David's Journal

David Pearl  No surgery date I get that all the time next Echo is on the 6th here in Bangkok next Cardiology exam is on the 7th . I did start on repatha by the way to bring down my LPA

Christopher T  I think you can have nurses stay at your home. A lot of elderly and disabled people have nurses in home. My sister is a RN and does this. 

meg oconnell  David, I think this is a great option. My vote would be to get the care in your home, it will help with recovery to be in your own space. I rented a lift chair which I pretty much slept in the first 30 days post surgery. It is helpful to have someone around to help with meds, check your pressure, and just help you relax when you may feel a little nervous. Nursing homes have their own set of challenges and you may not get the one on one attention you would like and need. Just my two cents.

susan harris  About 6-8 months ago, a woman on this site had OHS at Cleveland Clinic (I believe) and posted about how she went home with minimal/no support - I'll try to find her name...she mentioned things she did to prepare like - she moved all dishes and cooking things from upper kitchen cabinets to her counter so she could reach them without reaching up (same with bathroom cabinet), stocked up on crossword puzzle books, etc. and long charging cable for laptop, made soup, dinners and froze them, made sure she had button down or zip shirts to get on easily, got a chair to go in bathtub/shower to sit instead of stand...also, think about grocery delivery - do you have something like Instacart?, regardless of your religious views, churches are usually good places to find reputable people -- maybe a local priest/minister knows someone who would be willing to come in and help you -- maybe they'll want you to work out payment 1 on 1 or if they won't take $, make a donation to charity for them?, in U.S., we have at-home care agencies for elderly who are not nurses so they are less expensive but would be able to help, when I had surgery (admittedly not OHS), my husband had to go to work each day, so he packed a cooler for me at night with breakfast and lunch the next day and put it by my chair night before.  This can be done!    

Anna Ma  David, I remember you asked similar question before. If my memory serves me right, you lived in Thailand. You may try to do some research and ask your doctor to see if there are any recovery facility near or in the same city where you are going to have the surgery. My dad has his surgery in Beijing and he was wheelchaired to a heart surgery recovery facility next to the hospital. It was great, he had his own room and doctors, nurses, therapist and nutritionists, basically the whole team to take care of him. It is kind of expensive though and the insurance they have didn't cover much. 

Robert Miller  Unless you have other health issues, you really don't need any help at all. It's just a lot more cumbersome for 2-6 weeks. If you put on cloths, use a large t-shirt so you don't need to bend your arms too much (which moves your chest). If you want tea, put the pan on the stove and go back and forth to fill up the pan with a cup. If you just need one cup, nuke it for a couple of minutes on high. If you need groceries, chose one that offers delivery service.  

David Pearl  I'm also looking at what's known in Thailand as a service department where they're going to be regular cleaning turning things over try to get a separate room for another person to help me out everything is close by in Bangkok even though it's 10 million people. There's literally a hospital every couple of miles or every mile where I live. The subway is everywhere food deliveries everywhere malls are everywhere grocery stores are everywhere we're not having anything shut down like in America due to Crime inflation or people working from home or ordering too much from amazon. People still go to malls people are outside it's great 10 million people here so everything is close by thanks for all your feedback I'm sure between my girlfriend my friends and other people I'll find a way to make

David Pearl  Hey Robert my current apartment is actually pretty good if I don't end up bringing a stranger in here and I just have my girlfriend or friends come over it's pretty good my place is only about 300 square feet the balcony and the kitchen of course are both outside all I've got is a small bathroom and a pretty big bedroom it's very easy to maneuver my only problem is these damn glass doors in the building makes it hard to get in and out of the elevator so I'm looking to move or relocate somewhere else temporarily

David Pearl  My place is difficult because the glass doors that are heavy I'm going to go to nursing home for a month

David Pearl  Thanks everyone !  I think nursing home is best--no need to rely on others, everything turnkey--before surgery dump off a bunch of books and food--can order more food when I am in the home....My home is small and the condo complex is not disabled friendly..Do a nursing home for a month ok then can get back to normal ?

Robert Miller  I nursing home for a month sounds like a reasonably good plan for you. As for the glass doors, they can be a pain. Instead of using my hands, I would use my butt and feet to open and close them.  Or since you have a girlfriend, I would assume she stays over most of the time during this time so she should be able to help. 

Dan Fouratt  David,  Hope all is well.  A lot depends on your surgery.  I had a mini and could have taken care of myself post surgery.  My bride was with me which helped a lot but I would have survived without her and glad she was there.

Robert Miller  I had my wife and I am grateful for her help. But you really don't need anyone. You have to adjust but it's doable. There should be services for grocery shopping, etc. For cooking, etc don't carry a big pot of water but put the pan on the stove and then pure cups of water into it. It's more time but it's quite doable. 

David Pearl  I've got a girlfriend but I never know these things are going to end. I've also thought about reaching out the neighbors but conversely I'm looking to move out of my apartment because it's small and there's heavy glass doors. I'm looking to potentially live in what's known in Thailand as a serviced apartment. My place is molecular barely a studio so I think I'm going to need to have a place with at least two bedrooms at least temporarily if a stranger is going to be sleeping with me for the first month or so. Yes I'm thinking about getting a mini sternotomy .. I'm assuming the worst as I've never been married never have kids and my family's dead. If any neighbors friends show up that's icing on the cake if not I'll do it on my own and with professionals.

