Confused, scared, bewildered and overall dumbfounded! Never knew I had a problem

[jake]

Almost a year ago, I went to the hospital with what I thought was extreme acid reflux. I’ve had it before but never where it caused pain in my neck and arms. Turns out I had a near total blockage of my RCA that needed to be stented. I have not been in the hospital in my live, I’m only 44 and have not had as much as a bee sting or broken bone. While being cathed, they discovered I had a bicuspid aortic heart valve and a 4.8cm ascending aortic aneurism. Man, my life has changed and nothing will ever be the same for me. Not necessarily a bad thing, but moving on.....................

For the last year, I have seen several thoracic surgeons some of whom say its time to operate, some who say I’m not even close. Some say keep the heart valve and change the aorta, some who say change to an artificial heart valve some who say keep the bi-cusped heart valve and just get an aorta because the old heart valve is in good shape.

The major problem is that I work with my hands and going on blood thinners and anti-platelet meds for the rest of my life is not an option.

Honestly, I am confused and depressed as to what to do! I have great insurance right now, but get laid off pretty regularly from my job. I am a craftsman, and cant do blood thinners, I am an active guy who loves to skate and play hockey. My cardiologist wants me to stop taking plavix so I can get a new aorta like right now, but the folks over at U of M are telling me to cool my jets, 4.8 cm is really not that bad. Their mindset is that I need to hand on to my original equipment as long as I can because I am not a candidate for a pig or cow valve because of my age, the only option for a valve replacement is an artificial mechanical valve. Everyone agrees that this is not a matter of "if" but "when."

My last visit to the cardiologist has me at ease with moving forward with an MRI to check the see if the aorta has enlarged, but again, he wants me to get a replacement ASAP regardless. The Thoracic surgeon is good with leaving the bicuspid valve saying it will likely last longer than a cow or pig valve and hope for better technology.

I’m not looking for sympathy or even for anyone to tell me what to do. I put all of that in Gods hands, but I guess I would love to hear from someone who is on the other side of this horrifying prospect of major surgery, and made it through and has a "normal" life.

I am thankful to be among so many survivors and just want to walk in with my head screwed on straight about what is happening me.

Thanks

 

[Superbob]

Jake,

Wow, it sounds almost like you've had an excess of advice, if that's possible. Just no doubt confusing to be getting conflicting opinions... I wouldn't presume to tell you what to do, but it certainly sounds like close monitoring is in order and time for surgery may not be far away.

I'll just offer that I had the combined aortic root/valve replacement at age 63 and I am doing well more than five years later. My general understanding was that 5.0 cm aneurysm was a tipping point for surgery, though that may vary somewhat from one individual to another. Mine was 5.3 on my final echo and surgeon found it to be 5.5 when he went in -- probably in the nick of time. Wouldn't want to wait too long if it is increasing. Good idea to follow it closely and see if it is.

At my age, I decided on a tissue after weighing the pros and cons carefully. Of course, since you are younger, your decision might go the other way -- many folks here can tell you what the "blood thinner" regulation is -- and is not -- all about. I won't presume to get into that.

Glad that you have joined us. You can vent here, ask questions and get the benefit of a lot of perspectives. Welcome!

 

[Mentu]

Jake, welcome to VR. You are not the only one here to have received different advice from different Doctors. If you read more of the information available here, you will learn that coumadin is an anticoagulant. It does not thin your blood and it does not make you bleed profusely. It does slow coagulation. Part of the advice I was given when I first found this place was to get copies of my test results and learn what they said. This is not hard to do. You need to know what the status is of your heart valve and aorta but, perhaps more important, how have they changed over time. Your Doctor's should be watching this change and noting the development of symptoms. One problem is that some of us never develop a lot of symptoms. Getting a handle on the information can help you decide what you feel best about doing.

You know, Jake, until I read your last sentence, I had never thought of myself as a "survivor" but, rather, just a guy who had a problem that got fixed. However we think of ourselves, among the members of this community there is a lot of experience which we can share with you and perhaps that can both ease your mind somewhat and help you choose your next step. When my Cardio first told me about my valve, I could only think about getting it fixed immediately. It ended up being 10 years because the guidelines that are generally followed tend to be conservative which can leave us wondering.

It is a shock to learn that these things which we rely on deep inside us have developed problems that only surgery can fix....someday. Welcome, aboard, Jake.

Larry

 

[Luckyguy17]

Welcome Jake,

Am one of those that had a bicuspid aortic valve, which was replaced 30 days ago 56 years of age and I already feel better than before surgery. I was due for fixing.

