Richard's Journal

Jeff Williams  Lots of bacteria in the mouth. Dental work can lead to bloody gums and the bacteria get into the blood stream quickly.  It's considered a "dirty" procedure. Better safe than sorry. 

Kath Duggan  I am confused about this.I had a conversation with my surgeon and he said after the surgery I would need antibiotics but not for cleaning now. I asked my dentist at my pre surgery visit and he said cleanings are even more risky than procedures but he could not prescribe pre visit antibiotics anymore and that my cardiologist would need to do this..I am confused! Years ago I was taking them and then told not to because there was no danger of bacteria effecting my heart.

Marie Myers  You definitely need antibiotics for dental cleaning. As Jeff said, the mouth is loaded with bacteria, and it is easy for bacteria to get in the bloodstream. Artificial valves are prime targets for bacteria, which can lead to endocarditis ! This is a very important thing for those of us with “valve jobs”…

Susan Lynn  My dentist still has me pre-medicate, but apparently,  there is now a much smaller group of patients who should take antibiotics before dental procedures. 
https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/antibiotic-prophylaxis#:~:text=With%20the%20exception%20of%20the,circumstances%2C%20where%20the%20determination%20and

Rose Madura  I have always taken 2000 mg of Amoxicillin prior to any dental procedure. My dentist prescribed it.  I'd rather take it than to have any complications because I didn't. My dentist office will text me one hour before to remind me to take it and then ask me about when I arrive.  

Sharon Behl  Same here.  Since my first mitral valve repair in 2021 I've been instructed by my cardiologist to take one dose of amox. prior to a dental cleaning.

Rita Savelis  Infection can occur in your new heart valves. Bacteria can head down to your heart  - dental cleaning and procedures can provoke this. Most cardiologists (and many dentists) ask patients to take one dose of antibiotic pills about an hour before any dental procedure. I never was prescribed antibiotics before I had surgery (I was followed for 6 years pre-surgery) - but have been taking them for the past 8 years (after surgery). There are definitely different schools of thought about the necessity of antibiotics pre and post surgery.  Protocols change, but you should take advice from your cardiologist and your dentist.

Rose Madura  Yes, one dose of four 500mg pills.  My dentist prescribed 16 at a time because he says I'll pay the same for 16 as 8 would for 4.  

Klara Čičić  Guys explained it all perfectly, I can only confirm that I, too, take 2g of amoxicillin 1 hour prior to teeth cleaning or any bloody dental procedure. What I want to add is interesting fact which stresses the importancy of not only antibiotic prophylaxis but also maintaining of good oral hygiene: (from UpToDate)

Maintenance of oral hygiene is important to reduce the risk of gingivitis and periodontitis as well as the risk of infective endocarditis (IE). All individuals at risk for developing IE should establish and maintain a program of oral health care. Maintenance of oral hygiene plays a more important role than antibiotic prophylaxis in reducing the risk of IE, which is more likely to result from frequent exposure to random bacteremias associated with daily activities such as tooth brushing than from bacteremia caused by invasive dental procedures.

Richard Munson  Well, there is apparently a new protocol that states only replace not repair requires the antibiotic. My dentist says take it for both as a safety measure. Next year the new protocol will say , whoops, after careful consideration we decided repair and replace need it. Sorry about those that that got ill in between. They gave me amoxicillin but after i saw the warning label for it mixed with my gout medicine  i asked for something else and received it. No pain today from extraction so i worked a trade show but now my eye surgery tomorrow is my next hurdle. It never stops.

Grace Mason   Good point Klara! I've been using  an antibacterial mouthwash too, in addition to my usual brushing and flossing, just to be extra careful in the immediate post surgery period.

Thomas Brusstar  My doctor said it is the presence of a device in my ticker that requires the antibiotics.  I have the annular ring implanted after my mitral valve repair.  It doesn't move, but it's there, and apparently can be a magnet for infection.  I think the same specific bacteria that infect heart valves are quite common in the mouth.  So my cardiologist and dentist confirm that normal mitral valve prolapse no longer gets antiobiotics, BUT once you have metal in your heart you do need the drugs.

Marie Myers  Good morning, my Other Richard… I am guessing that since the aneurysm hasn’t changed significantly since your last one, the docs won’t order an MRI at this time. It is the rate of change that they are probably interested in, as well as the size. An MRI might show a tiny difference in size( larger or smaller) but not enough to push you into a worrisome size. That is my complimentary, and possibly worthless opinion…

Valerie Allen  It is true the CT scan is more accurate, but as Marie says since they are seeing it the same on the echo they would not feel the need to test at a more detailed level. According to my dr.

Cathleen Weed  Unchanged on an echo is all you need to know right now. That's great news. By the way, it was NASA who came up with the echo/color doppler technology that we use now. They are very accurate. Are you taking any BP meds to keep it that way? Don't skip those. If you are concerned, you can always do your follow-up echocardiograms at 6 month intervals instead of annually (depending on your insurance). I wouldn't worry

Richard Munson  Appreciate the responses, marie never worthless unless of course my aorta explodes and i die. I want to come back as a mitral valve. 

Kimberly Eisenhut  Richard, I understand your worry. Mine is 4.1 and staying steady for past 7 years as long as I take my lisinopril and amlodypine. I only get the echo also and it is accurate, as a few years ago with an MRI it was the same. You should bring it up with your Dr if you are worried, it is worth it to ease your mind. It would be nice at times to have an "OFF" switch to our brain to tell it to stop thinking about these things so much. Your sense of humor certainly helps! I, for one, am very grateful for your posts and the chuckles I've had thanks to you. Thank you

Richard Munson  You are very sweet kim and i appreciate your insight. My doctor scheduled the mri and will only cancel it if insurance says no. Peace of mind. 

