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Alex B

Alex B

VR.org Supporter
Supporting Member
Joined
Jul 30, 2009
Messages
73
Location
Portland, OR
Hi All,

I'm new to the forums. I'm 30 years old, BAV with AVR scheduled for Monday morning (less than 2 days away). Initially I wanted the On-X or St. Judes mechanical and didn't really even consider tissue. Mainly because recovery sounded really slow and rough. However, now I'm having second thoughts. The clicking doesn't worry me, I'm more worried about changes in lifestyle. I am a "rough and tumble" type guy. I am constantly getting bumps and bruises in my "normal" day. I play sports like basketball and enjoy it very much, without that I would be sad. If I had to give up basketball, it would be OK i guess. Re-op doesn't scare me, but I would like to avoid if possible.

Other things I'm considering: I don't pay much attention to what/when I eat/drink, and think it would be a burden to constantly watch everything. In 10-20 years the artery option could be the next operation for me, and since I've had two baloon valvuloplasty's I am aware of how those things go. The cardiologist I'm with now doesn't think "home testers" are safe/reliable, so I would probably have to go in for screening. I'm thinking I could replace the tissue with a mech valve at a later date when the tissue valve begins to fail. I am scared of getting a hemmorage or something like that. It may sound like I'm leaning towards tissue, but my wife/Dr. both think mech is better to avoid re-op. My wife doesn't think warfarin is that bad and thinks I should go for it. I think she is worried that I would be trading 55 good years for 15 great years. If that was the choice I would not take 15, but opt instead for 55.

Any advice?
 
You've got a LOT of reading to do if you want to make a truly informed decision. Start with the "Stickys" at the top of the Thread Listings under the Home Testing Forum and AntiCoagulation Forum. You may also want to read over AL Lodwick's website www.warfarinfo.com

You need to know that MANY Anticoagulation Clinics use Finger Testers instead of Lab Draws, including some of the same ones used for Home Testing (primarily Coaguchek but also some INRatio machines as they become more popular). Also, MEDICARE approves Home Testing for anticoagulated patients because it results in Fewer "Events" for patients.

I expect you already know that Tissue Valves "Wear Out" faster in younger patients (under age 60).

'AL Capshaw'
 
Alex B said:
Hi All,


I think she is worried that I would be trading 55 good years for 15 great years. If that was the choice I would not take 15, but opt instead for 55.
Click to expand...

Welcome to the Forum. Sounds like you are leaning towards a tissue valve.......and it is your call.

Personally, I think most of your concerns about anti-coagulant(warfarin) therapy are not warranted. I've been on the stuff for almost 42 years, since I was 31, and have found that it did not hinder my life or activies. I will add that my surgery in 1967 was the first and last time I have had OHS....and that's a GOOD thing.

There is NO right or wrong decision.....so long as you make the decision to correct the problem.
 
And this, ladies and gentlemen, is exactly why I tell everyone to study the Anticoag forum and learn about anticoagulation as part of their decision making process. You've no doubt been told or heard stories. We that are on the drug can tell you most of what you hear is a bunch of bull. I encourge you to read all you can at Al Lodwicks site www.warfarinfo.com No matter what, it's still your call, but at least then, you'd be making a truly informed call.
 
Alex...Im 44, had surgery my AVR at 42. I went mechanical (On-X) because I didn't want the prospect of not one, but maybe one or two re-ops ? I plan to make to 80s and I figure 15 years a pop if I were to have gone tissue. That might be too conservative and of course technology may change to where its a keyhole procedure at some point down the road. But I went with my gut at the time and have no regrets.

Im 18 months removed and play basketball once a week with a fairly competitive bunch of guys (30s and 40s). Im only 5'11" and I go pretty much all out. Prior to my surgery I couldn't run full court because of the BAV, now I can go hard pretty much the whole time. I bruise a bit easier and I've had a few cuts along the way but to be honest there isn't a whole lot of difference. I took an elbow in the mouth about 2 months ago that bled a good bit but I didn't think it was all that bad, and it did stop bleeding, just probably took a few minutes longer than normal.

I did give up hockey, it was a non-contact league but there is still alot of contact. Its the blunt force trauma kinda stuff you gotta watch out for. I skiied last winter and I also ratcheted it down a few notches. I wasn't a great skiier to begin with but I stay away the slopes that were really crowded. The nice thing about the black diamonds is that there are less people on them. I wasn't so much worried about falling (I know how to do that) as I was about somebody bodyslamming into me. I do wear a helmet now.

As long as your doing full contact type of stuff (karate, MMA, etc...) you will be fine. If you get a BIG cut then you gotta scamble to get the bleeding stopped and to the ER but you would be doing that anyway.

The only thing that kinda sucks is that you gotta watch the alcohol. You can still have it but if you go crazy your INR will spike. I limit myself pretty much to beer and when I have a DD I keep to under 6. Im cool staying in the low 2's with my INR and after a weekend of too much fun alcohol wise I've jumped up to 3.8 or so. As long as you moderate your consumption its all good.

Hope this helps some...
 
Just one comment on the alcohol, your INR could rise or it could fall. Each and everyone is different. We used to have a kid here that drank his butt off and it never affected his INR at all.
 
alex its your call,you are young and maybe a mech one is the way to go,i found it very hard choice,whatever people say about it being an easy choice well it wasnt for me,there is good and bad about both hence its difficult,whatever choice you make its gonna be better than the valve you have now,good luck and it will soon be all over mate,this time next week you be chasing the nurses lol......neil
 
awesome guys, I've not decided at ALL, so please don't presume I'm taking tissue, I was very set on Mech to begin with, and I did read all those stickies and check out the warfarin website already. Hearing about the competitive basketball sounds awesome, I hope I can do that too, since I've always been limited due to shortness of breath. I checked with my Dr. and they do the finger prick test, but I can't do it at home.
 