David Pearl  I'm used to being alone pretty much since my 30s. Just the way it is my family died off and I wasn't able to find a partner or have a kid. It just didn't work out that way

Pamela Gregory  Hi David, if you pre-plan easy meals and have people who can drop in daily to make sure you are ok and help you a bit would be ok I think. Make sure your medications are organized before leaving the hospital, have a spot set up to comfortably watch TV, and you will have to walk 2 times per day at least. I think you will be able to do more than you think but definitely have a good friend check in on you the first couple of weeks to make sure all is good. You won't want to lift anything too heavy so have a bed set up with pillows and whatever makes you comfortable. Just my opinion 

Susan Dunne  David, is there any way you can go to acute cardiac rehab.  It is only 10 or 12 days and it can set you up for being able to deal with the healing  at home.  If you have health insurance check it out.  I fought against going but was convinced after surgery and boy did I benefit from it.  Think about it if you can.

Robert Miller  It's harder but quite doable. Make sure you have everything taken care of that you think will require heavy lifting, etc. a couple months after surgery. Adjust how you do things. For instance, instead of taking a pan full of water and poor the water in a thermostat, take a ladle to transfer the water. Do smaller loads of laundry or don't do the whole load at the same time. The hospital should also be asking if you have someone to help. If not, there should be resources to help. Same goes for emotional support, btw. 

David Pearl  Susan--maybe but I am 100% cash patient so worried about cost containment..Best idea is a nursing home, home healthcare, non skilled support and friends..I am live with my girlfriend now but it's a bad relationship and may end at any moment...

David Pearl  Hey Robert here in Asia/Thailand the hospitals don't seem to care or have any control over things once you get released. I think it's assumed because it's Asia you must have family because it's such a communal, family oriented part of the world. There's not really any sort of outpatient outreach beyond follow up appointments, They don't at all or ask about emotional support either sadly. It's every man or women for themselves here..In Japan I understand old people die and there corpses aren't found for months...

Robert Miller  Without going into details, I know what you are talking about. I don't think the hospitals are this way because it is assumed there is family support. If anything, I think it's the other way around. There is family support because you can't rely on outside sources. In any case, recovery from heart valve surgery in most cases is a lot easier than what one would think. Having a partner helps for sure and I appreciate the help I got. But I could have done it myself without too many issue. My biggest issue was back/muscle pain from having to lay on my back. A partner won't be able to help with this. You do need to look out for complications like irregular heartbeats, etc. but again a partner won't be able to help with that. 

Robert Miller  Sorry for the late reply but this is doable even without any family at all. The biggest issue for the first couple of months will be grocery shopping, cooking, carrying around laundry baskets, etc. You can either see if there are services that can help with that. Or you have to break down things into small tasks. Like filling a thermostat with tea, you can't just lift the (heavy copper) pan. Instead, you have to use a ladle. Use tongs to move food from the pan into a serving dish instead of lifting the pan. It's cumbersome. I did all these things. It's manageable, though. Also, if I haven't mentioned it yet, at "check out" the hospital will/should ask you if you have someone that can support you. If not, they will be arranging somethings. 

David Pearl  Hey reading everybody's messages I'm just very independent don't have living family and I'm always thinking about breaking up with my partner. I've got a number of Home Health Care even people off Craigslist if and when the surgery happens I'll start reviewing all my support systems. I mostly thinking about moving out of my building because the heavy glass doors but the downside is I've got friends here I can count on whereas and a new condominium I don't know how long it's going to take time to find new friends. Who knows I might have a different girlfriend or many girlfriends and of course I'll reach out to every friend every social group. The condos overseas are very small so it's not that difficult to manage everything. Anyways reminds me again that I have a good owner and I have a lot of friends in my condominium which is actually three buildings probably over a thousand people live in these three buildings but again the lack of a separate bedroom the lack of it's going to be really hard to get in and out of the doors of the elevator here because they're super heavy so I need to get moving on moving before I need surgery by the way I got seen at UCSF and they're backing up everything that they're saying here in Thailand which is good and if I ever do move back to America I'm now fully connected to UCSF and 3 years and a few months I'll be eligible for Medicare I'm guessing the surgery will be next year or the year after

Daneen Douglas  David, Sorry that happened.  You must be frustrated.  Hope you get it figured out soon.  Any way you can come back to the states?

David Pearl  Daneen...No reason to come back to the USA--haven't lived there in years..No wife, kids, girlfriends, living family, home, career, car, job, partner, etc etc. I have zero infrastructure in the USA...Have not lived there since 2017.. At age 61 there would be zero reason to go back......I have an easy life here in Thailand for  the most part and I feel much less alone here...I never was able to have a career/wife/girlfriend/kids/home ownership in the USA so I left the country at age 54 because of loneliness...

David Pearl  I visited the USA for the 1st time in 5 years and was horrified at bad things have become there...Other than my cardiac issue I have a relatively easy life here

Daneen Douglas  Yeah it’s pretty crazy lately in a lot of parts.  That’s  great David!  Hoping you are able to get your problem resolved in the near future. 

Daneen Douglas  Awesome!  I was moderate for a long time!  Just keep monitoring it every 6 months to 1 year.  Glad your surgery date was canceled, after all! 

Jennifer Fuller  My surgery was also postponed a few days before it was scheduled. I believe there was an emergency and the OR was needed for another patient. It was certainly disappointing, but I was rescheduled and everything went fine. I think it happens a lot. 

David Pearl  Mine has been cancelled--the doctor was arrogant and couldn't handle my questions and cancelled the surgery just 5 days before the surgery so I am looking for a new surgeon/hospital. The hospital has stopped communicating with me

Sue Maize  It may need replacing without you being symptomatic. I have symptoms now but my surgeon said that ideally, I would have had my surgery a year ago! 😬

Tiago Rocha  Hi. I was always asymptomatic throughout the years and when I turned to severe regurgitation and the left ventricle dilated I didn’t notice anything. That was the right time to AVR. 5 days after the surgery my left ventricle recovered 100% and returned to normal size. So I do believe that in some situations we shouldn’t wait for the symptoms because it could be late to a full recovery. However every case is a different case and you should decide always with your doctor and in full informed conscience.

