What would you do?

[bbuck]

I talked to the cardiologist today. He said my condition is not going to get better. Its not an emergency at this point, but it wont get any better. I have a BAV and high blood pressure, when my BP spikes, my regurge goes from moderate to severe. My aortic root measures 4.8cm
My question is, given this info, would you have the surgery. The cardio is wanting to schedule me within the next couple months. I am getting a second opinion, but wanted to ask the folks here what they thought.

Thanks for your input

Bill

 

[yotphix]

What would I do? Exactly what I did, in the very same sort of circumstance. I scheduled the surgery for three months down the road. That was the amount of time I needed to sort things out comfortably for myself. My surgeon had said that in my shoes he wouldn't wait 6 months. I have absolutely no regrets, and by my complete recovery from Ventricular Hypertrophy I know that I did the right thing.
Get your second opinion (I did that too) and then make your decision. Please don't fear the one thing that can improve, your life, your health and your prognosis though. There is no other treatment for us, and this surgery is bloody inconvenient, but by far not the hardest thing I ever did.

Good luck

Paul

 

[kfay]

I would get my second opinion and then schedule my surgery with which ever dr. I felt more comfortable with. This isn't going to get better on it's own and you are better off taking care of it before any permanent damage is done to your heart. Also, you don't want it to turn into an emergent situation where you have no say in who does the surgery or what they do while they are in there!

Kim

 

[nngbwh]

You are doing the right thing by getting a second opinion. If you find two doctors saying the same thing then you know you are on the right track. Good luck and keep us posted.

 

[Boston Tiger]

I agree with everyone else in the thread. You have time to do some research and find a surgeon and hospital you are totally comfortable with, because that really helps calm you down as you head toward your operation day. When I visited the surgeon at the hospital my GP is associated with I was grudgingly accepting that I needed the operation, but the surgeon who gave me the second opinion had me fully at ease.

 

[Jkm7]

Many of us here on VR have found the worse our valve got the faster it got worse.
I did as the others have commented they did...... I scheduled my surgery before there was more permanent damage done to my heart.

The stronger and healthier you feel going into surgery, often (though not always) the smoother and easier recovery.

 

[Mom2izzy]

Ditto to what everyone else is saying...It was a tough decision for me too, but now I just can't wait to be on the other side...I'm scheduled for 2/28.

 

[bbuck]

Good luck Mom,, and thank you to everyone who has replied and who will reply. My wife and I are pretty much on the same page as all of you, our second opinion is at Northwest Memorial in Chicago. We already feel more comfortable with them than the VA. But we'll see what they have to say. Thanks again

Ditto to what everyone else is saying...It was a tough decision for me too, but now I just can't wait to be on the other side...I'm scheduled for 2/28.

 

[Mom2izzy]

Good luck Mom,, and thank you to everyone who has replied and who will reply. My wife and I are pretty much on the same page as all of you, our second opinion is at Northwest Memorial in Chicago. We already feel more comfortable with them than the VA. But we'll see what they have to say. Thanks again

Thanks...do you mind me asking where you got your first opinion? I see you are from Michigan. I'm having mine done at the University of Michigan, but my surgeon told me that if I wanted another opinion he would recommend a surgeon at Northwestern in Chicago...don't know if that's the same place though. I loved my surgeon (and he was technically already my second opinion because a surgeon at a local hospital referred me to him), so I never went to Chicago.

 

[normofthenorth]

You didn't mention (a) what kind of symptoms you're getting from that severe regurg, or (b) whether you've had the high BP for a long time, if it's being treated, or if it's responding to treatment, either with drugs or lifestyle and diet. There is a good case for going "sooner", and it's been presented above. Nobody should overdo the "later" approach, but I delayed for a while myself, and I think my decision was pretty close to the best for me. The main advantages of waiting are (a) you have a better chance to work the surgery and recovery into your schedule, (b) you have more time to get other affairs in order, and (c) waiting for more severe symptoms makes your rehab psychologically easier. E.g., when your friends ask you (or you ask yourself), "So, do you feel better yet than you did before the operation?" you'll be able to answer "Yes!" much sooner. (It may seem trivial or backwards, but it's real, at least for many of us.)

 

[bradvo]

My surgeon told me before my operation that heart valve failure is a main cause of sudden death. I think we have all read of people or have heard at one time or another about persons who have dropped over.

That was my answer when I said what if i did nothing.

I did not know months in advance about my condition, only that I was feeling horribly weak. Once the problem was discovered and I had surgery my doc told me I was in the top 5 worse valves he had ever saw. He stated if I had not under gone this procedure I was a candidate for sudden death and did not think would have made spring time.

He made it sound like he needed a jack hammer to get thru the calcification to replace valve , maybe that is why they don't like to wait to long ??
At any rate it is over and looking back , not all bad and I'm feeling so much better today.

Brad

 

[Lynlw]

You didn't mention (a) what kind of symptoms you're getting from that severe regurg, or (b) whether you've had the high BP for a long time, if it's being treated, or if it's responding to treatment, either with drugs or lifestyle and diet. There is a good case for going "sooner", and it's been presented above. Nobody should overdo the "later" approach, but I delayed for a while myself, and I think my decision was pretty close to the best for me. The main advantages of waiting are (a) you have a better chance to work the surgery and recovery into your schedule, (b) you have more time to get other affairs in order, and (c) waiting for more severe symptoms makes your rehab psychologically easier. E.g., when your friends ask you (or you ask yourself), "So, do you feel better yet than you did before the operation?" you'll be able to answer "Yes!" much sooner. (It may seem trivial or backwards, but it's real, at least for many of us.)

