Adam's Heart Valve Surgery Blog – Page 61

I’ll never forget when I learned my options for a heart valve replacement.

Dr. Trento, the first surgeon I interviewed, briefly discussed the pros and cons of pig valves, cow valves, human donor valves (homografts) and mechanical valves with me. While I immediately understood the use of mechanical valves and homografts for aortic valve replacement, it took me some time to truly understand how pigs and cows provided a suitable alternative for a human heart valve.

Now, however, I am fully aware of the benefits that pig valves (aka porcine valves) and cow valves (aka bovine valves) offer patients requiring heart valve replacement surgery.

That said, I was somewhat surprised to learn that patients might have another biological option to consider in the future. According to a recent report in the Canadian Medical Journal (CMJA), researchers in Quebec will soon begin testing heart valves from harp seals to determine if they are suitable for use in humans.

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I just received a very interesting email from Mandy about heart valve surgery, vertigo, headaches and vision complications after heart surgery. As you can read below, Mandy is asking for all of our help.

Mandy With Her Two Children

Mandy writes to me, “Hi Adam, I had valve replacement on September 16, 2009. I am 34 years old. I am doing really well but I am having some vision disturbances and periods of vertigo. At first it was just vision disturbances and I wrote it off as ocular headaches. Then, I started having difficulty walking straight with these vision disturbances. I looked on-line and found transient ischemic attacks (TIAs) as a possible cause. I do not take Coumadin anymore because I have a bovine valve. My question is… Did you or any of your readers have similar experiences and if so what has been done? Thanks! Mandy”

While I do seem to have more headaches after my aortic valve replacement, I did not experience vertigo or vision loss during my recovery. However, I have met several patients that experience similar issues during their recovery.

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Quick trivia for you…

According to The Cleveland Clinic, “How long does it take for blood to circulate through your vascular system?”

A. 2 second
B. 20 seconds
C. 2 minutes
D. 20 minutes
E. 2 hours

To find the answer, scroll down below the beating heart.

The answer is… 20 seconds.

That’s pretty amazing considering the complex network of blood vessels – arteries, veins and capillaries – that carry blood through the body. According to The Cleveland Clinic, that system is over 60,000 miles long. That’s long enough to circle Earth twice!

Keep on tickin!
Adam

When it comes to making investments, I’m no Warren Buffet.

However, every once in-a-while, I come across a company that is uniquely positioned within a growing industry. Such is the case of… Edwards Lifesciences (NYSE: EW). As you may know, Edwards Lifesciences, founded in 1958, is the leading heart valve replacement manufacturer on the planet.

I originally became familiar with Edwards Lifesciences as I prepared for my own heart valve replacement surgery. However, I really became interested in Edwards’ product and financial strengths during the research for my book.

In 2007, I was lucky to tour Edwards headquarters, to walk through its heart valve museum and to visit its manufacturing center in Irvine, California. During that visit, I learned more about the history of the company, its unique product portfolio and its ongoing dedication to patients requiring heart valve surgery.

The Heart Valve Museum At Edwards Lifesciences

Edwards commitment to the heart valve market is proving valuable to its shareholders. I just learned that the company’s shares touched $68.23 last week. That is a 52-week high for the Edwards. (You might recall that I have highlighted the company’s financial performance on a few occasions. Since my first blog, the stock has increased $14 per share, a 26% increase.)

Again, I’m no Warren Buffet… This is simply a very good company that is making a difference in the lives of people with heart valve disease.

Keep on tickin!
Adam

I just received an interesting question about memory loss after heart valve surgery from Paige Mitchell of Virginia.

Paige writes, “Hi Adam, I had my aortic valve replaced in March, 2009. A few weeks later, I became agitated that I couldn’t remember peoples’ names, what I had just been doing, etc. I mentioned this to my cardiologist and he said this may happen as a side-effect due to anesthesia and the heart-lung machine lowering oxygen levels to the heart and brain during surgery. The cardiologist also said my memory loss would diminish over time. I’m 11 weeks post-op and still experiencing problems remembering.  However, it is less than it was. Did you experience any of this? Thank you for writing your book and this blog! Paige”

While I never experienced any complications specific to memory loss, many patients report experiences of cognitive decline following heart surgery. In fact, this condition is often referred to as “pumphead” for the reasons that Paige provides above.

Interestingly enough, there is ongoing debate as to whether-or-not use of the heart-lung machine is really the source of memory loss after surgery.

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Great news!!!

Ed Koch, the former mayor of New York City, is reported to be in stable condition following his aortic valve replacement surgery earlier today.

A spokesman says the 84-year-old mayor is doing “as well as expected” after a challenging open heart procedure at New York Presbyterian Hospital.

