I think I made a decision...

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tabitha

Active member
Joined
Apr 2, 2012
Messages
27
Location
Canada
I think I'm going to go with the mechanical valve should my aortic valve need replacing. Man, this has been such a hard decision....

I saw my surgeon again on Thursday and while he said he'd choose the tissue for himself (being a surgeon and using sharp instruments and all that) he also said that if I was so paranoid about coumadin then they've probably represented the side effects of the drug poorly.

I've done my research and I think I'm at peace with it. I think....;)

He did tell me I could let him know for sure up until the day before my surgery, but telling him as I was being wheeled in to the OR was probably not ideal :cool:

I will be asking more and more questions about coumadin the closer I get, I am sure.
 
tabitha said:
........he also said that if I was so paranoid about coumadin then they've probably represented the side effects of the drug poorly.

.....I will be asking more and more questions about coumadin the closer I get, I am sure.
Click to expand...

I agree that much of the problems surrounding the use of warfarin are due to misinformation and "old wives tales". Given the current levels of understanding and dosing this drug, there is no reason to let it play a dominant role in valve choice.

While it does require care in dosing and monitoring, it is not, and never has been, the dominant factor in my life.
 
Yes, it is a hard decision. My fear of a "guaranteed" second surgery was much worse than the fear of Coumadin.
Also, taking Coumadin is a piece of cake compared to taking the beta blocker Metoprolol...what a piece of sh-t that one is. ;)
 
Bina said:
Yes, it is a hard decision. My fear of a "guaranteed" second surgery was much worse than the fear of Coumadin.
Also, taking Coumadin is a piece of cake compared to taking the beta blocker Metoprolol...what a piece of sh-t that one is. ;)
Click to expand...

LOL! Amen!
 
I decided this issue at 8PM the night before surgery when my surgeon called me. I had a needle phobia, but I should have also had a surgery phobia if I had been thinking properly. I was close enough to the traditional age cut-off for tissue versus mechanical and heard so much about many prominent surgeons strongly recommending tissue even for much younger patients, that I worked this issue over about as hard as I've done anything. In the end, I decided that IF you are otherwise very healthy, mechanical is the way to go essentially regardless of age. If you have any other significant heart, lung, kidney or endocrine disease, a tissue valve is fine and you are far less likely to outlive a tissue valve.

It seems also that the most common dangers of warfarin are primarily in elderly populations under poor control. Now, I hope to be real elderly one day, so this is a concern, but I never had major concerns about warfarin for the time being, and so far, after 2.5 years, it has been a complete non-issue. I'm over my needle phobia after finding astonishingly good phlebotomists at the lab I go to. I've had 2 phlebotomists who were not as good as the others, and most labs allow you to specify who you want. It's true that mechanical valves still present some risk, and that some argue that it's about the same as getting a tissue valve re-op. That's one reason this decision is so hard - the data is not complete enough to answer questions like this, but one fairly comprehensive look at this suggested that for healthy people, again regardless of age, mechanical has better over all results in terms of life expectancy. I decided to believe that.
 
Bina said:
Yes, it is a hard decision. My fear of a "guaranteed" second surgery was much worse than the fear of Coumadin.
Also, taking Coumadin is a piece of cake compared to taking the beta blocker Metoprolol...what a piece of sh-t that one is. ;)
Click to expand...

Way to scare me more!!! :)
 
I have been on metoprolol for about 7 weeks now, and It doesn't seem to be causing me any issues. At least none that I am aware of. I may not recognize the issues since I'm not sure what "normal" is now that my valve is fixed.
 
Tabitha,
The key here is that you have said that you are "at peace" with your decision. That's a great thing and I knew that I had reached the right choice for me when my mind was finally at peace with the decision. I think that means that you have reached the right decision for you. Now start getting all your other ducks in a row in preparation for after the surgery.
Best wishes for you,
John
 
I've been on metoprolol for 8 years and have no issue from it at all.
I had to take coumadin for three months post op from my tissue valve (many surgeons require that) and I had a very hard time with it. My surgeon instructed me to stop at 2 1/2 months. Had I gotten mechanical valve, it could have been a real problem for me but I had no way to know that in advance. In my case, I was extremely fortunate and grateful I chose tissue valve. My valve replacement surgery was my second OHS in four years so I well knew what I was facing when I made the choice.

