What would you do?

[tom in MO]

I got my first opinion from the cadio and the second from the surgeon. My problem is BAV with stenosis. The Cardio said it doesn't need to be done in 2 weeks, but it should be done soon, no later than 6 months. He talked a lot about the syndrome "sudden death". He pauses for dramatic effect before saying it .

The surgeon said not more than 6 months, but then he drew a power curve, flat straight line that then quickly falls off a cliff. He said that nobody knows where I am on that curve, but I'm somewhere on the edge of going over. You may have 6 months, or 6 days, but it's always best to plan the surgery rather than having it on emergency basis in whaterver town you are in. And there is always "sudden death." The surgeon recommended that I take care of whatever business I needed (e.g. colonoscopy to see if my rhoids would be affected by coumadin, get both cars fixed, Xmas and daughter's birthday) but don't wait.

I went to back to the cardio, and he agreed with the surgeon. Take care of business, but don't wait more than a few months. I was diagnosed in Dec and will be cut late Feb.


My surgeon said that for a sedentary job, 6 weeks back to work if all goes well. For an active heavy lifting job, 6 months. You need your chest fully healed to lift significant weight.

 

[Mom2izzy]

You were only off 6 weeks? I have been told a minimum of 12 and thats if you have a sedentary job,, I dont. So could be up to 6 months? I hope it dont take that long, I'll go nuts

My surgeon told me, he would have me back to work in 4 weeks! I do have a "sedentary" job, but that still seems quick. I wonder if there is a difference between AVR and MVR or if OHS is OHS and would have similar recoveries??

 

[bbuck]

My surgeon told me, he would have me back to work in 4 weeks! I do have a "sedentary" job, but that still seems quick. I wonder if there is a difference between AVR and MVR or if OHS is OHS and would have similar recoveries??

Are you having a mini sternotomy? I believe the recovery from that is shorter. If they do a full sternotomy I think the recovery time should be the same? At least for the sternum to recover anyhow.

 

[Mom2izzy]

The surgeon said not more than 6 months, but then he drew a power curve, flat straight line that then quickly falls off a cliff. He said that nobody knows where I am on that curve, but I'm somewhere on the edge of going over.

I got that very same speech from my surgeon. Mine was accompanied by the visual of an ink pen bouncing toward the edge of the desk, hovering there and then falling to the floor. During the fall, my surgeon asked, "Should I let you go over?"

Another part of the conversation:
DR: [said in all seriousness] When is your valve going to fail?
ME: [baffled by this question] I don't know!
DR: [triumphantly] Oh yeah....neither do I.

The major kicker for me was when he said that my life expectancy without the surgery is somewhat of an unknown but is definitely shorter than without surgery. With a successful surgery (mitral valve repair) my life expectancy is right back to normal. Also if my heart starts to fail before surgery, my life expectancy begins dropping and will not be recovered all the way back to normal even with a successful surgery.

This surgeon had me laughing through the whole appointment. The first surgeon I saw said (in a nutshell), "you need surgery soon, but I won't do it...you need to see someone who specializes in this type of procedure." then gave me a referral to my surgeon. Not very comforting at all...

 

[Mom2izzy]

Are you having a mini sternotomy? I believe the recovery from that is shorter. If they do a full sternotomy I think the recovery time should be the same? At least for the sternum to recover anyhow.

Not a full sternotomy, but not the 2 inch mini that I've seen on this site. Mine will be 4 to 6 inches. I'm pretty little, so that doesn't seem very mini to me. Also seems to me like the healing of the bone will take the same time to heal regardless of the length. In my case I also have the option of a thoracotomy (between ribs, no sternum cutting), but have heard it is WAY more painful and I'm a big sissy. My biggest problem with the healing time is that I won't be able to pick up my 3 year old until I'm recovered.

 

[Boston Tiger]

My surgeon told me, he would have me back to work in 4 weeks! I do have a "sedentary" job, but that still seems quick. I wonder if there is a difference between AVR and MVR or if OHS is OHS and would have similar recoveries??

I was back to work (at my desk job) in four weeks. Now, I have to admit that I was not pulling full days that first week back, but it was great to escape from the house!

 

[yotphix]

One of the reasons that I took three months from the time the surgeon told me we needed to do this, was that he also told me that I shouldn't go back to my physically strenuous job for six months, to give the heart a chance to remodel successfully, while doing my rehab. That's a pretty tall order for someone like me, who doesn't get paid in any way when I don't work! I am fortunate though, in that I was able to sort myself out fairly quickly. I took the six months off, and when I went back to strenuous labour, (actually, I cheated a little when I remodeled a bathroom and did laid some marble tile to pick up some extra cash and test myself at 5 months!) I really felt it. I could do it, but it was probably the best part of a year from the date of surgery before it got as easy for me as it had been. Plan to give your heart the time your doctors think it needs. Lifting heavy stuff over head is not likely in the cards for the first three or four months at least, perhaps longer. Remember that there is sometimes a difference between what is possible, and what is a good idea.

 

[2003miata]

From the time my primary care physician told me I needed to see a cardiologist to the time of my surgery was 3 months. I went to an annual physical unaware of any problems and 3 months later was having OHS (11 weeks ago today). I made the decision based on the amount of ventricular hypertrophy and the concern for "falling off the cliff" (I got the same kind of discussion from my cardiologist about the rate of heart failure). At my checkup 8 weeks post surgery, my cardiologist said he could already see a reduction in the size of my heart, so I think I made the right choice.

As for going back to work, my cardiologist left the decision up to me. I have a desk job, so lifting isn't an issue. I probably could have gone back after 4 weeks, but (with my boss's agreement) chose to wait 8 weeks to allow me to gain additional strength and stamina and continue with the cardiac rehab program three days a week. For me that was the right choice.

 

[Mom2izzy]

I was back to work (at my desk job) in four weeks. Now, I have to admit that I was not pulling full days that first week back, but it was great to escape from the house!

And again...with the similarities. I have a desk job as well.

 

[normofthenorth]

Bbuck just to be clear: I generally like to present the case for going in "later", but with your symptoms, you were already "later" a while ago. Now I'm with the "sooner" consensus in your case.

 

[SusQ]

Bbuck just to be clear: I generally like to present the case for going in "later", but with your symptoms, you were already "later" a while ago. Now I'm with the "sooner" consensus in your case.

Bbuck's wife here. I think you are right in that he's already at later as he's been having the SOB under exertion for years and they just kept treating him for asthma. :thumbd:

Thanks to everyone.

Now to just get everything in order and appointments lined up.

 

[SB42]

After all the research that I have done, my simple response (without knowing your history) is....get 'er done! :angel:

 

[RealtorRick]

You got lots of good advice here. I agree that you should find a surgeon that you are comfortable with and discuss pro's and con's of waiting. I was in the waiting room for 6 years. My cardio did ultrasounds every 6 months. I never had symptoms but in November he told me it was time. Once I knew that it had to be done, I wanted it done immediately. I had AVR on 1/11/12 and had I known how easy the process was going to be, I may have done it much earlier, if for no other reason to relieve the stress that my wife and family were put through. Post surgery you may be surprised by how much better you feel, almost immediately. Life is great!! Even though I sound like a clock.