Adam's Heart Valve Surgery Blog – Page 79

If there is one thing I know about going through heart valve surgery… you learn a lot about your body. From the moment you are diagnosed with the need to have heart valve replacement or heart valve repair, new words, new terms and new acronyms start flying in one ear and out the other.

At first, I called it medical mumbo-jumbo. Then, I realized I should sharpen up on my heart anatomy and learn what all these unique terms meant – bicuspid, regurgitation, leaflets, stenosis, Ross Procedure, percutaneous, catheter, mediam (broken sternum), etc.

Following surgery, the learning doesn’t stop. During the recovery, a new set of terms and tests will become part of your post-operative life.

One of the terms I came to know very well was referenced by cardiologist time-and-time again. That term was musculoskeletal. Any time I raised a concern about the pain in my incision or the pain in my chest, my cardiologist would say, “Don’t worry about that… It’s musculoskeletal! You’ll be fine.”

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Guess who I just got off the phone with???

Yup!!!

No other than Dr. Donald Ross, the inventor of the Ross Procedure, a special form of aortic valve replacement. To learn more about the Ross Procedure, click this link.

(So you know, Dr. Vaughn Starnes performed the Ross Procedure on me in 2005 at USC Medical Center in Los Angeles.)

Anyways, for being eighty plus years of age Dr. Ross is still a firecracker. The innovative surgeon was at his office working away in London.

I have to admit, it was quite surreal speaking with the man who developed the procedure that was now part of my heart. I guess it was a very good kind of surreal.

We talked a bit about how thankful I was for his innovative ideas on surgical approaches to enhancing heart health. Then, we spoke about my book, The Patient’s Guide To Heart Valve Surgery.

It turns out that Dr. Ross is on his way to China tomorrow to speak at a few heart conferences in Shanghai and some other cities in China.

Amazing, right?!!!

Keep on tickin!
Adam

Alright. You’ve made it through the surgery and your new or repaired valves are doing great!! You’re out of the hospital. Finally…you’re home. The recovery is ready to begin!

After week one, you look a little something like this after open heart surgery (if you are curious). If you have noninvasive heart surgery, the scar will be significantly smaller. This is a picture of me exactly seven days after my double heart valve replacement.

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Over the past few years, I have been incredibly close to unwelcome tragedy relating to heart valve disorders.  The word “tragedy” is the key part.

For those people who are asymptomatic, there are no warning signals. There are no mitral valve prolapse symptoms. There is no way of knowing the true impact of a mitral valve prolapse during a 26 mile race in 90 degree weather.

That was the issue with Chad Shieber who passed away during the Chicago marathon last week.  While initial reports placed fatal blame on the unseasonal heat of my former hometown city, Chicago, the autopsy and medical records showed that the other conspirator of this untimely death was a defective heart valve. To learn more about mitral valve prolapse, click here.

Chad Shieber had a mitral valve prolapse. Chad Shieber had been cleared by his physicians to run the race.

This is a tough blog to write.  Chad had a wife, three kids and was only 35 years old.

I am 35 years old. I am recently married.

While the similarities appear to stop there, my sadness for Chad Shieber and his family does not.

If only it wasn’t 90 degrees that day.

If only Chad stopped to take a break and walk on mile eighteen…

My thoughts and prayers go out to the Schiebers.
Adam

A great question just came in specific to driving after heart surgery. The question reads, “Hi Adam – Great website! Quick question. When can I drive after heart surgery? Thanks, Susie!”

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Finally, somewhat of an easy question… (You guys have been tough on me lately!)

Well, not really.

Let me explain….

There is a pretty standard answer to the question, “How Long Does A Mechanical Mitral Valve Last?”

In fact, the durability of a mechanical mitral valve is one of the biggest advantages of selecting a mechanical valve versus a pig valve (porcine valve), cow valve (bovine valve) or human valve (donor) for heart valve replacement surgery. To learn more about mechanical valves, click here.

The trade-off for the long-lasting life of the mechanical mitral valve, however, is the ongoing use of Coumadin (blood thinners) and the potential sound of a mechanical valve.

That said, a mechanical mitral valve can is reported to last between 20 to 25 years. Some suggest that the life of a mechanical mitral valve may even be longer.

You have to remember two things. First, heart valve replacement surgery is a relatively new medical procedure. It’s only been within the past 30 to 40 years that heart surgery has become a standardized medical procedure.

Second, you need to remember that mechanical mitral valves are made of very durable materials including titanium. Thus, there is some uncertainty as to how long the mechanical mitral valves may last in the human body. It may very well be longer than the 20 to 25 years referenced above.

I hope that helps answer the question, “How long does a mechanical mitral valve last?”

