Adam's Heart Valve Surgery Blog – Page 76

I wake up pretty early. Usually no later than 5:30am. Robyn (my wife) stays in bed while I make the coffee. A few minutes later, I’m in my office turning on my computer.

That is when my stitched heart really gets ticking. Why? Well, lately I have been receiving lots and lots and lots of email from folks like you – heart valve surgery patients and caregivers. Some emails are filled with fear. Some emails are filled with questions. Some emails are filled with frustration. And, some emails are filled with inspirational stories like this one…

A few days ago, I received an email all about Raye Gilliamsen. Raye’s daughter, Abby, wrote me to share her mother’s story. Raye just celebrated her one year anniversary after receiving a new heart valve replacement.

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Don’t be so quick to answer “true” to the above question.

Here’s why…

Until recently, it was recommended that patients with heart valve disorders receive short-term antibiotics prior to receiving dental treatment to prevent the risk of infective endocarditis (IE).

Now, however, the American Heart Association (AHA) has revised those guidelines. The AHA now suggests that many patients who have taken prophylactic antibiotics routinely in the past no longer need them.

 
But… Don’t be so quick to answer “false” to the statement above either.

Still, there are conflicting views on whether or not to pre-medicate for patients having had heart valve replacement or heart valve repair surgeries.

As you can read, during my most recent annual check-up (following my aortic valve replacement), Dr. Vaughn Starnes suggested I continue to pre-medicate with Amoxicillin prior to seeing my dentist.

It’s really no big deal. I’d rather be safe than sorry, right?

I thought you might want to know about this if you are going to need dental work and heart valve surgery in the future.

Keep on tickin!
Adam

As many of you know, I had a congenital birth defect known as a bicuspid aortic valve. After thirty-three years of opening and closing, my two-cusp aortic valve became incredibly diseased with aortic stenosis and regurgitation. Ultimately, I had aortic valve replacement and pulmonary valve replacement. Following surgery, Dr. Vaughn Starnes (my surgeon) informed me that my aortic valve was very calcified as well.

That said, I just received an interesting question about mitral valve disease from Kara. Unlike most questions that focus on mitral valve prolapse and mitral valve regurgitation, this question focused on mitral valve calcification.

Kara’s question reads, “Can you tell me about mitral valve calcification? Do you have any pictures of a calcified mitral valve? What are the symptoms? What is the treatment of mitral valve calcification?”

As you can see above, calcification can impact mitral valves just as it can impact other heart valves. This picture illustrates the build-up of calcium along the annulus of the mitral valve. Ultimately, that impacts the integrity of the mitral valve to open and close properly. My research indicates that most symptoms of mitral valve calcification are similar to the symptoms of other forms of valve disease.

As for treatment of mitral valve calcification, that will be determined by your cardiologist and/or your surgeon. Primarily, there are two forms of surgical, mitral valve treatment – mitral valve replacement and mitral valve repair.

I hope that helps share some insight on mitral valve calcifcation.

Keep on tickin!
Adam

Heart Valve Surgery Pop Quiz Time!!!

Complete the following statement:

“Waking up in the intensive care unit after cardiac surgery with a ventilator tube still in your throat is…

• A. “So much fun! I can’t wait to do it again!”
• B. “Uncomfortable. Not being able to talk is somewhat dislocating.”
• C. “The worst thing ever!”
• D. “I don’t know! It was removed before I woke up.”

And… The answer is.. “E”… It depends!

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Hola!

Over the past month, I have become friendly with Maribel and Sergio from Cancun, Mexico.

Sergio is the patient. At 54 years of age, his mitral valve needs to be replaced. Maribel, as you probably guessed, is his loving wife and caregiver.

Today, Sergio and Maribel are leaving their home in Cancun for Mexico City. Sergio’s mitral valve replacement surgery is scheduled for this upcoming Monday. (To learn more about Sergio’s procedure, click here.)

As Maribel writes, “We are so nervous! You can imagine! But at the same time, your book was incredibly helpful because we feel prepared for the surgery. I hope the days go by rapidly. I just want to see the doctor getting out of the surgery and telling me everything is all right. That is my golden moment. I dream of that.”

With that thought in mind, here is to your ‘golden moment’ Maribel.

My prayers and thoughts are with you. Even though the surgery is on Monday, I am sending you great, big, healthy thoughts from Los Angeles right now! May Sergio’s surgery be completely uneventful! (Those are the best kinds of heart valve surgeries.)

Keep on tickin!
Adam

Hi everybody,

As many of you know, I originally launched this website to help future patients and caregivers better understand the realities – the ups and downs – of heart valve surgery.

