Adam's Heart Valve Surgery Blog – Page 64

Patients selecting mechanical heart valve replacements are typically required to monitor their INR levels (international normalized ratio) to prevent risks of blood clotting, hemorrhage or stroke.

To ease this process, home INR testing machines are now becoming more affordable and easy-to-use. That said, here is a patient testimonial from Margaret R. about her experience with a home INR testing machine she just received:

Dear Adam,

I just wanted to let you and everyone else know that I received my INR home machine last week. I had a nurse from the company come to my home and train me on it. It’s just wonderful fast and easy, start-to-finish is less then a few minutes and only requires one drop of blood.

My doctor’s office has been great in getting me set up on the INR home test meter. My insurance company is paying for 80% of the rental cost and I pay 20% – which is only about $26.00 a month.

This amount covers the cost of the rental unit plus supplies of the reader card and needles. If anyone else would like to try and get a home INR machine, here is what I did. I went online and Google’d INR home test machine. The search came up with many options and I called them requesting the forms. They then called my doctor’s office with the information and 4 weeks later it was done.

I’m now enjoying a very long needed break to the veins in my arms and loving it.

Thanks for your book and blog!

Margaret

The term medical tourism is relatively new. But, more and more, I am hearing of patients traveling to places like India for surgical procedures including heart valve repair and heart valve replacement.

On this note, I recently saw a video about Robin Steele from Mobile, Alabama. Robin suffered from severe mitral valve regurgitation and a-fib (irregular heartbeats). After evaluating his options and his budget, Robin had mitral valve repair surgery in Bangalore, India at the Wockhardt Hospital, an associate of Harvard Medical International, under the care of Doctor Vivek Jawali, Chief Cardiac Surgeon.

This video describes Robin’s experience before, during and after his mitral valve repair in India. To watch this video, simply press the play button. Also, please make sure the volume on your computer is turned up.

As with any cardiac procedure – in any location – there are advantages and disadvantages. I can understand why patients like Robin utilize medical tourism to (i) save money and (ii) benefit from skilled surgeons, like Dr. Vivek Jawali. I can also understand why other patients (like me) chose to stay local for their valve surgeries.

I hope this video helps explain a little bit more about medical tourism and heart valve repair in India.

Keep on tickin!
Adam

Since posting Lisa’s mitral valve repair success story, my inbox has been flooded with questions about blood transfusions and blood bank safety like:

• When was the first blood transfusion?
• Who performed the first blood transfusion?
• Are there complications with blood transfusions?
• What are the blood transfusion guidelines?
• Are blood transfusions required during open heart surgery?

These are great questions. However, I’m not going to address all of these questions in a single, very long post. Instead, I’m going to answer these blood transfusion questions one-by-one over the next month in multiple blogs.

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2009… Here we come!!!

On that note, I want to wish everyone who visits this website – the patients, the caregivers, the nurses, the cardiologists and the heart surgeons – a very happy and very healthy new year!

May this be an incredible year for you and all the people around you!!!

And… Thanks for all your help in 2008! Your thoughts, your ideas and your comments in this blog have made a positive impact on the lives of many, many, many, many, many people around the world!!!

Keep on tickin!
Adam

This email just came in from Lisa, a registered nurse from Colorado, who had mitral valve repair surgery less than two weeks ago. I thought you might appreciate reading about Lisa’s experience, her attitude toward heart surgery and her early recovery. Here is what she wrote:

Dear Adam,

I had my surgery on Thursday, December 11th and things went pretty well. The surgeons were able to repair my mitral valve, which should last 20 years or so before any additional work may need to be done.

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I’m just returning from my annual echocardiogram with Dr. Ben Rosin, my cardiologist at Torrance Memorial.

As some of you already know, these annual exams are fairly stressful. The last thing I, or anybody, want to hear is that a heart valve surgery re-operation is required.

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I just received a strangely coincidental email from Jerry regarding life insurance after heart surgery.

Jerry’s question reads, “I am wondering if you know of the difficulties of getting a term life insurance after heart surgery.  I tried to increase the policy I had and was immediately turned down due to my history of heart valve replacement surgery. I would think that I am healthier today than I was four months ago since my bicuspid aortic heart valve has been replaced via the Ross Procedure. And, I have very little risk factors: low cholesterol, within suggested weight, no other disease, never smoked. Have you encountered this before? Or, do you know of any friendly insurance companies?”