Understand that it is not easy to be told that you may have some heart issues that may need addressing some day.

Take the tests and follow the guidance of the professionals and read on in the forum, you will find many cases and much useful information

 

[Philip B]

Nothing will be the same?

Nothing will be the same?

Nothing will be the same... hopefully, you're right and it will be better. You've discovered some issues that are fixable. Many of us are proceeding with our regular, every day lives despite OHS.

Why would "working with your hands" restrict you to a tissue valve? As others have noted, it seems you have dialed into some of the misconceptions about coumadin that are lurking out there. I took a tumble from my mtn bike in the desert this morning and skinned-up an elbow. I finished my ride, went home, and cleaned up the wound. It probably bled for a total of a couple of minutes at the most. Like most folks, whether on coumadin or not, I bleed a little when I cut or scrape myself. It's really no big deal; I bleed pretty regularly.

Whatever valve choice you make will be a good one. What's important is to get the problems fixed before the problems reach a point where things won't be the same because you're dead. Having valve replacement surgery and getting blockages removed is really about getting your life back.

Don't buy into the nonsense and misconceptions that are out there about heart surgery. This stuff is about life.

-Philip

 

[Maryka]

When an aneurysm is "ripe" for repair has changed over the years. When I first learned I had an aneurysm in the 4.5 ish range (through a routine chest x-ray, ironically), that was far from the replacement size. Now, however, because of the relative safety of today's heart surgery, the size for replacement is considered, in most cases, to be 5.0. It is a risk calculation. There are some on this list who had aortic dissection (breakage) at the size of your aneurysm. (Ross is one of those, I believe.) I have known people who died due to aortic dissection. I have a friend who almost died of aortic dissection when she went to play a friendly game of doubles tennis. (She had no clue she had an aneurysm before passing out, racquet in hand.)

You should probably converse here with Woodbutcher. I think he carves works of art with his hands. I think he is still doing that. (Other than that I do not know what you mean about working with your hands.)

I found the discovery of my aneurysm, and subsequently, my bicuspid aortic valve, gave me the opportunity to think about my relationship with my loved ones, my life-goals and my "higher power". It was a real blessing, I think now.

 

[OldManEmu]

Jake take a few deep breaths, this isn't the end of the world even though it may appear like it from where you are now.
You are most likely thinking they are planning to do that to me. Yes and you most likely will feel much better for it a few months post surgery.
The aorta at 4.8cm is getting close to the 5cm trigger point for surgery.
What is the BAV valve function like? If it is good you may be a candidate to a david procedure with the valve being cleaned up and reimplanted at the time the aorta is replaced.
If the valve is damaged it will need to be replaced, you get to choose if you want a tissue valve of mechanical valve.
Keep in mind that a tissue valve will require at least 1 maybe 2 redos if you live a normal life span. I received a tissue valve at 41 so you can at 44 if this is your choice.

 

[catwoman]

Jake:

My surgery involved the mitral, not the aortic. However, from what I've seen at this website, there are enough people who had BAV & an aneurysm who had only one thing done during the initial surgery (usually AVR) and then later on needed the other done.
Common sense would point most people into having both done at the same time to avoid a subsequent surgery. Of course, some people with BAV could probably go all their lives w/out needing surgery. However, if you've got one thing wrong that needs fixing, seems smart to get both fixed at the same time. You'd save on sick leaves (only 1 hospital stay vs. 2), hospital bills, recovery period (only 1 vs. 2), etc.
Exactly what do you do for a living

 

[BarbJean]

Welcome, Jake. It is very hard to get conflicting opinions, because in the end, you are the one to make the important decision as to when to have surgery done and what kind of valve to use. It would be easier on us if we just were told the same thing by all involved. My son's aortic root measures 4.59 right now. We were told he could wait if he wanted to. But, knowing he has weak connective tissue( Marfan Syndrome), we decided to go ahead and have it repaired now. We figure, if it is going to have to get done sometime, why not have it done now while he is in control of the who, where, when of it. In an emergency situation, you don't get options. We are choosing for him to have a valve repair rather than a replacement. But, he does not have a bicuspid valve, his is a normal tricusp and is in pretty good shape. The surgeon is hoping it will go another 15-20 years, but that is not a guarantee. Good luck with all of you decisions! Barb

 

[ARGreenMN]