Allen Carkner  Even symptoms during exertion or times of stress count as symptoms when it come to aortic stenosis. And depending on your case it’s sometimes indicated before symptom onset. 

Dan Fouratt  I am asymptomatic, the last three days i have spent 2:20 minutes on a tread mill alternating between 6 degrees and 10 degrees and 3.6 miles per hour. I am still looking forward to the replacement job next week, with the same valve as yours. As Valerie stated it is your decision.  I made the decision to get it done.  My doctor friend said I could probably last another year, maybe two, but if I was ready get it now.  Good luck with your decision.

christine blackway  Don't put it off, life expectancy declines with a leaky valve that goes past moderate, even without symptoms.

Brady Busch  Prior to finding out about my(previous)heart condition,I wasn't visiting doctors or getting checkups too much.If not seeing one,for something unrelated and her detecting a murmur,there is no telling what might have happened,as there were no symptoms.Maybe just a little tired,walking up long hills.
Heart disease is called a silent killer,for a reason.

David Pearl  Thanks everyone..>Dreading the scar, cost (Asia gotta pay), the long uncertain dispruptive painful recovery.....Re: Timing. Yes everything is leading to doing it earlier when still strong and asymptomatic

DeWayne Adamson  My scar has practically vanished. It is not as painful as I thought it would be. Easily controlled w meds. Time Flys with improvement every week. Just find a surgeon who has done a lot of them and get it over with. 

David Pearl  Mine has been cancelled--the doctor was arrogant and couldn't handle my questions and cancelled the surgery just 5 days before the surgery so I am looking for a new surgeon/hospital. The hospital has stopped communicating with me

Ana Brusso  It’s been a long road for you. Glad you are getting your surgery done finally. Will keep you in prayer 🙏❤️

Klara Čičić  Finally! I am happy for you David, you waited and researched for a long time! Hope everything goes well! You can do this!!!

David Pearl  I am looking at skipping surgery and dying of natural causes. Anyone else relate ?  I want out of this life ASAP and AS is my salvation

David Pearl  Mine has been cancelled--the doctor was arrogant and couldn't handle my questions and cancelled the surgery just 5 days before the surgery so I am looking for a new surgeon/hospital. The hospital has stopped communicating with me

Anna Ma  Hi David, I’m sorry to hear about your cancellation and poor experience with the medical team. If you can wait, maybe give yourself some time to find a better surgeon and hospital? Also give yourself to adjust and overcome depression. From your updates, you may be suffering from depression. We are never alone and I know God is always with us and loves us. 

Marie Myers  Please don’t assume that everyone else has it easier than you do. I have read many stories of heart patients on here who traveled on their own, across the country, to have their surgery and then return alone to recovery on their own. Many people pay a lot of money out of pocket for deductibles and home care also. Some probably pay bills for life if they do not have insurance. Everyone is fighting their own mighty battle in some way. 

David Pearl  My cardiac issues are pre-existing so they won't cover me. I checked with all the private insurance companies. I'm not employed here either. Only way to get free insurance here is if you're an actual citizen in the country. I could have moved back to America but it's 61 years old as a single man with no family there's no point in Living in America at this point in my life.

David Pearl  I guess it's odd because most people are living very conventional 9 to 5 live still living outside the country not having living family etc etc is probably hard for people to imagine

Joanne Heckmann  Your beliefs are limiting you.  Stop looking to what others are doing and look at yourself.  There are always possibilities.  You could move back, even if it's just for a year or so.  You could get involved with your community and build your own "family".  What would someone who loves himself do?

Valerie Allen  Joanne Heckmann… I am totally stealing that line! What would someone who loves himself do? Thoughtful question. ❤️

David Pearl  I was hoping for something more legitimate than a joke. Is that supposed to help richard? Where is the value in your cynicism?

Kimberly Eisenhut  David, I am so sorry you are going through so much. I thought your surgery had already happened because it was on the upcoming surgery list. Please reach out to us whenever you need a virtual hug , encouragement or just to let us know how you are. I will be looking for your updates. Wish there was a way I could better help you, I just do not know anything about where you live. Maybe if you can give us some more detailed information, we may be of more help. I am also sure Adam would be able to help you more, since he has such close ties to so many surgeons and hospitals. All the best and stay srong

Valerie Allen  There is one surgeon under Thailand in the SurgeonFinder, top right menu dropdown. Many more in India if you can get there.

David Pearl  So some of you asked me about where I live I know most Americans don't even have a passport don't know anything about living overseas I live in Bangkok Thailand there's hundreds of thousands of Americans living here it's a common retirement destination which is sort of if it came for me it's got the best medical in Southeast Asia after Singapore it's got medical quality that often meets or seeds American care. However Insurance here does not cover pre-existing conditions I was already on record having heart issues even before I moved here. So on basically shopping around trying to find the the best you know intersection of price and quality. Of course like all of you I'm trying to figure out which valve to get when to do it and then I've got to move some money over here from the states into my Thailand bank account. I do not have living family I can count on anywhere in the world that's why I moved here I came here at age 54 because I was lonely and I was single and never married the kids and never found a partner in America so 7 years ago at age 54 I picked up and moved to Asia it wasn't anything that happened out of nowhere a friend mentioned that I'd be better off in Asia I started visiting here and I eventually picked up and moved here. I have a lot of friends here I've got a small apartment which is good because it's easy to get things but it's going to make it awkward for some stranger to Stay With Me Like Home Health Care I basically just live in a small one bedroom you know it's just one room with a small bathroom small kitchen and a small town of course and that's it you know I just live a very simple existence here few hundred dollars a month rent I liv

