I Have a Date

[selma]

Went down to meet with Dr. David Adams and his crew at Mount Sinai in Manhattan. He spent a good hour with us, carefully explaining and illustrating the process of repairing my diseased mitral valve. The man is a wonderful educator (as well as a really nice guy and a surgeon rock-star), and inspires great confidence. He literally "wrote the book" on mitral valve repair -- there was a copy of it right in the middle of the conference table -- which didn't hurt, either. So....May 11 is my date.

The emotional roller coaster ride continues!

Selma

 

[Greg a]

Went down to meet with Dr. David Adams and his crew at Mount Sinai in Manhattan. He spent a good hour with us, carefully explaining and illustrating the process of repairing my diseased mitral valve. The man is a wonderful educator (as well as a really nice guy and a surgeon rock-star), and inspires great confidence. He literally "wrote the book" on mitral valve repair -- there was a copy of it right in the middle of the conference table -- which didn't hurt, either. So....May 11 is my date.

The emotional roller coaster ride continues!

Selma

On the calendar

 

[Sarah_Louise]

Thinking of you xxx

 

[epstns]

Ah, Selma,

It will all calm down now, or it should. Once you've made all those tough decisions, all you have to do is keep a list of what you are to do and when, then just do it. The sooner you build your list, the sooner you can stop worrying about whether everything is on it or not.

 

[Mom2izzy]

Congrats on the date and the great surgeon. I remember how much better I felt after spending an hour with my surgeon too, and now before you know it, it will be May (I had a 3 month wait after that initial appointment too and now it's only 6 days away). When I mentioned the possibility of getting a second opinion to my surgeon (not because I really wanted one but because I was sort of feeling like I wouldn't be doing my due diligence if I didn't at least ask), one that he mentioned was Dr. Adams.

I'm very curious about others having the same surgery. I'd love to compare experiences...if you don't want to answer I will completely understand, but...
- did you discuss approaches (sternotomy, thoracotomy, robotically, "minimally invasive")? Did he give you a choice or recommend any one above the others?
- did he give you any statistics regarding the repair success rate? Or how sure he is that it will be a repair instead of replacement?
- did he indicate or recommend that you choose a valve type in the slim chance that a replacement is required?
- did he give you an idea about what meds you would be on and for how long?
- do you have any symptoms at this time? If not, I'm wondering what advice he gave you to make you think "yep, I need to do this now,"?

 

[selma]

Hi, Mom2izzy, One thing I can say for Dr. Adams -- he's not Chair of the Cardio Department in a teaching hospital for nothing! What an educator. He has an incredibly detailed webpage (http://www.mitralvalverepair.org) which I all but memorized before seeing him. In a nutshell, he is a strong proponent of MV repair (as opposed to replacement) and having it done at a high-volume reference center by a very experienced surgeon. He cited numerous studies about the good outcomes of this surgery, the low morbidity, and the excellent quality of life afterwards. His recommendation for me (60, female, in otherwise good health) is to go for a mini-sternotomy as opposed to a thoracotomy or the robotic surgery. It gives him the best access and he can do it through a 4" incision. His repair rate approaches 100%, whereas the national average is much lower. He didn't even ask me about a valve choice. I regret not asking him about what meds I would be on and for how long. That's something I'll check on when I do my pre-op visit. I understand it's pretty standard to give most people insulin, and I seem to recall reading that a lot of folks are being given something for water retention and an anti-coagulant for a period of time after the operation. I am just at the point of beginning to get symptoms, though nothing major -- some palpitations and very occasional fibrillations. Best practices these days seem to point toward surgery for asymptomatic patients sooner rather than later and I went with that. Also, I have really good health insurance at the moment (I'm in the US where we REALLY need to consider that) and I do not know how long it will last. So, those are my answers to your questions. Please feel free to PM me with any others or if you just want to chat. You're only 6 days away! That's exciting/scary. You can be my trail-blazer.

Thanks to all for checking in. THis place is my new home away from home!
Selma

 

[Adrienne]

Hi Selma,

I just want to say that I was 60 when I had my MV repair by the head of surgery at the Montreal Heart Institute. Despite having had endocarditis, he was able to repair the valve, although it was a very complicated repair and not the usualy resection that they usually do. I also had a left maze procedure since I started having A-fib. My operation and convalescence went very well. I had a full sternotomy, but the scar is still only 6" long because he didn't cut the first two inches of skin, but pulled the skin back, making it easier to wear a lot of clothes!

Good luck!

 

[Mom2izzy]

Thanks for the responses. Sounds like our experiences are going to be very similar, right down to our surgeons' credentials. My surgeon is the director of the mitral valve clinic at the University of Michigan. I'm also having a mini sternotomy (although I did have my choice between that and the thoracotomy). I know I will be on an anti-coagulant after surgery, but I'm wondering about beta blockers...I've never needed them pre-surgery. I always considered myself asymptomatic, but my surgeon thinks I may have some minor symptoms that I probably just blamed on getting older or the fact that I'm constantly trying to keep up with a little one. Since talking to him, I've started to recognize some possible symptoms. I don't sing...except to my daughter when no one else is around, but I often find I just don't have enough air. The same thing sometimes happens when I'm reading a story or trying to walk and talk at the same time. I never really thought of it as shortness of breath because I wasn't huffing and puffing...I just didn't have enough air...couple deep breaths took care of it.

 

[selma]

Adrienne,
I think we've "spoken" before...I noted that we were the same age and you were from Montreal (my parents were, as well). 6" seems quite moderate for a full sternotomy. I'm not at all concerned about the cosmetics of the whole thing -- just want the doc to have the best access he can get. He did mention that the thoracotomy procedure generally took a bit longer, which would mean more time on bypass, something to consider. He also said something about the blood having to flow in the opposite direction since the machine would be hooked up through the groin, but I guess these surgeons all have their different approaches, and the proof is in the pudding, however they get there.
Mom2izzy,
I'm on a very mild dose of beta blockers now...hopefully, I'll be able to get off them after the surgery. They make me logy and a little depressed, which I don't need right now. It does sound like we're in a very similar place (well, you're just a young thing!). I chalked my fatigue up to getting older, but now I'm thinking maybe it's part of the whole syndrome. Oh, and I recognized your name from Ravelry....just sent you a note over there. Small world!

 

[Boston Tiger]

Having a surgeon and a hospital you have complete faith in really helps your peace of mind as you head toward surgery. Now that you have a date, you can start making some plans. If I recall correctly, you said your driveway is a little bit steep for a nice walk, so be sure to scout out other locations for those walks that will make you heal so much faster. Best of luck as you get prepared, and be sure to let us know if there are any questions that pop up.

 

[scott.eitman]

May 11th was a good day for me! Stay well.