I've crossed the line into severe and need to make a decision

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pellicle

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All which is a long-winded way of saying: You're listening to your body. Only YOU can do that. Smart, smart, smart move.
its sound and excellent advice, however if one hasn't had any basis for a base-line then its a little fraught for the inexperienced. Many is the time I've heard a new noise on a motorcycle (for instance) to have my mechanic say "oh, they all do that" ... sometimes (without the basics of HR monitoring and charting during training that goes back years or better decades) you really can't be sure till it sticks out like "prawns eyes".
 

pellicle

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and on the post operative side healing, I am seeing things much clearer. Simply put, there is no way I could intentionally plan to put myself thru this process again in approx 10 years.
agreed, not least because at each iteration you're 10 years older and training back up is hard (heck, just reducing aging losses is hard after a certain age). I recall well coming home from hospital (alone) to my house in a storm with a gutter down and water gushing into the (closed) back door and feeling way too frail to do anything about it. I wasn't even 50 then.

I recall clearly thinking that at 70 I'd be utterly unable to do a bloody thing about it.

Sure, some people are not handy, and would always call a plumber, but I've been a handy and active guy all my life. Being unable to do stuff (and having a surgery makes this a rapid onset) is hard to swallow.

This is about 7 months prior to my surgery (before I knew I had an aneurysm)

 

Chuck C

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It is so encouraging to hear all of your stories about how you live such active lives after your valve surgery.

This guy seems to be pretty active on his bike after getting his St Jude mechanical valve- same one that I plan to get in a few weeks:


My boxing and kickboxing days are over, but just about all other activities I do will still be on the menu.

No more of this for me:

 
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pellicle

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My boxing and kickboxing days are over, but just about all other activities I do will still be on the menu.

No more of this for me:

we all have different views of what's important but to me boxing has always been a young mans game, and inevitably leads to mental degradation over time. Especially bare fist stuff.

Its at best a good preparation for actual combat and combat is risky


Despite evidence of concussions occurring as a result of amateur bouts, there has been little study of the incidence of chronic TBI in amateur boxing. In a systematic review on CTE incidence in amateur boxers, 42% of studies found some evidence of relevant brain abnormalities in amateur participants.

its for this reason I picked Judo then eventually Aikido (and fencing in my younger days). There other ways to train for strength and fitness (which don't have such high risks of injury).

Best Wishes
 

Chuck C

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we all have different views of what's important but to me boxing has always been a young mans game, and inevitably leads to mental degradation over time. Especially bare fist stuff.

Its at best a good preparation for actual combat and combat is risky


Despite evidence of concussions occurring as a result of amateur bouts, there has been little study of the incidence of chronic TBI in amateur boxing. In a systematic review on CTE incidence in amateur boxers, 42% of studies found some evidence of relevant brain abnormalities in amateur participants.

its for this reason I picked Judo then eventually Aikido (and fencing in my younger days). There other ways to train for strength and fitness (which don't have such high risks of injury).

Best Wishes
"we all have different views of what's important but to me boxing has always been a young mans game, and inevitably leads to mental degradation over time."

I agree. It is for the best that I don't box anymore. My parents will be happy about that. I started boxing and kick boxing at 48- long story, but I'll be going back to my roots in Brazilian Jiu Jitsu, which is grappling and not striking. My dad never liked me boxing and was worried I would die or end up like Mohamed Ali. Ironically, boxing likely saved my life because it was a physical for my last boxing match that detected the murmur, leading eventually to an echo and aortic stenosis diagnosis. Had I not had that physical, I doubt I would have any idea of my condition and might have had a tragic outcome.

Boxing was so much fun, but I am ok saying goodbye to it for good. I had a few good moments that I can take with me:


1614732303012.png



1614732334205.png



This one actually got me in a lot of trouble with the wife, But, hey, what are you going to do when the ring girls want to take a photo with you?? 🤣

1614732415329.png
 

pellicle

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Ironically, boxing likely saved my life because it was a physical for my last boxing match that detected the murmur, leading eventually to an echo and aortic stenosis diagnosis. Had I not had that physical, I doubt I would have any idea of my condition
perhaps ... but equally I've seen guys (sat beside them in the waiting room) who keeled over at work (passing out) and it was found in an examination their stenosis was very advanced ... the guy was a bricklayer and so did a hard days work. His area was described to me as unbelievably small.

so its amazing what the body can tolerate. He was in his 60's and made a good recovery

Boxing was so much fun, but I am ok saying goodbye to it for good
its always good to know when to gracefully pull out and enjoy the times you had. I slowly reducing my motorcycling from mad as a cut snake to just enjoying things ... not for any other reason that I know my reactions aren't what they were and power-sliding a 1200 out of a corner has no room for error. I've seen enough people get the heli-lift out.

Now I just ride my a 500cc motorcycle to and from town (32km of nice roads) and enjoy the scenery and the practicality



its always nice to go out on my own terms if possible.
 

