Adam's Heart Valve Surgery Blog – Page 79

Earlier today, it was announced that Dr. Robert T. Light, American Board Diplomat of Psychiatry and Neurolgy, would provide expert medical commentary on Adam’s Heart Valve Surgery Blog.

Dr. Robert T. Light is a practicing physician in Virginia Beach, Virginia and specializes in drug interactions, human physiology, psychiatric medicine.

“I am thrilled to welcome Dr. Robert Light to our growing team of experts focusing on patient care specific to heart surgery,” noted Adam Pick, the author of The Patient’s Guide To Heart Valve Surgery and blog moderator.

Adam’s Heart Valve Surgery Blog was launched in December, 2006 to serve as a resource for both patients and caregivers dealing with the realities of heart valve repair and heart valve replacement – from diagnosis through recovery.

“Adam has taken his own experience as a heart valve surgery patient and created something very unique and very helpful for patients and caregivers around the world,” Dr. Robert Light stated. “I am very excited to share my own thoughts and medical expertise on Mr. Pick’s cardiac surgery blog.”

Dr. Robert Light has already begun sharing his thoughts on prior blogs including Coumadin and Prilosec as well as Contraindications of Ultram and Coumadin.

I must admit. Entering Torrance Memorial Cardiac Rehab Program was the turning point in my recovery from aortic and pulmonary heart valve replacements (known as the Ross Procedure). That said, I am a big, huge, tremendous fan of finding a good cardiac rehabilitation program following open heart surgery.

“Why?” you are wondering.

Adam Pick At Torrance Memorial Hospital
Cardiac Rehab Program (California)

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The other day, I wrote a blog about the Contraindications of Ultram and Coumadin. Since then, I have been bombarded with questions about other potential issues, conflicts and side-effects of Coumadin (Warfarin Sodium). That said, I will respond to each of your questions over the next few weeks. To advance this topic, I have consulted with a psychiatrist who might be co-blogging with me on this subject.

Anyways, one of the questions I recently received was, “Are there any potential issues of taking Coumadin and Prilosec following heart valve replacement surgery?”

First off, it helps if we understand what the drugs Coumadin and Prilosec are and what they were designed to do. As I have previously written, Coumadin is used by heart valve replacement patients following surgery to prevent blood-clots on their mechanical heart valve replacements.

Prilosec, on the other hand, is used to treat symptoms of GERD, or gastroesophageal reflux disease, and other conditions resulting from excess stomach acid.

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It was six months after my aortic and pulmonary valve replacements (known as the Ross Procedure). I was back at work sitting at my desk when….

All of a sudden, my heart felt like it was flip-flopping and beating upside-down in my chest. Literally, my heart started doing a foreign dance. It was one of the weirdest feelings.

Then, it was gone. My heart returned to its normal beat. Sixty seconds later, I was on the phone with Dawn, the nurse of my cardiologist, Ben Rosin at Torrance Memorial Hospital. Dawn was pragmatic. She asked me to describe the sensation.

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Earlier today I received an interesting question regarding Coumadin (Warfarin Sodium) and the drug Ultram. Specifically, the question read, “Are there any contraindications of Ultram and Coumadin?”.

I have to admit, this is the first time I ever heard this question. That said, I became intrigued by the possibility of learning even more about Coumadin and whether or not there were any contraindications of Ultram and Coumadin. As you may know, heart valve replacement patients which select mechanical valves are typically required to use Coumadin (generic name Warfarin) to prevent clots from forming on the mechanical valves.

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So, I just received an email asking, “Do you have any pictures of a bicuspid aortic valve?”

Well, considering I had a bicuspid aortic valve for the first 33 years of my life, I definitely researched and located pictures of bicuspid aortic valves for my book.

As you can see below, the aortic valve on the left is normal – the valve has three leaflets and three cusps.

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I just received an email from Eddie who is preparing for his heart valve replacement surgery. Eddie has mitral valve prolapse and severe mitral regurgitation. Eddie is 67 years old and is considering a tissue valve. Specifically, Eddie is leaning towards a porcine valve (aka a pig valve) and has several questions.

Eddie writes, “Adam – My surgeon has had a lot of success with porcine heart valve transplants. But, I still have questions including… What exactly is a porcine valve? Do you have any pictures or images of porcine valves? Are there any adverse effects of using a porcine valve? Are porcine valves safe? Thanks, Eddie.”

These are critical questions for the valve replacement selection process. That said, I’m going to do my best to answer Eddie’s questions about porcine valves.

First, let’s see what a porcine valve looks like. While there are several porcine valve manufacturers, above you will find a picture of an Edwards Lifesciences’ mitral valve replacement, known as the Carpentier-Edwards valve. Recently, I toured Edwards manufacturing center and learned how porcine valves are manufactured.

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One of the most common questions I receive about heart valve surgery focuses on the “recovery”. As you can read in my story, I had a special type of aortic valve surgery known as the Ross Procedure.

