Adam's Heart Valve Surgery Blog – Page 72

Sometimes when I write these blogs, the process is effortless. I sit down. I start writing. And… POOF! Five, ten or fifteen minutes later I have a draft specific to the question or topic at-hand.

Well… Not this time. Why? Well, I just received a question from Molly that reads, “What is the best way to care for a heart surgery patient?”

As I sat in front of my computer, I began to think about all the different elements (pre- and post-operative) that my own support group had to deal with – including the shock of diagnosis, getting a second opinion, finding the right surgeon, selecting the right procedure, my five days in the hospital, and of course, the challenges of heart surgery recovery (cardiac depression, pain, etc.).

In light of all that, a single answer to Molly’s question escaped me.

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I just received a question from Laura which asks, “My mom was recently diagnosed with a mitral valve regurgitation problem. During her discussion with the cardiologist, he said that her valve flaps were not closing tightly and causing a leak. What exactly does this mean?”

Understanding heart valve anatomy is critical to better understanding the diagnosis of heart valve disease and the surgical steps required to fix the problem. That is why this question about heart valve flaps is such a great inquiry.

Heart valve flaps are also known as heart valve leaflets. The flaps, or leaflets, are composed of tissue. The flaps sole purpose is to open-and-close tightly to secure that blood flows through the heart in one direction. Each heart valve has three (3) heart valve flaps, except for the mitral valve which has two (2) heart valve flaps. Below you can see two diagrams of the human heart* with the white valve flaps in the opened and closed position.

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The patient stories that arrive in my inbox are nothing short of inspirational. Here is the story of Vernon Young from Indiana. He writes:

Adam,

I’m scheduled for surgery next Wednesday – like you, I have to be at St. Vincent’s Heart Center of Indiana at 7AM. I have a great surgeon, Dr. Robert J. Robison, who will be performing the surgery.

I’m 63 years old and have known that I had some form of functional heart defect since I was 20. It was discovered by a United States Air Force (USAF) physician during my final physical before being assigned to Vietnam in 1965. At that time, it was not a problem… at least my USAF physicians didn’t think so.

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One of the most, highly regarded cardiothoracic surgeons I know is Dr. Kevin Accola from Florida.

Lucky for us, I just found a video that features Dr. Accola as he works on a patient requiring aortic valve replacement due to a congenital, bicuspid aortic valve. As you can see in this story Dr. Accola uses a homograft valve to replacement the patient’s defective valve.

Keep on tickin!
Adam

I’m incredibly lucky to receive touching and memorable letters from heart valve surgery patients and caregivers all over the world. In particular, I consider it a special honor when one of my book readers includes me on his or her email list during their heart surgery recovery.

Just today, Dean (from Colorado) sent me this wonderful email which illustrates his appreciation for his support group and his VERY RECENT heart valve replacement. I thought you might like to hear Dean’s thoughts on his hospital experience, so I asked him for permission to share it in this blog. Without further ado, here it is:

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One of the most popular forms of heart valve disease is mitral valve regurgitation. In fact, reports suggest that the mitral valve is the most commonly operated on heart valve.

As a result, I receive a lot of questions about mitral valve replacement and mitral valve repair. Earlier today, I received a question from Kim that reads, “Is there any way to naturally reduce mitral valve regurgitation?”

If you’ve been to this blog before, you know that I am an optimist. I believe that anything is possible. So it would be unlike me to answer that question with a definitive “no”. Interestingly enough, I have heard of some miracle stories from patients in which valve disease issues have mysteriously vanished over time.

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Hey everybody,

I just wanted to take a quick moment to thank you for all your incredible feedback and constructive criticism (following my request for ways to make this blog better). So you know, I received a ton of great ideas to enhance this fast-growing community of heart valve patients and caregivers.

Some of the key feedback items included:

• Add a video playback device into the blog that plays heart valve surgery clips and patient stories;
• Provide chat functionality so that our users can communicate in real-time;
• Create a patient success story directory;
• Enhance the navigation (links) throughout the blog;
• Consider adding a forum or Wiki-like tool to let users actively contribute content to the website.

I could go on-and-on-and-on. Instead, I’ll simply let you know that I will be working to improve this site over the next six months.

Again, thanks for all your excellent thoughts and guidance!!!

Keep on tickin!
Adam

Do you know how many open heart surgeries were performed in the United States during 2005?

