On-x valve repaced and now a possible deployment to Iraq/Afghan

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Z

zlever

Hello All--its now been just over 1 year since I had my Aortic Valve replaced with an on-x mech. vavle at Madigan Army Medical Center here at Fort Lewis, WA.
I am still amazed at how wonderful a job the surgeons did!
I feel terrific! I am now running 6 days a week (20-25 miles) and over 300 sit-ups and pushups a week! I love the decision I have made in regards to the on-x valve and will never look back!

I am an active duty soldier. 18 years in the Army. After the surgery the doctors told me I would not be allowed to deploy in a combat zone while on coumadin. For obvious reasons --1. Greater risk of bleeding faster and 2. No way to monitor the INR level.

But here is the deal if I stop taking the coumadin and put a whole lot of trust in the great advancements that have been made with the on-x valve I am deployable. Now ---the Army doctors have to tell me to take the coumadin based on the fact that the FDA hasn't approved the On-x for aspirin/plavix only use of yet. I guess we are 4-5 years away from that study being completed--or so I am told. But I am the patient and they can't force it down my throat.

With such great results from the 200 people in Germany that are On-xers and are only taking aspirin once a day, and the study in Africa as well as the preliminary results in the United States--I am very seriously considering deploying overseas again if my unit is so ordered. Right now my unit is scheduled to deploy again in about 10-12 months.
Obviously if I deploy --I will be going to aspirin once a day for the duration of the 12-15 months.

Any thoughts? Please I am open to any comments---even constructive criticism from the ones that think I am in idiot for even thinking about this.

By the way while back here in the states I will continue to take coumadin. I think taking coumadin has been a very easy transition for me. It hasn?t affected my diet at all (except I drink very little alcohol now).
I firmly believe in what Ross has said that in regards to coumadin "dose the diet versus dieting the dose". Great advice Ross and that?s exactly what I do. Once every three weeks or so I have them draw my blood and adjust mg's based on the latest INR. Surprisingly they haven?t had to change it much. I think that has to do with the fact that they are not chasing the diet as Ross has mentioned.

Any ways take care all! You all are wonderful people and this site will always have a special place in my heart!
Zack
 
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I wouldn't risk it. Plain and simple. Studies are promising, but the final results are not in. You got this valve to save your life. Don't risk it.
 
I think your decision was made when you had valve replacement. It's not fair to the others in your unit if something would happen as a result of your not taking the coumadin. Perhaps once the studies are completeld, but not for now.
 
It comes down to, "Do you want to risk being a vegetable the rest of your life should you be unlucky and have a stroke from a thrown clot?"

Bad enough other evil things can happen on deployment, but I'd sure hate to see you suffer a natural tragedy much less an enemy inflicted one.

Of course, it's your choice. How much is your life worth to you?
 
I am at a loss for words Zack! I cannot tell you how much I admire & respect your commitment to serve our nation but you are going above & beyond my friend! You were given a 2nd chance to live your life, don't ever forget that.

Like Karylnn said, aspirin and/or plavix, are in the experimental arena right now so the only thing that is certain is that coumadin is still the med to help prevent clotting on your valve. Don't risk it my friend, you've climbed the mountain & made it to the other side.....don't look for a replay!

Hope you reconsider! :)
 
Taking just aspirin would be risky. You have an idea of whether you'd take a baby aspirin, or a greater dose? I read somewhere about a guy that had an old ball and cage valve that just took aspirin for many years (like 25 or so), but finally had a stroke. An On-X is certainly less prone to clotting than the older valves. But still the risk is there. If you could get a doctor to prescribe Plavix for you it would be less risk. Then take aspirin and Plavix like in the Clinical Trial. I think that would be pretty safe; certainly less risky than aspirin alone. However, I think it is unlikely that there are many Doctors that would prescribe Plavix for you since that is not the standard of care, but perhaps you might be able to find one that would? Too bad you didn't get into the On-X Clinical Trial, but its too late for that now. You have to have been signed up for the Clinical Trial before your valve was implanted, and have follow up appointments at the same center that did the implantation. I'd guess that you might be all right taking the aspirin, but nobody could say for sure. There would be some risk. I guess I'd have to say that its probably not worth it; i.e., that you can serve your country in other ways that are just as meaningful without putting yourself at risk. You would not be doing yourself, or your family, or your country, any favors by having a stroke. I certainly applaud your enthusiasm, and thank you whole heartedly for serving your country, whatever your decision is.
 
Even if you're not thinking about stroke, you could have a GI bleed from the aspirin. That stuff is extremely hard on the stomach. Don't do it, man. You've done more than enough already for your country.
 
Today is the fourth anniversary of me having a stroke, the first real indication that I had a health problem.

If I was in your shoes would I come off warfarin? No sir, I would not. One stroke is enough for me, I really wouldn't wish to put myself at risk of having another.

If you deployed on warfarin you could be injured and bleed, if you have a stroke how will that affect your unit?
 
Zack,

First, I am retired military and I fully understand the desire to ?stay with your men? and to perform the job you dedicated 18 years of your life to.

However, you say the Doc?s told you would ?NOT be ALLOWED to deploy in a combat zone while on coumadin?. Bud, you ain?t gonna get thru the deployment physical without somebody noticing. This information is probably plastered thru-out your medical records. And they WILL look, believe me. You might make it outta the States but somewhere they will finally NOTICE. Then you will wind up being sent to who knows where while your buddies continue on.

