25 years coming up (and 6 years just passed)...

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Superman

Superman

Well-known member
Joined
Oct 2, 2009
Messages
1,920
Location
Grand Rapids, MI, USA
November 21, 1990 was my first AVR (just prior to turning 18) and October 15, 2009 was my second AVR / Ascending Aorta replacement. Proudly ticking and thinning for 25 years.

I'm slowly becoming the crusty old man with the Coumadin clinic ("How long have you been dosing this? Well let me tell you something...."). Still younger than many first timers - so I've go that going for me I suppose.

As I like to say, lifetime guarantee on the parts (as soon as they fail, the guarantee is up)!
 
sensei

well done :)

may the fates continue to blow you gentle winds.

Superman;n860479 said:
November 21, 1990 was my first AVR (just prior to turning 18) and October 15, 2009 was my second AVR / Ascending Aorta replacement. Proudly ticking and thinning for 25 years.
Click to expand...

so, your first avr was a mechanical?

it would seem we've had a similar path. Both BAV? I understand that the stats are that BAV and later aneurysm are correlated.

speaking of unstubstantiated by research theory, mine is that the BAV shields the aorta (like a pressure regulator in a hydraulic system) during early development and does not give it the required levels of pressure to stimulate its strengthening. Then after surgery to fix the valve it is exposed to greater pressures and begins to distend.


I'm slowly becoming the crusty old man with the Coumadin clinic ("How long have you been dosing this? Well let me tell you something...."). Still younger than many first timers - so I've go that going for me I suppose.
Click to expand...

undoubtedly you have more years on it than me, but I'm 53, do I qualifiy as crustier?

Hats off to you none the less sir.
 
pellicle;n860489 said:
so, your first avr was a mechanical?
Click to expand...

it would seem we've had a similar path. Both BAV?[/QUOTE]

First AVR was mechanical. In 1990 at 17/18 years old - tissue wasn't even presented as an option. Even if I had been offered tissue, I don't think the prospect of being opened up every ten years for the next 50 - 70 years would have been all that appealing. The native valve was BAV. The 2nd surgery was driven by the aneurysm. They replaced the valve to use a one piece valve/graft and to resize (went from 23 mm to 25 mm). I was still a skinny teenager when I got the first one, although I had reached my full adult height. The mechanical valve itself was performing fine and not in need of replacement when I had the second.

pellicle;n860489 said:
speaking of unstubstantiated by research theory, mine is that the BAV shields the aorta (like a pressure regulator in a hydraulic system) during early development and does not give it the required levels of pressure to stimulate its strengthening. Then after surgery to fix the valve it is exposed to greater pressures and begins to distend.
Click to expand...

I'm inclined toward the broader connective tissue disorder theory, but yours is an interesting one. A lot of BAV patients have functionally normal valves for years before they start to narrow and leak. Not too many of us are born with leaky stenotic valves. My aorta was perfectly normal for over 15 years after my first replacement. Measured 2.6 cm in 2006, 3.2 cm in 2008, then jumped to 4.9 cm the next year. They moved a little early relative to the 5 cm guideline given the rapid rate of change.

pellicle;n860489 said:
undoubtedly you have more years on it than me, but I'm 53, do I qualifiy as crustier?
Click to expand...

My crustiness is based on being an annoying patient with 25 years on warfarin telling the clinic staff how to dose me while dismissing their recommendations, not my biological age. I've read your stuff and have learned a lot from you on warfarin management. You can be as crusty as you want to be.
 
Congratulations on 25years. It's a bummer that a new problem forced the second surgery, but hopefully, everything is behind you now.

I agree with you about INR clinics........home testing solved the clinic problem for me. No clinic....no problem.
 
dick0236;n860492 said:
Congratulations on 25years. It's a bummer that a new problem forced the second surgery, but hopefully, everything is behind you now.

I agree with you about INR clinics........home testing solved the clinic problem for me. No clinic....no problem.
Click to expand...

Thanks.

