Adam's Heart Valve Surgery Blog – Page 57

As the new year begins, I wanted you to know that I recently began shipping advanced copies of the new 2010 edition of my book, The Patient’s Guide To Heart Valve Surgery.

Some highlights of the fully-revised 2010 edition include:

• Over 40 pages of new information specific to heart valve replacement and heart valve repair surgery.
• References to over 135 patient experiences with heart valve surgery (including more than 10 new patient success stories).
• A new Top 30 Most Recommended Surgeons listing.
• 20 more medical diagrams and patient pictures are included to help you better understand heart valve surgery from the patient perspective.
• Special eBook interactive hyperlinks to all Internet references within the text.

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I just received an interesting email from Sandy which addresses a key point and warning for patients – especially women. That said, I thought you might like to learn more about Sandy’s heart valve surgery experience. Here is what she wrote to me:

Dear Adam,

I am a 52-year old female. I had a mitral valve prolapse / heart murmur for 10+ years. So you know, I was never told I might need surgery someday. However, after my annual echocardiogram, the cardiologist informed me that I had severe regurgitation and an enlarged heart. At the time, my only symptom was fatigue.

Crooked Open Heart Surgery Scar

Well… I am extremely thankful and truly overflowing with gratitude that my doctors diagnosed my condition. My valve was repaired without any complications and I feel like I have a new heart!

However…

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Carole just sent me an email that touches on a common, patient emotion prior to surgery… fear.

In her note she writes, “Adam – Next week I am scheduled for surgery due to severe mitral regurgitation resulting from a prolapsed valve. I’ve known about this for over 15 years but I can’t believe the time is finally here. Thank you for your book and your blog. However, even with all the helpful information, I’m still scared. As the surgery approaches, I’m not sleeping well – which makes the situation even worse. I have to ask… Do you have any final pieces of advice to calm my fears? Thanks for all you do, Carole”

Like many of you, I can relate to Carole’s concerns as she prepares for surgery. Although statistics suggest most patients live longer, healthier lives after heart valve surgery, that does not stop fear from rattling our consciousness.

So… In response to Carole’s question, I do have two, final bits of advice specific to fear management that might help.

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In the past, we’ve discussed how patients, like Sylvia Woolworth, got physically and mentally fit prior to heart valve surgery. Specific to this topic, I recently opened an email from Dr. Michael Baity, a retired dentist from Michigan. Dr. Baity just had aortic valve replacement surgery at the Cleveland Clinic. Here is what he wrote to me:

Hi Adam – I live about 450 miles north of Cleveland, way up by the Mackinaw Bridge (Michigan).  I am retired but was a dental specialist (Periodontics). I also taught graduate Periodontics at the University of Michigan, part time, for fifteen years, so I have had a lot of academic medicine as well as clinical practice.

Dr. Michael Baity – Heart Valve Surgery Patient

Specific to heart surgery, distance from my home was not a consideration… experience and safety were.

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Emotions can be undeniably strong and turbulent as patients, their families and friends experience heart valve surgery.

On one hand, I experienced a profound sense of appreciation and thankfulness during my recovery. Like many of you, I found myself swirling in waves of emotions that often triggered tears. In fact, the running joke with Robyn (my wife) is that my human donor valve was definitely taken from a female because I became much more “emotionally available” after surgery.

On the other hand, I also encountered emotions (e.g. fear, uncertainty, doubt) that were, at times, daunting. Recently, I spoke with a former patient who told me, “I was downright angry at times… I was only 45 years old and dealing with heart surgery!”

Incidentally, that patient was Dr. Randolph Chitwood, a leading heart valve surgeon who practices at the East Carolina Heart Institute in Greenville, North Carolina. Doctor Chitwood, who is a specialist in minimally-invasive robotic valve surgery, required cardiac surgery several years ago. Later in our discussion, Dr. Chitwood said to me, “I can relate to what patients are going through – mentally and physically.”

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Patients and caregivers often ask me about the immediate, post-op experience in the intensive care unit. Common questions include:

• How long were you in the intensive care unit?
• Did you experience pain immediately?
• Was your family allowed in the ICU area?
• How many tubes were sticking out of you when you woke up?

However, one of more common questions I get is, “How did you feel as you came out of general anesthesia?” Honestly, I don’t remember much – just bits and pieces of the first few hours after surgery. But, lucky for me, my family has clued me in on the strange experience of waking up after heart surgery with a ventilator tube, Foley catheter and several other tubes still inserted in my body.