The first thing I would say is the idea you can't work with your hands, play hockey or skate on Coumadin is most likely false. You probably won't believe this for a while yet, but as you do more and more research, you're likely to discover that Coumadin (an anti-coagulant, not a blood thinner) doesn't usually prevent you from being active or working with your hands. When I first came into this site back in March, I was leaning heavily towards a tissue valve. See the paragraph that starts with "Here are some of the reasons I'm leaning against blood thinners..." in my first post by clicking on this link - http://www.valvereplacement.org/forums/showthread.php?34663-48-year-old-newbie-Lots-of-questions-to-come&highlight=. As I learned more, I ended up doing a 180 and going with a mechanical valve on May 5. I'd recommend you read some of the posts in the active lifestyles forum on here to get some examples of what people are doing on Coumadin. I've only been on it for a little over 6 weeks now, but so far I can vouch for what people on here (and my docs) were telling me - it's really not a big deal, and doesn't have to be life-changing. And you're talking to a guy who was a non-believer at first about that. I think you'd be wise to read much, much more and talk to many more people before dismissing a mechanical valve as an option.

Even though I ended up going mechanical and being very happy with my choice, I've got many friends on here who went the other direction (tissue) and they're equally as happy with their choice. Ultimately, it comes down to you deciding what's best for you. And I'm not trying to convince you one way or another, I'm just saying I'd recommend getting as much information as possible before you decide. And make sure you're comfortable that the information you get is accurate. Same is true with your doctors - they'll have different opinions too - so find one you're most comfortable with, try to understand the pros and cons the others are telling you, and go over those with the one you trust most.

I can't speak to whether it's time for surgery for your aorta, your valve or both other than to say if they can do both at the same time - I'd probably be all for that. As smooth as the surgery usually goes these days (you'll see this theme over and over on here - it's nowhere near as bad as you're likely thinking right now) it's still probably not something you want to do twice if you can get by with just doing it once. Which is another reason I think you need to research more about mechanical valves (if/when you need to get your valve replaced), because as you'll see, with the tissue option, at 44, you will need to get it replaced again down the road, at least once more, if not twice more. Although, again, there are many on here who have chosen tissue knowing full-well they'll likely need another surgery - it all comes down to personal preferences. Since it sounds like everyone agrees it's not if, but when you'll need your valve replaced (which is what I was always told too), if they determine you need your aorta fixed first, I'd definitely ask about getting that valve replaced at the same time.

On the timing, I think the insurance coverage thing is a HUGE consideration. In other words, if you're covered now, and might not be later - and are on the fence about getting the surgery now - insurance might be the tipping point to get it done now because this is a very expensive surgery and if you can get insurance to pay for it (or at least the vast majority of it) I think you probably want to pursue that.

You've found the most wonderful place possible for running questions by real people, who have actually been through this, and getting open and honest feedback. Many will have differing opinions on here too (which is to be expected - most of us are just patients, not medical professionals) but I think it's good to hear different angles. Some folks advice will probably hit home more than others with you, but ultimately I think this site will help you get more comfortable with your decisions. Information is power (as long as it's accurate information). Keep posting questions, giving us updates on what you're thinking, what else you're hearing from your medical teams, etc.

 

[Lynlw]

Hi, I'm sorry you are so scared and confused. It is tough enough to hear all this, and must be even more over welming to have so many surgeons telling you so many different things. If you don't mind, Who/where have you seen and which surgeons recomended what? You will wonat some one that has ALOTof experience with aorta and BAV. One question, I would ask all of the, is how much experience They personally have with not only aortic surgery, but valve sparring surgeries. I know more doctors are recomending valve sparring or repair, surgery for Aortic valves I would definately ask doctors that recomend thatfor you, why they think you are a good candidate for this and why your valve should be fine. I also would definately have a Plan B incase they get in there and your valve doesn't look as good as they hoped, so they know what valve you would like as your 2nd choice (this is a good idea for ANY choice, always discuss plan B with your surgeon, incase your first choice doesn't work besit for you when they see it)
As others said take a deep breath and relax, alot of what you believe might not be quite right, both about coumadin AND being a candidate for tissue valves. Many people work with their hands and do perfecty fine on coumadin. I don't know that I would personally recomend Hockey, since many people end up with bad concussions, even with the best helmets available, hitting your head hard alot of the problem has to do with your brain moving inside your skull when you head is suddenly stopped, like falls and helmets don't protect you from concussion, that coumadin most likely would ake worse.. But cuts that bleed can easily be stopped, it just takes a little longer, The bleeding concern with coumadin, from most edical people, is the internal bleeds you don't see right away and not cuts.
Also as for "not beng a candidate" for tissue valve at 44, that isn't necessarily true either. These days, many of the centers/surgeons like Cleveland recomend/and use tissue valve (usually bovine, but not always) tissue valves in younger patient (40 and up) mainly because of tissue valves lasting longer since they started treating them with anti calcification treatments (NOTE they will NOTlast as long in some one in ther 40s as over 65) and more importantly the fact the success rate for REDOS has improved so much in most centers, they are about the same as they are for 1st time surgeries.
Many people here are very passionate about valve choice and their opinions, but it is really a personal choice and what each person feels is right for them. It pretty much comes down to which downside, you would feel more comfortable you would prefer to live with. Tissue valve and the risks of repeat surgeries (and a small percentage of people end up on coumadin for life because of Afib anyway) or mechanical valve and coumadin, testing ect ( and like tissue/coumadin, a small percentage of mechanical valves will need replaced anyway) and the no mater how small risk of having a complication because of having a mechanical valve and take coumdin- bleeds or clots.
The really good thing, is there is NO bad choice, years of studies show no matter which valve you choose, the long term results are about the same, you will have a long happy healthy life. Certainly MUCH longer than if you didn't have surgery.