“Why does Adam consider Jerry’s email a strange coincidence?” you may be wondering.

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Are you ready for some interesting trivia about heart valve replacement devices?

The mitral valve is the only human heart valve that is bicuspid. Bicuspid means the valve has only two leaflets. Alternatively, each of the other heart valves (aortic, pulmonary, tricuspid) have three distinct valve leaflets – also known as heart valve flaps. Please see the top-side view of the human heart diagram below.

In light of this information, my true/false quiz to you is, “Mitral valve replacements have only two leaflets to best mimic the genetic and evolutionary design of the mitral valve.”

So… What do you think? Is that statement true or false?

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You don’t have to be Warren Buffet to know that investments in heart valve companies may pay off big time in the future.

The wants and needs of the Baby Boomers have triggered almost every financial trend since World War II. Don’t believe me? Consider the Baby Boomers’ impact on the popularity of select automobiles.

In the 1960s, as the Baby Boomers started turning 16, millions of drivers licenses were issued. The Baby Boomers wanted fast, sporty cars. Thus, the wild success of the Ford Mustang.

Then, in the late 1970s and early 1980s, the Baby Boomers had lots and lots of children. Lee Iacocca realized the Baby Boomers’ need for bigger, more convenient cars. Thus, the ridiculous success of the Chrysler Minivan.

Now, it’s all about health care for the 76 million Americans known as the “Baby Boomers”. When you consider the size of this market and the rampant surge in heart disease, it makes complete sense that the rate of heart valve surgery is going to soar during the next twenty years.

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With the recession lingering, I’m doing my best to save, save, save money this holiday season.

That said, I went to Costco fifteen minutes before it opened on Super Saturday. My strategic thought was, “Go early Adam! You’ll be the first one there with pristine dibs on all the goodies.”

It turns out that my brilliant idea, was… ummm…. not so brilliant.  When I drove up to the bulk superstore, my immediate thought was, “Yikes!”

As you can see in the picture above, I’m no genius.

I waited in a line of a few hundred, Super Saturday shoppers just to get into the store. I couldn’t believe it. By the time I made it to the register, the check-out lines were already 7-to-8 shopping carts deep.

Next time…. Amazon!

Keep on tickin!

Adam

It’s almost impossible to think that exactly three years ago today…

At this precise moment in time… 10:08am.

I was laying on an operating table having my aortic heart valve replaced.

Needless to say, it has been an ABSOLUTELY AMAZING 36 MONTHS AND IT IS TIME TO CELEBRATE!!!

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There is ab-sooooooooo-lute-ly nothing better than opening my inbox and reading these types of emails… Thanks Shelby!

Hi Adam,

Seven years ago I was diagnosed with a bicuspid aortic valve, which was stenoic with regurgitation.  I have had annual ultrasounds since then. In August of this year, I discovered that it was time for a valve job.  I am a 40 year old male, in excellent condition. My doctor and I decided on a Ross Procedure.  On November 13, I had my surgery with Drs. John Randolph and Dr. Ron Elkins at the Oklahoma Heart Hospital in Oklahoma City, Oklahoma.

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One of the most common, congenital heart valve disorders is a bicuspid aortic valve. Patients born with a bicuspid aortic valve have only two leaflets. Normal aortic valves have three leaflets. Ultimately, this can significantly compromise blood flow through the heart and body as the valve tissue degenerates (stenosis, regurgitation).

Earlier today, I received an email from Nikki. I perked up in my chair as I read her email about a unicuspid aortic heart valve.

Nikki writes to me, “Hi Adam – I am trying to find out more about my 2-year old heart’s condition when I came across your site. He has been diagnosed to have a unicuspid aortic heart valve. At what age will this start to effect him? Do you have any additional info on this? Greetings from Cape Town, South Africa! Nikki (Mom)”

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I just received a curious email from Jill. She writes, “Hi Adam – After several years of waiting and waiting, I’m finally going in for valve replacement due to severe regurgitation. Quick Question: Will I be glued or stapled after the sternum is wired? I’ve heard it can go either way. Any thoughts?”