Now, two years later… It’s amazing to see what is happening in this community – as we gather to share our thoughts, feelings and fears about heart valve repair and heart valve replacement surgery. Global friendships are being made. Plus, among all things, patients are helping patients and caregivers are helping caregivers.

One of the most powerful tools we developed to learn more about the patient perspective was our 2007 Patient Heart Valve Surgery Survey. This unique survey of 78 patients, uncovered several interesting elements of the patient perspective that were not previously documented (at least in my research). For example, we learned a good deal about second opinions prior to heart surgery.

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I recently received a great question from Jennifer (a caregiver) who is researching heart valve surgery options for her mother-in-law. Specifically, Jennifer wanted to know more about valve reoperations due to undone (loose) stitches around a replacement valve.

Jennifer’s question was pretty technical and I did not have an answer. So, I contacted Dr. Eric Roselli, a leading heart surgeon from The Cleveland Clinic, to get his perspective.

As you might imagine, Dr. Roselli had a thoughtful response to Jennifer’s question. That said, I thought you might like to read this patient case that was discussed via email earlier today.

Patient Background: In 1982, my mother-in-law (the patient) had her mitral valve replaced with a silastic heart ball valve (star Edwards no.4, model 6120, size 32mm) at Royal Prince Alfred Hospital in Sydney. Unfortunately, some of the stitches holding the valve in place seem to have torn away or come undone (according to her specialists), during the past 26 years.

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Every few days, I see a picture or image on the Internet that REALLY captures my attention. Many times, those pictures are diagrams and illustrations that relate to heart valve surgery.

As I remember it, before my aortic valve replacement and pulmonary valve replacement surgery, I had a difficult time grasping what actually occurs during the operation.

That said, I have included many pictures, drawings and images in this blog (and in my book) to help you better contemplate what occurs during the pre- and post-operative heart valve replacement or heart valve repair experience.

Your responses have so far been very positive. So, I am going to continue posting many more pictures – including human heart diagram, animated anatomy of heart functioning, mitral valve replacement diagram and more.

Above, you will see a very interesting diagram of the patient’s chest following the incision and median sternotomy – the sternum is already broken. As you can see, the surgeon now has full access to operate on the heart once the patient is placed on the heart-lung machine (bypass) if required. Then, the heart can be stopped, cooled and then fixed!

I hope you don’t think this is too gruesome. I found it educational and thought you might like to see an open heart surgery illustration of the chest during surgery. If you would prefer not to see stuff like this, please leave a reply below.

Keep on tickin!
Adam

I don’t know about you…

But when my first cardiologist, Dr. Bad Bedside Manner, told me that I needed open heart surgery due to my defective bicuspid aortic valve… I went into mini-shock.

Then, the stoic doctor, with the red nose, rapidly spewed a flurry of foreign words at me: calcification, leaflets, narrowing valve stenosis, regurgitation, normal ejection fraction, blah, blah, blah, blah.

“Enough medical mumbo-jumbo!” I remember thinking as Dr. Bad Bedside Manner continued to tell me that death was lurking in my future. “Please show me what you are talking about!”

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Hey everybody,

Good news!

Leslie is home following her mitral valve repair. (You may remember a blog that featured Leslie as she was preparing for robotic mitral valve repair.)

After five days at UCLA Medical Center, Leslie has now entered the recovery phase of heart valve surgery. Below, you will find an interesting account of her surgery which was longer than most surgeries due to some cardiac surgery complications that were fixed during surgery. Great job Dr. Shemin! To learn more about Dr. Shemin, click here.

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After the annual check-up with Dr. Rosin (my cardiologist), it was time to venture back to USC’s Medical Center to see Dr. Vaughn Starnes (my heart surgeon), for part two of my annual check-up.

I have to admit…

The fact that Dr. Rosin was happy with my recent echocardiogram results made the sixty-minute drive to USC rather pleasant for a change. I can remember many, other drives to USC that were drenched in fear, anxiety and doubt due to my much-needed heart valve replacement surgery.

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So you know…. I am not the best when it comes to organized religion.

I would say that I am more spiritual than religious. I do believe there are higher powers that tie us all together. And, I do believe the molecular meatpack, we call our body, offers us a special opportunity to create something meaningful during the seventy or eighty years that most of us traverse the Earth.

Okay. I just wanted to make sure you knew where I was coming from before I dive head-first into the topic of prayer before heart surgery.

Religion, Prayer & Heart Surgery

Just before my aortic valve replacement, my Uncle Marc advised me that prayer before surgery was not a bad idea. Marc is more than an uncle to me. Marc is a mentor in many aspects of my life.

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As you may be learning or have already learned…

Finding your surgeon is a critical process that requires due diligence and, at times, tenacity. That said, there are many tactics you can use to locate and select the right heart valve surgeon for you.