You can do it at home! All you need is a letter of medical neccessity and a prescription from your doctor. Most insurance companies will cover it, most only 80%.

Were not presuming anything my friend, just want you to be highly informed of the wrong things your hearing or going to hear. There is still a lot of myth and crap out there circulating.

As far as diet, don't buy into the bull about having to watch your vit k intake. Eat like you always have and dose that diet, don't diet the dose of the drug. The main thing is to be semi consistent in what you eat.
 
I'm 22 and had my surgery in May. In the end I chose a mechanical valve and am really happy I did. Before the surgery I used to think...reoperation isn't that much of a problem! But after going through the process I'm just happy with my choice. Speaking for myself, I could not have enjoyed my time knowing I was going to have another operation.

In terms of food, I don't monitor what I eat at all. I have a varied diet, and eat just like I did before my operation.

As for sports, well I don't play anything like baseball but I can see why that would be an issue worrying about a ball hitting your head. I myself play football (soccer...whatever you want to call it!). I don't really play comptetitively because that would have been an issue..and I'm not that good! But I do play with a few people for fun. I have no problems in things like this. The worry about clots and bleeding will always be there but once you have your INR stabilised you'll start to relax. At first I wanted to check my INR every 2 days! I'm not at the point of checking once a week. Even that is a bit frequent but my INR is settling down. So far so good is all I can say and I'm happy with my choice.
 
Hi Alex,

Best wishes for your decision and surgery.
I, like you, started out thinking I would definately go with mechanical, but am still waivering. Some of what I read about warfarin (on this site and the sites recomended here too!) just make it seem like a major hassle.
On the other hand, I've been through OHS once, and am on the waiting list for my second, and there is no way I want to do it again when I'm fifty something if I can avoid it. AVR is no walk in the park! I've had a good 19 and a half years with my tissue valve (homograft) but it just seems like yesterday that I was being wheeled in for surgery.

So even though I waiver, it is never for long, and I always come back to mechanical.

That On-X marketing video on line is quite flash!
 
Hello, Hello! Just drove in from Newport -- a night away with hubby to escape this heat!!! I'm close by, WL/LO. What hospital will you be in? I had my AVR at Good Sam (my cardio is there, and also figured everyone could have good sushi and fun window shopping on NW 23rd inbetween visiting me :))

I am in my 50's. Tissue was a "duh" for me and luckily I had a wonderful surgery and easy recovery. I have 3 kids in their 20's. If one of them needed an AVR I would almost certainly advise them to go On-X or mechanical. While the surgery is very manageable, I certainly would not want them to gamble and sign up for more surgeries at such a young age. Also, remember.... some people, though it is rare, go tissue and then need the anti-coagulation for some reason and take warfarin anyway!

Please feel free to PM (private message) me if you or your wife have any concerns that I could help you with since we're here in the same town.

Remember, you are choosing LIFE!!! This wonderful life will require you to make adjustments whatever comes your way. If you have to be more conscious of what and when you eat (this isn't like blood sugar at all, though, I don't think) then so be it!!! Regardless of your choice, your life will change a little after this experience.... it just does. It's a daunting event and it makes positive and curious changes in our thoughts and emotions.

Hang in there!!!!! Best wishes!!!

Marguerite
 
scotttnz said:
I, like you, started out thinking I would definately go with mechanical, but am still waivering. Some of what I read about warfarin (on this site and the sites recomended here too!) just make it seem like a major hassle.
Click to expand...

Scott you need to stop thinking of it as a hassle and consider it life saving. Some people here are very fortunate to have been able to have several surgeries, I however, will not be one of them. I've had all the surgeries I can endure as a given fact. Once around with heart surgery is enough for anyone and ideally, no surgery would be nice, but that's not reality.
 
My son has been anti-coagulated for 3 years. He has many health issues that you do not face. In spite of his health issues, he rides an off-road motorcycle and drives an off-road car. He home tests. If you are not playing competitive sports for a living I would not worry about the coumadin.


Best wishes with your decision. I am sorry that you have to face it at your young age, but I am confident that you will come through it all with flying colors.
 
thanks all, I really am getting a lot out of this. I'll keep you updated as I get out of recovery. Slightly leaning towards mech now.... lol, funny how that works.

Hi Marguerite, thanks for sharing your decision and the local flavor is nice to hear. I'm going to be at St. Vincent. The surgeon there is very experienced and I instantly got a very good vibe from him and a good feeling about the atmosphere there. I go with my gut feel a lot and it has worked for me in the past, so I'm now past aprehension and starting to get excited about my future.
 
Ross said:
Scott you need to stop thinking of it as a hassle and consider it life saving. Some people here are very fortunate to have been able to have several surgeries, I however, will not be one of them. I've had all the surgeries I can endure as a given fact. Once around with heart surgery is enough for anyone and ideally, no surgery would be nice, but that's not reality.
Click to expand...

Yes it is life saving, but it is also a hassle. I choose not to ignore either reality while I'm making my decision.
 
Hi Alex,
Good luck with your decision - I am sure you will do fine no matter which valve you go with.

Bridgette
 
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