Thanks again everyone. Tom, I may take you up on your offer to talk! I am also a regular at the gym, I do cardio five times a week minimum and hope to be back there doing light cardio within 8 weeks. Anyone have any particular exercise they wish they did prior to surgery? I've been working legs since I won't be using my arms too much the first few weeks.
Valve Selection
- Thread starter Kristen
- Start date
Help Support Valve Replacement Forums:
Kristen, just le tme know....I am back in Syracuse now, but return to Waltham quite often. As a runner, I kept running as long as I could....stopped when I could not complete one mile; that is what triggered my surgery. Took a couple of months to get all the appoitments, etc. before I actually had the surgery, so I did not do too much except walk a lot those last 6-8 weeks. Keep exercizing.....the better shape you are going into surgery, the better recovery you should have.
chaconne
Well-known member
Coumadin:
You may not like taking meds but you could get used to it. One year pre-AVR, I started taking Losartan for BP just as a precaution. I used this period to train myself to get used to taking a pill every day so that when I started Coumadin/Warfarin, it was easy. I don't notice much effects other than MAYBE I bruise a little easier, and MAYBE I bleed a little longer. I am an active mountain biker, runner, hiker and Do construction projects on my home.
Valve Ticking:
I can only really hear it in a room that is dead silent or one that has a lot of hard reflective surfaces like glass or tile. It's actually nice to have something to hear/feel to monitor my HR.
You may not like taking meds but you could get used to it. One year pre-AVR, I started taking Losartan for BP just as a precaution. I used this period to train myself to get used to taking a pill every day so that when I started Coumadin/Warfarin, it was easy. I don't notice much effects other than MAYBE I bruise a little easier, and MAYBE I bleed a little longer. I am an active mountain biker, runner, hiker and Do construction projects on my home.
Valve Ticking:
I can only really hear it in a room that is dead silent or one that has a lot of hard reflective surfaces like glass or tile. It's actually nice to have something to hear/feel to monitor my HR.
I read a fairly recent article, and my surgeon attended a seminar this year that stated the rate for warfarin use by tissue valve recepients was ~30%. Not all people who take warfarin take it because of their valves. My MIL was on warfarin before her tissue valve replacement, and she needed it, since she had a small stroke right after surgery, due to the INR drop for surgery. She hasn't had a stroke since she got her INR back up.
I can rarely hear my valve tick. Someone else has heard it only once, they were young, and it was in a small room in a museum. I don't hear it at night in bed, but sometimes in the morning depending upon my position in bed. If I want to hear it, and I am wearing a single thin shirt, I can tilt my head and listen hard and hear it tick. I don't here it during exercises, even when the pulse rate goes up.
When I hear it, I feel it is a reminder to me to sieze the day and be thankful
I can rarely hear my valve tick. Someone else has heard it only once, they were young, and it was in a small room in a museum. I don't hear it at night in bed, but sometimes in the morning depending upon my position in bed. If I want to hear it, and I am wearing a single thin shirt, I can tilt my head and listen hard and hear it tick. I don't here it during exercises, even when the pulse rate goes up.
When I hear it, I feel it is a reminder to me to sieze the day and be thankful
Good to hear but I think I read somewhere that the older you are the shorter life you are likely to get from a tissue valve. It looks like I will be getting the tissue valve because I also have Crohns Disease of the small intestine and am prone to internal bleeding so coumadin is probably a no-no. I will be seeing my Gastroenterologist next week to confirm this aspect of my choice.
I'm going to now concentrate my research on finding the best performing tissue valve (bovine of couse).
Thanks for you comments.
Tom
no the older you are the longer tissue should last , again theres no written guanantee on any valve you have mech or tissue,
Tom, I think you've read the research wrong. The older you are, the longer a tissue valves is apt to last. That's why so many mid-60's valve replacement candidates go tissue.