That said, I can provide some personal insight in answering questions like:

• “What is it like recovering from aortic valve surgery?”
• “When did you return to work?”
• “Is the recovery from aortic valve surgery painful?”

As you can probably tell, the list of questions regarding the recovery from open heart surgery could go on and on and on and on.

In my opinion, this is one of the biggest problems with cardiac surgery today.

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Earlier this year, I interviewed 78 patients about their heart surgery experience. Most of those patients had open heart surgery – including heart valve replacement surgery and heart valve repair operations.

One of the questions asked during this survey was, “Did you travel outside your hometown for your cardiac surgery?”

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I will never forget my first interview with a heart surgeon.

My cardiologists – Dr. Wyman and Dr. Chaikin – had already confirmed that my aortic valve was suffering from severe stenosis and regurgitation. As they both told me, I needed a new valve and I needed it soon.

That first, surgical interview I held was with Dr. Alfredo Trento, the Director of Cardiothoracic Surgery at Cedars-Sinai Medical Hospital in Los Angeles, California.

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The heart is an amazing muscle. For reasons described on this previous blog, “The Anatomy And Heart Function“, I am constantly marveling at all the complex elements that makes the heart operate. Interestingly enough…

Electricity has a lot to do with the actual starts and stops (aka contractions) in the cardiac conduction system. That said I thought you might like to see a diagram of cardiac conduction system.

I could go on and do my best to scientifically explain the cardiac conduction system illustration above. However, it’s the Internet age. So, I’m going to let the American Heart Association do that for me. Here is a link to an article all about the “Diagram of Cardiac Conduction System”.

It’s actually a very, very, very interesting article!

Keep on tickin!
Adam

As I remember…

When I was first diagnosed with heart valve disease, my immediate thought was, “Okay. What’s the first step to treating it? It must be curable, right?”

For this reason, when I receive an email that reads, “What’s mitral valve prolapse? Or, how can I cure mitral valve prolapse?”, I tend to stop and remember that moment.

As for the first part of the question, mitral valve prolapse effects the flaps (or leaflets) of the mitral valve. Simply put, the valve leaflets don’t seal properly. In mitral valve prolapse, one of the flaps, or leaflets, moves back into the atrium when the heart beats. This “prolapse”, or buckling, enables blood to flow from the ventricle back into the atrium as shown in the anatomy of the heart.

So you know, about one in twenty Americans has mitral valve prolapse – so, it’s a relatively common heart valve disorder. People are usually born with it as a congenital condition. Interestingly, more women have mitral valve prolapse and mitral valve prolapse symptoms than men.

Now, for the tough part of the question… “How To Cure Mitral Valve Prolapse?”

Well, the first thing you should know is that many people with mitral valve prolapse do not need to treat, or cure, their mitral valve prolapse. If the blood flow back into the ventrical is trivial, no treatment is necessary.

However, if the blood flow back into the ventricle is significant – a cardiac disease known as mitral regurgitation – the heart becomes strained as it is forced to work “overtime” to help circulate blood throughout the heart. If this occurs, symptoms of mitral valve prolapse may manifest in the patient.

• Sometimes, this may result in the patient taking medication to enhance the flow of blood through the mitral valve.
• Other times, if the mitral valve prolapse is very significant, the patient may need to have mitral valve repair or mitral valve replacement surgery.

I hope this help you better understand mitral valve prolapse and how to cure it.

Keep on tickin!
Adam

One of the most common questions I get via email is about heart valve disease symptoms. I just received an email that reads, “What are the tricuspid valve regurgitation symptoms?”

It’s a great question. Knowing what the documented, heart valve disease symptoms is critical as the patient or caregiver tries to diagnose themselves or their loved. But, you should be aware, some patients are completely asymptomatic – see more below. As discussed in the anatomy of your heart valves, the tricuspid valve is one of four valves in your heart. Along with the mitral valve, the pulmonary valve, and the aortic valve, the tricuspid valve acts to help manage the flow of blood in one direction through your heart. Similar to the pulmonary and aortic valve, the tricuspide valve has three leaflets.

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Hey eveybody,

One of my readers from Chicago, Tracey Orr, had heart valve surgery on Monday at 7am.

She had a cow valve replacement surgery.

According to her husband, Tracey is still in the ICU.

Unfortunately, Tracey’s heart rhythm has yet to stabilize.

If you have a moment, please wish Tracey a great, big healthy prayer.

Keep on tickin!
Adam

I’ll never forget the first time I heard the phrase “Pumphead”. I was interviewing a former patient about her heart valve surgery experience for my book.

She was discussing the short-term mental impact of open heart bypass surgery. Specifically, she was remembering a challenging time during her recovery when she suffered from cardiac depression.

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Leading up to my heart valve surgery, I had always been active and athletic. From soccer to surfing, I really enjoy sports. Mostly, I think I like being outside. But, I also like the endorphin rush after a good run, swim or hike.

