Bill's Journal

Rose Madura  I'm not a dentist or a doctor but I would think one (no matter the age) would only need a periodontal cleaning if you have periodontal disease. Maybe I'm wrong?

Joanne Heckmann  May I ask why your wife is going to an endodontist rather than a regular dentist?  That may give a clue as to why she was told this, and you were not.

Susan Lynn  If regular cleanings aren't sufficient to stay ahead of plaque buildup, or the patient has periodontal pockets, a periodontal cleaning might be necessary. But, since periodontal clearings require scaling (scraping) under the gum line, there's usually a lot of bleeding - it's unavoidable. Unfortunately, bleeding is the way germs from the mouth get into the bloodstream and hence the heart. I wouldn't be inclined to get periodontal cleanings prophylactically.

Anna Rakowicz  My husband has gum disease and goes regularly for periodontal cleanings. Though I get regular dental cleaning every 4 mos vs every 6 mos, periodontal cleaning has not been recommended for me. 

Robert Miller  I did read that dental hygiene can influence heart health. I am not sure how but I suspect it makes a pretty small difference. Still, I asked Adam if he could do some educational course about this topic. 

Bill Gillam  I agree that periodontal cleanings would cause excess bleeding over routine cleanings so I will proceed with routine cleanings twice per year with antibiotics.  My wife was at the endodontist for a root canal and just waded into the topic because of me.  By the way yesterday was my sixth valve-a-versery.  Sorry for not responding to  y'all earlier. 

Adam Pick  Hey Bill!!! Great to hear you are doing so well 2+ years after surgery! Take care and stay safe my friend!!!

Susan Lynn  Bill - sounds like you're doing well despite the detour on your path to recovery. I know that the procedure we both had requires collapsing the right lung. Do they have any explanation for what happened? Just curious.

Bill Gillam  Susan, best guess is that during deflation/ inflation scar tissue was formed. There's a study out there that states it is estimated that 20-25% of MIMVR has some sort of lung complication.

Diane Maher  Bill...interesting to see you were on Xarelto too...which I was taken off last week. There seems to be very few of ‘us’ on this blood thinner which I did not mind....no INR worries.

Richard Buckley  I'm only four weeks out of the same surgery and also have some pain around the incision. Probably nerves damaged. I saw my surgeon today and he said it looks good and the pains will go away. Didn't really give me a timeline. I am feeling improvement as weeks pass so am hoping that I will be pain free eventually.

Susan Lynn  It took months before the pins and needles ended for me. Hang in there, Bill and Richard. Better days are ahead.

Maryann Gomez  I’m so out of shape! I will have to start this a month or so after I go home. I need to lose 50 pounds. A huge journey!

Catie B  Like a lot of others here, I experienced some atrial fibrillation for awhile. Was treated with medication for a little over three months and needed to be on warfarin because of it. I realize the two rhythm disorders are not the same, but probably this principle is: I was told the heart can react strongly to being operated on and needs time to calm down, remodel and get used to its new normal. I hope the atrial tachycardia will settle down on its own as Afib so often does. Best to you!

Bill Gillam  Sort of muscle bound lumps that are tight and obstruct movement. Near your incision. They sort of have to be "worked" out. Better early than late if you are having stiffness. Glower told me I would need to give my right arm some attention.

Dan Vechiola  Way to go Bill! 5K is awesome! When its hot here I go to a giant store nearby and park in the farthest parking space and circle it a couple of times. Keep grinding your doing great!

Dan Vechiola  Yes I have done the "trust fall" in many training classes. Great analogy Bill! And you are right! Once I put my trust in the surgeon and hospital I chose a load has come off!

steven a husted  hi bill i think phase 1 of cardiac rehab is what you get in the down unit at the hospital it is about 3 or 4 days and phase 2 is after you leave the hospital medicare or insurance should cover it it lasts 36 weeks and then phase 3 you have to pay for out of your pocket and it lasts as long as you want the price is different in each state i pay $60 a month to me it is worth it because you get monitored and you have a nurse and therapist there to help you and if any thing goes wrong you are in the hospital already i had a friend who just passed away and he was in phase 3 for 26 years it really helps and you make a lot of new friends

Susan Lynn  Excellent news! Thank you so much for the update! Please let him know that we're glad to have him in the recovery club!

Kathy Sansone  Thanks for the update that's great! Bills surgeon is doing my repair in 2 weeks keep us posted on his recovery 🙂♥️

Diane Maher  Exactly the kind of news you need right now, Bill!
Since I will be busy crossing over the recovery line
first on Monday, sending huge best wishes for your surgery and will be looking forward to your posts❤️

Anna Jones  Good luck with the next INR reading. I had to search for a new cardiologist after surgery too. Sending best wishes for a smooth road ahead.

