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!!!