I just received an email from Tamara about diagnosing mitral valve regurgitation.

She writes, “Hi Adam – I was just diagnosed with moderate-to-severe mitral valve regurgitation. I’m an active, 64 year-old grandma that never even knew I had a heart valve problem. My cardiologist doesn’t believe I need surgery right away. Instead, he wants to monitor my mitral valve prolapse every six months with more echocardiograms. I’m curious to know, what distinguishes moderate regurgitation from severe regurgitation? Thanks, Tamara.”

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Great news!!!

I just learned that Robin Williams – one of my favorite actors and comedians – made an impromptu, stand-up appearance at 142 Throckmorton Theatre in Mill Valley, California on Tuesday night. It was Williams’ first public performance since undergoing double heart valve surgery on March 13, 2009.

Robin Williams – Actor, Comedian, Heart Valve Surgery Patient

During the four-hour operation, Dr. Marc Gillinov, from The Cleveland Clinic repaired his mitral valve and replaced his aortic valve.

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I just received a very important question from Dahlia about constipation and heart surgery.

She writes, “Adam – I’m quite embarrassed to be writing you about this but I just had mitral valve replacement surgery due to prolapse and mitral regurgitation. It’s been two weeks since my surgery and I’m incredibly constipated. Is constipation after heart surgery normal? Do you have any advice? Thanks, Dahlia”

Dahlia has ab-sooooooo-lutely nothing to be embarrassed about. So you know, it is very common for patients to experience constipation after heart surgery… And, it can be quite dangerous.

“Why?” you might be wondering.

Well. It turns out that one of the side effects of pain medication (e.g. Vicodin) is constipation. I personally experienced this following my aortic valve replacement surgery. I’ll spare you the details. But, I can tell you (and Robyn, my wife, can tell you) that I was really, really, really troubled by this patient issue.

Specific to the dangers of constipation after heart surgery, Jennifer Heisler, a registered nurse, noted, “In heart surgery patients, straining from constipation can cause stress on incisions, both internal and external, and in extreme cases, it can cause the incisions to open. Open heart surgery patients can be at particular risk from constipation as the heart is still recovering from surgery and cannot tolerate the changes in heart rhythm that straining from constipation can cause.”

Peri-Colace: Stool Softener Used With Heart Surgery Patients

To remedy this situation, consider using Peri-Colace, a stool softener that works (trust me!).  Peri-Colace is an over-the-counter medication available at most drug stores. I think it costs about $8 and there are cheaper, white label options at Wal-Mart, Walgreens, Rite-Aid and CVC.

If that doesn’t help, I would encourage you to contact your cardiologist or surgeon to get a prescription for a more powerful form of stool softener.

Keep on tickin’ and poopin’!

I was just reading The Mail, when I came across the interesting story of Edward Clark. I thought you might appreciate learning how minimally invasive techniques for aortic valve replacement helped this 82 year-old patient revive his golf game. Here is Edward’s valve replacement story, told from his patient perspective:

One morning nearly 20 years ago I collapsed while walking to the local shop. I was rushed to hospital, where doctors found the arteries around my heart were blocked. So several months later, I had a quadruple heart bypass. It took me three months to recover because it’s a major operation and left me with big scars across my chest.

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In response to a recent blog titled, “Do I Have Cardiac Depression?”, I just received a follow-up question from Eva. She writes, “Adam: Does every heart valve surgery patient go to cardiac rehabilitation?”

Patient Walking On A Treadmill At Cardiac Rehab

Specific to the recovery from heart surgery, I believe this is a great question for both patients (and their caregivers) to consider. That said, I asked this exact question to 75+ heart surgery patients, during a recent survey, to evaluate whether-or-not cardiac rehab was common among recovering heart surgery patients.

As you can see below, my research indicates that only 51% of patients surveyed did participate in a cardiac rehab program. So you know, I have a problem with that statistic. In my opinion, that survey result is wayyyyyyyyyy tooooooooo low.

Following my heart valve surgery, I learned the fundamental benefits of cardiac rehabilitation. The cardiac program I attended at Torrance Memorial Hospital not only strengthened my body, it strengthened my mind. Being around 20 patients every other day nurtured my belief and realization that a 100% recovery was possible – even with the complications I experienced after my aortic valve replacement (Ross Procedure).

While I have yet to coordinate any clinical research on this topic, I imagine there has to be some form of positive and direct correlation among those patients who (i) attend cardiac rehab programs and (ii) do not experience cardiac depression.

Adam At Cardiac Rehab Riding A Bike

I hope the information shared above encourages you to integrate a cardiac rehabilitation program into your recovery. If your cardiologist or surgeon does not share the benefits of cardiac rehab classes with you, please ask them about the local cardiac rehab programs that can help you post-op.

Thanks for the great question Eva!!!

Keep on tickin!