David Pearl  I didn't see any surgeons in Thailand I'll take a look again but I've already been visiting hospitals for 5 years I know about 20 surgeons that over 10 hospitals. I've already know what I'm doing here it's just making decisions about which surgery which hospital and where and then being comfortable with whatever fall out there is one of the biggest concerns at a government hospital here is communication after I get home but do I want to pay you know instead of 20 or 25,000 closer to 50,000 for communication I'm also like I said worried that my partner and I could break up soon I don't have living family in America either so please don't suggest that I go back there that's not an option at this point there isn't anybody there my brothers and I never had children one of my brothers's dad there's no nieces and nephews I didn't grow up with uncles aunts and cousins most of the people on 61 years old like you know older people like me my most of my friends and family are long dead I haven't lived in the San Francisco Bay Area since 2007

David Pearl  Dr. Suphachai Chuaratanaphong
Heart Surgeon.. I found him however he's in Northern Thailand hundreds of miles from me okay I need to be more specific here I've already got Doctors Hospitals and surgeons lined up I'm just trying to figure out where to go unfortunately cost is an issue so I have to pay cash I'm hoping to do one last appointment next week I've had this condition for 5 years I've been to like 15 hospitals in Thailand I know what I'm doing here I'm just sad that I don't have the vanilla 9 to 5:00 American lifestyle that's safe somehow I ended up living overseas I don't have a partner I don't have family and I don't have proper Insurance here and I'm 61 it's cool for me to start over in the states

David Pearl  He doesn't work at that hospital. And they don't have a cardiac Division and nobody in the city knows him

David Pearl  Mine has been cancelled--the doctor was arrogant and couldn't handle my questions and cancelled the surgery just 5 days before the surgery so I am looking for a new surgeon/hospital. The hospital has stopped communicating with me

Ana Kelton-Brand  I agree with Rose.  Things may look bleak now but that doesn't mean you'll always feel this way.  Find a good therapist for yourself to help get you through this.

Andrea Babcock  David!!! Don't give up!! Your life is definitely worth living and trying to pay for this surgery. After things will get better for sure. Please don't give up!

Brady Busch  Hi David,I was in a similar situation,after getting out of the hospital.A coworker was able provide transportation.I checked into a hotel for two weeks,because of an easy access shower and long hallways to walk.I used a service to pick up groceries a few times.Fortunately,there weren't any major difficulties,that occurred.

David Pearl  Hi Brady--thanks. I live with my girlfriend but I suspect that will end soon. I am looking to friends and professional or non professional care givers to stay with  me although my place is small.   I have a tiny apartment here in Thailand which will make it easy to get around but hard for another person to stay with me

J Alexander Lassally  Having just gone thorough this, I could advise a part time helper maybe 3-4 hours a day the first week or so.  (could phase down after 1-2 weeks)  They could help you with meals, and showering (which is a big deal first week). It eases up pretty fast, but definitely need someone around a  bit.Also think about the bed or recliner situation. You will need help if it is not an electric recliner.  
Hope this helps. 

Abhishek Sharma  Well arrange some helper , not for physical help but for emotional help.because during recovery u should need someone to talk with u.

David Pearl  Hey Brady that's interesting I live in Thailand and my condominium is kind of like a hotel it's actually good that it's small it's just a bedroom which is got everything in it but it's totally compact I've got a small kitchen outside of the balcony I've got a separate balcony and I've got a small bathroom luckily there is a elevator just a few feet away from my room there's probably about a thousand people living in my three buildings a lot of community a lot of connection where I live although I don't know if I can count on any of my neighbors I'm might be able to tap some of them I've also got a huge social networking Bangkok that's really good another thing is everything is super close where I live I can catch taxis really easily and get everywhere like everything is like super close here bangkok's like in New York it's like a you know bangkok's like in New York but there's no crime and it's small and everything is brand new and everything is like super close together here I figure if I'm single at the time of my surgery or even if I have a girlfriend I'll just hire professional or non-professional Home Health Care people cuz even if I've got a partner at that time that person may not be living with me or they may be busy with work but I definitely have more support here than I would in the states

David Pearl  Hey Jay Alexander just coming out of a week-long Meditation Retreat maybe I'm in better shape than I think I'm still currently in a relationship I've been with somebody for a year and a half my place is super small I'm just going to load it up with food it's super easy to get food delivered it's cheap we've got to elevator just a few feet away from my my apartment condo there's tons of people living in my building thousand people probably really easy to get food delivered and mail delivered once I have a surgical date I'm just going to fill my place up with books and food and you know I can have food all over the place and again because my place is so small it's easy to get around I just have a 250 square foot apartment it's just a balcony and a kitchen that's also on the balcony believe it or not and a small bathroom and yeah it's really easy you know to get around you know everything is just like inches or a feet or two away from me but I have every creature Comfort like I said I can get food delivered yeah the emotional part of it that's what I'm worried about of course once I know the surgery date I'll hit all my friends here I'll talk to people in my building my landlord I'll just talk to everybody and I'll work on Craigslist and Facebook and what the hospital to get home health but I'm a fitness fanatic I'm vegan I don't drink I don't smoke I don't do drugs I exercise like mad I've been this way since my twenties and I think my recovery is going to be short and I had covid for 16 days 2 years ago when I was probably sick aggregatly for a couple months and I know what it's like to be in the hospital for a while and I know what it's like to be really sick and when I had the coronavirus it was horrible because I had no girlfriend and everybody was everybody was still hiding out this is during the the worst outbreak in 2021 so I know what it's like to be in the hospital 16 days I had pneumonia almost died although I wasn't on a ventilator and I was sick for a month afterwards and a month before so I know the hospital experience I know what it's like to be alone at home after the hospital but as bad as almost dying from pneumonia was I think it's going to be much worse with the heart surgery

