Third OHS

[pellicle]

Hi

Yes, mechanical seems the obvious choice. I don't know much about the AR therapy though and how I regulate it!

firstly, soon after surgery the hospital will set you on a path. Once you are established you'll see what your dose is and then all you have to do is maintain it. Mostly that's as simple as
- continue to take the tablets every day
- make sure you take the right dose
- test weekly or every two weeks if you are tight on money

my blog provides some more detailed information
http://cjeastwd.blogspot.com/2015/10/managing-my-inr-example.html

remember: there will be natural ups and downs, just accept that and don't micro manage it ... keep a steady hand on the tiller (steady doses and don't change dose)

you'll be fine ... its simple really ...

 

[neo]

Hey, sorry about the news that you need #3! I know you have a lot you're thinking about; I was exactly in your same shoes almost three years ago with my 3rd surgery. I know what it feels like to realize that neither option (tissue or mechanical) is a perfect one. My best advice to you would be to look at what "currently" is going on in the world of valve surgery.

Ask major medical institutions, like the Cleveland Clinic, what they're using. Remember that individual surgeons can be partial to certain options whether it's because of their hospital's contract, a good relationship with a medical device company, or their reliance on studies with valves made in the 80s. I highly recommend you get multiple recommendations from highly rated surgeons at different highly rated hospitals, even if that means you need to drive a ways of even fly. There are great lists of highly rated surgeons and hospitals from US News top docs reports.

Take a look at the current 3rd generation tissue valves (St Jude Trifecta and Edwards Magna Ease). Both valves have excellent characteristics over former valves. I ultimately chose the Trifecta based on Cleveland Clinic going that way now even in young people. Take a look at what they're doing with TAVR valves, using them already in valve-in-valve surgeries. Remember that all things medical start out in high risk, move to moderate, and then to all. High risk data on TAVR is excellent, and they're now releasing results of moderate risk studies.

The reason i say to look at TAVR is that if you went with a 3rd-gen tissue valve like I did, and then someday it began to wear out, an easy fix might be with a TAVR valve-in-valve surgery. That's what many of the major institutions are predicting will happen on a regular basis.

Mechanical is also a good choice. It used to be the only choice for young people like us, but not anymore. Take a look at TAVR using stem cells as well. There are so many advancements in this field right now, you don't have to choose mechanical if you don't want to.

 

[Capizzi]

I just wanted to respond to Dylanm111's anxiety issue. Symptoms of my mitral regurgitation became severe in my mid-20s. The anxiety had me stopping in the middle of tests, sometimes in the middle of traffic while driving. I tried to act calm, but I know I often appeared distracted/nervous to others. A month prior to surgery at 51 years of age, I was prescribed beta blockers which unraveled all my adaptations. I became extremely emotional, and I lost containment of the anxiety. But I woke up after surgery and the anxiety was gone. The anxiety was like many voices screaming at me at once, and then it was quiet. I previously had to think carefully before speaking because I might say something I didn't really mean. I now have one thought and one voice. I speak without thinking about it. This was the anxiety generated by the bad mitral valve.
A different kind of anxiety crept up that was not due to the valve pathology. I had some anoxia, short-term memory loss, I still can't read well, and my perception of the world has changed. I think that a lot of people in this forum are not the same post-surgery. I am concerned that I won't adapt or be able to do the things I liked to do prior to surgery. Some things I've already let go of; that person is gone. Other things like reading I hold out hope for. But there is no timeline. I can't say in another year my goal is to be able to read a novel. I set the benchmark after it is achieved.
I probably should have tried to achieve this kind of perspective before surgery. The pathology of a bad valve made me feel like I was always dying, and it is a big challenge to be courageous or full of hope when you are literally suffering from a broken heart. I was never really worried about the pending surgery. I just hoped to find the sweet-spot in terms of medical advances and my pathology, which was pre-A fib. I now have a repaired valve with a little ring holding my valve in place, and I don’t know how long it will last. I don’t want to go through another surgery, but my opinion will change in future. If I need another surgery in 10 years, I guess those are the cards I’ve been dealt. I suppose it makes living well now more important.

 

[kevanndo]

My daughter had her third OHS when she was 10 to replace her mitral valve (She got an On-x valve). Two weeks after her surgery she was ecstatically running down our driveway (no small feat because it's 1/10 mile long). Prior to this surgery, she could not run any distance without getting completely out of breath. Interestingly, she is a fearless child who has no anxiety about anything. Her hospital stay after the MVR surgery was the longest stay (9 days) due to the transition from lovenox to the warfarin. Once we returned home, she immediately returned to her normal activities. We had to remind her to slow down and take it easy. I think her energy levels [FONT=Arial, sans-serif] had increased so dramatically due to the surgery that she just wanted to go, go, go. My biggest c[/FONT]oncern after the third surgery had been managing her warfarin. For some reason, that had terrified me. However, as many others have said on this forum, it really is not a big deal. I think the anxiety of the anticipation is far worse than the reality of the day-to-day management.