Ed Koch’s surgeon was Dr. Craig Smith, one of the leading heart surgeons on the East Coast. Doctor Craig Smith also performed a bypass procedure on former President Bill Clinton in 2004.

Dr. Craig Smith, M.D.

Ed Koch served as mayor of New York City from 1978 to 1989. Koch told Mayor Michael Bloomberg earlier this week that he was doing fine and was looking forward to getting out of the hospital.

Keep on tickin!
Adam

I just received a great question from Steve about heart flutters and palpitations following heart valve surgery. In fact, Steve’s question brought back a very distinct memory from my own heart surgery recovery.

Steve writes, “Hi Adam – I had my aortic valve replaced, with a pig valve, 7 weeks ago today.  During the past couple of weeks my heart is very fluttery and I feel like I have motion sickness.  It lasts for most of the day and is gone after a good nights rest.  Did you ever experience something like this? And, is this something I should worry about? I hate calling my doctor for something that is normal. Thanks, Steve”

I have a couple thoughts for Steve…

First, something similar to this happened to me six months after my double, heart valve surgery. I was at work when… All of a sudden, my heart felt like it was flip-flopping and beating upside-down in my chest.

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You might remember Shannon’s last email about diseased heart valves, pregnancy and child birth. Well…. Here is her post-operative update:

Hey Adam!

I wrote to you several months ago about heart valves and pregnancy. I just wanted to send you a quick update!

I had my surgery on May 14th at Emory University Hospital in Atlanta, Georgia. Doctor Ed Chen was my surgeon. I cannot say enough about how wonderful he and the Emory staff were to work with.

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Everybody,

I just learned that we passed an incredible milestone for such a young website!!! Last week, the 10,000th comment was made at this heart valve blog!!!

I really, really, really, really want to thank all of you for contributing your thoughts, ideas, beliefs, advice and stories about heart valve surgery. Together, we are making a significant difference in the lives of current and future patients around the world!!!

Keep on tickin!
Adam

Thanks to a great support group and medical team, I made a full recovery after my double heart valve surgery. However, I did experience a series of physical and emotional challenges during my recovery. One of those challenges was specific to my voice. As Robyn (my wife) could tell you, my voice became incredibly hoarse following surgery.

So you know, I’m not the only patient that experienced a hoarse voice following cardiac surgery. Patricia, age 71, just sent me an interesting email which details her vocal problems following a difficult insertion of the ventilator tube. Here is what she writes:

Hi Adam – For two months after my aortic valve replacement I had great trouble talking. My surgeon told me that I  had a “difficult intubation” during the procedure.

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I just received a unique question from Deana about aortic stenosis and erectile dysfunction.

She writes, “Hi Adam – My husband was just diagnosed this past January with aortic valve stenosis. His Cardiologist said that he was going to have to have open heart surgery to repair it. My question is can aortic stenosis cause erectile dysfunction? We have been trying to find a connection between those two and that is how we wound up on your web page. Any information you can give us would be great. Thank you, Deana”

When I don’t have a good answer to a patient question, I waste no time in “calling on the experts”. So, I emailed Dr. Eric Roselli, M.D., a leading cardiothoracic surgeon from The Cleveland Clinic. Minutes later, Dr. Roselli and I were on the phone chatting about Deana’s question. As aortic valve disease is one of Dr. Roselli’s specialties, he had A LOT of good information to share.

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I’ll never forget the day I opened the one-page letter from my insurance company, Blue Shield of California, which authorized my double heart valve replacement. I was beyond relieved given the mind-numbing frustration I experienced prior to that moment in dealing with Blue Shield.

I imagine I’m not the only patient that found themselves at war with their insurance company, right?

In fact, I just received an email from Linda which states, “Adam – I need help. I am looking for someone who has had robotic surgery and had it covered through HealthNet. Why? I was recently denied a robotic approach for mitral valve repair through HealthNet and I am in the process of appealing. I know this denial has been overturned in the past and I am looking for anyone who has been successful in doing this. Can you help?”

Given Linda’s question… Can you help her better understand the process for successfully appealing the request for robotic surgery to repair her mitral valve? If so, please leave a comment below. To learn more about robotic mitral valve repair surgery, click here.

In advance, thanks for your help!!!

Keep on tickin!
Adam

The “preparation for heart valve surgery” seems to be a very popular, patient topic these days.

First, Sylvia sent me a special note about her extraordinary weight loss before aortic valve replacement. Then, a few days later, Anita sent me her ideas and tips about being mentally and physically fit for surgery. I thought you might like to read Anita’s note, so here it is:

Hi Adam,

My recent experience with mitral valve repair is something worth sharing.  The surgery was done just four weeks ago (March 30, 2009) at The Cleveland Clinic, by Doctor A. Marc Gillinov.