Chuck C

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perhaps ... but equally I've seen guys (sat beside them in the waiting room) who keeled over at work (passing out) and it was found in an examination their stenosis was very advanced ... the guy was a bricklayer and so did a hard days work. His area was described to me as unbelievably small.

so its amazing what the body can tolerate. He was in his 60's and made a good recovery



its always good to know when to gracefully pull out and enjoy the times you had. I slowly reducing my motorcycling from mad as a cut snake to just enjoying things ... not for any other reason that I know my reactions aren't what they were and power-sliding a 1200 out of a corner has no room for error. I've seen enough people get the heli-lift out.

Now I just ride my a 500cc motorcycle to and from town (32km of nice roads) and enjoy the scenery and the practicality



its always nice to go out on my own terms if possible.
"I know my reactions aren't what they were "

But, they are still sharp enough to brake in time to miss that kangaroo you almost hit while riding your scooter! 😀

Nice bike- sounds fun!

"its always nice to go out on my own terms if possible."

Absolutely!
 

Chuck C

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its a lovely place and working from home has been excellent

Beautiful country!! Visiting Australia is definitely on my bucket list. I'm an abalone diver and, as I understand it, AU is one of the last places where diving for abalone is still allowed. There is a ban on diving in the US until 2026 or 2027, but will probably be extended forever, as the environmentalists now control Fish and Game in CA. There would be a lot I would want to do in Australia, but it's been 3 years since I've been diving for abs and I'm itching to go again, so that would be on the list. Lobster diving is still permitted, another one of the things I love and have been away from for a few years, and I can't wait to get back to that after surgery. Had a detour in the last 5 years with martial arts, but looking forward to returning to some of my former passions and developing some new ones.

Those who live in my area, who have helped me in this, (you know who you are) I am looking forward to catching lobster after my recovery and giving you a nice treat.

I really want to thank you again Pellicle for presenting so much of the literature on mechanical valves and sharing your experience with self monitoring. You never tell anyone which valve to choose, just present the data. For me, once presented with the evidence, and also the anecdote of the active life that one can have on warfarin, it was very clear to me that this was the right choice. Although, I still go back and forth from time to time debating in my mind the right valve, the data keeps leading me back to mechanical and self monitoring my INR. I don't fault anyone for choosing biological- it is a tough choice and an individual choice, but for me I feel confident that this is the right decision for me and the one which will give me the best chance at a normal life expectancy.
 

pellicle

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I really want to thank you again Pellicle for presenting so much of the literature on mechanical valves and sharing your experience with self monitoring.
thanks mate, you're totally welcome. Also thanks for the good feedback.

I have been known to say "you'd be bonkers choosing a bio-prosthesis" to people under 40, which is pretty close to telling someone what I think they should do.

Going back and fwd is a natural thing and in the end only you (should and) can decide whats best for you.

Best Wishes

PS: Australia is a big place, people often look at our population as a guide. Getting around takes time and hauling dive gear is a PITA

1614746159126.png


with respect to diving abalone, check local regulations ... I've got no idea personally :)
 

tezza

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Thanks for sharing that Tezza. I'm curious why you are still waiting for a date?
It has been a long merry-go-round between cardiologist and surgeon and tests to determine what is the best procedure. Finally got a date yesterday, 23rd March will be the big day. I'm leaning mechanical, but because of bleeding issues, they are pushing to biological. Next step is to see the haematologist for his viewpoint on my blood issues and warfarin. I will most certainly have to have a third OHS if I go biological, due to my anatomy and inability to do TAVR. Surgeon believes that it will never be an option for me.
 

Chuck C

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thanks mate, you're totally welcome. Also thanks for the good feedback.

I have been known to say "you'd be bonkers choosing a bio-prosthesis" to people under 40, which is pretty close to telling someone what I think they should do.

Going back and fwd is a natural thing and in the end only you (should and) can decide whats best for you.

Best Wishes

PS: Australia is a big place, people often look at our population as a guide. Getting around takes time and hauling dive gear is a PITA

View attachment 887598

with respect to diving abalone, check local regulations ... I've got no idea personally :)
Yeah, I don't blame you for being that direct when someone is looking at a biological valve when under 40. One can make a case for 50-70, but for under 40, really needs to be a very good reason, in my view.

AU is a big place, an entire continent after all. Hey, do you know this guy named Steve something, forgot his last name.......lol. I actually got that while travelling in France when someone learned I was from CA- our population is about 40 million.

Abalone diving on warfarin should be fine, as long as you don't get bit on the head by a Great White Shark. Which does happen, as it seems that for some reason where there are abalone there often are Great Whites- including where I grew up diving for them in northern CA. But, if you get bit in the head by a Great White, not sure if it will really matter much if you're on warfarin or not 🤣

 

Superman

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PS: Australia is a big place, people often look at our population as a guide. Getting around takes time and hauling dive gear is a PITA

View attachment 887598
I’m guessing a large portion of the northern hemisphere doesn’t fully appreciate how much standard map projections distort things.