Janet Skinner  Hi Bill. I've had a similar experience with my INR being too high ... I was an inpatient and I suggested to my cardiologist that I needed a spinach salad. He laughed and said have "your daughter bring in a big one!"

Kale, as you eluded to, has the highest Vit K content of all of the greens ... about 500 ug/cup of chopped greens! Under normal conditions, the daily recommended intake is 120ug for a male ... So maybe having a good cup of chopped kale would work! Good luck.

Bill Gillam  Thanks, Janet! Had a kale salad yesterday and another today. Plus broccoli! I'll get there and if not Friday, I still have three more days to go prior to the day of surgery. My current cardiologist seems to like drama. Well, he may not like it but he creates it at times.

LINDA ROBERTS  On my way to Cleveland so wanted to wish you a successful surgery. Are they also going to treat the AFib with a maze procedure?

Susan Lynn  Bill - I'm sorry to hear that you've been experiencing bouts of Afib, but you are perfectly positioned to go into surgery - let's do it! The sooner you put it behind you, the sooner you can get back to your life and good health!

Susan Lynn  I was on a blood thinner for 3 months after my mv repair. It was just a precaution, but I was happy on day 91 that it was over. Hang in there, Bill. Better days are ahead.

Chris Purvis  I started eliquis recently for 30 days and shaving had me worried as well. Luckily nothing has happened with that but I get anxious every other day when that time arrives.

Willie Radl  I'm on Warfarin and its not nearly as bad as I had expected. I'm a pretty hands on guy, like to do projects around the house, yard work etc. and I have had some scrapes and cuts on my arms and fingers and it does take a little longer to stop but its not like you are going to keep bleeding for hours. My INR is consistently between 2.4-2.8, also don't be surprised if you need it longer, many people even with biological valves may need to be on a blood thinner for other reasons.

Willie Radl  I too bought an electric shaver but only used it 2-3 times....man those things suck compared to the good old fashioned razors.

Susan Lynn  Bill - I'm sorry to hear that. Hopefully, you'll hear back quickly from Duke. In the meantime, they'll probably be able to control it with medication. Ii'll keep you in my prayers. You're going to be just fine. Please keep me posted.

Alina FH  Bill, thank you for the update. I am so sorry you had to go through this. Good luck with the surgery, and easy recovery!

Anna Jones  Hi Bill Gillam, afib is scary for sure! I'm sure Duke will move up the date. The surgeons seem to be flexible that way. Sending best wishes and prayers.

Debbie Moriarty  I have had Afib for 2 1/2 years and have been on Multaq for rhythm and Eloquis as my blood thinner. My surgeon is going to fix the Afib along with 3 others things. Even though the meds don’t bother me, I will be so happy to eliminate two more!!

Nancy Surprenant Takahashi  I have one and it's very accurate, I also purchased the one for the apple watch. My doc said if I go back into afib send the readout for him to review, so apparently he has faith in it also.

Sandy Laine  I, too, have one - and asked the cardiologist about it - he said it works well, but cautioned me to not get obsessed with it. I am pretty sure my a-fib episodes were over before the device arrived...

Bill Gillam  I ordered one today. Plan on using it for confirmation rather than pure diagnosis. Just another piece of the puzzle.

Marlise Conrad  I went to Duke for a second opinion. Met with Dr. Glower, hoping for less invasive surgery which is Glower's speciality. Dr. Glower took time to talk with us and due to needing two valve replacements, I would need a sternumectomy. He referred me his partners. You will be in good hands at Duke!

Kathy Sansone  Good news!! I was considering Duke but I'm about 3 hours from there. did you have other options? What is making you choose Duke?

Marlise Conrad  I could have had it done locally but we knew right off the bat in our consult that they were the ones. They were much more detailed and concerned about my many risks. We are about 2.5 hours away and although a nuisance at times, it was the clear choice for us. We went with Dr. Milano. Also, it's a beautiful campus & the staff are pretty friendly:) I'm unsure of yall's situation but I am fortunate to have a good family base so we rented a nice little air bnb for my husband and daughter to use as home base. They just alternated who stayed with me overnight.

Kathy Sansone  Marlise, I'm so happy you are doing well and you had a good experience at Duke. I'm located about 20 minutes outside Charlotte and considering Duke. I'm not sure how all the travel back and forth will work, I have 2 young kids and our extended family is all up north. We do have some friends in Raleigh which could be helpful :) the air bnb is great idea!

Marlise Conrad  Will be glad to recommend where we stayed. There is a big fenced backyard for the kids. Highly recommend having family stay in town during your hospitalization.

