By Adam Pick on August 14, 2007
In prior posts and discussion, I have called open heart surgery a medical miracle. The fact that a surgeon can open you, stop your heart, fix it, start it again and then stitch you up is, in my opinion, AMAZING!!
However, as a patient, I remember an immense amount of fear related to the “miracle”. My concern was not related to the success of the operation or my own mortality (click here to see why).
Instead, one of my biggest concerns was the “cracking of my sternum”. As an athlete, I had broken bones before. However, the central and sensitive nature of the chest did make think twice (if not a hundred) times as I headed into my operation. I was just very curious to know what the sternum fracture healing process would be like.
That said, I thought you all might like to see an xray of sternum before and after open heart surgery involving a cracked chest (aka median sternotomy). The first sternum xray is provided below. As you can see the chest plate is smooth and clear of any fracture.
By Adam Pick on August 13, 2007
My inbox just received an email that I can relate too.
The email reads, “Adam, What are the symptoms of bacterial endocarditis? Is chest pain a symptom of endocarditis?”
Before I dive straight into the answer, you should know that I was initially diagnosed with a bicuspid aortic valve as a little boy. I think I was five years old when I learned about my heart murmur.
From that moment on, I had to pre-medicate every time I saw the dentist. My mom told me it was very, very, very important to take medication every time I went for a cleaning or a cavity filling.
Now, I don’t like the dentist to begin with… So, this just added to my resistance.
At the time, I had no idea that my parents and dentist were protecting me from the problems of bacterial endocarditis. For those of you who don’t know, bacterial endocarditis is an infection of the heart’s inner lining (endocardium) or the heart valves. Problems of bacterial endocarditis can damage or even destroy your heart valves.
According to the American Heart Association, there are about 29,000 cases of endocarditis diagnosed a year.
By Adam Pick on August 13, 2007
Just wanted to give you a quick update on Melissa Causey from Texas. Her surgery was rescheduled for this Tuesday. If you have a minute, please send her a great, big healthy thought!
FYI, Melissa is having the Ross Procedure performed by Dr. William Ryan.
Here’s a picture of Melissa, her husband (Brian) and their daughter (Abigayle).
You’re going to do great Melissa!
Keep on tickin,
P.S. Your Uncle Ted loves you lots and lots!!!
By Adam Pick on August 12, 2007
It’s one thing to be diagnosed with a heart valve disorder. It’s another thing to be told that your heart valve problem has worsened and you need heart valve surgery.
I remember that moment all too well. I also remember the next set of thoughts that raced through my mind as my cardiologist gave me the sixty-second overview on heart valve replacement surgery. Questions immediately raced through my mind as the cardiologist spoke to me about open heart surgery and my diseased aortic valve.
- Who will be my surgeon?
- What surgical option should I choose?
- When should I schedule heart valve surgery?
For patients requiring heart valve replacement surgery, another question that arises is, “Which valve should I select for my replacement? What are the pros and cons of that replacement valve type?”
As you are probably aware, there are five categories of valve replacements – human valves (homograft), cow valves, pig valves, mechanical valves and your own valve (an autograft used for the Ross Procedure).
Recently, I received an email, that focused on the biological valve replacement alternatives from animals – including cow and pig valves. The question was simply, “Adam, what are the adverse effects of pig valves?”
Before answering the question, you should know a little bit about pig valves. First off, the more scientific name for pig valves are porcine valves. That’s not a critical point but it does sound a tad better.
By Adam Pick on August 12, 2007
Hi there everybody,
Earlier today, I received an email that reads, “I’m scheduled for heart valve surgery in two weeks, can you please tell me what is the usual prep for open heart surgery?”
That’s a really good question for one critical reason. As I personally learned during my open heart surgery experience, knowing what to expect is incredibly helpful for both the patient and their caregivers. That said, knowing the answer to “What is the usual preparation for open heart surgery?” eliminates the fear of the unknown.
That’s key… Eliminating fear. There are all types of fear with regards to heart surgery – mortality rates, physical recovery, pain after surgery, operative success, reoperation, etc. To help you minimize your fear (if you have it), you may want to read an excerpt of my book, “Dispelling The Fear Of Heart Valve Surgery” by clicking here.
So…. Getting back to the original question, “What is the usual prep for open heart surgery?”
I can detail some elements of the prep here in this blog. But, you should know, it’s a big question to answer. FYI, there are two chapters about this topic in my book, The Patient’s Guide To Heart Valve Surgery. That being said, here are some of the steps that your surgeon may require prior to your surgery:
- Blood work to determine your blood type and other parameters of your body chemistry. If you like, you may draw blood in advance of the surgery. Otherwise, the hospital can typically match your blood via their blood bank. The stored blood may be used if a transfusion is required during your surgery.
- Urine analysis to learn more about your particular body chemistry. Specifically, urine can be helpful in understanding the functioning of your bladder and kidneys.
- Although I didn’t require it, you may need an angiogram.
- A pre-surgery electrocardiogram to further examine the rhythm of your heartbeat and further screen for any cardiovascular disease.
