Has valve replacement affected your occupation?

[Andrew01]

In researching info for my valve selection decision, I came across a reference to a survey that asked VR patients if the valve disease or prosthesis significantly affected their work, career, or income. It said that 35% of mechanical valve recipients answered “Yes”, while the percentage for bioprosthetic AVR patients was 23%. I am somewhat surprised and curious why this would be.

If anyone would want to comment on their experience of their valve replacement or anticoagulation management affecting their work, I would appreciate reading any input.

Thanks,

 

[Cooker]

I think there are certain jobs / professions that might not want there employees on ATC. I know a girl who was drummed out of the army because she had to start warfarin ... I am sure others will come along with more specific examples... I have a mechanical and it has not been a problem for me.....And welcome to the zoo

 

[Lisa in Katy]

I would think it could affect those with careers as sword swallowers, UFC fighters, or mimes (tick tick tick)!

I'm sure there are some careers where being on Warfarin is frowned upon. I seem to remember someone saying that some law enforcement agencies don't allow those who are on ACT to be "out on the streets". I've never been in that type of career so I haven't had any affect on my career or income. I would expect that some of those who said yes had adverse outcomes after surgery, but since there are 23% for tissue valves and the % of adverse outcomes isn't nearly that high, I'm not sure what the rest would be.

 

[Jkm7]

I seem to recall a few VR.com members saying their jobs as firefighters and police officers were in jeopardy because of ACT. There were other police and firefighters from different districts/cities who said it made to difference in their job security/performance.

I never read that from anyone with tissue valves and not on ACT.

 

[Freddie]

All I can say is that my S/O has become over protective of me after having OHS and does not want to me to do anything physical. Had to quit a very physical job (a job that I thoroughly enjoyed) after receiving a black eye. When my S/O saw my eye the panic button was pulled. So, in order to keep the family happy I quit.

 

[Kim B]

Perhaps the discrepancy is due to more of the older patients past retirement age choosing tissue valves vs. younger patients still in the workforce being more likely to get mechanical valves.

 

[Cozycat]

I have a mechanical valve and it hasn't affected me adversely in any way. I'm my own boss so that isn't a concern. And no side affects from the warfarin. The way the question is worded, it could be that some of the people answering yes had damage to their hearts from a valve being bad for a long period without being repaired or replaced and that resulting damage may have affected their lives.

And, I'm sure there are occupations that you might want to stay away from...being a rodeo cowboy or matador come to mind. But those percentages seem a little high for most people who have more "run of the mill" lives.

Midge

 

[westie]

no and yes

no and yes

.
having a mechanical valve has had zero effect on my occupation/business and i should point out that it has had zero effect on my entire life:

except that it has actually resulted in a big improvement in my performance on the job. because of the recession, i employ fewer people than previously; meaning i end up doing heaps of heavy labour which young boys did previously. thankfully i had my ohs at the very start of the business downturn so i have been able to "get stuck in" to the job.

 

[Ross]

For those with mechanical valves and ACT, it's often a problem because of the ongoing lack of the medical professions ability to properly dose the drug. If all of the medical pro's would bother to get on the same page, I'm positive you'd see almost immediate drop in adverse events. I'm willing to bet around a 85% drop. I don't think it's going to happen in my lifetime though. We still have physicians running around telling people they'll bleed to death when their INR goes out of range by 2 seconds.

 

[ChouDoufu]

came across a reference to a survey

you're going to need to research that survey. i'll bet that very few of those
whose jobs and/or lives were affected negatively, would say it was due
solely to valve replacement or ACT. if anything, they should have seen
improvements due to the valve replacement.

they've likely had the respondents pick one surgical event to respond to
the survey, when they probably had multiple problems. so the guy that
had a valve replaced with an aneurysm and a squadruple bypass, along
with a kidney replacement, and various other problems was only allowed
to choose one surgery. and since many people getting valves replaced
have additional problems, there's no telling what effect valve replacement
or act actually had on their lives or jobs.

if the valve disease or prosthesis significantly affected

also, how is/are the data broken down? are they really lumping in the
valve disease with the prosthesis? so they are asking have you been
negatively affected by the cause and/or the cure? if so, then you could
have 22% noticeably affected by valve disease, along with 1% with
a poor surgical outcome.

EDIT: sorry, forgot to answer your question. beef valve. no effect on
occupation (student/tourist/lazybum). have lots more energy, sleeping
better, running faster and farther. lots of improvement since avr.
only on warfarin for 90 days, during that time no problems.

 

[Lisa in Katy]

Another Bogus Study

Another Bogus Study

Here's the study:

Comparison of outcomes after mitral valve replacement with a mechanical versus a bioprosthetic valve in patients between forty and sixty years of age

Here's the conclusion:

Patients in the age group of 40 to 60 years undergoing mitral valve replacement with a mechanical valve have a higher incidence of thrombotic and bleeding complications as compared to bioprosthetic valve, even though short term survival is similar. This favours implantation of a bioprosthetic valve in this age group.