Brady Busch  People and things being close by,should be big plus.It sounds like your physical needs will be no problem.
My surgeon recommended getting some easy microwave meals,like the Healthy Choice brand.After going through the first supply,3-4 deliveries were needed for the two weeks.
It sounds like there were some tough health issues.Personally,I don't think the recovery will be like those.I remember being very tired,at least for the first week out of the hospital.
Having a friend or relative visit is nice,but mostly,I wanted to rest.

David Pearl  J Alexander Lassally  We don't have room for and I don't have a recliner---just wedge pillows.  What will I need in regards to getting in and out of bed?

Brady Busch  Basically I did,with brief,couple of visits from coworkers.I think believing,will get a person through a lot of life's challenges.
Sometimes,people use the saying,"What doesn't kill a person,makes them stronger",in a humorous way,but there is truth to that.There are obstacles and overcoming them is a part of growing.
But honestly,we can't do it all on our own and need someone's help at times.
 

Marie Myers  No, not terrible! The surgeons will enlarge the aortic root to accommodate a bigger valve. I was only saying that the minimum size aortic valve to implant would be a 23 mm for future TAVR. 

Rich Butela  My Surgeon told me prior to surgery that they can enlarge the annulus. He was hoping to put a 23 in me, but once he cut away the old valve, a 25 fit perfectly.   Talk with your surgeon about your options and if you aren't satisfied, get a second or third opinion

Timothy Andre  I wear my scar proudly. Probably common to feel that way before surgery, but after I think many become proud of it. It’s a symbol of survival and strength 

Richard Munson  Its a badge of courage in my eyes. Anyone finding it offensive can take a hike. I can think of worse things one might display unclothed. 

Marie Myers  My scar does not bother me in the least! Days of low cut dresses were over for me even before I had the surgery…

Richard Munson  I think anyone having an issue with a heart surgery scar might be pretty shallow and not worth the trouble.

Klara Čičić  Dear David, as Richard said, partner who is concerned with something like a heart surgery scar, and not proud and supportive of your heart journey really isn't worth your time, so the scar may have a higher purpose in fact and serve you as a filter of sort :)))
The article, on the other hand, talks about something much more important, meaningful, and impactful which should be addressed more often. 

STEPHEN MORRIS  My scar used to bother me because it was a constant reminder of what I went through. I saw it every day in the mirror. It is also a reminder I survived. I joke with my kids that my modeling career is over now because of the scar. It's seems so long now, I photo shopped a picture from our last vacation just to see what it would look like without a scar...lol

Trygve Harris  Hi.
I'm not  sure about Thailand but Cleveland Clinic Abu
Dhabi was just voted best hospital in the Middle East so if you can wing
it, I can recommend highly. 

Klara Čičić  Dear David, those are some questions. I am so sorry you have to go through this. Educate yourself and read as much as possible, talk to your doctors, ask for a second opinion if needed and slowly you will make your decision that is best for you. This isn't easy. We are here for the support! 

Rose Madura  I retired when I had my surgery but don't see why having had it would affect your job search.  It shouldn't even play a role in it 

Rose Madura  Of course, everyone is different but I never considered myself too sick to work and I had "heart problems" all my life.  I worked for over 40 years and the last 15 we're very stressful as I was sales manager.  I was planning to retire in June of 2017 but just moved it up two months when I found out I needed surgery.

Angela Meletiadis  I am a public school teacher of PE in Greece. The director of primary school education in my area simply said, "Do exactly what your doctor tells you". I really appreciated this. I had surgery July 3rd. School began Sept 1 and I was given the time off from the beginning until now. It's all done from the dr's office electronically each month. I'm not sure if I will get January off yet. I would rather be completely well and work, but my work is quite physical and I am still in a bit of pain (minimally invasive mitral valve repair). I'm waiting to consult my cardiologist just before Christmas. Heart is healing well, however. 

Marie Myers  I was back at work part-time at 8 weeks. Some of the younger people were back sooner than that. I was 63 at the time of my surgery. But every person is different, as every surgery is different. Complications can really extend your recovery period, and complications cannot be predicted..

David Pearl  Thanks Marie ! I will ask my doctor about this..I am afraid I will get a job and then within about a month after starting work I have to take out an unknown amount of time for surgery and recovery..Since I am currently not working and live overseas this complicates the process

Brady Busch  Hello David.Who can perfectly predict the future?That's why the echo-cardiograms are done.I like the idea of getting the work done in California,if that's available. 

Arthur Schoeller  Hi David. I am 67 and have been tracking my aortic valve, aneurysm, plus mitral valve issues for a LONG time with, like you, semi-annual echo's and occasional MRI's. Aortic aneurysm has been a stable size over 10 or more years. It's not clear to me how they have done the "future math" for you! My last exam noted a decrease in my ejection fraction which was sufficient for my cardiologist to finally go get the surgery done. Not that I am an expert, but trending of ejection fraction is a key indicator on valve health and over time decline. So maybe give that a check. I have seen articles that say normal range is 50% to 70%. My last one was 52%, but it was the rate of decline since my last exam that has triggered my cardiologist recommendation for surgery. Since I have the aneurysm PLUS bad family history may all add up for a more assertive approach than JUST the ejection fraction. Hope this helps. I am going to have a MRI to tune up the echo finding, then possibly start surgeon interviews.

