heart surgery (OHS) I'm afraid !

Thinking about it, the reason why your cardiologist told you that heart surgeons are crying out for OHS is because a lot of people who had bypass operations to clear blocked coronary arteries now have them done via stents that are introduced via catheters as day patients, they used to be operated on with OHS. Looking at the statistics of cardiac surgeons, coronary bypass looks like their bread and butter so they're losing those surgeries !

 

[Rachel]

Hi valdab

I also have hypothyroidism but I'm on medication to control it - I just made sure the hospital staff knew about it so they could supply me with the meds I needed after my surgery. Of course I informed all my docs that I was having OHS but in the end it having a throid condition really wasn't really a big deal for me

 

[valdab]

Thanks for the reassurance Rachel - good to know. It's never been an issue at all for me until the past couple of years when I started having a very really problem converting T4 to T3. Slowly getting it under control. I think!

 

[valdab]

Of course - how silly of me. I realised you had diabetes - didn't make the connection.

You're right about the stents - the cardiologist mentioned bypasses and was just about to explain when he got called away.

I'm sure all will be well with your surgery -however I can totally understand your anxiety. Try to think positive thoughts and not dwell on the details. You are in very good hands

 

[Paleowoman]

No you're not silly valdab ! Most people with diabetes don't see endocrinologists, at least not long term - mine is because I'm atypical: thin and not insulin resistant.

Did you see what I wrote about minimally invasive surgery being open heart ? I think it's a real con calling it minimal just because it's a minimal cut but still open heart as though it's no big deal :confused2:

 

[valdab]

Did you see what I wrote about minimally invasive surgery being open heart ? I think it's a real con calling it minimal just because it's a minimal cut but still open heart as though it's no big deal :confused2:[/QUOTE]

I did see that and I must admit I didn't realise. I suppose I haven't really delved too deeply into the details of OHS and in the back of my mind I thought minimally invasive suggested a tiny incision in the groin. Ah. Wishful thinking eh?

 

[Paleowoman]

I did see that and I must admit I didn't realise. I suppose I haven't really delved too deeply into the details of OHS and in the back of my mind I thought minimally invasive suggested a tiny incision in the groin. Ah. Wishful thinking eh?

You may have been thinking of TAVR where they do make a tiny incision in the groin and a new valve is threaded up to the heart and 'sprung' into place, bit like a stent - it's only given to people who are too frail to withstand open heart surgery and are probably not very active. There are no long term studies on it and the mortality is quite high really due to stroke - 20% after one year Obviously one day it will be an option that is better and long term for people who are active etc.

 

[AZ Don]

Valdab,
I think there are 3 general approaches to heart surgery: OHS, through the groin, and another where they use a smaller inicision than open heart and go between the ribs - I think Cleveland Clinic does this for valve replacements. In any case I don't think aneurysm repairs are done with the minimally invasive options because they need better access. While there have been aneurysm repairs through the groin, I don't think those held up well and the grafts used for this were recalled. I had mine repaired via OHS and it really wasn't bad.

 

[Paleowoman]

Here's a site which explains the surgical options for aortic valve replacement with photos (they are not graphic but of a male chest before surgery : http://umm.edu/programs/heart/services/programs/surgery/valve-surgery

I will be having Option B which is the shorter sternotomy - not sure actually if the shorter one will be 'short' for me, it says it's 6-10 cm long but my sternum is only about 10 cms long to begin with so will be interesting to see whether the surgeon actually goes on to do a full sternotomy on me !

 

[epstns]

Not trying to confuse the situation, but individual surgeons may also have their own versions of the approaches shown in the link posted by paleogirl. At least in my case that was true. For me, they made a shorter incision in the skin (more like 4-inches), but cut the entire sternum bone open. I guess this gave them all the access of a full sternotomy but with a cosmetically less visible scar. It probably would have been a lot more important to me had I not already been near my mid-60's. My "beach-magnet" days were over by then. . .

 

[Paleowoman]

Not trying to confuse the situation, but individual surgeons may also have their own versions of the approaches shown in the link posted by paleogirl. At least in my case that was true. For me, they made a shorter incision in the skin (more like 4-inches), but cut the entire sternum bone open. I guess this gave them all the access of a full sternotomy but with a cosmetically less visible scar. It probably would have been a lot more important to me had I not already been near my mid-60's. My "beach-magnet" days were over by then. . .

I would hope that the surgeon has chosen to do a small sternotomy on me on the basis that that is the best way for surgery for me and that it is not a cosmetic thing at all - in fact I'd rather a full sternotomy if that would mean an easier operation with less time on the heart lung machine. I would think very lowly of a surgeon who chose an incision based on cosmetic reasons

 

[pellicle]

My "beach-magnet" days were over by then. . .

did you misspell this or were beaches drawn to you?

Like the southern guys seem to say "life's a beach then you marry one"

 

[epstns]

No - just a halfway jest that I am no longer a young guy who fancies himself the babe-magnet of the beach. Those days are LONG gone. . .