 

[ALCapshaw2]

Welcome Aboard Jake !

You have received some excellent responses already. I found Andy's experience to be especially relevant to your questions and issues.

It would help to know the Background / Experience level of the Medical Providers you interviewed with YOUR conditions, i.e. BAV and Aortic Aneurism. You need to know that Surgery of the Aorta is another step up in complexity from 'mere' Valve Replacement Surgery. Fortunately, you are within close proximity to several Excellent Heart Hospitals, such as Beaumont Hosp. in Royal Oak, UofM in Ann Arbor, and Cleveland Clinic (#1 rated Heart Hospital) in Cleveland.

It would also be helpful if you obtain copies of ALL of your Test Results. You will find Much More Information than what the Doctors tell you during your (typically brief) Office Visit(s). By Law, your medical records must be made available to you. You will have to sign a Release of Information to Yourself for Personal Use and there may be a copying charge.

What kind of test did you have to measure your Aneurism? Echo's are notoriously poor at aneurism measurement. The Gold Standards for more accurate measurment are a Chest CT or MRI.

Unfortunately, there is still an (overly pessimistic) view of Bleeding Risk while on Coumadin hanging on from the Old Days before INR testing was created in the 1990's which allows for much better control of levels and risks, especially among medical practicioneers who have not kept up with modern developments in the area.

I encoaurage you to read the links provided by Andy and to continue your research on BAV and your options.
Feel free to ask more questions as they arise in your quest.

'AL Capshaw' (Go Blue !

 

[jake]

Thank you all so very much for your responses and information

Thank you all so very much for your responses and information

Well, I have received so much information and so many responses that I must say, I am so very relived to know that there is not just life on the other side but GOOD life!

To answer a few questions, the hospital systems I have been working with are the one that discovered the problems (Henry Ford Hospital) and thus far, a second opinion from the University of Michigan.

Henry Ford Hospital's thoracic surgeon, Dr. Nemi, was recommended to me by my cardiologist, who has genuinely taken a personal interest in my particular case. Long story short, he asserted that if he or better yet, one of his children needed this surgery, this would be a no-brainer for him.

At U of M, I went to visit Dr. Hast, thoracic surgeon who felt that, thus far, I had been handled well by HFH. He just disagrees that I need to move forward now, but could elect to be imaged every 6 months. One huge reservation I have had with the whole idea of long term monitoring of the Aorta is that both surgeons are beating the drum for CT scans every 6 months. It’s pretty scary to think that the amount of radiation coupled with a lot of contrast die filtering through my internal organs will have to occur every 6 months. Thus far, in the last year, I have had one chest CT scan a year ago, along with an Echo, and 6 months ago I insisted that Henry Ford switch me to MRI with Gadolinium. Although Gadolinium carries some risk, I am told it is less risky than the iodine based contrast die used for CT and no radiation. The images are not quite as clear with MRI, but everyone concerned says it’s about size vs. features. Unfortunately, going from CT scan to MRI is comparing apples to oranges size wise so the MRI I get next week pretty much gets us a very realistic idea of growth (if any), if not a hell of a lot of detail.