Keep on tickin!
Adam

Drum roll, please …

The innovation that will have the biggest impact on health care in 2008: robotic catheter technology.

That’s the prediction of a panel of Cleveland Clinic doctors. Clinic doctors pared down a list of about 100 of today’s coolest medical innovations to what they believe will be the most important in the coming year.

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I’ll never forget my second opinion from Dr. Chaikin, a cardiologist in Los Angeles.

I was having my second echocardiogram…

Unlike many cardiologist, Dr. Chaikin was actually present during the echocardiogram. He studied the monitor as it flashed pictures of my beating heart and pictures of my heart valves. I studied the monitor as well – with great purpose and intent. But, I had no idea what I was looking for.

As it turns out, eight weeks later I would find myself having double heart valve replacement surgery via the Ross Procedure. Similar to most patients, I became much, much, much, much, much more interested in heart valve anatomy once I scheduled my open heart surgery with Dr. Vaughn Starnes.

One of the questions I had was, “What does a heart valve really look like?”

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Every once in a while, I receive an email that triggers a distinct memory from my heart surgery recovery. As you may have read in my story, I had a double heart valve replacement at the age of thirty-three in Los Angeles by Dr. Vaughn Starnes at USC.

Following my heart valve surgery, I experienced some challenges with my body temperature. I write about this in my book, The Patient’s Guide To Heart Valve Surgery.

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I just received an email asking, “What is the number of mitral valves in the heart?”

To help answer the question, you will see a human heart diagram (below) that shows a top view of the heart. As you can see there are four heart valves in the heart. The heart valve types are – aortic valve, tricuspid valve, pulmonary valve and… one mitral valve.

So the answer to the question of “What is the number of mitral valves in the heart?” is… one mitral valve.

It is interesting to note that the mitral valve is the only bicuspid valve in the heart. That means that the mitral valve has only two leaflets. As you can see, the other three heart valves each have three leaflets.

However, it is possible for the other valves to have two leaflets. Personally, I had a bicuspid aortic valve which led to my heart valve surgery. Bicuspid valves can trigger heart valve disease including heart valve regurgitation and/or stenosis.

Keep on tickin!
Adam

It happens often!

I will be talking with a heart valve surgery patient when they say something ab-sooooo-lutely brilliant.

As I learned when I had my aortic and pulmonary valves replaced, speaking with former cardiac surgery patients was incredibly helpful. There is a sense of related-ness that is simply unmatched.

For this reason, I started a new category in my blog called “Excellent Patient Quotes”. I’m going to use this space to share with you some of the inspirational, wise, motivational and loving comments that I hear when I’m out speaking with heart valve surgery patients and caregivers.

Today’s excellent quote is about the recovery from heart valve surgery. As I personally experienced, recovering from open heart surgery can be extremely difficult for the patient and their caregivers.

Kathy Benson – Heart Valve Surgery Patient (Minnesota)

Anyways, Kathy Benson from Minnesota recently had an excellent quote about mis-managing your expectations of recovery and comparing yourself to other patients. Here is what Kathy revealed:

“Don’t gauge your surgery and recovery on others. Each surgery is unique and each patient will handle things in a different manner. It seems that patients strive to become normal as fast as they can. What is normal? We will forever be heart surgery patients.”

In my opinion, that could not be more true.

Keep on tickin!
Adam

After I was diagnosed with severe stenosis and regurgitation in my bicuspid aortic valve, I was required to make a pretty significant decision.

Since the echocardiograms showed that my aortic valve was beyond heart valve repair, I needed heart valve replacement surgery. (FYI, I had two echocardiograms to confirm my heart valve condition. I highly, highly, highly encourage you do the same. Second opinions are critical.)

That said, I had to answer the question, “What type of heart valve replacement surgery should I have?”

The Ross Procedure – Special Aortic Valve Replacement

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I’m just getting back from dinner at my mother-in-law’s house. Bonnie really is such a great cook! She made this cheese, blintz souflee that was yummm-eeeeee.

Anyways… During dinner, I started speaking with Robert, a retired pharmacist. We started talking about heart valve surgery and the problems I had during my recovery from double heart valve surgery (specifically cardiac depression). I mentioned my post-operative issue with Vicodin and Robert became very intrigued by the discussion.

Robert used to work as an I.C.U. pharmacist. He went on to tell some really interesting statistics about Vicodin and heart surgery patients.

Specifically, Robert told me that Vicodin is the preferred pain medication administered following cardiac surgery. Are you ready for the statistic that blew my mind?

For every ten patients who use Vicodin regularly following heart surgery, one of those ten patients become addicted. One in ten! Or, 10% of heart patients have an addiction to Vicodin!

