By Adam Pick on June 27, 2007
As I have written before, selecting the right surgeon and medical center is a very serious consideration as you prepare for heart valve surgery – either heart valve repair or heart valve replacement. There are several strategies and tactics for finding the right surgeon for you. I actually dedicate an entire chapter to that topic in my book. Anyways, in a previous blog, I noted that mortality rates were reported to be on the decline (see below); however, a recent report surfaced that St. Vincent’s hospital is experiencing the exact opposite trend.
Here is that story from Erie Times-News:
ERIE, Pa. – St. Vincent Health Center is in talks with the Cleveland Clinic and two other health systems about a cardiac-care affiliation, according to a St. Vincent spokesman.
Pete Sitter, however, said no contracts have been signed.
The talks come after St. Vincent heart surgeons posted higher-than-expected mortality rates for heart-valve surgery in a recent report.
If St. Vincent affiliates with the Cleveland Clinic, patients from the Erie area wouldn’t have to travel to Ohio for heart surgeries. Instead, the Cleveland Clinic would help hire and supervise heart surgeons at St. Vincent.
For an annual fee, the Cleveland Clinic also will allow the affiliate to use its brand and offer its experience in administration, medical education, quality assurance and other areas.
Cleveland Clinic officials said they do not comment on negotiations.
To learn more about heart valve surgery mortality rates, please read “Dispelling The Fear Of Heart Valve Surgery: Chapter Two Of The Patient’s Guide To Heart Valve Surgery Book”.
Keep on tickin!
By Adam Pick on May 19, 2007
Following my aortic and pulmonary valve replacements, I experienced my fair share of challenges (pain, cardiac depression). I also experienced several opportunities as well (my engagement, a new found perspective on life).
However, one of the most apparent issues I had following heart valve surgery dealt with my energy level.
By Adam Pick on May 10, 2007
I recently received a question from Roger Sudbeck about heart rates after heart valve surgery. Roger recently had open heart, valve surgery and noticed that his heart rate was still elevated several weeks following his procedure. FYI, Roger had aortic valve replacement in Lincoln, Nebraska by Dr. Ed Raines.
Here is Roger’s question
I want to know if you experienced an elevated heart rate post op. I am sure you have seen my posts indicating that I am running higher than pre op normal which was about 60. Now it seems I am running at about 80 to 90 which feels strange. I am just curious if you experience that as well and if so, how long did it take to come down? Also, did Dr. Starnes have you on BP med post op or a Beta blocker?
Here is my response
Thanks Rog. And, it’s a great set of question about heart rates following heart valve surgeries – repairs and replacements for mitral valves, aortic valves, pulmonary valve, and tricuspids. FYI, my heart rate has always been high but, like you, it spiked considerably following my aortic valve replacement.
However, it has come down a decent amount since the surgery. So, be assured that what you are experiencing is normal. No need to get worried. While I do not have any scientific data to share with you. I have spoke with several patients about this. In fact, in the new printing of my book, there is a survey of 75 former patients about many issues of the heart valve surgery process – from diagnosis through recovery. The survey results are fascinating.
That said, it’s interesting to watch the heart rate decline, over time, both at rest and during exercise.
Actually, it’s amazing to watch. I monitor my heart rate primarily when I’m riding the bike. (I think it would quite hard to do when I’m surfing…)
When I started cardiac rehab, my heart rate would rocket to 160 at the slightest increase in tension on the wheel. The nurses at Torrance Memorial Cardiac Rehab were very sensitive about not pushing the heart too quickly following my Ross Procedure. Now, however, I’m fifteen months post-op and I’m peddling away at level 11 with my heart rate hovering just over 170. I even pushed it the other day and got above 180.
I guess my point is your brain and body are still coming together, still integrating, still healing. In time, I believe you will see a drop.
Plus, I think you are only post-op 40 days or so, right? Give it some time.
So you know, although I considered my physical recovery complete when I surfed in February, I still have a tough day here and a tough day there.
I still listen to my heart with a stethescope every once in a while. Maybe I’m crazy. Or, maybe I’m still mentally healing from open heart surgery.
I hope that helps.
Keep on tickin!
By Adam Pick on May 6, 2007
One of the greatest parts about running this website is hearing from the caregivers of heart valve surgery patients. Recently, I met Denise Hill via email. Denise’s story about her son John was so touching that I asked her if I could post it here in my blog. She was warm to the idea and provided me with a picture of her son, John Hill and his fiance, Tabitha.
There is no doubt that John is a model for us all… Even with a problematic Ross procedure, he is moving onto bigger and better things!!