I agree it is certainly worthwhile getting a 2nd opinion, and that it would be more helpful to know more details, you menton BAV and Moderate regurge, and an aortic ROOT of 4.8.
Since it is the root which is normally bigger than the rest of the Aorta, that isnt as close to needing surgery like it would be if it was the ascending or someother section. How is your valve? beside being bicuspid, is there stenosis? IF a surgeon reccomended waiting, I'd want to know what they were watching for (valve, Aorta?) , and what results/numbers would they reccomend surgery. I think it is a great idea to go to Northweestern, I would probably go by what they reccoemdn as to when you should have surgery as well as what needs replaced/repaired.

 

[bbuck]

Thanks...do you mind me asking where you got your first opinion? I see you are from Michigan. I'm having mine done at the University of Michigan, but my surgeon told me that if I wanted another opinion he would recommend a surgeon at Northwestern in Chicago...don't know if that's the same place though. I loved my surgeon (and he was technically already my second opinion because a surgeon at a local hospital referred me to him), so I never went to Chicago.

My first opinion was given to me by the VA hospital in Milwaukee. I've always had pretty good service there, but for something like this I want to have the second opinion.
And, when we opt for surgery, it will most likely be at Northwestern.

 

[bbuck]

You didn't mention (a) what kind of symptoms you're getting from that severe regurg, or (b) whether you've had the high BP for a long time, if it's being treated, or if it's responding to treatment, either with drugs or lifestyle and diet. There is a good case for going "sooner", and it's been presented above. Nobody should overdo the "later" approach, but I delayed for a while myself, and I think my decision was pretty close to the best for me. The main advantages of waiting are (a) you have a better chance to work the surgery and recovery into your schedule, (b) you have more time to get other affairs in order, and (c) waiting for more severe symptoms makes your rehab psychologically easier. E.g., when your friends ask you (or you ask yourself), "So, do you feel better yet than you did before the operation?" you'll be able to answer "Yes!" much sooner. (It may seem trivial or backwards, but it's real, at least for many of us.)

Norm, I get drastically short of breath under exertion, I've had the High BP for a while and yes it is "stable" with meds and diet and exercise, I have a high stress job at times with alot of physical activity, and so in these situations its nearly impossible for me to control it. I did just get my report from the cardiologist and what it said was under normal conditions I have moderate regurge, but when they intentionally stressed my heart to increase the blood pressure, it went from moderate to sever and sometimes torrential, not sure what torrential means,, but it dont sound good..

 

[bbuck]

I agree it is certainly worthwhile getting a 2nd opinion, and that it would be more helpful to know more details, you menton BAV and Moderate regurge, and an aortic ROOT of 4.8.
Since it is the root which is normally bigger than the rest of the Aorta, that isnt as close to needing surgery like it would be if it was the ascending or someother section. How is your valve? beside being bicuspid, is there stenosis? IF a surgeon reccomended waiting, I'd want to know what they were watching for (valve, Aorta?) , and what results/numbers would they reccomend surgery. I think it is a great idea to go to Northweestern, I would probably go by what they reccoemdn as to when you should have surgery as well as what needs replaced/repaired.

I did give a bit more info a couple posts ago, but I still have one thing to correct, I thought it was my Aortic root that was at 4.8, but it is at 4.2 it is actually my ascending Aorta that is at 4.8. Also, there is mild stenosis. And after talking with the cardiologist yesterday, he told me there is no advantage to waiting. He said in order to control my HBP to the point of not having problems with my valve when I am under activity, I would be lethargic when not under activity.
We are waiting to hear from Northwestern today to schedule for the consult, and then the surgery. I dont intend on trying to wait.

 

[Bean Counter]

I did not read though all the comments, but am in the camp of getting a 2nd opinion and getting it done sooner vs. later. I was agressive with the cardiologist pushing to get it done early and he would not budge. Within 4 months it got to the point where we needed it done. I jokingly referred to my recovery as my summer vacation as I was off of work for 6 weeks from later June to early August.

 

[bbuck]

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

I did not read though all the comments, but am in the camp of getting a 2nd opinion and getting it done sooner vs. later. I was agressive with the cardiologist pushing to get it done early and he would not budge. Within 4 months it got to the point where we needed it done. I jokingly referred to my recovery as my summer vacation as I was off of work for 6 weeks from later June to early August.

 

[AgilityDog]

"Torrential" sounds like the regurge I had on my mitral valve. My internist had poo-pooed my concerns about my symptoms, but I was in class IV CHF. Class V is probate, btw. (insider joke here).
My cardio told me he looked at my TEE after my surgery, and my valve was "flapping in the breeze." Yeah, without the September surgery I'd have been dead by Christmas. No joke.
Best wishes on a quick surgery and rapid recovery!

 

[AgilityDog]

Buck, the healthier you are, the quicker your recovery. 12 weeks is what it takes for the sternum to heal, mas o menas.
Sedentary job, I went back to work part time after 8 weeks the 2nd round. 12 weeks the first round 'cause I was one sick puppy.
Manual labor type job - you'll be on restricted duty until at least 12 weeks, maybe 16, maybe more. It depends on your recovery and your job.

 

[bbuck]

Buck, the healthier you are, the quicker your recovery. 12 weeks is what it takes for the sternum to heal, mas o menas.
Sedentary job, I went back to work part time after 8 weeks the 2nd round. 12 weeks the first round 'cause I was one sick puppy.
Manual labor type job - you'll be on restricted duty until at least 12 weeks, maybe 16, maybe more. It depends on your recovery and your job.

Dog,
My job consists of lifting 60 to 80 pounds over my head repeatedly, cumulatively I lift up to, and many times, over 4000 lbs each day. I also do a lot of pulling that I am not sure of what the weight of the torsion of doing that would be, but its very physical work.
I know I cant do any of this until the sternum is at least healed, but wonder how long it will take to get back to full duty