Adam's Heart Valve Surgery Blog – Page 74

I just received a great, often-overlooked question from Tim who asks, “Hey Adam – I just saw the pictures of your chest scar after heart surgery. I’m curious to know… Did you use any special creams or gels to assist in the incision healing?”

The answer to that question is a definite “Yes!” I used a product called Mederma. The gel is an over-the-counter product that does not require a prescription. You can purchase Mederma at most pharmacies. If you are interested, they have a $2 off coupon at the Mederma website. 🙂

However, please make sure that you ONLY USE MEDERMA as directed. Do not use Mederma right away. I think you need to wait two weeks after your surgery. And, I made sure it was okay with my surgeon, before I started using it. My surgeon, Dr. Vaughn Starnes, looked at the Mederma ingredient listing on the package and said, “This looks pretty good. Go ahead and try it out!”

Keep on tickin!
Adam

A little over a month ago, I visited Edwards Lifesciences to tour its heart valve manufacturing museum and learn more about Edwards’ heart valve replacement devices (pig valve transplants, cow valves, minimally invasive technologies).

After reading my blog, Debbie (a recent heart valve surgery patient) decided she wanted to visit Edwards as well. A few emails later, Debbie was on her way to Edwards’ headquarters in Irvine, California to visit the world’s largest heart valve manufacturer. Considering that Debbie’s cow valve replacement was manufactured by Edwards, I guess it was sort of a homecoming for Debbie’s new pulmonary valve.

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As you read the success stories of heart valve surgery patients (Veronika Meyer, John DeFalco, Taylor Browning, Leslie LaFayette, Raye Gilliamsen, John Turan), it is great to see that medical care can have an incredibly positive impact on heart valve disease.

However, it seems like everywhere I turn these days, reports of bad medicine are all around me. In the past few days, I’ve read or watched terrible stories about:

• Trasylol and heart surgery
• Drug administration mishaps that endangered and/or resulted in the unfortunate passing of several children
• Negligent surgical preparations alleged to be the source of Stephanie Kuleba’s recent fatality

During a 60 minutes report about Dennis Quaid’s children, I heard a troubling statistic. The actor revealed that over 100,000 hospital deaths occur each year as a result of human error. That’s more fatalities than AIDS, breast cancer and auto accidents combined.

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Prior to heart valve surgery, patients are faced with many, many, many questions. One of those questions is specific to potential blood loss during the operation. That question is, “Would you like to donate your own blood or use blood from the hospital blood bank?”

I’ve written about this topic of blood banks and heart surgery before.

However, I just read an interesting article at the Mercury News which reveals that heart surgery patients treated with donated blood older than two weeks were more likely to die or suffer problems than those treated with fresher blood.

Which makes these findings — about blood bank safety — even more problematic is that blood supply is chronically low.

“If the shelf life was reduced from 42 to 14 days, we just wouldn’t have enough blood around,” said Dr. Ross Herron, medical director of the American Red Cross Bay Area, which sends blood to hospitals throughout the East Bay and South Bay. “We need to have that shelf life to move blood around.”

I did not donate my own blood prior to my aortic valve replacement operation. Luckily, Dr. Starnes did not need a transfusion during my surgery. However, given these findings I would probably change that approach if I was to need heart surgery again. To learn more about aortic valve replacement, click here.

I hope this helps you better understand blood bank safety.

Keep on tickin!
Adam

A few days ago, I posted a blog about what normal heart valves look like.

Well… Here’s a quick, interesting follow-up to that story about each of the four heart valves.

I was just on Youtube.com and came across a very neat video which shows each of the four heart valves opening and closing within during heartbeats – the aortic valve, the mitral valve, the tricuspid valve and the pulmonary valve.

It’s a pretty fascinating video that shows not one but each of the four heart valves, so I thought I would share the link.

I hope this helps better explain how the four heart valves open and close.

Keep on tickin!
Adam

The incision on my chest was throbbing.

It was two weeks after my aortic valve operation and I had taken my last Vicodin several hours earlier. While we had a refill, it was late at night (around 9pm) and our local Rite-Aid was closed.

Robyn (my wife) frantically searched Rite-Aid’s website to find a 24 hour pharmacy. Luckily, there was an all-night pharmacy about twenty-five minutes away. In a split-second, she kissed me good-bye and was out the door.