David Pearl  Arthur totally understood at all levels..I just came into the severe category although I am not sure how this is derived as by most measurements the valve seems to be ok..I am getting a 2nd opinion today and maybe a 3rd and 4th as well as potentially seeing my doctor again....

Arthur Schoeller  Hi David - let us know how the second opinions pan out, including any deeper insights into the ejection fraction metric to determine severity.

Rose Madura  I don't think there is any way to know what complications you may or may not have. But odds are in your fa or for a successful outcome. 

Susan Lynn  David - Glad you're staying on top of your situation, but timing can be very subjective from surgeon to surgeon for many valve repairs.

The cost isn't bad at all. I paid more than that for my deductible, copays, and non-covered services WITH my employer's insurance here in the US. I had the usual pre-op procedures and minimally-invasive mv repair. I was out of the hospital in 3 days without any complications. I thought it was completely reasonable considering the total charges were over $250k and I had one of the most experienced mv surgeons in the country.

Medical care is one area of my life where I don't comparison shop for the most competitive option. I only had one chance to select the right surgeon and I felt confident on game day that I did my due diligence. Whatever my out-of-pocket was going to be, I was simply going to pay it. I realize everyone is not always in a position to do that, but for those who are, I don't think a few thousand dollars is worth taking a chance in the name of price. Good luck with your decision.

David Pearl  Susan Lynn   I am 100% paying cash and I do need to shop around.  I live in Asia; pre existing conditons are not covered and I am 100% responsible for the bill BEFORE surgery even commences

Ginny Turner  Hi David, all good questions to ask as you prepare. I would suggest that you buy a copy of Adam Pick’s book, The Patient’s Guide to Heart Valve Surgery. It’s a very detailed account of Adam’s personal valve surgery experience, as well as excellent general information on valve surgery. I found it invaluable prior to my surgery, and it will answer most of your questions. It’s available on the Store tab on this site. Best of luck to you going forward!

Rose Madura  Well, there are plenty of videos on this site and on you tube that can help you prepare. I would pre cook and freeze meals to heat up when you get home. And if you don't have any friends or acquaintances who would stay with you overnight for a few days I'd consider hiring a nurse. Here in US, the hospital arranges for a nurse to come to your home after surgery but again, insurance pays for it. You may have to just bite the bullet and hire someone. Your health is worth it.

Susan Lynn  A PDF of Adam's book is available. If you scroll down the store page, you'll see it. You could be reading it, today.

Bradley Dunn  I did all this research 3.5 years ago. Risk of stroke, sudden death varies by the hospital.

I had mine done at Cleveland Clinic due to the quality of the surgeons and institution. I believe the chance of death there around 2% or less with stroke around 5%. They take a lot of high risk patients so I figured my chances were much better.


My surgery I believe was around 160K.

Any other questions?

David Pearl  I live in Asia--prices much lower.. thanks for asking and contributing...I trust the hospitals here..I am going to re visit or visit new government hospitals here in Bangkok to drive cost down.. Any complications post op or op ? I am thinking of doing mine at Vejthani but also looking at Siriraj and going to visit Chest Disease Institute of THAILAND - Nonthaburi as an American friend reocommended it.. I am also going to revisit Bangkok Hospital in Bangkok and re interview a surgeon...How did you find the chance of death at your hospital ? I live in Thailand so I doubt I could find that information.......

Bradley Dunn  I read a lot of general studies. And Cleveland Clinic has a bunch of data and studies on their own hospital site. I found them all just by using Google.

Barbara Wood  David, I'm so sorry to see this. Are you still in Thailand? I know Thailand has some excellent medical care...could you hire someone to help you out? Or use visiting nurses if you're in the US? Letting it run it's course will not be a quick or easy death, you might well suffer heart failure that lingers on. I had a mitral repair for regurgitation 4 years ago & I assure you in the grand scheme of things it is just a small blip, a short inconvenience. I currently am fighting metastatic breast cancer & it is many times harder, I would do open heart several times over in trade, it is just not that bad- and you will recover & be good as new.
I understand the feeling of hopelessness, but I do hope you reconsider & have that surgery taken care of & find a professional to talk with. My very best wishes are sent to you.

Lynn Loudermilk  I thought you mentioed a brother who was here in the states at one point. Can't you ask him for help? I am the worst when it come to asking for help....but during this you need it. DO NOT be afraid to ask. I would also do see the doctor for something to help your depression.

Rose Madura  David, I'm not sure if you are serious or joking around but I'm going to assume you are serious. This is not normal. You need to talk to your doctors about your thoughts and communicate to them that you need help in your aftercare. I'm certain they will assist you in finding help for you.

Nancy W  David, you have reached out to such a supportive group. I see that Adam sent you a message. I am sincerely hoping that you contact him. I am confident that he can assist you to locate services to help you physically and emotionally. Wishing you all the best.

Rita Savelis  I hear you David. It's all hard and sometimes we feel like not going through difficult treatments. But then we do. One makes it through one day at a time.

David Pearl  Lyn my brother is very sick and very shy-little to no use..>The Bay Area is a nightmare cost wise--to start from zero at 58 in the Bay Area especially after living in Thailand would be a hard thing..

David Pearl  Lynn Loudermilk-he is utterly useless dead to me...I am relying on friends, I pray a partner, medical pros etc etc)

David Pearl  From Harvard:
As I suspected: Emotional stress including depression, insomnia, stress and loneliness induce heart disease

Conquering loneliness

Loneliness affects more than a third of older Americans. Another third of older adults feel isolated: they may be living alone, lack transportation, or live far from loved ones. Or they may have outlived a spouse or friends.

