Adam's Heart Valve Surgery Blog – Page 74

I just received an interesting question from Mia. Her email reads, “How I am going to change after open heart surgery?”

As we all know, emotions of fear can accompany the unknown. Ultimately, I think it is the unknown of heart surgery that stimulates thoughts like, “How will I be different after my operation?”, “Will my physical abilities change after heart surgery?” and “Will I experience mental changes after bypass- like pumphead?”

That said, I have to be honest with you and every other person who reads this blog. In my opinion, there is no single response that encapsulates the potential changes that patients face as they experience open heart surgery.

After my experiences with aortic valve replacement procedures, I will be the first to share with you that the recovery can be difficult – full of daily changes, weekly changes and monthly changes. However, there are many patients, that experience no relative, long-term changes after open heart surgery.
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This deserves a “Wow!”

I could ramble on about how neat this is… Instead, I’ll simply let Geoff explain. Here is Geoff’s email:

Hi Adam,

I am home from my surgery!!

The mitral valve repair was performed last Tuesday morning. I left Duke Medical Center, five days later, on Saturday morning at 9:45 am!

I am fairly weak and somewhat sore. But, overall I am doing great. I spent the first night after heart surgery in the intensive care unit (ICU). The breathing tube and TEE were removed in the first few hours after surgery. I had tubes coming out of me from many places – an IV in my neck, left arm artery, left arm near elbow and right arm.

I can’t say enough good things about the staff at Duke Medical Center. My surgeon, Doctor Donald Glower, was able to repair the valve so that there was 0% mitral regurgitation. If you are interested, I have attached the before and after pics. (To learn more about mitral regurgitation, click here.)

Thank you for your heart valve book, and all the blog members, for their stories and insight. Heart surgery truly is an emotional journey. My fiancee, Lisa, and I are very happy to be through it.

Thanks… Geoff

For all the Starbucks fans out there needing heart valve surgery, I have some difficult news to share with you.

Brace yourself… Here it is:

“Coffee is not recommended right after any form of cardiac surgery, including heart valve surgery.”

Yes, I know. That’s a tough one. I can personally relate to what you might be going through right now. I remember thinking, “WHAT? NO COFFEE!” as I was discharged from USC Medical Center after my aortic valve surgery. (Actually, it wasn’t that dramatic.)

FYI, I typically start everyday with some form of hot caffeine drink – coffee or chai tea. (Did you know 90% of adults in North America drink at least one caffeine-enhanced drink every day? And, did you know that caffeine was discovered by a German chemist in 1819?)

Anyways, after cardiac surgery it is highly advisable to let your central nervous system (and heart rate) not react to artificial stimulants, like the caffeine in coffee.

Don’t worry though… It’s not permanent. My cardiologist gave me the green-light to start drinking coffee a few weeks after my aortic valve replacement.

Keep on tickin!
Adam

One set of recurring questions I receive from patients and caregivers relate to the costs of heart valve surgery and bypass operations. The questions typically go something like, “How much does a heart surgery cost?” or “How much does open heart surgery cost in the USA versus India?” or “How much will my insurance cover – including all the hospital costs, surgeon fees and anesthesia fees?”

This morning, I received an interesting email Geoff (pictured below with his fiancee). In preparing for his mitral valve replacement surgery, Jeff researched these topics and learned some interesting information. That said, I thought you might like to read the note Geoff sent me.

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I just received an interesting question from Elias. It reads, “Dear Adam – I am scheduled for aortic valve surgery (via the Ross Procedure) May 12, in New York City. My wife wants to know if I will be able to get in-and-out of the bed by myself when I get home. My surgeon claims this should not be a problem. I am 60 years old and in good health. Please reply. Thank you, Elias”

Elias raises a great question. Why? Well, let me be the first to tell you that getting in-and-out of bed following heart valve surgery can be a bit painful. I’ve written about this in my book and in prior blogs. That said, here was my direct response to Elias (sent earlier today).

Hi Elias,

Nice to meet you.

Every patient case is different. But, given what you have told me, it sounds like you will be able to get in-and-out of bed by yourself when you return home from the hospital.

In fact, you will probably be encouraged to get in-and-out of bed by yourself while in the hospital. So you know, I got out of bed myself on the second day in the hospital.

One other thought for you to consider… Some patients use recliners after heart surgery to minimize the pain.

Let me know if you have any other questions!

Keep on tickin!
Adam

First, she had cancer as a child. After chemotherapy and radiation, she won that battle.

Years later, Sara learned that she needed mitral valve replacement procedure. After a minimally invasive surgery that was filled with minor heart surgery complications, she is now recovering alongside Lucyfur Ladyhawk, her horse.

This is Sara’s story…

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I just received a follow-up question from Dave regarding my earlier blog about heart valve prolapse. The question reads, “Do you have a better mitral valve prolapse diagram? I still don’t understand the physical problems with a prolapse.”