On this topic, I just read that the video below was one of YouTube’s Top 10 Videos of 2009. The video titled “David After Dentist” has been watched over 37 million times this year. It’s not an exact match to the experience of waking up after heart surgery but I think you might find some silly and honest humor as little David talks candidly with his father after dental surgery.

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Please remember, each patient case is unique. Just because David was a tad loopy after his surgery, that does not mean you will have the same experience.

Keep on tickin!
Adam

Not only is today the Winter Solstice, the shortest day of the year…

But, it’s also the anniversary of my aortic and pulmonary heart valve replacement surgery!

I have to admit… It is somewhat unbelievable to think that at this exact moment, four years ago, I was in the operating room at USC Medical Center. And, it is unbelievable to think how much good has entered my life since Dr. Starnes “fixed” my heart.

Adam with Dr. Vaughn Starnes (His Heart Surgeon)

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In addition to Robin Williams, Barbara Bush, Elizabeth Taylor, Ed Koch and many other public figures who had heart valve surgery in 2009…

Fitness pioneer Jack LaLanne is now recovering from heart valve surgery at his home in Morro Bay, California. LaLanne’s publicist, Ariel Hankin, said earlier this week that the 95-year-old underwent the procedure at a Los Angeles hospital on December 8th.

Jack LaLanne – Heart Valve Surgery Patient

Hankin says that before surgery LaLanne told his family that “dying would wreck his image”. The weightlifting guru is doing fine and expected to make a full recovery.

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I’m very, very, very excited to announce that the new Heart Valve Surgeon Database (Version 2.0) is going public today. You will quickly note there are several advanced features of the database including:

• A completely revised look (shown below). I found a web design team that made the database incredibly easy for patients and caregivers to use.

• Over 470 surgeon profiles!!! Thanks to your contributions, the database now has surgeon reviews from patients in 25+ countries around the world.
• New surgical procedure descriptions. On the “Search Surgeons” page, we created pop-up windows which describe the different types of heart valve surgery.
• A new, easy-to-remember domain name. You can now access the database directly at www.HeartValveSurgeons.com. And, if you look above, you will notice a permanent link to “Heart Valve Surgeon Database” is at the top of every page in this blog.
• Special Featured Surgeon page. Each month, we are going to feature one surgeon that you nominate.
• Interactive Listings for heart valve surgeons. Now, sponsor surgeons have interactive buttons which read “Learn More” and “Contact Surgeon”. The Learn More buttons hyperlink to dedicated, surgeon profile pages which provide patients with biographical information, educational videos and more. Also, patients and caregivers can now contact surgeons directly through special Contact Surgeon buttons.
  

Thanks again to all the former patients that contributed your surgeon profiles to the database! And, a special thanks to all the heart valve surgeons (Dr. Gillinov, Dr. Starnes, Dr. Paul Stelzer, Dr. Gaudiani, Dr. Chitwood, Dr. Stewart, Dr. Massimiano, Dr. Khan, Dr. Adams, etc.) for your ideas and support of this project!

Because of our combined efforts, I believe the Heart Valve Surgeon Database will continue to grow and help patients all over the world.

Keep on tickin!
Adam

I just received an interesting question from Regina about heart valve repair surgery. Her question focuses on the use of annuloplasty rings to treat leaky heart valves.

Regina writes, “Hi Adam – Although I’m 58, I was recently diagnosed with mitral valve regurgitation. My cardiologist thinks I may need surgery in the next year. The disease is categorized as moderate-to-severe. The cardiologist mentioned the potential use of an annuloplasty ring but did not explain why I might need one. Can you help me better understand the role of an annuloplasty ring? Thanks, Regina”

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I’m currently traveling through Europe for work. Right now, I’m on a train going from Eindhoven to Amsterdam in The Netherlands. Yes, it’s cold. But, not as cold as Helsinki, Finland where it was freeeeeezing.

Luckily, I have a few moments to read personal emails. One of those emails was from Mark Linnus, a 46 year-old patient from New York who was diagnosed with mitral valve prolapse and severe regurgitation. Over the past year, I have corresponded with Mark about his upcoming valve surgery. In particular, much of our exchange focused on surgeon selection.

Well… Mark has good news to report. Here is what he wrote to me:
 

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From Robyn, myself and, our little one, Ethan… Happy Holidays Everybody!!!

May you have an incredibly healthy and happy holiday season!!!