Everything went smoothly, and the staff, including Dr. Gillinov, were amazed at how quickly my body healed.  Dr. Gillinov stated that my initial recovery was two days ahead of most of his patients.  My nurse practitioner called me her “WOW” patient. In total, I spent just 10 hours in intensive care and was discharged after only 3 days.

I was truly blessed to have surgery at The Cleveland Clinic.  Not only were the doctors and staff experts in their field, but also they were extremely compassionate, caring human beings. Their kindness and expertise greatly helped my recovery.

I wanted to share some of the steps that I took to enhance my recovery:

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On the topic of heart valve surgery recovery, I just received a very important question from Holly.

Her note reads, “Hi Adam – I’m nervous, anxious, concerned, afraid, excited and, most importantly, hopeful regarding my mitral valve replacement surgery next week. I have severe regurgitation from mitral valve prolapse. Beyond the surgery, I want to know how long will it take to be 100% recovered. I am an active 66-year old that loves to chase my grandchildren around the park. Thank you, Holly”

As noted above, I believe Holly raises one of the most relevant questions for patients evaluating the entire heart valve surgery process, “How long does it take to feel 100% again?”

While this is a great question… I do not have a great, explicit answer which details a specific day or exact time in which patients consider themselves “fully recovered”.

Instead, I offer patients and caregivers an honest, two-word response to this inquiry.

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Heart valve disease really seems to be impacting royalty in 2009.

First, it was the Sultan of Malaysia, now it’s the former King of Greece… King Constantine.

Greece’s Former King Constantine – Heart Valve Patient

“King Constantine underwent successful aortic valve replacement and single aortocoronary bypass surgery at Wellington Hospital, London,” Professor Giles Dreyfus, who performed the procedure, said in a statement posted on Constantine’s website.

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When talking with patients and caregivers about heart surgery recovery, I can never say enough about cardiac rehabilitation programs. I hear from patients over-and-over-and-over-and-over again about how valuable cardiac rehabilitation programs are for their physical, social and mental well-being after heart surgery.

Here’s a quick note I just received from Charles Harrall, an active 65-year old businessman from Nevada, about cardiac rehab, goal setting and medication management. Charles writes:

Hi Adam,

I am one year past my aortic valve replacement, mitral valve repair and a triple bypass.

Patient At Cardiac Rehabilitation – On Treadmill

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Janice has a question about mitral valve prolapse and panic attacks.

She writes to me, “Hi Adam – I’m curious to know if you’ve come across patients that have panic attacks and mitral valve prolapse? I’ve looked up the symptoms of mitral valve prolapse and I don’t see “panic attack” listed there, just anxiety. The reason I ask is my 59-year old husband was diagnosed with moderate-to-severe mitral regurgitation and I’ve noticed a very unusual, very anxious side to him lately. Is there any connection between this valve disease and panic attacks? Thanks, Janice”

So you know, Janice isn’t alone. I receive this question every once-and-a-while from patients and caregivers. Initially, my research did not suggest a direct connection between mitral valve prolapse and panic attacks. However, during the past few years more research about this co-occurrence has forced some members of the  medical community to take a position on this condition.

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Here is a fantastic patient success story from 73-year old, Sylvia Woolworth, of New Jersey. As you can read below, Sylvia’s preparation for heart valve surgery was… extra-ordinary!

Hi Adam,

Five weeks ago, I had aortic valve replacement surgery. I was diagnosed with severe aortic stenosis although I had no symptoms except a heart murmur.

 Sylvia Woolworth – Aortic Valve Surgery Patient

Thankfully, before my procedure, I read your book which greatly helped me prepare for surgery. My doctor, John M. Brown III, Chief Thoracic Surgeon at Morristown Memorial Hospital in Morristown, New Jersey, also prepared me during our face-to-face appointments.

I wanted to be in the best physical and mental condition for the operation. So, during the past twelve months, I lost 35 pounds. I went to the YMCA four-to-five days a week and I joined Weight Watchers to learn better eating habits.

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It seems like 2009 could be “The Year Of The Celebrity Heart Valve Patient”.

In February, Barbara Bush had aortic valve replacement. Then, in March, Robin Williams had aortic valve replacement with a bovine valve and a mitral repair. Later that month, Aaron Boone, professional baseball player with the Houston Astros, had aortic valve repair.

Yesterday, we learned that actress Jenny Garth was diagnosed with a leaky heart valve over seven years ago.

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There is nothing better than waking up, kissing Ethan (my 6-week old son), turning on my computer, and opening an incredible email from one of my readers.

That said, I thought you might like to read this inspirational note from John O’Neill. As you can see, John discusses many of the experiences common to heart valve surgery patients – including symptoms, diagnosis, surgical care, genetics, recovery, cardiac rehab, Coumadin, etc. So, with John’s permission, I am posting his email below:

John O’Neill – Bicuspid Valve Replacement Patient

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