Thanks for the question Dave! To help you, I just searched the web and found a pretty good diagram that illustrates the key problem with a mitral valve prolapse. Here it is:

As you can see above, the valve leaflets do not seal properly (right image) which results in mitral regurgitation (left image) and could lead to heart valve leakage symptoms.

If you would like to see more images of the heart – simply click anatomy of the heart or anatomy of the heart valves.

I hope that helps!

Keep on tickin!
Adam

This is slightly off-topic but…

Since my aortic valve replacement operation, I have slowed down a bit. (I don’t mean that I have physically slowed down. Nope. I’m still exercising about five times a week.)

The slow down I’m referring to is my enhanced ability to better appreciate all that life has to offer – especially my family and friends. I believe the most fitting cliche for this thought process is simply, “Stop and smell the roses.”

Well… Guess what?

I decided to take the cliche literally.

When Robyn (my wife) and I moved into our new house, I decided to become our gardener and tend to the newly planted roses in the front yard. We have white, red, purple, orange and pink roses.

Although it is spring here in Los Angeles, it feels like summer. Yesterday, it reached over 90 degrees. As a result of the great weather, our roses are going into full bloom. I thought you might like to see some pictures. So, I posted them in this blog.

Come to think of it, I am heading outside right now to cut a few roses for Robyn. She is getting home late from work tonight. So, I am going to make us some dinner and the roses will be a nice touch for the dinner table.

Keep on tickin! And, keep on smelling your roses!
Adam

Over the past few weeks, I have received two emails from heart surgery patients which experienced interesting, allergic reactions while in the hospital during their valve replacement surgeries. As you will read below, Jeff had an allergic reaction specific to the adhesives used in the surgical patches.

Here is Jeff’s account of the situation:

Hi Adam,

Thanks for writing. I did get a lot of useful support and information from you book, and do appreciate your concerns and interest.

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This is a tough moment.

I just learned that one of my readers, Connie Stone, did not make it through her mitral valve replacement surgery. Her husband, Mike, shared with me that there were heart surgery complications during her operation – specifically uncontrollable bleeding. Connie was having her second, heart valve surgery to replace a diseased mitral valve. Connie had previously had an aortic valve replacement twenty seven years ago.

Connie was 49 years old when she passed on April 24, 2008.

My thoughts and prayers are with Connie’s husband Mike and the entire Stone family.
Adam

Selecting the right heart valve replacement is not and should not be easy to do. There are many factors that need to be considered including your age, your lifestyle, your overall health, your like / dislike of ongoing drug monitoring.

G.I. Bill is getting ready for aortic valve replacement surgery due to aortic valve stenosis. While his surgery is three weeks away, he is still trying to determine the best valve replacement type (mechanical valve or tissue and biological valves) for him.

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As we have already discussed, there is much interest in stem cells and heart valve replacements these days. Here’s an interesting report about heart valve tissue generation in sheep.

A Wake Forest University researcher has successfully created eighteen types of tissue, including a sheep heart valve, in his laboratory.

Dr. Anthony Atala, who is studying the science behind growing new organs, uses cells in a laboratory and an ink-jet printer for the purpose.

“When people ask me ‘what do you do,’ we grow tissues and organs. We are making body parts that we can implant right back into patients,” the Environmental News Network quoted him as telling CBS. He believes that soon researchers will start growing organs like human hearts in laboratories from a patient’s own cells, doing away with the need for organ donors. Atala even hopes that the injection of stem cells will facilitate the healing of damaged organs internally, reducing the need for open-heart surgery and other invasive procedures.

Keep on tickin!
Adam

If there is one question I alllllllllllllllll-ways ask patients preparing for heart valve surgery, it is the following, “Did you get a second opinion?”

I can not emphasize this enough.

Recently, I had a discussion with Neil (a forty eight year old husband, father and very smart businessman from the East Coast). As our discussion began, Neil jumped right to the topic of valve selection – mechanical versus tissue.

I said, “HOOOOOLLLLD ON!!! Did you get a second opinion?”

Neil said, “Ummm. No… My cardiologist is one of the best around!”

I said cautiously, “Hmmm. Okay… But it might be worth it to get some extra feedback.”

Guess what?

Neil took my advice. He got a second opinion.

Another… Guess what?

The second cardiologist noticed something different from the primary cardiologist. Now, Neil may delay his heart valve replacement surgery AND he may be able to have an aortic valve repair instead of a valve replacement!!!

So you know, this does not always happen. In my case, my second opinion completely agreed with my cardiologist. (In fact, Dr. Chaikin accelerated the timing of my surgery.) However, knowing that both cardiologists agreed on my aortic stenosis diagnosis put my mind at ease.

Remember, as the graph above shows, about 35% of patients do not get second opinions. Please do not be one of them!

