Bruce's Journal

So here four years later still doing fine. I learned something new. I had lumbar surgery scheduled and was ready to go into surgery, but they cancelled my surgery until I saw hematologist. He said if you bleed after surgery you have a good chance of becoming paralyzed. Turns out I am a hemophilia A which explains some of my bleeding problems from colon polyp removal and after having aortic valve replace. My brother, unusual my daughter and also one of my grandsons are hemophilia A. I suggest if you have a family history get checked as I am now a bleeder on warfarin and it may have made a different in my choice of going with a mechanical valve. My PC was surprised that after having a dozen surgeries and my age that it was never discovered. Until I made a list of my surgeries and every instance of a bleeding problem including non surgery he said you have a bleeding problem we will make sure you get into hematologist. Found out going over medical records of 20 years nobody ever did an aptt blood test until after I had heart surgery. It is a basic blood clotting test and then they do other test to check which clotting factors are off. You have to be off blood thinners to get the testing done. So now I have a plan and can reschedule my back surgery.

Well so far I am doing great. I had my problems early after surgery but everything has settled down and I am doing well. My wife and I have moved, the move reminded me why last time I said never again. if we do ever move again what we don't sell will stay with the house. I plan on living long and figure when I die it will be for a reason other than my aortic valve.

So I just had some lab work and I am still pretty anemic. I know last the last time I received blood it took almost 6 months to get to normal levels. Receiving 6 units this time I hope it does not take longer. Still by the end of the day I am tired, so tired but I think more active than before.

So I have learned that we all heal not so differently just at different rates. Two weeks after my valve replacement I was feeling pretty good but a couple days later I was back in the hospital. When I got out of the hospital again things seem to fix fast over two weeks but now it seems to be slower going. The surgeon said between the heart lung machine and the anesthesia it take a lot our of you. being put under two more times almost dying twice getting 6 units of blood it will take a while for your body to fully recover even though the actual surgery will be fully healed in 3 months. The last time I was in the hospital the Chaplain came into my room and stated I heard you keep trying to check out. I told him no I am still here and plan on living a long time.

Tomorrow I go to cardiologist for my 6 week follow up. The scar is looking good still have a scab where drain was put in after last emergency surgery June 20. Checking to see if the cardiologist is ok with me doing a 8 hour drive to Lake Havasu. My INR so far is stable with only 2.5 mg of Coumadin. I still tire easy but most of my pain is from ,my sciatica. Even though I am doing well I am nervous about doing activities that put me at risk or so far from my hospital. you can see my scar from the first 2 times and then the scar the last time went from where the old one stopped to where the first drains were put in. you can also see a portion of my old cancer scar.

So as you all know my AVR was on June 1 and then went back into surgery for bleeding. Friday June 19 My wife took me to the hospital because I got dizzy a couple of times and hurt when I took a deep breath. They did a ct scan and thought I had a blood clot around the heart. They tried for hours to stabilize me as I was having SVT and A-Fib every time they gave me something in the iv I would get nauseated gag and blackout. The surgeon showed up at 3:00 am and said they had to get me into surgery right away that I had fluid build up around the heart and the pressure was so high that the heart was no longer pumping. because of the lack of blood pressure they had trouble getting the iv and A-line in. They pulled out over 1,000 cc of fluid, as little as 100-200 cc can cause problems. it took about 4 hours after they drained the fluid to get my heart back into normal sinus. It is now the 29th of June and I am recovering quickly. I have been through a lot but the staff and doctors at Kaiser Fontana are great, it is in the top 5 heart hospitals in California most of the doctors and nurses come from Loma Linda and St. Bernadine hospitals. I am glad my body as a whole is strong and I was treated by a great group of people. The doctors were amazed by how well I did after each time into surgery. I was able to walk second day after surgery about 1,000 feet.

Well i had my surgery Monday morning. went back to surgery at 3:00 pm for bleeding was given 6 units of blood. The surgeon got squirted in the face with blood. woke up 9:00 am Tuesday mornimg

I know some people wonder about their scar from surgery. I learned from cancer surgery, I have a bulge from loss of muscle control and a scar from the sternum along the ribs to the back about 16" long. People look when my shirt is off but I say it is my award for surviving and I will feel the same way from my heart surgery. When I was getting my pre-op met a few people that had just had surgery done, makes you feel better. I have read how many people choose tissue valves, I am going with mechanical, I am a big strong guy out of shape and plan on getting back into shape the more work you put on a tissue the shorter the life if I live as long as my father will or both of my grandfathers did then I have about 40 more years which means if I go with tissue it will be for sure one more time maybe two. no one in my family has had dementia so I figure I can handle taking blood thinners regularly. A women that was working out at the Curves my wife owned, she had a St Jude mechanical replacement 18 years ago and never looked back at her decision. When you make your decision, no matter what you pick it will never be the wrong choice since they are both good choices. What makes this type of surgery scary compared to others with about the same risk is you know they stop your heart but think about those who get transplants and have to deal with the thought of their heart being completely removed from their body. If they can do it so can we. I knew a transplant patient who went to work for me 6 months after the surgery and the amount of medications he took was nothing compared to taking a blood thinner.