Furthermore, you will be required to sign a Consent For Surgery. If improperly prepared for this moment, it could be a very challenging episode in your heart valve surgery preparations.
I hope this helps!
Keep on tickin!
By Adam Pick on August 10, 2007
When it comes to a successful open heart surgery recovery program, cardiac rehab exercise is critical. Although your cardiologist and surgeon may have a cardiac rehab program already lined up for you post-operation, you may want to find your own cardiac rehab center.
“Why do I care so much about helping you find the right cardiac recovery program?”
Well, after my surgery… Neither my surgeon or cardiologist suggested a cardiac rehab exercise program for me. At eight weeks after my open heart surgery, the result of not attending a cardiac rehab center was devastating. My upper chest was a mess. Specifically, my incision area was incredibly sore and my physical confidence was gone.
I think because I was on the younger side of open heart surgery patients (33 years old), my doctors felt I would “snap-back” into shape. That was a faulty assumption in my case. (FYI, I learned a lot about this while doing research for my book. In actuality, only 49% of patients register and attend cardiac rehab programs during their recovery. In my opinion, cardiac rehab exercise is a must for an efficient and healthy recovery from open heart surgery.)
Anyways, my mom and I located a cardiac rehab progam after consulting with a pain management specialist.
Adam At Torrance Memorial Cardiac Rehab Program
By Adam Pick on August 9, 2007
Ready for a crash course called, “Heart Surgery History 101”?
I don’t know about you… But, as I was preparing for a double heart valve replacement surgery of my aortic and pulmonary valves, some of the questions that ruminated in my cranium were:
- “How long has open heart surgery been around for?”
- “What’s the history of heart valve surgery?”
- “Is a heart-lung machine a new idea or an old idea?”
- “Who was the first cardiac surgeon?”
In light of these questions, I did what most heart valve surgery patients do… I Google’d it!!!!
I wanted to know more about the cardiac surgery history and guess what… Google did not let me down.
Under the search term cardiac surgery history, there were over 2.1 million pages of information.
Under the search term heart valve surgery history, there were 1.7 million pages of information.
And, under the search term heart lung machine, there were 1.9 million pages of information.
(FYI, for fun, I Google’d my own name, Adam Pick. I did the search in quotes – like this “adam pick” – to filter random queries. Only 1,150 pages of information. I guess I’m not as popular as the heart surgery terms above.)
With that said, I found some bits of information and created a page of information to help you better understand the history of heart valve surgery and heart bypass surgery. Click below to read it!
Keep on tickin!
By Adam Pick on August 8, 2007
Ever since I launched this site and published my book, I have received many, many, many emails from the caregivers of patients needing or recovering from heart valve surgery – both heart valve replacement and heart valve repair.
Needless to say, these emails are beyond touching and heartwarming (pun intended). 🙂
It is soooooooo wonderful to read about the love and support that family and friends have for those needing help. I’m trying to post a lot of these stories on this blog, but it is really hard to keep up. The stories of Ted Eisenmann and Michelle Browning exemplify what I’m talking about.
For this reason, I wanted to take a quick, electronic moment to acknowledge all of the caregivers that are helping their loved ones through this trying time. If that means you… Thank you for all you do! Thank you for doing research on heart valve surgery! Thank you for easing the mind of your loved one. Thank you visiting this site!
You are making a tremendous difference in the life of the person you care for!!!
That said, “Cheers To You!!!!”
FYI, this is a picture of Robyn and I on our honeymoon in Fiji last month. I must say, Robyn is not only my wife, she is my inspiration. During my recovery from double heart valve replacement surgery, I suffered a number of setbacks. Each time, Robyn was there to support me, to encourage me and, most importantly, to listen to me. I am so thankful we were setup on a blind date three years ago.
Keep on tickin!
By Adam Pick on August 2, 2007
I just received an interesting email from Carol that directly relates to heart surgery recovery. Carol writes, “Hi Adam – My husband had mitral valve replacement three weeks ago. I’m curious… Did you experience depression after heart valve surgery? Is it common for patients to experience cardiac depression following heart valve repair or heart valve replacement?”
Let me start by answering Carol’s first question. Yes, I did experience both heart surgery and depression. I had my pulmonary and aortic valves replaced in 2005. As for cardiac depression, I did not have any immediate form of depression during my 5 days in the hospital or during the first three weeks following my heart valve replacement surgery recovery. However, as I entered into my fourth week of recovery, I did begin to experience many symptoms of this post-operative condition.
By Adam Pick on July 28, 2007
There are many ways to diagnose diseased or defected heart valves. One of the simplest methods to diagnose problematic heart valves is to listen to the patient’s heart beat sound through a stethescope.
During my diagnosis, my cardiologist listened to my heart murmur sound and said, “Yep. That is definitely the sound of a heart murmur!” As it turned out, I had a bicuspid aortic valve that suffered from stenosis and regurgitation.