Funny thing is, after learning about the "tell tale signs" of valve leakage and regurgitation, I have been suffering with minor symptoms for years. Ironically, MRI's of my spine as far back as 4 years ago vaguely showed the aneurism but they simply were not noticed as no one was looking for it. A minor heart attack a year ago essentially may have saved my life! If not for this event, I would have never known and I would still be lifting, toating, and riding defensemen into the corners and blocking shots on my goaltender. I am very blessed and lucky to have had that heart attack. Furthermore, every sunny day, every breath I take is now a gift from God! When someone tells you that you have a time bomb in your chest, it’s pretty heard to sweat you kid getting into a minor car accident, know what I mean? LOL!!

Needless to say, I am already on Plavix, really, how much different could it be from Cumadin? I have had many cuts, some pretty serious, a root canal, and a few other things without major problems. I have never taken cumadin, but Plavix has really taken a lot of energy out of me until I discovered D-Ribose, L-Carnatine and Co Q 10 (Ubiquinol) therapy thanks to my 90 year old aunt who had heart failure. What do folks on anti-coagulants do if one needed another surgery, a tooth pulled, or a simple colonoscopy or develop a stomach ulcer? Has anyone had an experience like this?

One of the reasons that Henry Ford didn’t want to crack my chest earlier was that they wanted me to finish my 1 year of Plavix from the Stent placement so as not to risk another heart attack. With all the talk of Plavix rebound and the like, that’s just one more issue I need to educate myself on and seek more information about. My cardiologist team seems to be all in agreement that quitting the Plavix on the one year anniversary (July 3rd) should be uneventful.

I know I am all over the place on this, and for that I apologize. Despite my babble to the contrary, I am feeling a lot better about this now that I did a day ago. What a difference a day makes! [/B]

 

[delvalle6]

Wow. Just take good care of yourself. What a shock.
Just remember a job isn't worth your life. Neither is money. You are more important than either of those things. If you're a carpenter, maybe you can position yourself to transition into doing bids and estimates-- or something a little more on the "paper" end of the deal. I knew a guy who got a job at the local college as a professor teaching carpentry classes-- and right now they have some primo incentives to go into teaching...
Just saying-- there are always alternatives to work- money- whatever, but there aren't any alternatives on your health and life. Just take it all in, relax a little (if you can) and weigh your options. Choose what is best for you and yours-- and that choice will surely involve you getting the best care-- regardless of medications.

 

[ARGreenMN]

Jake, glad you're feeling a little better about all this already. There are others who can speak to this in a lot more detail, as I haven't had to do it (dental work or some other type procedure while on Coumadin). Although will likely soon need some 30+ year-old crowns replaced (from a car accident when I was in high school). So I'll be a guinea pig for ya When you have to have some kind of surgery, I think they usually take you off Coumadin temporarily, and do what they call a bridge (I believe) with another medicine. I think they either use Hepperin or it's milder cousin Lovelux (probably spelling them both wrong, but someone will correct me I'm sure). Then afterwards, you're put back on Coumadin. They used hepperin on me in the hospital for my heart surgery too - before the Coumadin had worked it's way into my system. So it must do something to lower the risk of clots w/o lowering your INR, but I don't know what the difference is between those meds and Coumadin.

 

[Freddie]

Dumbfounded??? just add OHS 5 days after being told and we'd both be in the same boat.

One BIG advantage you have over me is that you found this forum before your surgery, I found this fantastic forum 3 months after my surgery.

We are here for you.

 

[Bill B]

Just to clear one thing up - I'm on warfarin and I cut myself all the time. I work on cars doing heavy mechanical work. Tools slip, and wounds happen. Even at 2-3 times normal INR, I have no problems getting the wounds to stop bleeing. I ripped my thumb open a few weeks ago, Yes, I bled like the proverbial stuck pig. I probably would have had I not been on warfarin. Anyway, a pressure bandage and it stopped and healed fairly normally.

Ross should be checking in soon and will tell you about the hazards of assuming a 4.8cm aorta is not that bad. With BAV it's not just the size of the aorta but the quaility of the tissue that is important which cannot be determined except by direct observation in surgery. Mine was a lot less than 4.8cm but the tissue was a mess. All better now.

 

[ALCapshaw2]

Most Dental procedures, including simple extractions, can be done While AntiCoagulated. You just need to find a Dentist or Oral Surgeon who appreciates the Risk of Stroke when going OFF Coumadin. New Dental Guidelines support this policy.

SOME Gastroenterologists will perform Diagnostic Colonoscopies while anti-coagulated. IF polyps are discovered, then you may need to have a repeat procedure, OFF Coumadin, to have them removed. That said, Ross had some small polyps removed while anti-coagulated with NO bleeding problem. I'm thinking the GI Doc may have cauterized the cuts.