Barb Edmonds  Eager to hear how this went. Your situation sounds so much like mine. I'm out here in the middle - no big cities, no big hospitals but had a very successful surgery 14 months ago. Good luck.

Jennifer John  Wish you the best in your decision, Bill. If you’re able to have your MV repair done with minimally invasive surgery, go for it. Just make sure your surgeon has done a lot of them. I wasn’t eligible for minimally invasive anything because of scar tissue from a previous OHS via sternotomy in 2001. So on 5/31 they performed a right thoracotomy in order to see everything inside my chest, repair the mitral valve and do a maze procedure. It worked out just fine, and I’m all fixed. I’m into Week 5 since surgery. Muscle soreness and nerve pain in my side and chest from the large incision has so far been the toughest part of my recuperation. Takes time, patience and lots of extra strength Tylenol!💪🏻❤️

Susan Lynn  Bill - I had a mini-thoracitomy for my mv repair and would do it again. It was easy and painless. No driving restrictions, afterward, either. It does require a femoral cannula, which the sternotomies do not. Do your homework and pick the entry that's right for you. Good luck!

Dan Vechiola  Keep on pushing Bill! I heard a stat today that the mortality rate of valve surgery is 2.5% and if you go to a hospital that does ALOT of them the mortality rate goes down to 1%. For that reason I am going to Northwestern University next Wednesday for an echo and meetings with Drs. Jim Thomas (cardiologist) and Patrick McCarthy (surgeon). Both are on this website a lot in the video library. Hey we get one shot at it so its best that we take our best shot. As I was told on this website, we are the engineers on this journey train! (thanks Chris) wow that was the second time I used your quote tonight!!

Jennifer John  Bill, it’s so ironic that you said that! My good friend from down South gave me a pink cap that says “Bless Your Heart” on the front. Love it!❤️

Bill Gillam  Susan , can you explain the femoral cannula as it relates to MI surgery? I am having a cath Monday and my cardiologist does not yet know I'm thinking of going to Duke. Just havent had a chance to tell him.

Ralph Thompson  Totally non-professional opinion - I am up for trying the newest of anything - - - But after watching several videos of the operations in which your chest is opened up and your heart is exposed - it looks to me like I want my Surgeon to have all the room he needs to work on replacing my Aortic Valve. Hard to imagine this being done without everything being exposed. Good luck on your selection of surgeons.

Penelope Bodek  Duke is a GREAT place. I'm having my BAV replaced and the aneurysm that goes with it removed at the end of the month.

Thomas Brusstar  Bill, my surgeon said minimally invasive requires more disruption to the ribs, which are very painful in recovery. He didn’t seem to be considering that for me, so I’ll do sternectomy, although possibly a “mini” one. I truly do not care what the scar is like, and he says with the sternum all wired tight afterwards, it will heal fast. I want the surgeon to have all the room he needs to make precise cuts and see the whole deal.

Susan Lynn  Bill - During the minimally invasive, right mini-thoracotomy, a line is placed at the top of your thigh in your femoral artery. It is the access point for the heart/lung bypass machine. Prior to surgery, I had a CT with contrast of my chest, abdomen, and pelvis to ensure it was all clear. I don't think that's a required pre-op test for sternotomy patients.
The reason I mentioned it was that I saw a post recently from a patient who complained of post operative issues with his leg after minimally invasive surgery from the cannula. I think it's important to ask your surgeon about post-op complications of all kinds - including this one.
As part of my research, I looked for a surgeon who worked with an experienced team. I'm guessing access to the femoral artery can be problematic for some.
In addition, my doctor utilized a camera through a very small incision on my right side to keep rib spreading to a minimum. I had absolutely no rib tenderness or pain. I think that could be an issue with less experienced surgeons.
I was very pleased with this approach and you will need to weigh the options for your procedure.
I simply couldn't comprehend the restrictions and the extended recovery of a sternotomy when there was another option available that was effective and didn't extend bypass or intubation time.

Don L  Hi Bill, I had minimally invasive(Robotic) surgery to repair my mitral valve(complex repair, both leaflets) 14 wees back, very happy with process and results; Prior to surgery to determine risks/best approach, as opposed to a Cath, I had a full body CT Scan(Chest, abdomen, pelvis), which is less intrusive, painful, and no sedative or recovery time needed. If surgeon says CT Scan is option for you in your situation, I would recommend it. As for Surgical approach, my surgeon had experieince with 'Standard' minimal invasive and Robotic, so it was my choice. Based on no blockage, no other health complications, large enough arteries(Femoral) for the cannulization for heart lung machine, and enough room in chest wall, he recommended the Robotic approach for me.(he was indifferent on my choice). As Susan states above, a great hospital with an experienced team/Surgeon(ask for their stats on 1) number of mitral valve surgeries? 2) ALL potential Risks/complications they have experienced? 3) What is their successful Repair percentage?(should be VERY high). (lots of posts on here with great questions)

Susan Lynn  Interesting Don L. I probably could have skipped my catheterization and calcium scoring. Cha-ching! I paid for both of them out of my pocket. 😥

Tracy Fallu  I had minimally invasive Mitral Valve Repair, right side under breast incision. I did not have any complications with the femoral artery heart/lung machine.
I was lucky enough to have a well known surgeon who has mastered the surgery”in my back yard”, Dr Marc Sakwa, Royal Oak Beaumont, Mi.