I was always curious to know what my heart sounded like. I knew there was a muffle sound to it which indicated the murmur. However, I never heard exactly how a heart beat sound differed between a normal heart sound and an abnormal heart sound.
Well… I recently searched Google and YouTube, looking for heart sound audio. I was amazed what I found by simply typing “listen to heart sound” in the search engine.
“No More Murmur!!!
I even pulled out my own stethoscope to see how my heart sounded now versus the other abnormal sounds on the web. My heart sounded pretty darn good after my double (aortic and pulmonary) valve replacement!!!
That said, here are some heart sounds (and an educational explanation) if you would like to hear the murmurs for yourself:
I hope that helped you learn more about normal and abnormal heart sounds.
Keep on tickin!
By Adam Pick on July 27, 2007
As most heart valve surgery patients will share with you, there is a certain amount of fear that appears during the recovery from open heart surgery. As an heart valve surgery patient, your sternum has been cracked and your heart has been stitched….. OUCH!!!
That said, most patients typically require a recovery period following heart valve surgery which is used to restore (i) mental confidence and (ii) physical capability of the upper chest. As a former cardiac surgery patient, I can personally relate and attest to this.
From stretching at cardiac rehab to running along the beach, it takes a significant amount of time to heal and get back in the physical swing of things. The saying, “No pain. No gain.” actually applies somewhat to heart valve surgery recovery.
I’ll never forget when my surgeon told me to “Play through it Adam!” Dr. Vaughn Starnes, my cardiothoracic surgeon, was referring to the soreness and pain I complained about in my chest. “Your heart is doing great,” he said, “Better than before! Now you just need to play through it. Your discomfort is muscular-skeletal.”
I took those words of wisdom to heart (pun intended).
Soon enough, I found myself lifting light weights, swimming laps in the pool, riding my bike and even running. Once I graduated from cardiac rehab, I took on another challenge… Returning to my surfboard!!! (See my “Surf’s Up!” blog to read about my return to surfing.)
Recently, I broke through another physical barrier that I will share with you:
In 1999, I became a certified SCUBA diver. Shortly thereafter, I became a SCUBA diving nut. During the following five years, I logged over 100 dives across the United States, Mexico, the Carribean, Bali and Thailand. SCUBA diving is an amazing sport. It’s probably the closest I will ever get to being an astronaut.
Considering my valves were replaced using the via the Ross Procedure in 2005, I figured that my days of SCUBA were over! However, just to be sure, I emailed Dr. Starnes and asked him whether or not I could SCUBA dive following my cardiac surgery. His response was clear. The email read, “You are fine to go scuba diving after heart surgery.”
I have to admit I was happy and concerned at the same time. On one hand, I desperately wanted to get back in the water, submerge 50 feet and swim with all types of fish, eels, sharks, coral and anemones. On the other hand, I was a little frightened that Scuba diving after heart surgery could be disastrous. “What if something wrong happens?” I thought to myself. “What if the pressure under water compromises my valves?” A million different “What if’s” drifted through my brain.
Well… Fear, as you probably know, can be a dangerous mind-game. Someone once told me that fear is really nothing more than a foolish acronym, F.E.A.R.
Life is too short to be controlled by F.E.A.R., right?
Needless to say, during my recent honeymoon to Fiji… I slipped into a wetsuit, popped on my buoyancy control device, and.. BLEW SOME BUBBLES!!! (That’s diver slang for going SCUBA diving.)
Guess what? I’m still alive!!!!
Guess what? Robyn, my new bride, also dived with me. It was her first dive. She did great!!!
Now… What else can I do? Maybe… Go to Tibet and climb Mount Everest like Veronika Meyer?
I hope this helped you learn more about Scuba diving after heart surgery.
Keep on tickin!
By Adam Pick on July 23, 2007
So, I’m on my honeymoon in Fiji… It’s been 19 months since my Ross Procedure.
Life couldn’t be better!!!
After an amazing wedding, Robyn and I are enjoying a wonderful resort in Savusavu called Namale. Our days are filled with Scuba, snorkeling, hiking, horseback riding, bowling (yes bowling), backgammon and… an endless supply of tasty food.
One night, Robyn and I are sitting around the Kava bowl meeting other honeymooners and enjoying Joe, the lead guitarist of the Namale band. Next thing I know, I’m speaking with Pettine, a delightful member of the Namale staff. Pettine has a contagious laughter and the warmest smile.
We share our backgrounds and somehow it comes out that I had heart valve surgery a few years back. Pettine looks at me with concern and says, “Noooooooooooooo. You? You look sooooo young! Heart surgery? Come onnnnn. Noooohhh?”
Pettine simultaneously points to her chest with both hands and queries me, “Ya mean the surgery with the scar down the middle of your chest?”
I nod my head up and then…. I nod my head down, “Yes”.
By Adam Pick on July 8, 2007
Robyn and I got married yesterday.
An amazing, perfect day in Malibu…
So many wonderful memories…
I am the luckiest man in the world.
We’re off to Fiji for the honeymoon.
Keep on tickin!
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.