Loneliness and isolation can have serious health consequences. Research has shown that people who feel lonely or isolated are at increased risk for developing coronary artery disease, stroke, depression, high blood pressure, declining thinking skills, an inability to perform daily living tasks, or an early death.

David Pearl  Nancy W--I have heard nothing from Adam.He is in LA and I am in Bangkok so I am not sure what support groups you are referring to...except the digital ones..He has a family so my situation is probably too horrible to comprehend

David Pearl  Rose Madura---yes but they cannot provide people 24/7...And I am 58 no family or girlfriend--it's devastating

David Pearl  Post op concerns
Dating after surgery
Who to take care of me post op ?
Recovering post op solo
Going into surgery and post op alone
Scar after surgery
Going to the beach etc w scar
Breathing tube cannot talk
Depression
PTSD
Activities of daily living especially if recovering solo
Doing surgery uninsured
Getting a ride home after
Coming back to empty home post op
Op and pre op complications
Pumphead
Can't relate to anyone who never had OHS.
Post op pain
The surgery itself
Trying to get back to the USA from Asia get housing get insurance and start over from zero and get the surgery when I become severe here in asia

Marshall Rader  I'm sure there's someone that can look after you for one week until you can move around a little bit better on yourself.

Marie Myers  Even If you have to hire someone, you need to do that for at least one week. Or, pay to go to a rehab unit or hospital if that is available. Open heart is not a simple surgery.

Rose Madura  David, I dare say that if I was alone when I came home, I very well may not be here today. I had complications more than once. I suggest you hire an aid 24/7 for at least one week and then see how you are before releasing them in case you need help longer.

Michael Morrison  I agree, do whatever you can to have someone there to help you. For at least 1, if not 2 weeks. There is no way I could’ve made it through that first week myself. Not to mention, you’ll need someone to drive you home and to go pick up meds. You can’t drive for at least 4 weeks

David Pearl  I have no family or friends I can count on in the USA or Asia or anywhere..the only option I see is a nursing home or hiring someone...Has anyone went down this route

David Pearl  Michael--I don't have a car live overseas; I take the sky (above ground train, subways, motorbike taxis, walk

David Pearl  Marshall sadly no..Not unless I hire someone/pay someone..This is my sad reality...I have ZERO family, live alone, single, can't count on friends...As we say in the 'hood, "It is what it is"..I fly solo 100% post op --no choice

Marshall Rader  Well Dave, I think everybody here has pretty much tried to help in any way they can. I think it's time for you to press on and finding resources to help you since I don't think you're getting the answers you're looking for here.

Rose Madura  I was just thinking, surely there are advisors or advocates in a large city like Bangkok that can offer advice and assistance. I'd be sure to check them out.

Deena Z  If you have no savings, then you can apply for Medicaid in the States. Every State application is a bit different, since it is a State/Federal cost sharing program. You may need a residency requirement though to get on Medicaid. If you have no family or friends, then yes, a nursing home would be covered by Medicaid. As to what's available in Thailand that is something that you will need to speak to your surgeon about and the health system. You need professional guidance.

Patsy Stewart  David, after scheduling my surgery, the first question my surgeon ask was if I lived alone. He said that if I didn’t have anyone to care for me, that I would have to go to a nursing home. Also, in my paperwork, it mentioned that I would have to have someone pick me up from the hospital. They did not allow you getting a taxi or taking a bus. Is there anyway that you could go to a nursing home for a couple of weeks and then transition back to your own home? There is no way that I could have went home and cared for myself. You will be very limited as to what you can do. Your body will be weakened from the trauma from the surgery. You will not have the use of your arms if they go through your sternum. In order to heal, you cannot do this alone. Have you mentioned these concerns to your cardiologist or surgeon? Maybe even contact a patient advocate at the hospital you are planning on going to. There should be programs that you could sign up for and this would be the best places to start asking questions. As you said, you are surely not the first one to be in this situation. Do not just give up. Do some research and find a resource that could help you.

David Smith  I would move back to The, great ole USA!
That’s where I would begin my journey. There are SO many awesomely talented surgeons, doctors, nurses, and medical first responders, fire, etc..God bless these people. They will truly save your life. 🙏
The amazing people at the Cleveland Clinic and the Mayo Clinic saved mine. I wish you the best.

David Pearl  Tracy--who said any doctor was gonna operate on me w out any post op help ? Where do you come up with this stuff ? I am simply saying I have no family friends etc to count on post op

David Pearl  Patsy--I guess a nursing home it is..I am so sad, lonely, depressed and alone that I welcome death from a cardiac event..I am ready to go..I don't even have anyone to take me to/from the hospital

Susan Lynn  David - We're all following your story and certainly empathize with your situation. I wish I had a better answer for you, but I don't. Even if you have a very uneventful surgery, it would be advisable for you to have someone with you for at least a week or two after surgery, and checking on you periodically, for another week or two. You may or may not need help with daily tasks, but you may have periods where you feel weak or tired. A simple fall could be problematic - remember, you're not able to use your arms to lift your weight after OHS.

Everyone's experience is unique. I didn't have any issues with self-esteem, loneliness, etc., but cardiac depression is a real condition and we have had some heart warriors who have experienced it after their procedures.

I hate to say it, but you have to plan for the worst and hope for the best. If you need support, it's better to have someone ready to provide it. You will not be in a position to coordinate help at the last minute if you have problems after OHS.