She returned about an hour later with my pain medication. (Robyn is my guardian angel.)

My point of this little story? Be prepared. If possible, find out (in advance of your heart valve surgery) where a local 24 hour pharmacy is. You may need it for pain medication, severe constipation, etc.

Keep on tickin!
Adam

Given my recent blog about heart valve surgery in patients over eighty, I thought you might like to read about John DeFalco from Ponte Vedra Beach, Florida.

His daughter, Coreen writes to me:

My father, John DeFalco, is 83 years old. Due to his age, our doctors told us he was at high risk for aortic valve replacement surgery. (Click here to learn about AVR.)

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This is the courageous, patient story of John Turan. As you will read, John had a triple-whammy heart surgery – a Ross Operation (aortic and pulmonary valve replacements) AND his ascending aorta was replaced due to an aneurysm.

I could go on-and-on about John, Mercy (his wonderful mother) and Dr. Bleiweis (his incredible surgeon), however, I think it’s best to hear his side of the story.

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I met Carolyn, a heart valve surgery patient, last Tuesday. We chatted on the phone about her bicuspid aortic valve and her upcoming surgery. Carolyn is currently doing her diligence on surgeons. That said, we talked alot about the process of how to find the right surgeon and how to interview your surgeon.

A few minutes after we hung up the phone, I received a follow-up email from Carolyn.

“Adam, I forgot to ask you something. We live in a two-story home. There is no bedroom on the first floor. Will I have trouble walking up and down the stairs after surgery? I imagine I will have to stay upstairs for a while? After my back surgery (a few years ago), I came down in the morning and went up at night for a while. Any thoughts?”

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As a follow-up to my post about pig valve transplants, I received a specific question, “Do you know exactly how long a pig valve might last in the human heart?”

It’s a good question for patients to consider as they determine which is the best valve type for them – biological (pig valve, cow valve) or mechanical.

According to Dr. Isadore Rosenfeld, “Pig heart valves do not last as long as mechanical valves and for that reason are not usually implanted in patients much younger than 60 years.”

Dr. Rosenfeld continues, “Although recent reports from The Cleveland Clinic (whose surgeons have a great deal of experience replacing heart valves) suggest that the newer biological valves often last 17 years or longer, they frequently must be replaced after 15 years. So, except in unusual circumstances, younger patients still are given a mechanical valve.”

I hope that helps explain more about how long pig heart valves last in the human heart.

Keep on tickin!
Adam

Like many heart valve surgery patients, I was born with a bicuspid aortic valve. However, unlike many of you, I was not diagnosed with the bicuspid aortic valve defect as a newborn baby. It wasn’t until I was five years old that my family doctor heard my heart murmur. After that, diagnosis of the bicuspid valve was formally issued following my first visit to the cardiologist.

After I had an aortic valve replaced, I was curious to know, “How do bicuspid aortic valves impact newborns?” and “What other problems can bicuspid valves cause in newborns and children?”

I knew that the bicuspid aortic valve occurs when the aortic valve does not develop normally while the baby is in the womb. However, I wanted to know more.

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I just received a question that reads, “Adam, can you tell me more about pig valve transplants? My surgeon thinks that is the best valve choice for me.”

Sure thing. However, I want to make sure you know there are other options for tissue (also called biological) valve replacements besides pig valve transplants. The four key types of biological valve replacements are:

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I just received a question that reads, “Can you tell me all the different heart valve disorders, treatment and surgical procedures to fix heart valve disease?”

I have to admit, that is a HUUUUUUUUUUUUUGE question. As you probably know, there are many different forms of heart valve disorders and their are many different types of valvular treatment.

That said, to answer this question about heart valve disorders, treatment and operations would take the rest of the week (and it’s Monday morning).

However, I have created the Heart Valve Learning Center to help you get started answering this question about heart valve disorders, treatment.

Keep on tickin!
Adam

I was recently asked by Doug, a patient preparing for heart valve replacement, “Have you been weightlifting after open heart surgery?”

My answer was a definitive and delightful, “Yes. I have lifted weights after open heart surgery.”

However, I DID NOT rush back into the weight room after heart valve replacement surgery. It took several months before I was lifting weights again. You should also know that I never lift to bulk-up.