The continental US can fit inside the Sahara desert. Australia is much larger than Greenland (there’s a reason ones a continent and the other is an island). Alaska is big, but it’s not THAT big.

There’s a website called “thetruesize.com” that’s fun to play with.
 

pellicle

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AU is a big place, an entire continent after all. Hey, do you know this guy named Steve something, forgot his last name.......lol.
funny story, when I lived in Tokyo I was (uncharacteristically) in Ginza (near the Emperors Palace) and a guy walking towards me turned out to be a guy from my Dads fishing club.

we were both surprised.

"So, are you on that tour, I didn't see you" ... "no I live here, over there {points} in Bunkyoku".

Abalone diving on warfarin should be fine, as long as you don't get bit on the head by a Great White Shark. Which does happen
a lot ... even for surfers. Here's my take Great Whites hunt seals, seals are mammals ... mammals piss different stuff to fish so:
  • dress like a seal
  • smell like a seal
  • act like a seal
attract a predator ...
Those things will rip you apart and that one was just curious.

btw, urine in the water trails behind you like a scent for miles and miles
 
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Amy

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Hey Chuck -
I'm trying to learn more about the difference in various mechanical valves - how did you determine on the St Jude mechanical over the others? Or why did your surgeon choose that one? Did he not say, like others have been told, that he'd like to wait and see which mechanical valve was a better fit anatomically?
 

Chuck C

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Hey Chuck -
I'm trying to learn more about the difference in various mechanical valves - how did you determine on the St Jude mechanical over the others? Or why did your surgeon choose that one? Did he not say, like others have been told, that he'd like to wait and see which mechanical valve was a better fit anatomically?
Hi Amy,
During my first consultation I expressed to my surgeon that I wanted a biological valve. By the time I had crossed into severe and was facing surgery, only 6 weeks after the first consult, I had done a lot more research and felt that a mechanical valve was right for me. I had messaged him ahead of time to inform him of my new preference and also that I was primarily interested in the St. Jude or Onyx valve, again based on research. I like that the St Jude has 30 year outcome data- showing great durability: https://www.jtcvs.org/article/S0022-5223(18)32341-9/pdf#:~:text=Thirty-year freedom from reoperation,and mitral valve replacement, respectively.

On the other hand, I liked the idea that the Onyx valve might allow a person to get by with a little lower INR, thus less coagulant, although the literature in support of this is controversial. When I arrived he presented me with two mechanical valves and asked me to choose which one I would want him to put in me, knowing nothing other than their physical appearance. One was about half as bulky as the other and I chose that one. He said, that is the St. Jude. He said he strongly prefers the St. Jude and was critical about the Onyx due to the size- it is literally about twice as bulky as the St. Jude. He also brought up the argument for the Onyx and said that he and most of his colleagues were totally unconvinced by the data suggesting that the Onyx can get by with a lower INR. I had been leaning towards the St. Jude, because they held up so well in the 30 year study and I have heard such good things about them from folks that had them put in decades ago. To be fair, I have heard good things about the Onyx too and I know that many are happy with their Onyx valves. I think that they are both probably good valves, just prefer the proven track record of the St. Jude. In my view, if something lasts as long as the St Jude, with great hemodynamics, why try to invent a new wheel? But, I would have gone with the mechanical valve that he preferred. It just so happened that he prefers the one that I was already partial to, so I was glad to hear his views. I can tell you, they are truly remarkable little devices. It was nice to be able to play with each of them and see how sturdy they were. After handling it a bit, I told him to make sure he rinses it off really well before he puts it in me, 🤣 I'm sure that is not the one they will use, the display model- at least I hope not.
 
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Chuck C

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funny story, when I lived in Tokyo I was (uncharacteristically) in Ginza (near the Emperors Palace) and a guy walking towards me turned out to be a guy from my Dads fishing club.

we were both surprised.

"So, are you on that tour, I didn't see you" ... "no I live here, over there {points} in Bunkyoku".



a lot ... even for surfers. Here's my take Great Whites hunt seals, seals are mammals ... mammals piss different stuff to fish so:
  • dress like a seal
  • smell like a seal
  • act like a seal
attract a predator ...
Those things will rip you apart and that one was just curious.

btw, urine in the water trails behind you like a scent for miles and miles

  • dress like a seal
  • smell like a seal
  • act like a seal
Yup!! I always hated it when the seals got close to us, for this very reason. The sharks are drawn to the seals, but have very poor vision and probably the vast majority of attacks happen due to this mistaken identity. When they take that first bite and get a mouthful of bony human instead of the juicy seal blubber they were expecting, it is too late for the diver.

I would dive for abalone with my brother. I used to tease him about the fact that I knew it was impossible to outswim a shark, but I was not too worried about it, because all I had to do was to outswim him. Always dive with a dive buddy who is larger than you and a slower swimmer and you should be fine 🤣
 
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