Adam Pick At Cardiac Rehab Clas

Interestingly enough, I was never really interested in monitoring my heart rate during the first 35 years of my life. Then… I had my open heart surgery.

Guess what? From then on, I became a little more interested in the pattern of my heart beats. I really became good at heart rate monitoring during my second month in cardiac rehab. Thanks to the excellent help of Debbie, Karey and Socorro at the Torrance Memorial Cardiac Rehab Clinic, I was able to get a solid understanding of how and when to (i) increase my heart rate and (ii) decrease my heart rate.

To help me, I purchased an inexpensive heart rate monitor. I believe you can get heart rate monitors at most sporting stores (Sport Chalet, Big Five) or Wal-Mart. I just looked at Amazon. If you want, click below and you will be taken straight to Amazon’s heart monitor section.

I think my heart monitor cost $40. From what I hear, you should not buy an expensive model. Most of the monitors (e.g. Polar) all use the same technology.

Keep on tickin!
Adam

Earlier today, I received a question that reads, “Do you have a cat scan of the aorta? How are cat scan aorta images used during diagnosis?”

I’m not sure I completely understand this questions. But, it turns out that I just found a cat scan image of the aorta. But first, I thought we all might want to know a learn a little more about what a cat scan is and how cat scans are used relative to heart valve surgery. As Radiology Info notes, CT scanning—sometimes called CAT scanning—is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions.

CT imaging uses special x-ray equipment to produce multiple images or pictures of the inside of the body and a computer to join them together in cross-sectional views of the area being studied. The images can then be examined on a computer monitor or printed. CT scans of internal organs, bone, soft tissue and blood vessels provide greater clarity than conventional x-ray exams.

Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders.

Here is a cat scan picture of the aorta:

According to Radiology Cases In Peditric Emergency Medicine, the cat scan aorta image above is from a 15 year-old male who is complaining of chest pain. The CT scan demonstrates a small, left-sided pneumothorax. The arrow (above) points to the air space within the pleural space. That said, the aorta is normal.

Wow. That was way over my head!

Regardless, I hope this helps you better understand what a cat scan of the aorta looks like.

Keep on tickin!
Adam

As I have posted in prior blogs, there are a number heart surgery centers that are practicing heart valve repair and heart valve replacement using minimally invasive procedures including robotic surgery devices and transcatheter approaches.

That said, I received a few emails asking me if I have any keyhole surgery images that explain how this non-invasive heart valve surgery occurs.

Luckily, I do.

Here is a keyhole surgery image that explains how aortic heart valve replacement occurs using a catheter.

If you are interested to read patient success stories using this procedure style, please click below:

• Pulmonary Valve Replacement Patient Success Story
• Keyhole Aortic Valve Replacement Patient Success Story

I hope the keyhole surgery images and noninvasive heart surgery patient success stories help!

Keep on tickin,
Adam

Over the past week, I have been sharing with you the story of Melissa Causey. Melissa and I became friendly after her Uncle Ted sent Melissa a copy of my book.

If I remember right, that was about two months ago. Like me, Melissa needed aortic valve replacement surgery. And, like me, Melissa chose the Ross Procedure technique as her surgical option.

Throughout this process, Melissa has had an amazing attitude. Although I’m sure she had her moments of fear, uncertainty and doubt (like most heart valve surgery patients), her story is inspiring.

Last Tuesday, Melissa entered the hospital for her heart valve replacement operation. Dr. William Ryan of Cardiothoracic Surgery Associates of North Texas, a highly regarded Ross Surgeon specialist, was Melissa’s surgeon.

Guess what? Today, five days later, Melissa will be going home. Amazing!

Wooo-Whooooo!!!!

Keep on tickin!
Adam

Every so often I receive an email that really makes me remember my heart valve surgery experience, especially the recovery.

Some of those memories are joyful. And, some of those are…. well… not so joyful.

This blog is in response to an email that reads, “How sore are your chest muscles after heart surgery?”

Hmmmmm. To answer that question, I have to let you know that there are many different types of heart surgery – some procedures require the sternum to be split and some heart surgeries are noninvasive that do not require “chest cracking”.

My aortic and pulmonary valve replacements surgery (the Ross Procedure) required my chest bone to be broken to give the surgeon better access to my heart.

That said, I will respond to the question about chest muscles after surgery from my own personal perspective.

Make sense?

Okay. Here goes.

“Owwwwww!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!”

Yep. That about sums it up! I could go on and on but I won’t.

So you know, I have interviewed over 100 patients about their chest muscles after heart surgery and they all basically say the same thing…

“It hurts! But, sore chest muscles after heart surgery is a small pain for a long-term gain!”

I hope this isn’t too honest. I just want to give you the patient’s perspective on the realities of heart valve surgery.

I write a lot about the recovery, chest pain and healing in my book. If you’re interested you may want to read it.

Keep on tickin!
Adam