Less then a week until surgery and still unsure about tissue or mechanical.

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AOS518

Member
Joined
Dec 30, 2012
Messages
22
Location
Hampton, New Jersey
Surgery is Thursday the 17 and I'm freaking out a bit. I was fine before my first surgery but for some reason this time I'm a basket case. I still haven't decided between a tissue valve or mechanical valve. I'm so afraid that I'm going to regret my decision. Whatever I choose. Any advice is appreciated. This group has provided me so much info and support already and I will be forever grateful.
Sara
 
Sara,
We all understand. It is one of the hardest decisions we have to make.
There is no wrong choice. Either mechanical or tissue is a good choice but only you can decide for you.
What persuaded me was right for me doesn't matter for you.
Try to be totally detached while weighing the benefits of each. Don't try and kid yourself or lie to yourself. It is you that has to live with your decision.

For most of us it boils down to:
Would I rather face possible (or probable) reoperation and enjoy not having to deal with coumadin and maybe a loudly ticking valve. When coumadin dosing and range are easily maintained, it's not a big deal being on coumadin. The 'big deal', if you will, comes from ill trained and out of date medical professionals who have no idea how to dose/handle coumadin and they get anti-coag patients in a mess of chasing their tail trying to stay in range or even worse at risk when they demand cessation of coumadin for excessive time prior to procedure/tests which may involve bleeding. It can be very stressful when you know you are being put at risk but you must do the procedure and you cannot reason with the practitioner who is in control of your ACT.

On the other hand, having a tissue valve does not absolutely guarantee you will never have to be on ACT but your odds are very good. No ticking, no coumadin for most of us and you can get on with your life until or unless you need a re-op.

I received my tissue valve at my second OHS and was firm in my choice for tissue. For ME, it was the absolute right choice.

You have to decide what is the choice for you.
I feel for you and understand the stress. This really is the worst part of it IMO
My second surgery was very much easier on me than my first. I recovered very quickly the second time.

Wishing you all the best.
Please let us know how you are doing.
 
We all know how you feel; it ain't easy. From your profile it looks like you had a tissue first. If you are still young and if you don't plan for more kids, and since the second surgery is giving you fits, you may not want a third, then mechanical may be the right choice for you.

Either way, it'll work. I found prayer helpful, if only to settle my mind and bring the right decision forward.
 
Hi

Surgery is Thursday the 17 and I'm freaking out a bit. I was fine before my first surgery but for some reason this time I'm a basket case.

greater knowledge, greater life experience, more understanding of what to loose.

I was fine as a child going into my first, fine as a 28 yo going into my 2nd, but as a late 40's person going into my third I was anxious. I just simply was not prepared to give up being with my wife.

But it was ultimately for her that I calmed myself as the agitation was too much for her to cope with. Even though she was coping well on the exterior I could see the stresses.


I still haven't decided between a tissue valve or mechanical valve. I'm so afraid that I'm going to regret my decision. Whatever I choose. Any advice is appreciated. This group has provided me so much info and support already and I will be forever grateful.

I recovered from my first, and my second with no issues. There were post operative complications on this operation (albeit not severe) but it was enough to require a debridement surgery and some months of antibiotic treatment.

While in hospital this time I also spoke with a fellow who's daughter underwent a similar issue on the recovery of her third.

The nature of complications and chances for complications increases with every surgery. While you may not be able to have another pregnancy with a mechanical valve, you do run the risk of being unable to be with your family if you have a longer string of surgeries.

How many times do you want to do this? The chances of requiring reoperation with a tissue valve are MUCH higher than with a good mechanical.

Sure having my 'thumper' bothers me ... but not as much as not having my wife with me anymore bothers me. What would your families lives be like if you chose a tissue now, and did not make it through other surgeries?

Lastly I would recommend that you read these posts:

http://www.valvereplacement.org/forums/showthread.php?41176-Intubation&p=532439#post532439

http://www.valvereplacement.org/forums/showthread.php?41176-Intubation&p=532460#post532460

while the operations are very safe things, they are not without risk, so do not take lightly this serious and life saving surgery. Asking yourself how many times you wish to do this is not being a 'worry wart' it is exactly a prudent thing to do. The surgeon will not suffer the same losses as your family if there are problems.

