Routine Physical at 51, and I end up needing a new Aortic Valve

[Philip B]

Welcome

Welcome

Welcome to the group. There are lots of us with similar stories. I blew-off seeing anyone about my bicuspid aortic valve for twenty-seven years. I wouldn't have had it checked when I did if I hadn't landed in the emergency room for a bad cut. The ER doc and my wife saved my life by nagging me mercilessly for a solid week.

Experiences and return to activities tend to vary among members as does the advice given by doctors about restrictions due to coumadin use. Personally, I returned to work almost immediately after being released from the hospital. I've pursued an active lifestyle since having my valve and aorta replaced. So far, coumadin use has presented no major complications or barriers.

Until moving to Arizona last June to escape the cold and snow in Colorado's Rocky Mountains, I continued to downhill and back country ski following AVR surgery. I don't think I slowed down much. I gave-up whitewater boating (kayak & dory) several years prior to my AVR surgery because I didn't have time to mess with trips and shuttles. My interest had shifted to sailing anyway.

I often tell people that this kind of surgery is simply about getting a problem fixed so one can get on with living the life he/she chooses to live. I really do believe that.

Interestingly, both of my rough and tumble Chocolate Labs were great companions following my surgery. They seemed to sense that something had happened to me and altered their normal behavior until I was fully mended. Both were very attentive. We lost one to cancer a little over a year ago and we miss him.

-Philip

 

[Ras1151]

Hello,

Thanks for all the support, stories, and information.

I feel very fortunate. From the time of finding out about my BAV to the time of surery, it will be less than two months. I don't believe I have any damage to the rest of the heart, nothing mentioned anyway.
I am not too worried about up coming surgery (report to hosp. two weeks), But have to admit it is on the mind quite a bit lately. I don't know how I would handle it having to wait months or even years.( Canada's wait period...) I do know they say "don't get done too early, but still.... It seems to play on the mind a bit, anticipation, everyone is a little different etc...

I have been healthy my whole life. I went 11 years without seeing my doctor(just haven't been sick growing up). My parents are in their mid 80's and healthy as can be. So... this is new experience for me. I have always been the visitor and never the patient, til now.
Also with the holidays time is flying by.
also have good insurance, Max out of pocket is only $600 per year.
Lots to be thankful for...Thanks again everyone
Ron

 

[Ras1151]

Hello again,

I just remembered a question I have.

My Coronaries are clean, but my Blood Pressure is high, it is about 160/95 give or take.

Question is what is causing the high BP. Doctors have not said anything about it. Systolic went to 200 after angigram, and they gave me some nitro to get BP down, still nothing said about BP.

Ron

 

[scott.eitman]

Ron,

Welcome aboard. I am glad to see you made a decision so quickly about valves. I just had my second AVR and almost everyday for a couple months I flip-floped on the decision.

As I tell people, skiing is a risk-reward question. I am a bicyclist who has been told by some to not ride. I have been riding for 30+ years and cannot imagine not riding. I would not have opted for the On-X and Coumadin had I not been willing to accept the risk. For the past 40 years, you have in one way or another been making this decision as well. There are frequently reports of people being injured or killed skiing, but that has not stopped you. You will need to be aware that after a spill, you will most likely need to be checked out for internal bleeding. Therefore, keep in mind that it is not the skiing that is bad, it is the falling.

Best of luck to you and welcome aboard.

Scott

 

[Lily]

Hello again,

I just remembered a question I have.

My Coronaries are clean, but my Blood Pressure is high, it is about 160/95 give or take.

Question is what is causing the high BP. Doctors have not said anything about it. Systolic went to 200 after angigram, and they gave me some nitro to get BP down, still nothing said about BP.

Ron

Hi Ron -

From what I've read, people with bicuspids tend to have clean arteries. Isn't that nice to know :smile2: Also, some of us tend to have or to develop labile hypertension.