Want to take a guess? Go ahead… Close your eyes and think about it. Okay. Now open your eyes.

(Scroll down for the answer.)

According to the American Heart Association, the number of annual open heart surgeries performed in the United States was approximately 699,000 during 2005. The break-down of some open heart surgeries, by procedure, was:

• Bypass (cardiac revascularization) – 469,000
• Heart transplants – 2,200
• Valve replacements – 106,000

Why did I write about this?

Well. I am hopeful that it will help future patients and caregivers better understand that open-heart surgery, while complex and risky, is a relatively routine procedure. Click this link to further dispel your fear of heart surgery.

Keep on tickin!
Adam

Once diagnosed with severe aortic heart valve disease (stenosis) and an enlarged heart, I went into action mode.

Yes. I was confused. Yes. I was scared. Yes. I may have even been a little bit depressed (and a tad angry).

Still, my heart needed to be fixed quickly. Dr. Chaikin, my second opinion cardiologist, had given me 30 days to relieve the stress and strain on my dilated (enlarged) heart. Otherwise, Dr. Chaikin told me there could be more damage to my cardiac muscle.

During the surgeon selection process, I set up interviews with surgeons including Dr. Starnes (USC Medical Center). I would use this time to evaluate my potential surgeons and my options for valve replacement devices (mechanical, tissue, homograft valves) and surgical procedures (open heart, minimally invasive, robotic, ross procedures).
 

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Even though the cartoon (below) got me to chuckle, I really thought to myself,  “These are EXACTLY the type of heart surgeons patients should avoid!”

Hey everybody,

Thanks for all your nice emails and comments. However, do me a favor… PLEASE CRITICIZE ME AND MY BLOG! That’s right. Fire away. I’m the target pictured below! And… there is no need to be nice about it.

“Why is Adam asking me to do this?” you may be wondering.

Well… I want to make this blog better. The only way I can do that is to ask YOU for honest feedback. So please, please, please help me out (if you have a moment). What do you like about the blog? What do you dislike about the blog? What other features would you like included in the blog?

I’m open to any and all suggestions. I really want to make this website a helpful resource for all patients and caregivers preparing for, or recovering from, heart valve surgery.

You can either leave a comment below or send me an email at adam@heart-valve-surgery.com. I’ll get back to you asap.

In advance, thanks.

Keep on tickin!
Adam

If I had to define the process of being diagnosed with heart valve disease in one word, I would use the word “dislocating”. I’ll never forget my initial diagnosis from Doctor Bad Bedside Manner. And, I’ll never forget those strange feelings of, “Oh my gawwwwd. Is this really happening? Open heart surgery? Am I going to die?”

As you would imagine, I’m not the only patient to experience those dislocating feelings and emotions. What made my situation more challenging to digest… I was almost completely asymptomatic. Of all the leaky heart valve symptoms, I only had one symptom.

Guess what? I’m not the only patient to experience that strange combination of being asymptomatic and being diagnosed with heart valve disease – aortic valve stenosis or mitral valve regurgitation. In fact, I just received an interesting email from Sherri (pictured below with Farah, her dog) about this exact topic.

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There is nothing better than hearing from one of my readers after their open-heart surgery recovery is complete.

Recently, I received a very nice note from Melissa Causey. As you might remember, Melissa had a Ross operation in 2006 by Dr. William Ryan in Texas. She attached a recent picture that I have posted below.

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For most patients, open heart surgery recovery is filled with pain.

Pain levels vary, so the medical community developed pain scales to help patients better communicate with their medical team in the hospital and during cardiac rehabilitation. If you are a future patient, be prepared to see something similar to the pain scale example below.

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Aloooooooooha Everybody!

Robyn (my wife) and I just returned from celebrating our one-year wedding anniversary in Hawaii. Needless to say, our vacation was incredibly fun and most importantly… relaxing. The weather was spectacular and the food, especially the fish, was extraordinarily yummy.

I uploaded two pictures below. In one of the photos, you can see that my open heart surgery scar continues to fade through the years.

If you are curious, I used Mederma Scar Gel to help heal my incision scar during the recovery from aortic and pulmonary valve surgery.

Keep on tickin!
Adam

You just don’t know how good you have it until life offers you a great, big piece of Humble Pie, right?

I know that’s how I felt following my double heart valve replacement. After the cardiac depression… After the pain… After the fear of needing a heart valve re-operation… I was so thankful for everyone and everything around me. My friends and family, in particular, rallied around me like guardian angels. They lifted me up with encouragement, support and lots of good love.

