Need some answers, Please....

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Farid

Farid

Well-known member
Joined
Oct 11, 2006
Messages
62
Location
Monmouth Junction, NJ (7/09) Bel Air, MD
My dilemma ...:confused:
Situation:
1. One doctor refuses to consider On-X Valve. This is the hospital (Morristown Memorial Hosp) where I really wanted to have my Surgery. He said he'll ONLY used St. Jude. Are there different types/designs of St. Jude for aortic valve replacement?

2. The second hospital (Columbia) is far, he'll use an On-X, but I'm already dreading the trip just for an MRI, and follow up for the surgery. How often do I need to visit my surgeon after the Op?

I know it is my choice and whatever suits me best. But, I need to know YOUR opinion and experience; just in case I'm missing some elements to consider. I?ll never say so&so said.....:D
 
I was operated on 100 miles from home, and I only had one post-op appt. with my surgeon. Your cardiologist will resume your care, so it will be easier if he is nearby.

Surgeons tend to go with what they're most familar/comfortable using, so you've been given a heads up by your local surgeon that he won't implant an
On-x. Knowing that, it seems that you will either need to change your valve choice or change your surgeon.

Good luck with whatever you choose to do.
 
Farid.

If your local doctor won't use the On-X because he is not familiar enough with it to install it, that is very good news that he stands by the extent of his experience. If he won't use the On-X for other reasons, and you completely value this surgeon, please be sure to consider his reasons.

The whole image of this surgery and recovery is so daunting before you have it done. There are so many unknowns. Nothing about the whole "journey" is going to be something that you would normally do. So to think that normally you would dread going to Columbia for tests and benign activities is certainly understandable. BUT. If your favorite, most loved person on the planet desperately needed you and you had to go to Columbia to help this person -- well -- you wouldn't hesitate for an instant, would you? No. So Farid. You are currently your own favorite and most loved person on the planet. You must treat yourself as such and honor whatever feels right to do, no matter what the inconvenience. :)

My surgeon wanted to see me twice after surgery. Once at 3 weeks, again at 8 weeks. After that we had a few phone conversations and one peculiar, not necessary visit at 5 months. People differ on these visits. You should ask each surgeon what his preference is....they might be different, but they certainly have their own standards.

My surgery was local. We only had to drive 20 minutes to get there. I was able to get the valve I wanted, and be operated on at what I considered a state of the art facility by a gifted and impeccably schooled and experienced surgeon. If any of those variables were missing I'd have driven up to Seattle, probably... 3 hours away......and without hesitation.

My 2 cents. :D

Good luck, and keep thinking it through. It's important enough to give the answer time to come to you.

Marguerite
 
I traveled 3 + hours

I traveled 3 + hours

I was happy to travel to a larger better facility with gretter experience in differing types of valves and options.
You need to first, understand why your original surgeon is refusing. Once you know that, you have a choice to make on what type & where.
As far as how often you need to go to your surgeon after the AVR. That normally depends on the surgeon along with your travel distance and quality of cardiology care you can receive locally. I go back to see mine annually.

Hope this helps.

Ben
 
If I couldn't get the valve I wanted from a certain surgeon, I would find a new surgeon. The mechanical valve (hopefully) is something you will live with for the rest of your life, so I would think it is worth some extra effort in the short term to get what you really want long-term. However, that's just how I would approach it.

As far as the number of post-op surgeon visits - I only had one (at about two weeks). I lived about 50 miles from UCLA, but getting through LA traffic meant that it was at least a 2-hour trip each time. I was actually surprised by how quickly I was handed back to my Cardiologist, but that seems to be pretty standard from what I've learned here.
 
I was in a very similiar situation. The local guy would only use St Judes & I would have to travel quite a distance to get the on-x. My decision came down to 3 things: where was I most comfortable with the surgery, did I trust my surgeon, and what was to be gained by the two different valves.
In my opinion, you can't go wrong either way.

For the St Judes, right now their latest & greatist model is called the St Judes Regents.

Good luck,
 
The surgeon is usually just a one post op visit (or sometimes none if he works close w/ the cardiologist) So I wouldn't really worry about that if i were you. Lyn
 
Farid, using a surgeon at a distance is not a problem as everyone else here has stated as you usually only need one follow-up with the surgeon at 6 weeks and then are turned over to your local cardio. So, I guess it comes down to deciding why and if you really want the On-X. If it were Dick or I, it would be worth a visit to the second surgeon for a second opinion and to discuss the choice and then it will all depend on which surgeon you like the best. You definitely want a surgeon that is familiar with the valve that you want.
 
The St. Jude REGENTS is another third generation valve so you may want to ask your local surgeon if he is familiar with that one (and if he would implant it).

I had surgery 100 miles from home and only saw the surgeon once, in the hospital, following surgery. My Cardiologist, PCP, and ER did my 'follow up' care.

'AL Capshaw'
 
My surgeon turned me over to my local cardiologist immediately, said that although normally he would do the 6 week post op check, he thought it was unreasonable to expect me to travel hundreds of miles, mostly by air, just to see him for a few minutes when the check could be done locally by my cardiologist.

I looked at that site with the different valves and upon checking, I see that I have one each of the two different types made by ATS, one says AP and the other doesn't so I assume that it is a 'Standard'.
 
I too had my MVR at a hospital (Duke) which is about a 2 hour drive from home. I have never seen my surgeon since I left the hospital over 3 years ago. My cardiologist took care of all post-op check-ups. Eventually, I will probably have to have my AV replaced and I plan to do that locally since facilities here have made huge strides in the last couple of years. I had a heartport procedure to replace my mitral and that wasn't done in my locale.

BTW, that is a great link you posted.
 
Farid

I chose to travel 1 hour to go to UCLA so I could have the On-X valve put in. It really comes down to what valve YOU want put in. Hopefully the valve you choose will be the one you sport inside of you forever. So it is a big decision. After OHS I only had to go see the surgeon 1 time, 2 weeks after surgery. Then my primary doctor and local cardiologist took over. Goodluck you make the right decision for you:)
 
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