A heart felt WELCOME to our OHS family glad you found the site , there is a wealth of knowledge here for the future ... and I have listed some links for your research and prep ....WAITING IS THE WORST PART..and as many have said the choice you have to make is very personal and depends on your lifestyle and plans
Bob/tobagotwo has up dated a list of acronyms and short forms http://www.valvereplacement.org/foru...4&d=1276042314
what to ask pre surgery http://www.valvereplacement.org/foru...t-of-questions
what to take with you to the hospital http://www.valvereplacement.org/foru...al-a-checklist
Preparing the house for post surgical patients http://www.valvereplacement.org/foru...House&p=218802
These are from various forum stickies as mentioned above and there is plenty more to read as well
And Lynw recently added this PDF on what to expect post op
http://www.sts.org/documents/pdf/whattoexpect.pdf
Jkm7
Well-known member
Tom,
You have misunderstood and it is true that those persons 60 years and older get more years from their tissue valves than those in the 30-50 years range. With the new generation of tissue valves, most surgeons start talking tissue with patients who are 50-55 and over. Young women who want children are a big exception and there are others who are exceptions for various reasons.
TheGymGuy
Well-known member
RE: EXERCISES before surgery.
Wanted to suggest that you do sofa and couch squats and bathroom squats and try to get off the floor without using your hands. Try 3-5 sets of 5 each for all these exercises as often as you can. Also, your abs will be less functional after surgery while the sternum is initially healing. Lastly, do not hold your breath or rock too much when squatting off of all these different surfaces. All this practice and you will be able to get up help free from pretty much anywhere as well as sit down help free. One other advice is that if your couch is soft and you have an option you can put wood boards under the couch cushions and this way make couch a lot harder but also easier to get off of.
Wanted to suggest that you do sofa and couch squats and bathroom squats and try to get off the floor without using your hands. Try 3-5 sets of 5 each for all these exercises as often as you can. Also, your abs will be less functional after surgery while the sternum is initially healing. Lastly, do not hold your breath or rock too much when squatting off of all these different surfaces. All this practice and you will be able to get up help free from pretty much anywhere as well as sit down help free. One other advice is that if your couch is soft and you have an option you can put wood boards under the couch cushions and this way make couch a lot harder but also easier to get off of.
I believe its actually the opposite. The younger you are, the shorter the life expectancy from a tissue valve. The older you are, the longer the valve will last.
Matt C
Well-known member
Correct at your age I read your post I would go Mechanical I did also was leaning tissue until a second surgeon spoke to me prior to surgery. He outlined better then everyone and was what changed my mind. Do you honestly want to go trhough this that many times? At your age you don't know how long tissue will last I have read some a few years it may last 8 to 12 if your that lucky person maybe longer but odds are against you or I with age we want to be active. He told me more but basically you yourself have to let it sink in and think about it is a major surgery.
I am 53 and had surgey in Feb. My surgeon and cardiologist wouldn't be specific about how long a tissue valve would last. The way it was presented, was given my average life expectancy of mid-70s, if I choose tissue at 53 yo, to expect at least one repair. My surgeon said he routinely replaces valves in older patients up into their 90s.
Jkm7
Well-known member
No surgeon or cardiologist can be specific about how long this generation of tissue valves will last as there isn't anyone yet who has had one into 20 years. These valves have not existed that long. They are basing their estimates on the last generation of tissue valves and the 'perceived improvements' made in the newer ones.
Also as far as someone in their late 50s or above needing another replacement if/when the tissue valve they get now needs replaced in 10-20 or so years, chances are pretty high they would be would be able to have it replaced in the cath lab (percutaneous valves) and not need OHS. there are quite a few threads here about percutaneous valves like the Sapien that is already approved for higher risk patients.
That is one of the reasons why many of the leading centers and surgeons are reccomending tissue valves to younger patients, some (like CCF) even reccomending them for patients in their 40s and up, beside the chances of possibly avoiding a 2nd OHS with percutaneous valves, other reasons are because the newer tissue valves (2nd and 3rd generation) with the anticalcification treatment valves are usually lasting longer and even the most commonly used valves like the CE perimount bovine DO have proven track records since they have been used since the early 80s, and the fact the succes rates even now are very good for 2nd surgeries IF you do end up needing one
About the percentage of people who have tissue valves ending up on long term Coumadin anyway, as othrs said the% of people is much lower thn 50%, my guess was that is a "fact' from a mech valve manufacturers site. But many of those people are on it for Afib, already there are other anticoagulant approved for AFib patients and others in trials, it will probably be quite a while before the newer ones would be approved for mech valve patients. YES they are still anticoagulants so have increased risks of bleeding, but they dont need the constant testing and since they aren't vit K antagonist, they arent affected by food or as many drugs as coumadin and they dont effect the other important jobs vit K is needed for. So my GUESS would be the % of tissue valve patients needing to be on Coumadin anyways will drop quite a bit in the nxt decade or so.