From Denise Hill:
Our son at the age the age of 16 received the Ross procedure in 1995. We initially saw it as an answer to prayer that would allow him a greater level of activity compared to receiving a mechanical valve.
Although he had excellent doctors, we still felt alone during this time. The Ross procedure had just started being performed in our area.
Our son also became part of a research study. After his initial surgery, he underwent an additional surgery 5 days after his first and had to have the two valves replaced four and a half years later because of the failure of the Ross. It was very difficult to be one of the 4% of people for which it failed. We are so grateful that we had understanding doctors who worked with him regarding his athletic activities. As parents we knew that the most important thing was for our son to be alive; however, we also had to balance that with our son’s quality of life.
By Adam Pick on March 6, 2007
On December 21, 2005, nearly 435 days ago, I had open-heart surgery to fix a congenital defect in the aortic valve of my heart. After thirty four years of life, my bicuspid aortic valve which suffered from stenosis and regurgitation, needed to be replaced. As many of you know, this open-heart medical operation (known as the Ross Procedure) triggered a series of challenging lows (e.g. cardiac depression) and a series of memorable highs (e.g. my engagement to Robyn).
Well… Two days ago I experienced another memorable high that I wanted to share with you – my friends, family and blog subscribers.
“What happened?!” you wonder as you see my smiling, much in need of a shave, face.
By Adam Pick on March 4, 2007
As a former, double heart valve replacement patient (read my story here), I’ve learned to really watch my exercise, diet and lifestyle choices. The one thing I know after a challenging open heart surgery recovery is to not take your heart for granted.
Sooooo… Here are some interesting tips and tricks for heart healthy consideration I just saw posted on the web.
I didn’t do the research behind the tips and tricks but some of them just make logical sense.
1. DRINK POMEGRANATE JUICE
Learn to love pomegranate juice. Buy some and drink up — according to the National Academy of Sciences, heart cells treated with it produced 50 percent more nitric oxide, a substance that fights plaque and staves off hardening of the arteries, and may even reverse it.
2. DAIRY CONSUMPTION
Consume three servings of dairy every day. Trick: it can be yogurt, milk, or cheese — just make sure it’s low-fat. The National Heart, Lung, and Blood Institute says three servings can lower systolic blood pressure (top number) by about four points in people who don’t consume a lot of saturated fat.
Lower your resting heart rate just by eating fish. Your resting rate can be an indicator of heart attack risk, and lower is better. A new Harvard Medical School study shows that people who eat five or more servings a month of fatty fish like tuna and salmon (which are high in omega-3 fatty acids) average about three beats a minute fewer than those who eat little or no fatty fish.
3. TAI CHI / YOGA
Try tai chi — a Chinese martial art that uses slow, relaxing movements — to lower your blood pressure. In one study, participants who practiced tai chi for 30 minutes a day for 12 weeks lowered their systolic blood pressure by almost 16 points.
4. LAUGH! LAUGH! LAUGH!
Watch funny movies, or do anything else that makes you laugh because it improves your blood flow. A University of Maryland School of Medicine study prescribes 15 minutes of ha-ha time a day. Tip: Lower your blood pressure by breathing deeply. If you take 10 breaths a minute instead of the usual 16 or more, and do this for 15 minutes a day over a period of two months, studies show you will lower your blood pressure.
5. SLEEP! SLEEP! SLEEP!
Women should get plenty of sleep — they should imitate “Snorella,” not Cinderella, who danced until midnight then rose at 4 a.m. to go to work. Insufficient sleep plays havoc with women’s hormones, blood pressure, and blood sugar, according to a study from Brigham and Women’s Hospital in Boston. The study says women who sleep fewer than five hours a night have a 30 percent higher risk of heart disease than those who get eight full hours.
6. LISTEN TO MUSIC
Regulate your body’s rhythms with music. University of Oxford researchers say you can lower your heart rate by tuning in to slow, meditative music, and — just the opposite — you can rev up your circulation and breathing by turning on to tunes that are fast-moving toe-tappers.
7. SOY HELPS YOUR HEART
Daily soy shooters in your food (marinades, soups, etc.) can help fight heart-damaging substances generated by smoking, obesity, or diabetes, according to a study by the National University of Singapore. Dark — not light — soy sauce has 10 times the antioxidants found in wine. Trick: use low-salt versions because some soy sauces are loaded with salt, which can raise blood pressure.
Keep on tickin!
By Adam Pick on February 28, 2007
It’s a great question. And, as I personally learned after my double heart valve replacement operation (known as the Ross Procedure), it’s a tricky question to answer. Plus, if you’re like me and you really enjoy your sleep, this is a critical question to ponder.
Actually, to best answer this question, you need to consider the time following your operation to determine the best position for sleeping after open heart surgery. Why?