One of the things we say over and over, is the power of positive thinking. If you let surgery consume you, it will affect every part of your life. I like to think of my heart issue this way - I wasn't ill, I was temporarily broken. I'm fixed now and it's behind me. Life goes on and I truly am better, physically and emotionally, for having had the experience. You can make your OHS something that allows you to develop and grow, too! Our most developmental opportunities often result from overcoming adversity. Focus on the good things about heart surgery and you will get through it just like we all did. Best of luck to you!

Susan Lynn  Marshall- I'm glad you are inspired! Heart surgery is a small investment of time for decades of good health and great adventures! Be sure to plan something fun for the summer - you're going to be ready to celebrate. All the best to you! ❤

Marshall Rader  I just retired, and then the heart news !! Ouch !! 60 years old waiting for a heart tune up !! New valve and single bypass !! Not bad !! Wife keeps buying things eg water jugs , food Processor, monitors so she can work at kitchen table in keeping an eye on me, lolol, oh, gates for living room in keeping dog out !! Lol

David Pearl  I am very alone no family or friends I can count on even on the way to/from the hospital. I have no wife kids girlfriend parents or family....No friends I can count on..I live alone since 2000...I don't even know if I will be in Thailand or the USA..I don't own a home and I have no job or career...I have no one to take care of me..I am lonely, alone, scared out of my mind...I already suffer from major depression

David Pearl  "remember, you're not able to use your arms to lift your weight after OHS"... Can anyone explain this ?

David Pearl  Susan Lynn David - We're all following your story and certainly empathize with your situation. Explain

Susan Lynn  David – When I said that we’re following your story, I meant that those of us who have read your posts on this site know that you’re living abroad without available caregivers after surgery. Of course, you’re going to feel a lot of emotions. We recognize that it’s not easy without people around you.

No matter how many, or few, family, friends, and relatives support a valve patient, getting the news about heart surgery is a shock. If you’re feeling scared out of your mind, that’s exactly how we all felt! And, to some extent, there is an element of loneliness about this diagnosis. At the end of the day, we all go into that operating room alone. BUT - That’s the beauty of this site – we get through surgery with the help of the heart warriors who have been through it before us! They walk beside us on this journey - before, during, and after our treatment. We’re never alone and you aren’t either! Moral support, however, is not a substitute for actual post-operative care. Some heart warriors have spent their first several weeks in extended-care facilities and others have hired private temporary help to be with them at home. I think your surgeon, and everyone on this site, would tell you that 100% solo is not an option.

Susan Lynn  I mentioned that using your arms to lift your weight is initially restricted. For example, you have to refrain from pushing on the seat or arms of a chair when you stand up, pushing off of a mattress when you get out of bed, using your arms to get in/out of the passenger seat of a car, or in the case of a fall, using your arms to regain your balance from the floor. Whether you have a sternum entry or opt for a minimally invasive entry, the initial restriction is the same, only the duration changes. Your healing body can be easily aggravated by simple movements that we take for granted every day. That's only one of the reasons, you may need help.

If you’re currently receiving treatment for your depression, you should discuss your feelings about heart surgery and thoughts about death with your treating provider. If you’re not receiving treatment, reach out, today, to your primary care physician for a referral to a professional. Facing surgery is a stressful experience and it sounds like it may be compounding your current level of depression. I am certain of one thing, there’s no reason you should die from anything that’s treatable – and, if you’ve learned one thing from this site, valve disease is treatable! We’re all living proof of that and you will be, too.

Believe that your life is worth the small inconvenience of a few hours of surgery, a short hospital stay, and a couple of weeks with a caregiver.
Improving your heart function may just give you a renewed enthusiasm and appreciation for how precious every day truly is! I wish you all the best, David!

David Pearl  What complicates everything is I have no family either in America or Thailand doesn't matter where I go I have no friends I can count on I don't have insurance that covers me in if I had to start over in America it would be a nightmare on 58 I have no career no family no home no nothing in America so it's either stay and Thailand try to find people I can lean on or go back to America and start over be the way I've no insurance no family actually nobody to count on I've been living alone for 21 years I'm going to have to fly 100% solo post off that's how I roll or maybe I just won't get the surgery and I'll just die of natural causes that's totally an option just don't do the surgery and die of natural causes I don't have any reason to live anyways I'm alone I've got a lot of medical problems I have no family how in the God's name did you guys end up with family? How did everybody get partners get married have kids? I don't get it don't understand it don't get it don't understand it don't get it don't understand it don't get it don't understand it

David Pearl  I think best to not have surgery and die alone of natural causes/from the heart disease----I am so lonely and alone anyways..I am ready to go

Marie Myers  Getting used to the new stronger heartbeat was a little hard for me. I still notice the stronger heartbeat when I take a deep breath Only If I am breathing very quietly or shallow, I do not notice my heartbeat.

Lisa Coombe  My partner has a mechanical valve and I find it calming, I will be getting a mechanical valve within the next 6 months

Marie Myers  I found it difficult to sleep for more than a couple hours at a time for weeks after my surgery. Sorry to say, I am still not sleeping great even now 4 years later. But I think that is due to factors unrelated to surgery.

Joseph Heinzmann  1. No experience
2. Yes, but it's getting better.
3. No
4. Yes. But not severe and it's getting better.
5. Only a little.
6. Only when I get a random pain in my chest.
7. At the beginning but went back to normal pretty quickly.
8. It's tough to answer given the COVID situation messed everything up for me prior to surgery.

Warfarin was easy. 90 days only for me so I cut out vitamin K foods and had pretty consistent readings. INR nurse was great. Finger sticks really didn't hurt.

Domestic surgery.