Michael's Guestbook

Michael Shaughnessy  Been away from the site for awhile. Good luck. I haven't missed a workout in almost 3 months straight! It sucks that your first surgery needs repair, but we all know the day will come. My daily mind and body workouts are preparing me for my next surgery, whenever that arrives. I am ready. Run on. I live in Cleveland. Give me a call if your local and I can cheer you on. Mike

Frances Halley  Thanks Michael. My current work day is drawing to a close but I will be working on Monday as well. I'm waiting to hear from Allegheny General with the actual surgery time on Tuesday morning. I think I will be the first case. Tell your mom and dad I send my greetings and I hope you all have a great holiday.

Michael Shaughnessy  My position is steadfast. In todays world of anticoagulants, I do not want to be on them. Given the choice for more surgery versus a mechanical valve, I choose more surgery. A mechanical valve probably won't last long enough either. I'm counting on technology advancing as rapidly as it has been that our choices wont be so limited when its time for my next surgery. My replacement valve works at 100%. It was evaluated as "normal" at a recent echo 4 years out of surgery. I am not a cardiologist and cannot speak about re-repair outcomes. If you were my daughter, I would not want you on anticoagulants, and would recommend an UNstented biologic valve. Hope this help.

Emily Rowley  What happens when a mechanical valve doesn't work properly, do they need replacing?
How long do they last?

Me too, in years to come hopefully medical advances with continue.

That's great to hear! :D

Does the pig valve she described to me sound like it could be unstented? I wasn't given a choice in stented or stentless...

Aw is that because the affects Anticoagulants have?

Is it true tissue valves calcify during pregnancy?

Michael Shaughnessy  I have commented extensively on this subject. My valve , the Medtronic Freestyle, is pure tissue. Our discussions on this site do not go into detail of mechanical versus stented tissue versus unstented tissue. Unstented tissue have the BEST hemodynamics of any valve but are technically more difficult to implant. If your surgeon doesn't use them his/ her experience / skill will prevent them from trying them. There are a lot of studies of stented versus unstented. I knew mechanical was a no for me. Coumadin is too dangerous of a drug especially for my lifestyle. Stented valves have more complex second surgery. Unstented xeno or homografts act as closely as possible to a natural human valve. No clicking, no high transvalvular gradients, excellent LV function, good lifespan. My surgeon has a few patients now 17-18 years with a Freestyle. Mine is 4 and on echo is indistinguishable from a normal valve. I count my blessings and am only a study of one, but a very successful one.

Enrique K  Hello Steve, Michael commented on this 8 days ago extensively look for that post it's more descriptive under Peter Bergan. I too myself being a very active person and getting a pig valve (porcine) was the best decision I could have ever made. I am 4 weeks post-op and feel stronger and stronger each day. My surgeon told me he has a few patients that have tissue valves going on for 20-25 years. Even if it's 10-15 years I will take that rather than taking Coumidin all my life and listen to a clicking noise of my valve opening and closing. I have researched this subject extensively and for me personally I know the decision was the correct one.

Michael Shaughnessy  The naproxen could certainly be affecting your stomach but your protonix should be getting rid of all the acid. Baby aspirin and metoprolol should not be causing it. I personally found after my heart surgery that my appetite and eating habits were drastically different for several months. I would recommend smaller meals avoiding spicy or fatty foods. Also you might want to add a probiotic to your daily routine. If you are still struggling get in to your PCP. I think an ulcer would be unlikely unless you have a history. Make sure you have regular bowel movement as well. Your body is still healing. Give yourself time to get to your new normal.

Enrique K  Michael, thank you so much for the detailed response I will go ahead with your suggestions. No history of Ulcer will update you on my progress. Again, you have been such a great help.

Michael Shaughnessy  Staph definitely more common these days. Washing is best preventive medicine. Your cultures should have ID'd the exact species of Staph and its sensitivities. If you are a carrier for some of the worse strains like MRSA that can be tested with nasal and throat swabs. Infection was my biggest worry with surgery. If your eye infection was MRSA or other "bad" staph; definitely get tested by an infectious disease specialist prior to heart surgery. A post op infection can be deadly. I live in Solon (grew up near you went to St Ignatius) and am in the book. Feel free to call me and talk more details.
Mike

Peter Bergan  Thanks for the advice; I will definitely follow up with the Infection Disease doctor -- they initially did think it was MRSA.

I also went to Ignatius (Class of '02). I may reach out to you after my mid-December consultation/pre-op appointments. Thanks for your help.

Michael Shaughnessy  I diagnosed my own murmur at age 25 in medical school listening to my own heart. I saw doctors from the Cleveland Clinic and UH over the next 17 years and other than my echoes, no one ever recommended any other imaging. My aneurysm was just above the sinus. My aortic root was slightly enlarged but not enough to concern any of them. I am not interested in going back to ask them why. I have a lot of marfanoid characteristics and in hindsight I should have been screened for defects. I have had a good life. Dr. James Fang from UH (now in Oregon) saved my life. I would have never seen my next echo. He ordered my first MRI in 2011. I have observed over the years in practice that sometimes patients have a hard time owning their diagnosis. My heart disease is programmed in my DNA. Medicine continually evolves. 100 years ago most of us are not survivors. My murmur was present at birth but ignored as a normal variant in a healthy baby. I cannot go back. My defeats in life lay out the paths for winning and succeeding. No regrets. No excuses. Dr. Alan Markowitz performed my surgery at University Hospitals of Cleveland. (I did get a consultation at the Clevekand Clinic.). I have previously posted why I chose UH over CC. My doctors will come and go over the next, hopefully 40-50 years, and I continue to get my regular MRIs (every other year) and echoes (annually). I control my disease it does not control me. It guides me but does not define me. More hurdles are inevitable. I am grateful to be alive. Eyes to the future.

Gregg Nissly  Michael, can you lead me to the post on Warferin that Enrique refers to? I'm still on the fence. I'm an active 54 year old getting an AVR.

Thanks.