Regarding the clinic, I do home test. However the clinic (insurance) provides the machine and monitors results (which I report). Without that set up, I'd be paying out of pocket for the machine and strips. They are covered by insurance as all part of lab work with this set up.
 
That is a big congrats, Superman! You have earned the badge of honour to be 'crusty' . :)
Many, many more years of good health and crustiness! :)
 
Hi

Superman;n860490 said:
My crustiness is based on being an annoying patient with 25 years on warfarin telling the clinic staff how to dose me while dismissing their recommendations, not my biological age.
Click to expand...

It brings my heart joy to hear that I'm not the only annoying patient saying "no"

:)

Live long and prosper my friend
 
[/QUOTE]
First AVR was mechanical. In 1990 at 17/18 years old - tissue wasn't even presented as an option. Even if I had been offered tissue, I don't think the prospect of being opened up every ten years for the next 50 - 70 years would have been all that appealing. The native valve was BAV. The 2nd surgery was driven by the aneurysm. They replaced the valve to use a one piece valve/graft and to resize (went from 23 mm to 25 mm). I was still a skinny teenager when I got the first one, although I had reached my full adult height. The mechanical valve itself was performing fine and not in need of replacement when I had the second.
[/QUOTE]

I'm just a few months behind you, July 1991. I was 43 and a tissue valve was not an option then either. Almost everyone under 60 is advised to get a mechanical valve because the risk of another surgery outweighs the inconvenience of blood thinners. Mine is 31mm which I gather is on the large side even for men, but I was a runner and always had great aerobic capacity. If I had known about valve selection at the time I would have asked for 33mm telling them I'm going to push this thing to the limit, which I have.
 
I'm also approaching 25 (August 21), and have also become a crusty old grouch who educates the anticoagulation 'clinic' more often than not. Some of their guidelines just don't make sense.
My current clinic may be trying to give up on me. They told me that if I prefer to self-test and not go to the lab, they can handle this. They didn't go as far as saying that they'd work on providing a meter or strips. For me, the lab is yet one more measure against which I can compare my meter(s). I like to have both available to me - even if I have to provide my own meter, strips and lancets.

Congratulations on your 25 (and, as with the others, it hardly feels like congratulations are in order for me, at least - I did nothing besides laying on the table when the operation was performed, following some guidelines, and staying alive long enough to hit that landmark).
 
Superman;n860493 said:
Thanks.

Regarding the clinic, I do home test. However the clinic (insurance) provides the machine and monitors results (which I report). Without that set up, I'd be paying out of pocket for the machine and strips. They are covered by insurance as all part of lab work with this set up.
Click to expand...

I test on Saturday. I call in my INR on an automated system. The clinic calls me on Monday and tells me my self reported INR. I love the ridiculousness of it.

Congrats on 25 years. All The longevity here is inspiring. I am going on 6 months.
 
Superman, pellicle, dick and Jack - You guys are great role models for the rest of us "newbies" at valve replacement. You have shown us that life can really be "normal" afterward.

Thank you for all your help and support.
 
epstns;n866120 said:
Superman, pellicle, dick and Jack - You guys are great role models for the rest of us "newbies" at valve replacement. You have shown us that life can really be "normal" afterward.

Thank you for all your help and support.
Click to expand...

Haven't posted in a bit, just saw this.

Funny place, this. I think I'm still relatively young in this group, chronologically (43). However - I'm one of the seasoned veterans when it comes to valve age (approaching 26 years now) .
 
Trina - I'm (almost) 69, and this group is STILL inspiring. We have such a range of members, many of whom have had their valves for literally decades and still just wring the life out of each and every day. They all have helped me to realize that having my valve replaced was just another event in a "normal" life, and that I should just go on about living it like I always planned.

That works for me!
 
This is an aside, but I found it inspiring to learn that Arnold Schwarzenegger told interviewers that he would have run for president in 2016 had he been able (he cannot due to his not having been born here).

I know he's not your typical guy, but if he feels up to that 20 years after AVR, then there's got to be hope.
 
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