For surgery, you will need to come OFF Coumadin. There is NO Standard for Bridging Therapy using either Heparin or Lovenox. I am aware of (and written posts) about 3 different philosophies / protocols used by different surgeons regarding Bridging. Been There, Done That, a couple of times now.

Regarding your 4.8 cm aneurism, different Surgeons have different opinions. Ross (and several other members) support the philosophy that "Sooner is Better". Given that it will need to be addressed at some point, What is the Benefit of Waiting with the concomitant Risk of Rupture? Why not just 'Get it Fixed' and over with? To my mind, the Risk of Rupture exceeds the Risk of Surgery (1% morbidity, 1% mortality nationally, less with Top Surgeons). FYI, Ross had His Aneurism Disect at 4.7 or 4.8 cm. and was one of the lucky 5% to survive such an event, after a LONG and 'incomplete' recovery. He has written about his torturous experience.

You obviously understand the trade-offs between a CT and MRI. I agree with you, the MRI would be my preferred method.
Insurance companies probably prefer CT's as a lower cost option.

One last comment. All CardioThoracic Surgeons are NOT equal. You need to ask the ones you interview about their specific experience dealing with BAV and the often associated Connective Tissue Disorder(s) that often result in Aneurisms. They need to be able to Recognize Problematic Tissue and KNOW how to deal with it (i.e. sew in a valve and NOT have the stitches pull out as has happened to a few of our members who used 'less experienced' surgeons). FYI, 90% of OHS are for ByPass Surgery. 10% for Valves or other less common issues. The Top Aorta Surgeons are typically found at Major Heart Hospitals. Dr. Svensson at Cleveland Clinic leads their Aorta and CTD group. I don't know who the Aorta Specialists are in Michigan.

'AL Capshaw'

 

[Maryka]

I have cousins in the Detroit area and in the Cleveland area. It really is not that far to go to Cleveland! (You aren't one of my lost cousins, are you? Bicuspid aortic valve run in the Detroit faction of my cousins...)

 

[jake]

Coumadin, Plavix, INR, there is a lot I need to know!

Coumadin, Plavix, INR, there is a lot I need to know!

This is a terrific resource for information to say the least. I am a little confused though, I do understand why blood coagulation control is important with mechanical heart valves, but most of the information I have seen out here is regarding the use of coumadin. Does anyone who has had a mechanical heart valve replaced use plavix? Most of the doctors at HFH are saying that Plavix is now the weapon of choice for new mechanical heart valve recipients. Thus far, I have tolerated plavix pretty well with the exception of some sluggish feelings of low energy now and than and some VERY weird nightmares at first. Hell, when you get those little platelets all slippery, they must really cause the brain to do some weirdo stuff out of the gate, know what I mean?

I was truly amazed at the different heart valves and their construction. The On-x is a real engineering wonder to say the least, but I still have a lot of research to do. By reducing the turbulence, thus reducing the amount of damage to blood cells, the risks of clotting, although still a concern, are greatly reduced! Being an engineer, mechanic and over all gear head, I can really appreciate some of the design improvements of heart valves and the "what’s and whys" of keeping INR numbers under control. I just don’t know if I can do all that! Hell, sometimes, I have a tough time remembering where my keys and wallet are some days. I can only imagine what the inclusion of the supplements like Omega 2’s, ribose, Carnatine and Ubiquinol would do to ones INR numbers.

So just how much effort do you folks who have mechanical valves put into monitoring INR? I’m not a diabetic so regular blood testing is a prospect that is new to me. When I brought it up to my surgeon, he keeps insisting that my best bet is to get the new aortic root and arch and leave the well functioning bi-cusped heart valve in place as its working fine to avoid having to take anti-coagulant drugs. He seems to think the original valve, bi-cusped as it is, would likely outlast a pig or cow valve and that there is a good chance that with proper control of BP and some other factors, may last a lifetime. Of course, "other factors" was his way of telling me to lose about 70 lbs! LOL!!!!!!

Oh yea, nope, no immediate relatives with any of these abnormalities that I know about, in my immediate family, I am the only one. In my extended family, only one person who is diabetic and suffered with heart failure. Everyone else has lived well into their 80’s before passing away so if they had it, they took it to their graves at a ripe old age.

I sincerely apologize to anyone who does not appreciate my levity in some of this stuff, I have to laugh to keep from crying, know what I mean?