Doctor Vaughn Starnes, my heart surgeon, told me that lifting heavy weights puts additional strain on the heart valves. Over time, the strain on the heart valves can become problematic – both before and after surgery. That said, Dr. Starnes told me to lift for tone (repetition) not for muscle build-up. To learn more about my surgeon, click here.

I’ve taken his advice to heart (pun intended) and really focused on aerobic exercises I learned to really enjoy during cardiac rehabilitation.

Remember, heart valve surgery SHOULD NOT be the end of your active lifestyle. However, to be incredibly safe, I suggest you contact your surgeon to discuss weightlifting after open heart surgery. As you probably are aware, every patient is unique.

Keep on tickin!
Adam

It was my third day in the hospital. I just had my aortic valve replaced.

Even though my surgery was deemed a complete success, I was experiencing significant respiratory pain due to a common heart surgery complication. There was fluid in my lungs.

It hurt to breathe – like a little pinch or cramp in my left side after every inhale and every exhale. My medical team started me on respiratory therapy. So, throughout the night, I did fifteen minute breathing exercises at 11pm, 2am and 5am.

I was ab-sooooooo-lutely exhausted.

Then, my wonderful family began to arrive at USC Medical Center. It was Saturday morning. The “Adam Pick Family Support Machine” was in full force. First, my wife (Robyn) arrived. Then, my parents, my brother, my sister, her husband and their children trickled in.

Room 550 had turned into a zoo.

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I think it’s called a coincidence, or maybe serendipity, or even deja vu.

Regardless of the official terminology, I just received two, back-to-back email questions about cigarette smoke and heart valve surgery. That’s pretty strange because I have never received any questions about cigarettes during the past 18 months I’ve been writing this blog about heart valve replacement and heart valve repair. Quite odd, right?

Anyways, the first smoke-related question I received was from Michelle, a concerned mother and caregiver. She writes…

“Hi Adam – I have an 8 year old daughter who had open heart surgery when she was 4 years old. She had a mitral valve repair. Long story short, she is doing wonderful. My problem is, my fiancé does not understand me how dangerous it is for my daughter to go to his mothers house to visit. My fiance’s mother and her husband are smokers. They smoke inside their house. Can you help me with some facts that I can bring to my boyfriend’s attention to help him realize the truth about second hand smoke and heart patients.”

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Ever wonder, “What does a normal heart valve look like?”

I did.

So, I thought you might want to know what I learned before I went into my aortic valve replacement surgery.

First, you have to know that all heart valves do not look the same. As you can see in the diagram of the heart below, heart valves differ in size. The aortic valve and the pulmonary valve are smaller than the mitral valve and the tricuspid valve. And, you can also see that the mitral valve is the only valve that is naturally bicuspid. A bicuspid valve only has two leaflets while all the other valves have three leaflets.

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My inbox is filling up with some very interesting questions. I just received a question that reads, “Is stress a symptom of mitral valve leakage?”

As I’ve written before, there are several leaking heart valve symptoms identified by leading heart care facilities including The Cleveland Clinic and The Mayo Clinic. (Please click here to view those symptoms.)

However, from my own research, I have not seen any clinical studies which suggest that mitral valve leakage is directly related to stress (as a symptom). However, as a former patient, I could very easily see how being diagnosed with mitral valve leakage creates stress.

If you have any, extra information on this topic of stress and mitral valve leakage, please help out and leave a reply below.

Keep on tickin!
Adam

Yes, Forrest Gump is one of my favorite movies.

That said, I had to borrow that famous line for this very rare patient story about Brad Mueller. In case you can’t remember the complete movie quote, Forrest Gump said in the movie, “My momma always said life was a like a box of chocolates. Ya never know what you’re gonna get.”

Brad and I started emailing each other a few months ago. Brad had read my book and had some additional questions about stamina after heart valve replacement.

On February 29, Brad went in for an aortic valve replacement. Brad’s surgeon was Dr. John Oswalt from Austin, Texas. Like me, Brad had a bicuspid aortic valve with an erosion due to endocarditis. Over time, the endocarditis had severely compromised the integrity of the aortic valve.

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I just received a great question via email. In fact, this particular question brought back memories to when I was first diagnosed with severe aortic stenosis and told that I needed heart valve replacement surgery.

The question reads, “Adam – Do you have any statistics about the success or failure rates of heart valve replacement surgery?” Interestingly enough, I have collected some statistics about how successful heart valve replacement surgery is.

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