The only wrong choice in valves is to not make a choice. No one but the individual can make that decision and as long as you choose one or the other and go forward with your surgery, you will have made a good choice. Make your decision and never look back. It will be the right choice because it is yours.
 
Dear Tabitha,
Im away from posting but do read times im able and 20 years ago the surgeon made my decision.
I didnt even have tis site nor did i have a clue about warfarin,so, im glad your able to at least
learn alot here to make your decision.
However i don't regret my valves or my coumadin when i found vr i purchased my machine and it made vein draws
lighten the load painwise.
metropol alot of years to ive had no beef.
coumadin no sweat and im a huge vit k consumer havent had problems yet in 20 years since i was 31 im now 51
Read and ask and when youve made your decision dont look back.....be at peace either way no sweat what you decide
on you will do fine.
Wishing you all the best God Bless
 
I never really considered the use of warfarin in my decision. What appealed to me was the likelihood of a permanent solution a mechanical valve offers rather than facing replacement surgeries with tissue valves. Coumadin use quickly became second nature.
 
warfarin was a decision in my choice ,its the 2nd worst drug for cases of hospital visits in the usa,on one report which i read 73000 cases in one year, thats not to be sniffed at, am not trying to be downbeat on any choice but sometimes people on here say its just popping a pill no problems at all, no side effects everthing fine, and in most cases there right,but never the less the dangers should be pointed out as re ops are, whatever you pick is gonna save your life and if i was offered a mech 2 morrow that was gonna do that and i thought it was the right choice for me then no problem i would go that route, i know 2 or 3 people who are my friends who have mech and there love them but also are aware of the problems anti coags can give as i am aware of the dangers re ops can give, last word is pick your choice go with it and am absol sure you will do just great
 
neil brewer said:
warfarin was a decision in my choice ,its the 2nd worst drug for cases of hospital visits in the usa,on one report which i read 73000 cases in one year, thats not to be sniffed at, am not trying to be downbeat on any choice but sometimes people on here say its just popping a pill no problems at all, no side effects everthing fine, and in most cases there right,but never the less the dangers should be pointed out as re ops are, whatever you pick is gonna save your life and if i was offered a mech 2 morrow that was gonna do that and i thought it was the right choice for me then no problem i would go that route, i know 2 or 3 people who are my friends who have mech and there love them but also are aware of the problems anti coags can give as i am aware of the dangers re ops can give, last word is pick your choice go with it and am absol sure you will do just great
Click to expand...
Neil, I'm going to bet that the majority of those cases were in patients with mis-managed INR levels, or in those patients
with additional risk factors, such as bleeding ulcers etc. Warfarin on it's own, well managed, doesn't usually cause an ER visit.

Yes, warfarin/Coumadin can be dangerous, just as any other medication which is prescribed or even not prescribed.
It is up to us to be informed, take the med as prescribed, do our tests, and be as healthy as we can be.
No smoking, no excessive drinking, no obesity.....and then we are off to a good start in our new future.

Like Neil said, make a choice, go with it and don't look back.
Best wishes :)
 
Tabitha,

Don't worry about the metoprolol. You may not have any problems with it at all. And if you do there are lots of alternatives. I fully agree with Bina's opinion and will be be pushing my cardiologist for an alternative but I don't find the side effects to a huge proble. More of an ennoyance that I would rather not deal with.

Gary
 
There's no particular reason to expect Tabitha will be put on metoprolol. Warfarin is a given, but not metoprolol. And just to defend metoprolol from the beating it is being given, I've been on 100mg a day for almost 3 years to control blood pressure and can't identify any adverse effects. It did a nice job of controlling my racing heart rate post-op as well when it was started. I've had no problems with it or warfarin.
 
Home testing for INR

Home testing for INR

Is very convenient and makes any adjustments easy to do. I had a tissue valve that didn't last long and replaced it with a mechanical valve. I feel terrific and the coumadin management for more than two years now has been routine. If you decide on mechanical then be sure to find out about home INR monitoring. In my experience, it is the way to go!
 
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