So the only things that this study thinks influences valve selection is clotting/bleeding events? Length of study was 3 years so they didn't consider risk of reops. They also didn't really define what a complication was. When I cut my head and it was still seeping hours later, I went to the ER and they glued it together. That's a complication, most likely related to Warfarin, although certainly not life threatening. The overall complication rate they noted for mech valves was 6% vs. 1% for tissue. If you really read the study, they are talking about outcomes in the developing world, where access to meds and testing might not be available. Obviously a different story, but it's not spelled out in the study or conclusion.

How about this study:

Factors Influencing Patient Knowledge of Warfarin Therapy After Mechanical Heart Valve Replacement
And the conclusion:

In summary, a significant number of patients receiving mechanical prosthetic valves were found to have insufficient knowledge of warfarin therapy 3 to 6 months postdischarge. Older patients with a lower family income, lower education level, and those who were unemployed had significantly lower warfarin knowledge scores. Younger age, knowledge of the concept of INR and the acronym, and receiving education after discharge were significant positive predictors of warfarin knowledge scores on multivariate analysis. These findings suggest that although in-hospital education provides basic knowledge, increased attention needs to be placed on ensuring that patients have access to either an outpatient education program or to a community counselor to effectively build upon in-hospital education of warfarin therapy.

Hope they didn't waste much money on that one because they could have just asked me and I would have only charge $10 for the answer.

 

[Ross]

In summary, a significant number of patients receiving mechanical prosthetic valves were found to have insufficient knowledge of warfarin therapy 3 to 6 months postdischarge. Older patients with a lower family income, lower education level, and those who were unemployed had significantly lower warfarin knowledge scores. Younger age, knowledge of the concept of INR and the acronym, and receiving education after discharge were significant positive predictors of warfarin knowledge scores on multivariate analysis. These findings suggest that although in-hospital education provides basic knowledge, increased attention needs to be placed on ensuring that patients have access to either an outpatient education program or to a community counselor to effectively build upon in-hospital education of warfarin therapy.

Hope they didn't waste much money on that one because they could have just asked me and I would have only charge $10 for the answer.

Ooo, Ooo, do they have one of those for the Doctors? I bet they scored even lower. How can they expect the patient to get it when they don't?

 

[dick0236]

Perhaps the discrepancy is due to more of the older patients past retirement age choosing tissue valves vs. younger patients still in the workforce being more likely to get mechanical valves.

I think that Kim B makes a good point. My mechanical valve had some influence on my occupation and activities. It did cause me to sometimes "take the safer way". However, those were self imposed restrictions. In hindsite, those restrictions were not warranted.

 

[MarkU]

My AVR hasn't had any direct effect on my occupation. I did change careers shortly after my surgery, but it was for professional reasons not due to any heart-related issues.

If anything, I engage in more "high risk" outside activities now than I did prior to my surgery. I volunteer regularly at Habitat for Humanity building houses (using hammers, saws and other sharp stuff) and train for triathlons by doing long-distance cycling on public roads.

I've always have been an active person and have no intention of letting myths and misinformation dictate my lifestyle. I think it's ironic that I'm in far better shape physically than most of my "healthy" friends of the same age.

Mark

 

[sue943]

I lost my job and at fifty-eight it isn't easy to find a new one especially when the job application forms have the question "How many days did you have off sick in the last twelve months", answer "Eight months". I hasten to add that the eight months was me having endocarditis, a stroke then open heart surgery a few months later, not just a valve replacement on its own.

I lost my job because my work needed to be done during those eight months and I think with me having first the stroke then the double valve replacement that my employer thought I wouldn't be returning to work so made alternative arrangements for my work to be done. They got a shock when I said that I was ready to work again.

I don't think my cardiologist of that time nor my GP really wanted me to return to work, they have their way now.

 

[tobagotwo]

There are certain occupations that tend to be less tolerant of people on ACT. That would include some police, fire, and military functions as examples. And even with them, it varies in terms of tolerance. Some places are okay with it, others won't allow it. It doesn't have to do with what's fair or reasonable, but rather where that particular power group decides to stand on employees on ACT.

As such, it is likely that those who have mechanical valves are more often affected jobwise than those with tissue valves. That doesn't, of course, address whether that situation is morally or practically right or wrong.

Best wishes,

 

[zipper2]

I have a high risk job at times and others in my workplace have

had heart surgery some not on coumadin,but everyone very

understanding regarding my coumadin etc. even when it came time

my cardio wrote me off working niteshifts afew noses were up of healthy beings cus they hate nites

So far in my 6years there no problem from anyone regarding act,but then
im not a police officer ,theres been worse delimas than act for officers
such as ms or injuries and other accomadations for their best interests
are accomadated in different areas of work but still in detachment

Prior i worked mental health and never come across any struggles
in 18 years of being employed in any line of work.

Guess it all depends alot on people and their additude and how prepared
and their understanding about heart valves and coumadin i mean when
i first heard about it for myself 18 years ago i thought my life was over till i understood it wasnt the end of the world

 

[starrman]

It did not change my occupation although I probably take things a little easier now and have more fun whenever the opportunity presents itself. I do have problems sleeping with that incessant clicking........so I get to work later in the morning and leave later in the evening. Fortunately, my job requirements allow flexible hours.