You should know that this feeling of “thankfulness” is common among heart valve patients. To prove it, I recently surveyed 78 patients about their feelings towards their heart valve repair or valve replacement operations. Guess what? The majority responded that heart valve surgery had a “positive impact” on their lives.

As you may have read in a prior blog, Jim Lehrer, PBS broadcaster, recently had aortic valve replacement surgery. The trusted anchor of “The NewsHour with Jim Lehrer” recently returned to his television.

During the closing of a recent show, Lehrer offered the audience his own, personal take on the outcome of his heart surgery.

“Before we go tonight, a few personal words, if I may. Mostly, there are just two words: Thank you. Thank you for the messages of concern and encouragement the last two months. I wanted to respond personally to each, but there were just too many, thousands of them, and still counting. I read every one of them. They mattered very much to me. There is no mystery about what happened. The aortic valve in my heart went bad and it was replaced, skillfully and perfectly. I will be easing back to work a couple or so days a week at a time, so please don’t think anything’s gone wrong again when I turn up missing. For the record, one of my doctors said a valve procedure like mine is known to make a person feel and act 10 years younger, so stay tuned.”

Well said Jim!

Keep on tickin!
Adam

Thanks to the wonderful patients, caregivers, nurses, cardiologists and surgeons who write me, I continue to learn many interesting and helpful details about heart valve surgery. That said, I often take those emails and post them in this blog for you to review as well.

Recently, Jennifer wrote me about the health challenges of her husband. In her note, Jennifer shared her thoughts about the harmful impacts of radiation pills on heart valve function due to infection.

Dear Adam,

Good morning! I received your heart valve surgery book I ordered from you on Saturday afternoon. Needless to say by Saturday night, I had finished reading it.

A quick brief rundown of our situation… Back in March, 2008, my husband took radiation pills to kill an overactive thyroid. A week after he took the pills, he became extremely sick with a high fever, chills, etc.

It seemed to get better. But, over time, the symptoms never went away. It was like clockwork. Every evening, my husband would get chills, sweats, low grade fever, aches, pains, just plain misery. This went on for 2 months.

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Depending on who you talk to, general anesthesia is either one of the GREATEST or WORST parts of heart valve surgery.

I can see both sides. On one hand, general anesthesia is great because your pain receptors are numb. On the other hand, general anesthesia can be scary for patients because your brain and body are, quite frankly, paralyzed. Plus, there are many patients, nurses and doctors which suggest that general anesthesia may have some lingering effects on the brain and body that are not all positive.

As for me, I opted to value the benefits of general anesthesia during my aortic valve replacement. I am aware that some patients are now having open heart surgery while awake but, for me, I didn’t want that experience.

Recently, I was asked the question, “How many patients receive general anesthesia each year during any type of surgery?”

It’s an interesting question.

After doing some research, which included watching the movie “Awake” starring Jessica Alba, I learned that approximately 21 million patients will be under general anesthesia each year. FYI, that number is for all surgery types, not just cardiac-related operations.

Keep on tickin!
Adam

This is very interesting!!! (Especially, for those of you wanting to learn more about human heart valve anatomy.)

I just came across a three dimensional, reconstructive image of the human heart valves. While this animation also shows echocardiogram images (on the left), I was more fascinated with the colorful, 3D presentation of the heart valves opening-and-closing (on the right).

If you look close at this 3D image of the heart, you can see the leaflets of the mitral valve, the aortic valve and the tricuspid valve. Unfortunately, the pulmonary valve is not visible.

So you know…

When I learned that I needed aortic and pulmonary valve replacement operation, I wanted to learn as much as possible about the human heart and its heart valves. My hope is that these types of pictures will help future patients and their caregivers better understand the anatomy of their own hearts before heart valve repair or heart valve replacement operations.

Keep on tickin!
Adam

Robyn (my wife) will tell that I don’t really like to use cliches.

But, if there is one thing I have learned since my heart valve replacement surgery, it is that “there are no guarantees in life”.

Yes. I did just use a cliche. But, it is sooooooo appropriate to heart valve surgery. As you may already know, there are risks, there are uncertainties and there are surgical complications that are undeniably associated with cardiac surgery.

As we have already seen (in patient stories from Leslie Lafayette or Brad Mueller), “there are no guarantees in heart surgery”.

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