Well, immediately following open heart surgery you will not have a choice. Sorry to be a buzz kill.
As you can see here in my pictures from the I.C.U., there are tubes everywhere. The only real option for you to sleep is on your back.
By Adam Pick on February 27, 2007
Ahh yes… The good ole’ sternum cracking question. I’ve received this question a number of times from friends and family following my surgery. As you can read in my story, I had the Ross Operation performed.
Unfortunately, my cardiothoracic surgeon, Dr. Vaughn Starnes (USC), could not use a minimally invasive procedure considering he needed direct access to my defective aortic valve which was suffering from aortic stenosis and regurgitation. My congenital bicuspid valve had become very calcified during my 34 years of life prior to the surgery.
In any case, Dr. Starnes needed to perform a median sternotomy to perform the valve replacement. So you know, median sternotomy is a type of surgical procedure in which a vertical incision is made along the sternum, after which the sternum itself is “cracked”. This procedure provides access to the heart and lungs for surgical procedures such as heart transplants, corrective surgery for congenital heart defects including heart valve replacements.
By Adam Pick on February 12, 2007
One of the advantages of using the Ross Procedure is the fact that patients do not require the use of any medications (e.g. Coumadin) following the operation.
Recently, however, I learned from Lee Crowley that Dr. Ryan suggests that all Ross Procedure patients take beta blockers. My cardiothoracic surgeon, Dr. Vaughn Starnes, has a different opinion as I am not currently taking any medication. Yet, I found Lee’s email to be very interesting. Therefore, I thought I would post it for all you to consider. Here it is:
I am on 50 mg Toprol XL 2X/day. Dr. Ryan (William Ryan III) puts almost all of his Ross patients on a Beta Blocker, as I understand it. I actually called him a couple of weeks ago to see if I could reduce the dosage, and he recommended I not do that at this time.
He said the reason for the Beta Blocker is two-fold.
- One, it keeps my BP in check. He said Ross patients need to keep their Systolic pressure below 120 (preferably around 110). My “normal” BP well before my surgery was around 135/80. Now, it is usually around 112/70.
- Second, the Beta Blocker will reduce my heart rate, especially during activity. This is important to reduce the stress on the heart, especially while it goes through remodelling. I had significant LV Hypertrophy.
Dr. Ryan said he likes to keep his Ross patients on a Beta Blocker indefinitely most of the time. He strongly believes it will help the longevity of the valves. He said I will probably be able to reduce my dosage to 25mg 2X/day at 1-year post-op, and down to 25mg 1X/day one year after that.
I mentioned side effects in my previous post. One side effect I attribute to the Toprol XL is I feel a little sluggishness when I play tennis. I play at a pretty high level, and feel a “micro-second” slow when I play. That’s the best way I can describe it. I played tennis right up to my surgery and did not have this problem. Also, I am cold a lot more often than before, which is a known side effect.
I also occasionally have weird, vivid dreams that I did not have before. I actually enjoy this side effect.
These are not really significant in the grand scheme of things. I can definitely live with them.
I hope your recovery continues to go well. I really enjoyed your pictures of the surgery.
By Adam Pick on February 3, 2007
Recently, I received an email from Taylor Browning. Taylor is going to be having an aortic valve replacement in March, 2007. He has selected an artificial valve and the surgery will be conducted by Dr. Craig Miller at Stanford.
Taylor’s questions was, “I’m having problems concentrating at work knowing that my surgery is in a few weeks. Should I take some time off work before the procedure?”
My opinion and response to this question is yes.
So you know, I took six days off before my Ross Procedure (aortic valve replacement).
Well, for one thing, I wanted to get mentally prepared for the operation. Specifically, I wanted to take care of any and all loose ends that existed in my life so that my recovery would not be impacted. I paid bills in advance. I purchased birthday presents in advance. And, so on…
The other reason I took time off is that I wanted to spend some extra time with my family and friends prior to the operation. As you can read in my book, I felt it was very important to connect with my support group and inform them of the upcoming surgery and the recovery. This was very critical. Going into the heart valve surgery, my family and friends were all on the same page.
While this is my opinion, I have spoke with many patients about their time prior to surgery. The majority of them — that still worked for a living — did take some time off before their surgery. And, for the few who did not take time off, in retrospect, most felt they should have.
If you have any questions, please send them to email@example.com.
Keep on tickin!
By Adam Pick on January 9, 2007
Hi there! Welcome to my site!
I thought you might want to know a little more about me and why I developed this site and wrote the book, “The Patient’s Guide To Heart Valve Surgery”.