Jill’s question just brought back a very interesting memory for me…  I was in the intensive care unit after my aortic valve replacement surgery. The obstructive vent tube had just been removed from my throat. I was woozy (from the anesthesia) but conscious. My eyes sluggishly opened for the first time in six hours. I remember seeing my dad and my wife. Then, I looked down at my chest and thought, “Huh? Is something wrong? I don’t see any stitches on my scar.”

Shortly thereafter, I learned that my surgeon used a special type of glue to seal the incision after my median sternotomy. As you can see below, there are no stitches or staples on my main, 8-inch incision.

However, you should know, this is not always the case. Many surgeons still use staples.

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Former New York Mayor David Dinkins joined the growing list of public figures requiring heart valve replacement surgery. According to reports, Mayor Dinkins is recovering in a Manhattan hospital following valve replacement surgery.

David Dinkins, New York’s first African-American mayor, is a cardiac patient at New York Presbyterian Weill-Cornell Medical Center.

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Last week, Robyn (my pregnant wife) and I experienced something incredible…

A 4D ultrasound of our developing baby boy.

At times, I laughed. At times, I was close to tears.

It was amazing to see our little boy in the womb. He was soooo cute. Here you can see his face. One hand is under his chin and the other hand is holding his ear.

We could be wrong but we think Baby Pick might have Robyn’s nose and my lips. Yes, I know it’s a early (23 weeks) to be assigning traits to the little boy, but we’re just so excited to officially meet him in April.

Again, thank you for all of your wonderful emails and phone calls regarding our first pregnancy.

Keep on tickin!
Adam

As you may know, many patients and caregivers stress the importance of getting a second opinion prior to surgery. Without a doubt, second opinions are a critical step for validating or challenging a primary diagnosis of valvular diseases including mitral regurgitation and aortic stenosis.

Today, I received an email from Ken that stressed a very interesting element of his own, second opinion. As you can read below, Ken’s surgeon performed some additional tests which led Ken to question whether-or-not echocardiograms are the most effective test for detecting valvular disease. Here is what Ken writes:

Dear Adam,

I almost was going under the knife for aortic valve replacement (AVR) until my doctor friend found an inconsistency in the cardiologist’s report. The surgeon then requested a CAT Angiogram.

Apparently, for athletic patients, echocardiogram readings are not that great. Needless to say, the CAT showed a SIGNIFICANT DIFFERENCE in my aortic root dilation.

According to this new test… SURGERY IS NOT NEEDED AT THIS TIME!!! Please suggest to your readers that a CAT or MRI might offer additional information for proper diagnosis.

At times, as in my case, echocardiograms may not be the most reliable test for valve disease diagnosis.

Thanks for your ear, your blog and your heart valve surgery book!

Ken

Earlier today, I received an email from Geraldine that reads, “Adam – I can’t believe it. Your book has already arrived. I ordered it just yesterday. Thanks so much for the quick delivery. I can’t wait to read it as my aortic valve will be replaced next Tuesday. By the way, who handles the distribution of your book?”

First off, my thoughts and prayers are with Geraldine. After learning who her surgeon was, I know she is going to do just great with a new mechanical aortic valve.

Second, I had to smile and chuckle after reading Geraldine’s question, “Who handles your distribution?”

Why? Well… If you knew how my book was packaged and distributed, you might laugh too. Here’s how distribution is handled:

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Something wonderful comes over me when I receive a thoughtful email from a loving caregiver.

Since I was/am an aortic and pulmonary valve replacement patient, I can directly relate to the fear, uncertainty and doubt that caregivers encounter as they collect information on behalf of their family and friends.

So you know… Sometimes I can email back-and-forth up to 30 times with nervous caregivers as their loved ones prepare and recover from heart valve repair and/or heat valve replacement.

That said, I thought you might like to read a recent email exchange between Julie and myself. Julie’s daughter has an aortic aneurysm and a leaky aortic valve. Here is what she writes:

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I was just reading the Annals of Internal Medicine when I came across an interesting article about mitral valve prolapse and its impact upon men and women. The summary (below) is from a report titled “Sex Differences in Morphology and Outcomes of Mitral Valve Prolapse”.

Here are the key findings from the report:
 

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