My approach would be to use the information you have picked up here. You know you can ?home test? no matter where that home might be. Firefighters and Police have won the right to keep their job even with ACT. Sure, an IED might not be something you would want to experience, even in a MRAP or Up-Armored HUMMV. Hell, I wouldn't want to experience that even OFF ACT. You might bruise a little bigger that that ugly, stinky guy next to you. However, I would NEVER even consider going off coumadin, especially behind their back. You are coming up to your retirement window you know. Unfortunately, I have seen guys booted with just under 20. If you are an officer you would get something but enlisted?this is the way to the nearest VA.

So I know where you are coming from and don?t consider you an idiot for looking at all options. But stopping coumadin should not be one of them.

Good luck, my friend but DO NOT even consider coming off the coumadin. Even if you can say NO, them Military Docs can then say ?Well, here are your discharge papers?.:eek::eek::eek:

May God Bless,

Danny
 
Zack -

Two Items / Quesitons -

First, your Subject line is confusing. I interpreted it to mean that you *had* an On-X valve but got IT replaced with something else (like a tissue valve) because you wanted to stay active with your unit. After reading all of the posts, I'm guessing that is NOT what you meant.... Now I'm thinking you meant to say that you NOW (still) have an On-X Valve in you. Right?

Second,

EVEN IF you were to 'go off Coumadin' and take either Aspirin or Plavix, they are BOTH Anti-Platelet medications and can cause / worsen Bleeding, just in a different manner than Coumadin. From the viewpoint of the military, I suspect there would be NO DIFFERENCE, i.e. you would still be considered to be "A Bleeder". (I'm thinking I recall that some of our members had more "Bleeding issues" with Plavix than they had on Coumadin... it's a fuzzy memory)

Just my Non-Professional observations / thoughts.

'AL Capshaw'
 
I hope you make the right decision,. but that decision is just that yours.

I always wanted to join the military and was in Jrotc when it was offered (way back in the days) at my school. I was on the drill team & color gaurd. I took the test and received very high marks, then I took the Physical and that was the end of that. I am sponsoring a soldier right now over in Iraq. I send him things time to time, and he appreciates it very much.

My point in short is there are ways to serve with your men without taking too much of a risk. My opinion is you should serve out your career behind a desk & help them by sending supplies. What better to ask for donations & socks for the troop than in full dress?

I wish you the best of luck in making this difficult decision.
 
I wish you the best of luck in your decision. I know all the hype that the On-X valve gets and that they have very promising results. I am just reporting here what my surgeon told me ... "all new valves that come out they hope to have the same non-coumadin needing effect, but they haven't found one yet". That doesn't mean this isn't the one, it just means that according to my surgeon, there have been many others out there that had others just as hopeful as you that ended up disappointed. I truly hope that the On-X is the one!!!
 
The way the Canadian military works is that an order from a Medical Officer is as good as an order from a Commanding Officer and ceasing your Rx would be akin to disobeying a lawful command.

Someone must order you overseas in the first place so, without your name on the travel order I highly doubt you'd find yourself on a ship, aircraft or bus carrying you into active duty.

It's hard but you really must face facts, you are between a rock and a hard place. Are you fit for active duty, honestly? Be a good soldier and follow orders, or don't and take your discharge.

Take Heart, at least you're alive to make the decision.
Pamela.
 
You sound like you are doing extremely well. That is great!No matter your cardiac situation. I hate to hear that you could be going to that giant sand bed. If you do get deployed over seas any where keep your head down and take care. May God keep you in his tender loving care while you are there.

Lettitia
 
Sounds to me like you'd have been a good candidate for a tissue valve and not a Mechanical valve in the first place if you were intent on running about with guns and stuff again ?
As for your question, it would seem that there are hundreds of people around the world doing very well with On-X and little or no ACT so why not just go for it ? There'll be plenty of people with weapons there that dont want you in their country trying to kill you so surely it wouldn't be too high on your list of things to worry about anyway ?

I think your biggest hurdle would be convincing the medics to let you go in the first place.
Good luck.
 
Dear Zack, Welcome to our little club of valvers. Thank you for your dedicated service! As for going off coumadin so you can go back to active duty, I say don't risk it. I haven't read up on the On-x for about a year, but from what I am familiar with, I'd say it is not worth the risk. Glad to hear you are doing so well! Do stay in touch whatever you choose to do. Thanks again, Brian
 
I think that is wonderful you want to go back, but agree with the others that said they wouldn't risk it, especially since If I remeber right you have a wife and small kids to consider if you go off coumadin and something happens.
 
gadgetman said:
Zack,

First, I am retired military and I fully understand the desire to ?stay with your men? and to perform the job you dedicated 18 years of your life to.

However, you say the Doc?s told you would ?NOT be ALLOWED to deploy in a combat zone while on coumadin?. Bud, you ain?t gonna get thru the deployment physical without somebody noticing. This information is probably plastered thru-out your medical records. And they WILL look, believe me. You might make it outta the States but somewhere they will finally NOTICE. Then you will wind up being sent to who knows where while your buddies continue on.

May God Bless,

Danny
Click to expand...

I think deep down inside, you know Danny is 100% correct. You may fool them for a bit, but not long and then those consequences might be worse then never deploying in the first place. ;)
 
Thank you all so much for your replies! I value all the opinions you all have expressed. The good news is I have at least a year or so before I have to make a decision.
The 4 decisions being. 1. Keep things the same 81mg aspirin and coumadin with an INR of 2-3 and not deploy. 2. Bring the home monitoring device with me and keep my INR at a lower level (1.5-2.0) 3. Aspirin/Plavex combo. 4. Aspirin only.

God bless you all! Thanks again for all the infromative responses. You all are wonderful people! Life is good!
I will keep you all posted!
Take Care-Zack
 
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