Keep on tickin!
Adam

Again, I find myself touched by another heart surgery success story. Last week it was eighty-three year old John DeFalco that inspired me after his aortic valve replacement operation. This week, it is all about Taylor, a two-year old with that needed cardiac bypass surgery.

Her mother, Michelle, tells the story best…

Dear Adam,

My daughter was 18 months old and had ASD repair. There is potential she may need a valve replacement. After surgery, July 5, 2006, she had a small valve leak. As of Fall of 2007 it is a moderate leak, but no heart enlargement.

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Looking back on my aortic valve replacement procedure, I remember several, distinct moments of physical and mental confusion. I might even consider that confusion as “dislocating” considering the process of having heart surgery is so foreign to regular, every-day life.

Sometimes, that dislocation evolved into fear (e.g. cardiac depression). At other times, that dislocation actually transformed into tremendous joy (e.g. taking my first shower after surgery).

One of my “dislocating moments” was entering the pre-operating room. I’ll never forget that final hug with my family after the nurse called my name. I’ll never forget the nervous tremors in my hands as I pushed the door open.

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If anyone knows that laughter is the best medicine, it might just be Joanne Harris.

Over the past few months, Joanne and I have emailed back and forth regarding her heart valve surgery. Joanne had a mitral valve repair with maze procedure. She suffered from mitral valve regurgitation (leaking heart valve).

Anyways, I recently received a note from Joanne that really shows her incredible attitude towards her cardiac bypass surgery, her broken sternum recovery and her innovative ways to trick the incentive spirometer used to defend against fluid in her lungs.

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I just received a great, often-overlooked question from Tim who asks, “Hey Adam – I just saw the pictures of your chest scar after heart surgery. I’m curious to know… Did you use any special creams or gels to assist in the incision healing?”

The answer to that question is a definite “Yes!” I used a product called Mederma. The gel is an over-the-counter product that does not require a prescription. You can purchase Mederma at most pharmacies. If you are interested, they have a $2 off coupon at the Mederma website. 🙂

However, please make sure that you ONLY USE MEDERMA as directed. Do not use Mederma right away. I think you need to wait two weeks after your surgery. And, I made sure it was okay with my surgeon, before I started using it. My surgeon, Dr. Vaughn Starnes, looked at the Mederma ingredient listing on the package and said, “This looks pretty good. Go ahead and try it out!”

Keep on tickin!
Adam

A little over a month ago, I visited Edwards Lifesciences to tour its heart valve manufacturing museum and learn more about Edwards’ heart valve replacement devices (pig valve transplants, cow valves, minimally invasive technologies).

After reading my blog, Debbie (a recent heart valve surgery patient) decided she wanted to visit Edwards as well. A few emails later, Debbie was on her way to Edwards’ headquarters in Irvine, California to visit the world’s largest heart valve manufacturer. Considering that Debbie’s cow valve replacement was manufactured by Edwards, I guess it was sort of a homecoming for Debbie’s new pulmonary valve.

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As you read the success stories of heart valve surgery patients (Veronika Meyer, John DeFalco, Taylor Browning, Leslie LaFayette, Raye Gilliamsen, John Turan), it is great to see that medical care can have an incredibly positive impact on heart valve disease.

However, it seems like everywhere I turn these days, reports of bad medicine are all around me. In the past few days, I’ve read or watched terrible stories about:

• Trasylol and heart surgery
• Drug administration mishaps that endangered and/or resulted in the unfortunate passing of several children
• Negligent surgical preparations alleged to be the source of Stephanie Kuleba’s recent fatality

During a 60 minutes report about Dennis Quaid’s children, I heard a troubling statistic. The actor revealed that over 100,000 hospital deaths occur each year as a result of human error. That’s more fatalities than AIDS, breast cancer and auto accidents combined.

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Prior to heart valve surgery, patients are faced with many, many, many questions. One of those questions is specific to potential blood loss during the operation. That question is, “Would you like to donate your own blood or use blood from the hospital blood bank?”

I’ve written about this topic of blood banks and heart surgery before.

However, I just read an interesting article at the Mercury News which reveals that heart surgery patients treated with donated blood older than two weeks were more likely to die or suffer problems than those treated with fresher blood.

Which makes these findings — about blood bank safety — even more problematic is that blood supply is chronically low.

“If the shelf life was reduced from 42 to 14 days, we just wouldn’t have enough blood around,” said Dr. Ross Herron, medical director of the American Red Cross Bay Area, which sends blood to hospitals throughout the East Bay and South Bay. “We need to have that shelf life to move blood around.”

I did not donate my own blood prior to my aortic valve replacement operation. Luckily, Dr. Starnes did not need a transfusion during my surgery. However, given these findings I would probably change that approach if I was to need heart surgery again. To learn more about aortic valve replacement, click here.

I hope this helps you better understand blood bank safety.

Keep on tickin!
Adam