Grace Mason   Hope you get your peace of mind scan. That can be as important as the regular testing the doctors choose.👍🤞

Cathleen Weed  My ascending aortic aneurysm stayed at 4.2 for 10 years from the time they first noticed it. Ten years later, it grew to 5.5 and then quickly over 6cm (huge) during a very stressful time in my life. I had an emergency open heart and my ascending aorta was replaced with a dacron graft. I had been taken off my beta blocker a year prior by a different cardiologist, which in retrospect was a big mistake. That's why I mentioned staying on any BP meds (above). Keep your stress low if possible and stay on the meds and maybe yours won't grow Mine was easily tracked and measured by echocardiograms, but the MRI will give you another baseline to go by if you go that route.

Rose Madura  Richard, I'm praying the MRI will show nothing different than the echo and then you will have peace about it. I was never told I had an aneurysm until I met with the surgeon and I didn't ask, but now wonder if he saw it in the CT scan. Anyway, I feel your pain.....

Richard Munson  Yes rose, i believe they withhold things probably meaning well but in reality not. My wifes breast cancer was one that jumps out at me. We’ve been watching this for a couple of years and we think you should see a specialist now that its grown. Knock on wood, 10 years and it has not returned. Cathleen, if i can get another 10 years from aneurism i will be 91 so fingers crossed. Yes, still on metropolol and amlodipine and baby aspirin. As far as stress goes. Trying to avoid it is a losing battle i think. 

Kath Duggan  Fingers (and toes) crossed for the MRI to show no change my friend. I know I am a worrier….not good, but you are wise to advocate for yourself ❤️❤️❤️

Ana Brusso  I actually spoke with a cardiologist who told me that the surgeon on my first surgery could have seen my huge aneurysm and just felt it was better to take care of the small aneurysm and the replacement. Sometimes they make what they think is the best decision. Now, even though I love my cardiologist, I’m getting another cardiologist in my area to have what Rose always say “a second opinion”. Totally get Richard’s pain. 🙏❤️

Sharon Behl  My understanding is that over 90% of mitral valve repairs are "one and done."  I guess the unfortunate 10%, like me, are the ones who show up on this website?

Ana Brusso  Hey Richard, I’m hoping that Kath Duggen will show up on Sunday at the car show and also to meet you. I remember when you provided her with your surgeon and she is now in November will be healed by him. I, of course will be praying for her. Hope you both have a good meet. Take pictures and share them with us. Have a fun car show. 👍🎉🎊🙏❤️

Richard Munson  I just hope for sunny skies. Its all about the weather. I never plan very far in advance due to poor weather forecasters. They have no clue for some reason. 

Ana Brusso  We have the sunny skies, but I don’t like the heat we are having, yesterday 119 today 116. Umbearable. You’ll have good weather 🙏

Kath Duggan  Richard are you going to the car show in Wareham on Saturday at the Elks Lodge on Cranberry highway? II saw the ad in the local paper and I would definitely come. 

Susan Lynn  Not just you,  Richard.   Same here and I'm reading on an Android.  I am using Chrome,  so that could be the problem.  What are you using? 

Richard Munson  Just using my regular old aol and bing  that i have used since columbus discovered america. It has to be on their end. Glad it is not just me. If it stays like that i can see it shortening my blog time. Maybe they are trying to tell us something. It was fine yesterday.

Rose Madura  Same here. I'm using a Google phone.  I also can't see the number next to news that told you how many and who responded on a post that you responded to 

Brady Busch  Hold on,I scrolled down after writing that comment and instead of automatically bringing up the posts,it has next,to click on.When doing that,the page is like half done,with names and other things,all over the place.

Adam Pick  Hi guys and gals!  Ana just let me know about this issue. Our programmer just told me he fixed this issue for iPads.  Are you still seeing this issue? Thanks! Adam

Susan Lynn  You're funny, Marie! You and Richard may have a future comedy act in Vegas!
Sorry about Shadow - dogs ears are so sensitive- I can't imagine how awful it must have been for him.

Shelly Hubbard  Poor Shadow! I dread July 4. Our dog Kirby hates it. I feel so bad for all the dogs that can't handle the noise.

Ana Brusso  Yes Richard, they knew it would drive Shadow crazy and then would destroy the house 😂Just kidding. Funny, Marie.

Kath Duggan  While you were in Energizer bunny mode I was wiped out napping. I finally see him in 2 weeks and hope he can repair my heart valve. You give me hope!

Richard Munson  You will love him. Great guy and very talented. I do my share of napping also. Might be age related. 

Donna Casaletto  Richard you are the Energizer bunny😂‼️Great news Kath best of luck with your appointment and keep us posted! 

Ana Brusso  Richard, and the man Upstairs as you call him 🙏I wish I could take naps but glad you and Kath can. 

Susan Lynn  You're also running after a puppy which is as exhausting as chasing a toddler. You are earning those naps, Richard! 🥱 😴

Klara Čičić  Wow Richard, sounds like you are in great shape. Glad you have the energy! Stay active. As I said, my surgery is in 10-20 years! Counting on you 😁😁😁 

Richard Munson  After chasing 3 toddlers a lifetime ago, i can safely say that a puppy has them beat. Our 3 are only a year apart from each other and my girls are only 11 months . I was also tons younger. I still remember the 3 car seats strung across the back seat. Of course the modern safety police would never approve. Better times. My 13 year old grandson just signed up for tackle football. Ugh.