Don L  Susan, they do a Calcium score as part of the CT Scan. The test costs are very small compared to surgery cost!

Lisette Heckathorn  I see you have gotten a lot of advice already, but I am 16 weeks out from a mini thoracotomy mitral valve repair. My recovery was painful, much more so than the surgeon told me, and it was a solid 3 months before my pain subsided to a less frustrating level. However, I had an emergency 2nd exploratory surgery which I'm certain contributed to the extra pain. Small incision and scar. Perfect repair and things are ticking along great, running and everything already!

Michael Meyer  Bill:

I had minimally invasive robotic mitral valve repair in 2014 at Cleveland Clinic. I had a second opinion for a median sternotomy at the local hospital in St. Louis with one of the best median sternotomy surgeons in the country. That is what he does. He agreed that I needed a repair.

I pursued the minimally invasive repair on July 14, 2014. You need a high volume surgeon and hospital team just like everyone has said. The femoral cannulation is a little more complex and will depend on your physiology. During your presurgical work-up sonograms of both femoral arteries will be done to determine that the arteries are not too small in diameter for bypass. Cannulation at the heart is simpler. I was also marked for a mini sternotomy as this was the surgeon alternate choice if there was a safety issue.

My cardiologist was not familiar and my wife a nurse was not familiar with the minimally invasive procedure. They were not fans of the procedure because of their perception of the access question. The data really does not show a difference/greater access is an asset. That is of course different with other valve repairs.

I have had great results, you just need to go to the right physician and hospital to ensure a good outcome. I wish you well in your decision.

Tim Chapman  I have a cardiologist and a surgeon watching my Aortic Aneurysm and Bicuspid valve, I am still getting a second opinion from another surgeon from one not in my area.

Don L  Assuming you have had an echocardiogram analyzed to to suggest this? If determined 'severe', a TEE would then be ordered for you to confirm with more accuracy if Severity is High, and surgery is necessary.I beleive these steps are 'first' under guidance of a cardioligist, as your surgeon would need this data. I had my surgery 14 weeks ago, and this was the process.

Anna Jones  I just had my MV repaired. First The cardiologist determines it is time. Then you start researching and interviewing surgeons at various hospitals and practices. You need to hear the different types of surgery that can be done, which surgeons think they can repair vs replace it, and who you feel most comfortable with. Sending best wishes.

Darlene Smith  For a repair, I would first make sure that your surgeon has done thousands of repairs and is a mitral valve specialist. Most people like to get a second surgeon's opinion if there is a question as to whether the valve needs to be repaired since you may come out with a replaced valve if it was too difficult for the surgeon to repair. So make sure you have a mitral valve expert at a reference center/center of excellence for mitral valve repair, and if that's the case, you might not need that second opinion. If your surgeon is not an expert, I'd definitely get another opinion.

Steve Farthing  If the surgeon says the mitral valve needs to be replaced (not repaired) or probably needs to be replaced, then you definitely need a 2nd opinion from a different surgeon preferably associated with a different hospital. Mitral valves rarely need to be replaced (vs repaired) so watch out for that.

Thomas Brusstar  I agree you want a surgeon who has done thousands of valve surgeries. I am told that valve repair, much more so than bypass grafting, for example, is an art, with some "craft" in structuring a valve repair so it will work. My surgeon says 98% chance he will just repair what he finds, 2% chance of cow.
I also note that my cardiologist and surgeon were so happy with the quality of the trans-thoracic echo images that they didn't need a TEE to diagnose and plan my surgery.

Bill Gillam  I've had the TEE and echo. They were pretty conclusive. The trigger for the TEE was that i went into afib during a routine colonoscopy. My take away here is to insure my surgeon has done a whole lot of mv repairs. If I don't feel 100% comfortable, trust me. I will move on. Thanks for all of the caring comments!

Susan Lynn  Bill - that's exactly correct! Experience in MV repair and lots of it! Keep looking until you find the surgeon you trust. There are many good ones out there!
I also agree with Steve - the ability to repair is pretty high on mitral valves with surgeons who know what they're doing.
Good luck with your research and selection!