Here is a website if you would like to read more about bicuspids: www.bicuspidfoundation.com And BTW, there seem to be varying degrees of intensity among various people with bicuspid valves; while some may have or may later develop connective tissue issues also, maybe not all do. Apparently there is a lot that is yet unknown about bicuspid and related issues.

 

[Mentu]

Ron, with respect to the blood pressure issue, your valve could be contributing to it or even be substantially responsible for it, especially, if your blood pressure has only been a problem recently. The anxiety of waiting can also produce a change in BP. After surgery, it is likely that your surgeon/cardio will recommend a beta blocker for a few months; Metoprolol is commonly used. That can keep your blood pressure on the low side while your heart recovers from surgery. After a few months, once the beta blocker is stopped, it is common for the blood pressure to fluctuate some but after a few weeks it should settle down. When I stopped taking Metoprolol at six months, my BP was running 100/60; at one year post surgery, my BP was back to 115/70.

 

[Ras1151]

Larry,

That's is very interesting. I kind of figured they would take care of it after the surgery. So haven't been to concerned.

Thanks
Ron

 

[normofthenorth]

Hello,

Thanks for all the support, stories, and information.

I feel very fortunate. From the time of finding out about my BAV to the time of surery, it will be less than two months. I don't believe I have any damage to the rest of the heart, nothing mentioned anyway.
I am not too worried about up coming surgery (report to hosp. two weeks), But have to admit it is on the mind quite a bit lately. I don't know how I would handle it having to wait months or even years.( Canada's wait period...) I do know they say "don't get done too early, but still.... It seems to play on the mind a bit, anticipation, everyone is a little different etc...

. . .
Ron

Again, "Canada's wait period" seems to compete with the best in the world, including major US centers. Calgary, Alberta, on the other hand, seems to have trouble electing competent governments, so they have to phone 911 from hospital ERs and do other crazy things instead. If I lived in Calgary, I'd probably choose to blame Canada, too, but we're mostly getting great medical service while occasionally watching Calgary horror stories on the TV news. (Ironically, if the federal government -- aka "Ottawa" -- tried to exert some control over Calgary's rotten wait times, most Albertans would probably see that as a declaration of Civil War!)

My "Canadian wait period" was so short I had to skip the first few OR dates I was offered, because I couldn't get ready that soon. Can we avoid slandering great national health systems without foundation, puh-LEESE?

(BTW, I've spent many years living in Boston, Princeton NJ, and Toronto, and I've never felt so well medically covered as I do now, in TO. I've got a few bones to pick, but they're generally minor, and I suspect somebody's working on them.)

 

[normofthenorth]

Timing AVR surgery is (IMHO) largely a tradeoff between the physical and the psychological. Physically, there are some benefits of waiting, esp. if you're opting for a tissue valve. For every (say) month you delay, the life expectancy of the valve increases more than a month, maybe 5 weeks or so. And we don't live forever, alas, so for every month you delay, your life expectancy drops a fraction of a month.

But still talking physically, waiting makes your heart do more adjusting and accommodating. Some of that accommodation can cause permanent changes (aka damage), which you'd rather avoid. I now have a Dacron reinforcement ring around my Mitral valve which I almost surely would NOT need (or the associated 3 months of Coumadin) if I'd gone for surgery 3 or 4 months sooner, when I still felt perfect but my area was already less than 1cm2. I suspect that some other accommodations increase the post-op recovery time during which your heart is doing weird things instead of settling down to good "refurbished" performance.

Psychologically, it's a bear to come out of any surgery feeling significantly WORSE than you did going in. And if you still feel worse in a month, or in TWO months, etc., etc., then the whole recovery has a kind of shadow over it that many find quite depressing. "Remind me again why exactly I went through all this??" type thing. Fact is that most post-HVR patients aren't running full speed at 3 months post-op or even 6 months or a year. Except for my torn-and-recovering Achilles, I think I would have been running full speed at around 3 months PRE-op (I felt like I was bicycling full speed), so I'm facing a frustrating period of cardio rehab, while I'm significantly less fit than I was with the old gnarly destroyed valve(!).