In my opinion, one key ingredient in the surgeon selection process is the heart surgeon interview. Personally, I interviewed several heart valve surgeons prior to picking Dr. Vaughn Starnes for my aortic valve replacement.

Recently, I was reading the Wall Street Journal when I came across an interesting article about the challenges of asking surgeons tough questions.

This article was appropriately titled Asking Your Surgeon The Tough Questions. It’s a pretty good article that provides some interesting thoughts and references, so I linked over to it for your review (if you like).

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I will be the first to admit… The rewards from publishing this blog and my book are more positive than anything I have ever experienced before.

Actually, it is a privilege to help patients and their caregivers through their heart valve repair or valve replacement surgery experience.

That said, I recently received an email from Debbie Hurd. Debbie is now six weeks post-surgery. As you can read below, Debbie is doing very well even though she has experienced some patient complications following heart surgery.

Still, Debbie’s attitude is positive and her will is strong. I found her words insightful, so with her approval, I have posted them here for us all to consider and learn from.

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This is just great.

Earlier today, JD emailed me several questions about aortic root and aortic valve replacement. As many of you know, I did not have aortic root replacement (I had the Ross Procedure), so I couldn’t really comment on all of JD’s questions.

However, a friend of mine, Taylor Browning, had an aortic root and an aortic valve replacement in 2007. That said, I forwarded JD’s questions over to Taylor.

Wow! Talk about a response! Taylor went above-and-beyond the call of duty to support J.D. as he prepares for surgery. First, I will post JD’s email and then I will post Taylor’s reply about about this unique, heart valve surgery that Taylor personally experienced just one year ago.

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Yesterday, I received a fearful email from Janice – a very concerned caregiver and mother. Janice’s daughter is preparing for heart valve surgery.

In her email, Janice noted that her daughter is planning on returning to work just 3-4 weeks after surgery. She also noted that her daughter is nervous that she might lose her job because of the medical leave-of-absence.

I wasted no time in immediately responding to Janice for several reasons:

First, I have been through double heart valve replacement. That said, I know that the recovery from cardiac surgery should not and can not be rushed. Healing is a very personal and individual process.

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I’m not sure about you…

But, as I prepared for my heart valve surgery, one of the many critical questions I wanted to answer was, “Which are the best heart care facilities?” and “Who are the best heart valve surgeons?”

I did ALOT of research on the topic of cardiovascular disease treatment – best hospitals and surgeons. (So you know, I consider heart valve disease in the realm of cardiovascular disorders although others may consider the term isolate to arteries and veins.)

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One of my readers / friends, Taylor Browning, is traveling to Hawaii for a vacation with his wife Michelle. (If you want to learn about an amazing recovery from aortic valve & root replacement, click to read Taylor’s inspiring heart surgery recovery.)

That said, Taylor just asked me about taking care of his chest incision in the hot, sunny and tropical weather of Hawaii after heart surgery. Specifically, Taylor noted in his email, “I plan on applying some heavy-duty sunscreen to the incision scar itself but wanted to see what you did given your proximity to the beach!”

First off, I’m jealous. I need a vacation!!! “CAN I COME TAYLOR?”

Second, here’s a picture of me ten months after my double heart valve replacement surgery.

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Recently, I received an interesting question about bacterial endocarditis. The question was, “Adam: Do you know of any celebrities with endocarditis?

It’s a good question. I remember when I first learned that I would need heart valve replacement surgery, it helped to know there were many, many, many, many public figures who had experienced heart valve surgery and continued to live a full, dynamic life afterwards.

As for a particular celebrity with endocarditis (the heart valve disease), I unfortunately do not know of any. Sorry.

That said, I didn’t give up. So, I did what most people would do – I “Google’d” it.

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There’s nothing better than helping patients and caregivers prepare for and recover from heart valve surgery. The stories of Jim Bonk, Taylor and Michelle Browning, and Kathy Benson are both inspirational and heart-warming.

Over the past two months, Leslie Lafayette (pictured below) and I have emailed back and forth about the fears, the risks and, of course, the pain of cardiac surgery.

Together, we have settled those fears and doubts – even the overwhelming concern about the vent tube post-surgery, right Leslie?

Well…. I just want to let you all know that Leslie has selected a heart valve surgeon, a heart valve procedure and an official date for her mitral valve repair. I have to give Leslie a lot of credit. Her research, specific to her upcoming operation, has been incredibly detailed.

Early this week, I received another interesting email from Leslie that shares her unique, patient perspective about her mitral valve surgery. I thought you might like to hear some of the steps that Leslie is taking to prepare for heart valve surgery.

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