Keep on tickin!
Adam

Some may call David’s story ironic. I call it fantastic. That said, I thought you might find this unique story of interest. Here is what David wrote to me:

Hi Adam,

I just had my calcified aortic bicuspid valve replaced with an Edwards Lifesciences pericardial (bovine) valve on October 28, 2009. I also had a single mammary bypass for a calcified lesion in my LAD coronary artery. I am 69 years old. I think I have a little different perspective on all this as I worked for and retired from Edwards Lifesciences, the world’s largest heart valve replacement manufacturer, after 33 years employment.

David Swendson With Dr. Bethencourt – Discharge Day!

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Kelly just sent me this very interesting story which touches on several critical factors specific to heart valve surgery from the patient perspective. That said, I thought you might want to learn about Kelly and her surgeon, Dr. Kevin Miller. Here is what she wrote to me:

Kelly Gaul – Heart Valve Replacement Patient

Hi Adam,

It’s been about 7 or 8 months since I first found your web site, ordered your book and touched base with you.  I am a 56-year old woman who leads a very active lifestyle – hiking, backpacking, and cross-country skiing.  I knew I had a heart murmur since I was 25 years old, but didn’t realize it was a bicuspid valve accompanied by aortic stenosis until about 7 years ago (mild-moderate at the time).

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I just received a great question from Heidi about heart valve disease, surgery and seniors.

She writes, “Adam – My mom, Betty, has recently been diagnosed with severe aortic stenosis. Although her murmur was detected years ago, I never thought she would need open heart surgery. She’s 68 but acts like she’s 38. No symptoms at all. I’m curious… How common is valve disease and surgery among seniors? Thanks, Heidi”

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Here is some great patient advice from David about (i) treating heart valve disorders in a timely fashion and (ii) being your own, best patient advocate. David wrote to me:

Hi Adam,

I’m a 55-year old man living in Maine. I just underwent aortic valve and ascending aorta replacement surgery on November 10, 2009.

David Belisle – Heart Valve Replacement Patient

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I don’t know about you, but I am a very visual person. For some reason, diagrams, pictures, illustrations always help me better understand concepts. As a result, I could really relate to Wendy’s question about heart valve replacement diagrams.

Wendy writes, “Hi Adam – I’m 59 and preparing for mitral valve replacement. Everybody keeps talking to me about what is going to happen but I still don’t understand it completely. Do you have a picture that could help me understand where the valve will go in my heart? Thank you, Wendy”

No problem Wendy! To support you and others, I just came across this great diagram which illustrates where the heart valve replacement device will be positioned in your heart.

As you can see above, this diagram shows two valvular disorders – aortic valve regurgitation and mitral valve regurgitation. The picture also shows the two types of valve replacement devices that can be used within your heart (mechanical valves and biological valves).

I hope this helps!

Keep on tickin!
Adam

It has been a very tough morning for me. Without a doubt, these are the hardest blogs to write.

I recently learned that Valerie Fisher Raley Moriarty passed away over the weekend due to complications following her heart valve surgery.

Valerie Fisher Raley Moriarty (1980-2009)

According to her husband, Valerie experienced multiple organ failure and a heart attack following double heart valve replacement surgery. Having traded emails with Valerie leading up to her surgery, I am deeply saddened by her passing.

Memorial services will be at Bridges Funeral Home on Rutledge Pike, Wednesday, November 18 at 6pm in Knoxville, Tennessee. Her burial will be Thursday, November 19 at 11am at Caledonia Cemetery on Ruggles Ferry Parkway.

My thoughts and prayers are with Valerie, her husband Bill, her family and friends.
Adam

Alice just sent me a great question about incision and scar care after heart valve surgery.

She writes, “Adam, I am 55 and had open heart surgery to replace my valve about three weeks ago. Most of my scar looks OK, flat and thin.  My concern is the top of the scar — around and above the top of the incision is a big protruding lump.  It is soft, not hard, and is not sore. Did this happen to you? Thanks, Alice”

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It is perhaps one of the most common and appropriate questions I receive from patients and their caregivers. That question is, “What is my life expectancy after heart valve surgery?”

As we all know, every patient case is unique. But, the research suggests that life expectancy after heart valve surgery continues to improve thanks to incredible advancements in medical technology and surgical know-how.

To this point, I was just reading a very interesting story in the Sentinel-Tribune about Bobby Baker.

In case you didn’t know, Bobby Baker just received a Guinness Book World Record for being the longest, living survivor of heart valve replacement surgery.

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