So you know, I am a senior analyst for iSuppli Corp., a market research firm based in El Segundo, California. I’ve been lucky to be called a “leading analyst in my field”, and have been featured in The Wall Street Journal, BusinessWeek, CIO Magazine, The Economist and several other publications for my odd, weird and unique knowledge of electronics manufacturing for products like computers and cellular phones.
I grew up in Sherman Oaks, California, a suburb of Los Angeles. For college and graduate school I went to the University of Michigan in Ann Arbor, Michigan.
I learned that I would need heart valve replacement surgery on November 3, 2005.
Eight weeks later, Dr. Vaughn Starnes performed an aortic valve replacement (the Ross Procedure) on me at the University of Southern California Medical Center.
After a very challenging recovery, I am now back to work, exercising five times per week and traveling the world for fun and business.
My heart valve surgery success story was elevated on May 20, 2006 when I asked Robyn Podell, my girlfriend of two years, for her hand in marriage.
As part of my experience with heart valve surgery, I learned the highs, the lows, the challenges, the opportunities and the frustrations of heart valve surgery. The book, “The Patient’s Guide To Heart Valve Surgery” is my attempt to further educate future heart valve surgery patients and caregivers about this life-saving medical procedure.
Feel free to email me at firstname.lastname@example.org if you would like to chat or ask me a question.
Until next time… Keep on tickin!
By Adam Pick on January 3, 2007
I recently received an email that asked, “Adam, what was the most challenging aspect of your heart valve surgery?”
It’s a really good question – one that I do not answer quickly given the ups, downs, ups and downs of dealing with heart valve surgery.
However, I would say the hardest part of heart valve surgery was the recovery. It’s unfortunate but I found that the health care specialists failed to properly manage my expectations following my aortic valve replacement.
I was in the hospital for five days. Then, I was discharged. There was very little guidance as to what to do and what not to do. I did receive a 15-page handout but the only pre-planned events were a follow-up appointment with my cardiologist (2 weeks) and my surgeon (3 weeks). It was quite troubling. Besides that, there was no structure to my recovery. Ultimately, this led to several challenges in my recovery – pain medication dependency, cardiac depression, etc.
That was not fun.
Ultimately, my family and I took it upon ourselves to advance my recovery in the seventh week post-operation. We learned a number of post-operative strategies to enhance the recovery process.
To be honest, that is the key reason, I wrote my book. The patient needs to know what might happen at each phase of the operation. Personally, I felt like I was ‘left out in the cold’ following my aortic valve replacement.
I do not want you or anyone you know to have that experience.
The physical discomfort was one thing but the mental discomfort was completely unexpected and quite dislocating.
I believe a lot of those challenges could have been avoided had my cardiologist and surgeon structured my recovery a little bit better.
I hope that helps!
If you have any questions, please email me.
Keep on tickin!
By Adam Pick on December 19, 2006
Good news! Good news!
I am very happy to report that earlier today I saw my cardiologist (Ben Rosin, Torrance Memorial) for my one year check-up. The echocardiogram came back very positive.
Dr. Rosin said, “I’m very delighted with this. Now, get out of here!!! I don’t need to see you for two years!” Even though Dr. Rosin was a USC football player, he’s a great guy. FYI, I went to Michigan and our two teams are playing each other at the Rose Bowl this year.
I’m in shock!!! I’ve reread the echo report three times. I still can’t believe what has transpired over the past twelve months. My official surgery date is December 21. I think I’m going to take the day off work and relax.
Today, I’m going to see Dr. Starnes at USC, my cardiac surgeon, for the follow-up visit. Hopefully everything will go well there too.
If you have never seen a picture of Dr. Starnes, the guru of heart valve replacement surgery. Here is a picture of him on your left.
Keep on tickin!
By Adam Pick on December 17, 2006
Well, here it is! My first blog at my website www.heart-valve-surgery.com!!!
I have to admit. I never thought this would be happening. As some of you know, I had a very challenging time before, during and, most importantly, after my aortic and pulmonary valve replacements.
My recovery was filled with ups and downs. Lately, however, there has been a whole lot more ups than downs! I guess that old cliche, “Nothing that’s worth it, is easy” really applies to heart valve surgery.
And to think… I just got engaged (see picture), I’m back to work and I just spent two weeks in Europe!!!
That said, I want thank all of you for your support – with the book, with the website, with your endless support and cheerleading for me.
I would not be as happy and healthy if it wasn’t for you.
Looking forward, I am going to use this blog to post my thoughts and ideas about my personal experience with heart valve surgery. If you have any special thoughts or questions you would like me to address, send me an email at email@example.com. I will get to them as soon as possible.
Until then, have a great holidays!!!