I guess I was part of that ten percent group. Looking back on it, there was nothing fun about my Vicodin issue.

Keep on tickin!
Adam

I don’t know about you… But, when I was diagnosed with severe aortic stenosis and valve regurgitation I became a heart valve research fanatic. I read up on every possible heart valve option, surgical procedure, the top cardiothoracic surgeons, etc.

Anyways, the term XENOGRAFT appeared during my research on heart valve replacement. So, surprise… surprise… I just checked my email and guess what I found? An question that read, “Adam, Do you know what is a xenograft?”

According to MedicineNet.com The proper definition of a xenograft is a surgical graft of tissue from one species to an unlike species (or genus or family). For example, a graft from a baboon to a human is a xenograft. The prefix “xeno-” means foreign. It comes from the Greek word “xenos” meaning stranger, guest, or host. (Xeno- and xen- are variant forms of the same prefix.)

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Yes. It’s true… For patients requiring heart valve replacement surgery, one of your surgical options will be a pig valve replacement (also known as a porcine valve and a bioprosthetic heart valve).

I’ll never forget when I was diagnosed with severe aortic stenosis (AS). That was a difficult experience. Open heart surgery was definitely not in my “life plan”. The challenge of digesting that diagnosis was compounded when I learned that a pig valve might offer my dilated heart relief. To learn more about aortic stenosis, click here.

I remember thinking, “HUH??!!! A PIG VALVE REPLACEMENT? YOU WANT TO PUT A PIG VALVE IN MY HEART?”

As I would later learn, pig valves have been used as human heart valve transplants for over twenty years. Companies including Edwards Lifesciences and St. Jude Medical are the leading pig valve replacement manufacturers. Interestingly enough, cow valve tissue is also used in the construction of pericardial heart valve replacements – known as bovine valves.

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Earlier today, I received an email with a pretty interesting question that reads, “Do you have any statistics about heart valve operations and whether or not surgery infection is common?”

As always, I love questions that I have never heard before. This question about heart valve operation and surgery infection was definitely a new one.

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When it comes to heart valve surgery, I know that the human spirit is resilient, creative and inspiring.

“What the hell is Adam writing about?” you may be wondering.

Well, hold on now! Give me a moment to explain.

Everyone I know will experience many obstacles in life. For me, one of those low-points was the day my cardiologist told me that my heart was dilated and I needed aortic valve replacement.

“Ya-ya-ya-ya-ya mean, oh-oh-oh-oh-open heart sur-sur-sur-surgery?” I queried my heart doctor in stuttering disbelief.

In that moment, a unique fear struck me. Maybe it struck you too? Several questions pulsed through my conscious – “Am I going to die?” “Will I surf again?” “How long will I be out of work?”

And lastly… “Why… Oh… Why… Did I get a lemon for a heart?” (Okay, maybe the thought wasn’t that dramatic.)

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Nothing like a little heart valve humor to start the weekend, right?

I hope you enjoy this… It got me to chuckle!

Here goes nothing!

So… A mechanic was removing a cylinder head from the motor of a Harley, when he spotted a world-famous heart surgeon in his shop. The heart surgeon was waiting for the service manager to come take a look at his bike.

The mechanic shouted across the garage, “Hey Doc can I ask you a question?” The famous surgeon, a bit surprised, walked over to the mechanic working on the motorcycle.

The mechanic straightened up, wiped his hands on a rag and asked, “So Doc, look at this engine. I also can open it up, take valves out, fix’em, put in new parts and when I finish this will work just like a new one. So how come I get a pittance and you get the really big money, when you and I are doing basically the same work?”

The surgeon paused, smiled and leaned over, and whispered to the mechanic, “Try doing it while it’s running.”

Keep on tickin!
Adam

There is nothing better than receiving an email from a patient following their surgery and hospital discharge.

Today, I received an email from Sharon Slattery, a reader of my book who just had heart valve surgery. The words in her email were absolutely powerful.

Sharon’s attitude towards her procedure has always been amazing. After she read my book, she wrote me an email telling me that she had plans to sky dive on her 61st birthday in January, 2008.

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Hey everybody,

I just want to take a quick second to thank you for your emails.

I just checked my inbox for the first time in a few days and I was touched, moved and inspired by the nice emails from my book readers and visitors to this site.

I can’t tell you how good it feels to know that I am helping patients and caregivers better understand the realities – the good and sometimes challenging – of heart valve surgery.

I never imagined that this little website and book would be helping so many people around the world!!!!

Thanks again and have a great day!

On behalf of Robyn (my wife) and I…

Keep on tickin!
Adam