We all say to ourselves "well there won't be" ... and thats a good strategy. But it is a strategy for helping yourself be calm, not one for applying to analysis of the risks.

Best of luck with it all, post here when you get on the other side. I'll be looking for it
 
sara,

I know axactly what you are feeling when you say your freaking out, I had to wait two months for my surgury, never had any before, and that for sure was the hardest part. Within the last couple of days I just wanted it to come sooner and be over with, I knew I would be better off with the surgury done than not. For me picking a mechanical, thumper as Pellicle says, lol, it was no problem. I am 49 yrs of age and if I have a small chance of avoiding a second surgury, that is the way for me. I had been on warfarin 30 months prior to surgury and found that wasnt much of a game changer. I self test at home and did self medicate for the last 24 months, but after this surgury the Edmonton hospital is managing my dosing, we will see how they do, as not all of the staff can be very experienced with this management. If I have to take back ownership of this management I will, it's not rocket science, least it wasnt the last two years.

I think most come to terms with what they pick for a valve, and I know you will too. It is a very personal choice, but for me, I made the right choice. I also chose the ON-X valve and conduit, my surgeon was familiar with the valve and thought it was a good choice also. I didnt recieve any gaurentee paper when I left the hospital 6 weeks ago, but I'm hoping this will give me the best chance to avoid a re op. Im learning to live with the noise of the valve, which is only really apperent when Im very quiet, reading and at bed. Sounds like a nice vintage pocket watch. Its a small price to pay for an extention of life, in my opinion.

Good luck to you on the 17th with what ever you decide, I will be wishing you a good outcome and a speedy recovery. Look forward to hearing from you on the other side when you are able.

Doug
 
tough decision but either one you pick will be good for you, what does your cardio and surgeon say on the matter?, it boils down to having tissue and a re op down the line or mech and being on anti coags which some people do not want to be on for the rest of they lives, i choose a tissue and dont regret it for one minute,i would hate to be on anti coags , but remember thats only my opinion,others would disagree totally,whichever you pick is the right choice for you,at the end of the day its gonna save your life,good luck and a speedy recovery
 
Sara,

What does your surgeon suggest you do? From your profile, it looks like you're 27 or 28 years old and you're a mother. Do you plan to have more children? If so, your doctor will probably suggest another tissue valve (no need for Coumadin). If you're sure that you're finished having children (I'm guessing this is the source of your uncertainty), your surgeon will probably recommend a mechanical valve due to your young age and previous experience with tissue valve failure. If you get another tissue valve, expect to repalce it again within 10 years given your past experience. If you get a mechnical valve, it may never need to be replaced again.

I've had both kinds of valves. My first replacement valve was a bovine pericardial valve at the age of 41. It calcified after 8 years and I had it replaced with a mechanical valve on July 3rd of last year. I'm not a woman, so the issue of pregnancy and chld birth was never a consideration. I was very happy with the tissue valve until it failed and I'm doing fine now with the mechanical valve and Coumadin. If it's any consolation, my second surgery and recovery were easier than my first.

Good luck with your decision.
 
I want to thank you all for your advice, words of wisdom and experiences. This has been a rough month and I'm so thankful for this group and the information that has been provided. I always felt so alone and as though no one understood and i come to find out theres so many more people out there with valve replacements that understand what i'm going through. thanks again.
Sara
 
I want to thank you all for your advice, words of wisdom and experiences.
For my own part , you are most welcome :)
This has been a rough month and I'm so thankful for this group and the information that has been provided. I always felt so alone and as though no one understood and i come to find out theres so many more people out there with valve replacements that understand what i'm going through. thanks again.

One of the things about the internet is that it allows you to step outside of your geographical area and see the world in a different way.
Some people have it rougher than others, sometimes its easy to think ones own situation is unbearable. There are things to be learned from seeing the paths others walk, that is always good for perspective.
 

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