Did my pre-op last Thursday met my primary surgeon and the primary anesthesiologist. My surgeon is Dr. Daniel Lee Serna he has over 20 years of experience even though the wife said he did not look old enough. He said well my health looked good except the tight aortic valve, my heart is working hard to try and push blood through an opening the size of a pin head. I will try to update while in the hospital but who knows.

You know I am a bit more anxious about having my heart surgery than I was my cancer surgery. I did not have any choices with my cancer surgery. I think what bothers be is knowing they stop the heart but then I am hoping my energy level will work its way back up. if it needs done then the odds are always better having the surgery. This is one of those things where the risk not having surgery can be higher than having surgery. I am calm some say too calm.

I am a 61 year old male needing aortic valve replacement. I was first diagnosed with high blood pressure when I was 17 years young weighing in at 155lbs. I had blood pressure that ranged 190-210 over 90-110 all my life. I have also suffered from dizziness and sometimes fainting when standing from a sitting position since I can remember. Over the next 15 years none of the doctors seemed to care much about my blood pressure or fainting, just stating I had a heart murmur. I had been a smoker and quit, gained weight and have slowly been putting on weight since, now pushing 280 lbs. From that point on the doctors only seemed to think I needed to lose weight to control my blood pressure. I am the only person in my family that I know of to have high blood pressure their whole life. All this changed when one of my primary care doctors who was overweight with high blood pressure died of a heart attack. My new doctor who took over, the first thing he did was put me on blood pressure medications. Over the next 30 years I was on so many different blood pressure medications, at one time, I was on alpha blockers, Beta blockers, calcium blockers, ace inhibitors, HCT and Lasix, this is a lot to take at one time. I am now on the least amount of meds in 30 years only 2 with Lasix as needed and my blood pressure is ok. In 2001 I had surgery for kidney cancer it was caught early so they saved my kidney. 2002 had gall bladder removed, sinus surgery, surgery on tongue and uvula, for sleep apnea, my first colonoscopy, and a muscle biopsy. The muscle biopsy was because I had been on Lipitor and reached a point where I could not walk and it took around 2 years for muscle enzymes to get close to normal. Over the years I have had a number of echocardiograms with and without treadmill. I was diagnosed with mild aortic stenosis with left ventricle enlargement of significance, right ventricle with slight enlargement mild, slight regurgitation at every valve and supraventricular tachycardia, they also did a nuclear heart scan which was fine. Nobody told me the seriousness of any of this. Doctors kept stressing about weight and cholesterol About 12 years ago on one of my visits to my primary doctor complaining again about my all over body aches and pains always feeling like I had the flu at the time I was also sweating with palpitations and edema in my legs with mild chest pains she had me taken by paramedics to the closest emergency cardiac care hospital for possible heart attack. A week after this I got my first angiogram and was told I had the best coronary arteries they had ever seen for my age. In late 2008 I was having problems standing without getting faint, the longer I stood the dizzier I got. Went to cardiologist and got another echo stress test was told I had moderate aortic stenosis and bifacicular block.I knew for years that I had right block. He changed my medications to Losartan and Eplerenone with Lasix only as needed. In 2011 I started going to Kaiser the cardiologist I now had she had me get a new echo stress test, she told me that I needed to lose weight that at some point I will need aortic valve replacement and I needed to be in heathy shape for it. The plan was to lose a couple of pounds a month so I would be ready in about 10 years. Next visit she said the insurance wanted me to try spironolactone you know because it is less expensive than Eplerenone. I told her ok but you know the side effects. 2013 my wife falls and gets surgery for torn rotator cuff in right shoulder a few months later I am getting gynecomastia surgery from the spiro and then had to get the breast drained of fluids multiple times. I have fully recovered from that and off the spiro. 2014 the wife had surgery on her left rotator cuff since her right had healed enough. After her surgery I had another colonoscopy, they removed 3 good size polyps should have been no big deal. The next day I started bleeding put off going to hospital until following morning almost died got 3 units of blood they did another emergency colonoscopy to stop the bleeding watched most of it on the monitor as they almost lost me on the table. Was taken back to ICU was given another unit of blood, I spent 5 days in the hospital as long as when I had my surgery for cancer. Now comes January 2015 thought I was dealing with bronchitis but nothing seems to help my wheezing, or shortness of breath. I already had seen cardiologist 8 months late so while I was being treated with antibiotics, inhalers, prednisone, Lasix I got an echocardiogram and a complete pulmonary function test. Even though I was born with asthma, have frequent bronchitis and at least 4 bouts of pneumonia my lungs were in great shape. My echo came back with severe aortic stenosis mainly because of velocity. I was told it is time to get the aortic valve replaced so I was sent for an angiogram. When they were through with the angiogram the doctor said well your coronary and pulmonary arteries all look good the other valves look good, just the tight aortic valve. They required me to get all pending dental work done now I am just waiting to get scheduled for surgery. I will be discussing with the cardiologist on valve type when I meet with him. I am 62 my father is 87 and plans on another 10-15 years, his oldest sister just turned 90, his father lived to 99. Never guess here it is Wednesday May 20, 2015 just received a call they wanted to schedule my surgery for Friday May 22, 2015, not ready so now it is set for June 1, 2015 at Kaiser Fontana, California