Hi
I've had 3 OHS, spaced by about 20 years each. First was when I was 9 or so.
#1 was a valve reconstruction
#2 was a human living tissue implant
#3 is a ATS pyrolytic carbon mechanical
I had about four weeks to do research on Warfarin and start making the mental adjustment. I had reached the point that it didn't feel like as horrible an option, as I previously imagined
its funny isn't it, how its made out to be the boogey man in "common knowledge" but when you actually dig into it its actaully not that bad.
I too was given the impression all my life that "well at least you're not on
WARFARIN" by medical people. All I can put this down to is a combination of ignorance and a slanted perspective.
Discussion yesterday with a pharmacist mate of mine (I am an ex-biochemist) was interesting. We discussed a fellow who was on one of the warfarin alternatives (Pradaxa). He fell down stairs and broke his nose. Not horrible, but it wouldn't stop bleeding. They had to give him dialysis for some days to clear his blood. Had he been on warfarin the this could be cleared almost immediately with a simple injection of vitamin K.
That's one of the reasons why I like simple solutions to problems.
My spouse was a med tech in her earlier life and has had quite a bit of experience interacting with warfarin patients. Most of her experience is not positive.
its a bit like asking an Ambulance driver or a Policeman questions about what they see every day ... its usually only the worst of everything. By definition they just don't see the people who have no problems.
This has to give you a slanted perspective on stuff (just as having no experience does).
This was nearly 30 years ago, likely before home testing. Even so, I still felt that the warfarin was better than facing the surgery again.
which is exactly my usual point. I'm expect that your partners view is different now to what it was then...
I feel that the worst side effect of warfarin is that it will make it more likely that you don't need re-operation and will get old and die of old age just like everyone else.
It is true that there are a number of reasons for re-operation that even a theoretical perfect valve made of something that didn't need warfarin and never wore out would not prevent.
- further complications of the heart (say the need for bypass or an aneurysm)
- complications from the surgery
- pannus growth
- ...
so a mechanical valve isn't a ticket to "freedom", but it is far far less likely that the mechanical valve will need to be replaced due to structural failure than a tissue valve (which may be 20 years or so).
I'm still not decided, but after a few days playing with the idea of tissue, I'm moving back toward mechanical. I'll meet with the surgeon in a few weeks, we'll see what he has to say.
Only you can make the decision, however I can only attest to the following personal experiences and how I view them:
- avoid re-operation if you can (check
my post here for my reasons)
- self testing (as you mention) is both available and is much more likely to keep you within your therapeutic range. I have a Coagucheck XS and having it enables me the freedom to travel as I wish, while keeping a check on my INR so as to not go out of range (either direction)
- selft testing and monitoring enables you to be "empowered" and take an active hand in your health. This has flow on effects into other areas. You may become more aware of things related to your health and cease taking it for granted (ok in your youth, dangerous in your later years) and manage it yourself.
I wish you wisdom in making your choice and peace in living with it after that point.