We used to have a couple polls going here asking how many tissue valve patients are on Coumadin anyway, and while it certainly wasnt a scientiic survey only a small percentage were on it or other anticoagulants
My surgeon highly recommended tissue valves for me (at 57 Years young). He assured me that by the time I needed replacement or repair, he would do it percutaneously! As I could not find any research about this at that time, being so disturbed at that time with the surgery news and the fears, etc. etc. and not sure what my health or the health of those around me will be when I needed to be admitted to the hospital next time, I chose mechanical. But, if I were younger and stronger "mentally and emotionally" at that time, I might have gone tissue. I am not saying this to encourage you or discourage you towards any valve type. Jus my 2-cents thoughts, in case they might shed additional useful information. One of the surgeons I interviewed before my surgery thought I was too young to be on Coumadin. I did not ask for explanation then although many young people are on Coumadin. I neither asked if she was not comfortable with mechanical valves, as this could make a difference why that comment was made!
Again, good luck
Gail in Ca
Well-known member
I am a thinner person, and yes, the valve is very loud when you lay down to sleep! I've had this carbomedics top hat valve inside a graft for 3 yrs now, and I'm still bothered by the loudness of it at night. Otherwise, I really don't hear it at all. Even when I play clarinet duets in concert it doesn't bother me. My cardio always jokes that he doesn't have to use his stethescope with me, as he can just hear it clicking away. I really couldn't do a tissue valve for my 3rd surgery. Just be ready to hear a mechanical valve. Some of us hear it more than others. And, remember, you can't hear it in the hospital after your surgery. You may think, wow, I can't even hear it! But, when you get home and all is quiet, it's really clicking away!
My surgeon specifically warned me not to count on percutaneous valve replacement. It is still quite awhile before it will be approved for "normal" or "low" risk patients. In addition, he indicated the valve is of smaller diameter than one replaced the "normal" way. This does not make a difference for the current "high risk" patients undergoing the trial, but could for someone else.
Funny how much it varies depending on which surgeon you talk to. Duke University Medical Center is one of the major hospitals where clinical trials have been ongoing. Duke is where I had both of my surgeries and my surgeon is actively involved in the clinical trials. He said while there were no guarantees, he thought that if I got the "average" life expectancy out of my Edwards bovine valve (given my age of 50 at surgery) he felt that percutaneous valves would be a realistic alternative by the time I needed it replaced. Since he has actually performed this procedure and has been a part of the clinical trials I felt he had a good feeling for the timeline on the progress of this technology.
Having said that, this wasn't the only reason I chose a tissue valve, just one of several considerations. One of those reasons is that I have a homograft pulmonary valve which will most likely be over 20 years old by the time my aortic tissue valve needs to be replaced. There is a good chance that it will need to be replaced in my lifetime as well. If one or the other goes and the percutaneous technology is not still available, I would have both valves replaced at the same time.
Having said that, this wasn't the only reason I chose a tissue valve, just one of several considerations. One of those reasons is that I have a homograft pulmonary valve which will most likely be over 20 years old by the time my aortic tissue valve needs to be replaced. There is a good chance that it will need to be replaced in my lifetime as well. If one or the other goes and the percutaneous technology is not still available, I would have both valves replaced at the same time.
babshappy
Well-known member
i chose a mechanical valve for the simple reason I did not want to have another surgery 10 years or so down the road..I had my surgery 3 years ago and have been on warfarin since , I get my blood checked once a month , eat a consistent diet , take a pill everyday, every once in a while my INR numbers go a little above or below the recommended setting and they just adjust the dose... I hear my valve ticking at night just as im falling asleep and it is comforting..then snore snore until morning..you really dont hear it as much as you might think Its a hard decision good luck
