My follow up scans didn’t go as planned

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Spookygal

Active member
Joined
Jan 24, 2024
Messages
33
Location
NJ
So if you saw my first post yesterday you’d of seen I was going to get repeat scans after first getting diagnosed with BAV in April 2022..

My ascending aorta was 3.6cm then..

Today, it was 4.2 x 4.1 cm and with that I was referred to a thoracic surgeon.

I am quite literally out of my mind with anxiety and worry. I cannot believe this is happening to me as 2 years ago my life was normal.

I have no idea how to proceed, what questions to ask, anything. Idk what happens next. I’m so scared!!!

Can anyone explain anything? Has this scenario happened to you?

Please and thank you.
 
Hi

well the reason we have follow ups is to see that's happening. So it could be argued that your followup did exactly what it was supposed to do; catch changes early.

I have no idea how to proceed, what questions to ask, anything. Idk what happens next
firstly these things are not precise.
secondly its a long time ago that your ascending aorta was 3.6 and so that its moved a small amount to 4.15 (averaged) is an indication that its dilating and will eventually be repaired, probably sooner than later. All this depends on the growth rates (which will be determined by future readings)

That you know about this is a good thing.

I'm not good at understanding what I seem to not be pre-disposed to understand and which is illogical (yes I'm probably a bit autistic) but panic reactions have always seemed the worst and most pointless reactions. I say the worst because I've seen people killed by panic reactions. Hard to imagine worse than that.

So the usual process is to now increase monitoring. This is the current Australian guidelines, I expect the American ones are pretty similar.

https://www.racgp.org.au/afp/2013/june/aortic-aneurysms
The majority of AAAs detected with screening are below the threshold for elective repair. The management of patients with small AAA most importantly includes cardiovascular risk management with lifestyle advice, smoking cessation, pharmacotherapy (anti-hypertensives, statins, beta-blockers), and ongoing aneurysm surveillance. Suggested surveillance intervals are listed in Table 3, although local protocols may vary based on accessibility to imaging, patient preference and logistical factors.​
Table 3. Suggested AAA surveillance intervals
AAA diameter (cm)​
Surveillance interval (months)​
3.0–3.9​
24​
4.0–4.5​
12​
4.6–5.0​
6​
>5.0​
3​
While pharmacological interventions such as doxycycline, beta-blockers, statins and angiotensin pathway inhibitors to reduce AAA growth and rupture have been promising in animal models, these benefits have not been consistently reproduced in human studies.21,22 Optimal cardiovascular risk factor management should include smoking cessation, a statin, antiplatelet and antihypertensive agents to improve life expectancy by reducing cardiovascular mortality. In addition to preventing aneurysm related mortality, screening for AAA will identify patients with small aneurysms who are at increased risk of cardiovascular events and who will benefit from cardiovascular risk management.​

Ultimately be guided by your surgeon or cardiologist.

Do Not
do research to promote panic, do research to promote understanding. Do Not do searching like "how quickly will I die" because that's not a good research question. You can't be spoon fed by Google, because Google is not designed to answer your questions. You also need to ask wise questions if you want wise answers

My aneurysm was discovered at something like 5.6cm and I was operated on 3 months later.

Good further reading more specific to Ascending Arch is here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497177/
also

https://www.jacc.org/doi/10.1016/j.jacc.2022.10.001
At centers with Multidisciplinary Aortic Teams and experienced surgeons, the threshold for surgical intervention for sporadic aortic root and ascending aortic aneurysms has been lowered from 5.5 to 5.0 cm in selected patients, and even lower in specific scenarios among patients with heritable thoracic aortic aneurysms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384009/
Finally, surgical repair may be performed at a lower threshold (ie, 5.0 cm) if the patient has low operative risk and the procedure is performed by an experienced operative team with established results.

There is a lot to read so I strongly advise taking your teams advice and don't panic.

Being hypochondriac or anxious is not something you want to keep as a personality trait, so I suggest strongly that you get good counselling and listen to it. I took this well known meme and altered it a bit
1706221221489.png


HTH
 
Last edited:
So if you saw my first post yesterday you’d of seen I was going to get repeat scans after first getting diagnosed with BAV in April 2022..

My ascending aorta was 3.6cm then..

Today, it was 4.2 x 4.1 cm and with that I was referred to a thoracic surgeon.

I am quite literally out of my mind with anxiety and worry. I cannot believe this is happening to me as 2 years ago my life was normal.

I have no idea how to proceed, what questions to ask, anything. Idk what happens next. I’m so scared!!!

Can anyone explain anything? Has this scenario happened to you?

Please and thank you.

Hey Spookygal. I'm sorry to hear about the results and I totally understand your concern and anxiety over this. It's a big adjustment to accept that something is wrong with one's body that needs fixing. However, monitoring it and fixing it is the absolute number 1 most important thing to do so you can keep living and enjoying life.

People with BAV's aorta getting bigger over time is a fairly common occurence. This usually doesn't result in symptoms, but if left unchecked/untreated for a long time, is usually dangerous and can be life-threatening. When I was first told my aortic root was 4.2cm, I was so worried about dropping dead of a dissection. My cardiologist told me straight up, "at these dimensions you're not going to have a dissection." And he was right.

Many people here have had surgeries to replace or fix their aorta because of this condition. The procedure is safe and effective, and routine for cardiac surgeons.

Most likely, they will increase how often they check on it and if/when it reaches a certain threshold, they'll schedule you for surgery. You can read about many people's experiences with surgery here, it was really helpful for me to hear first hand accounts of what its like. And from what I can tell, it's usually very routine and you can get back to living life within a few weeks or months. Obviously, it doesn't feel so easy someone who is in the "waiting room" like us, so to speak. I honestly find the waiting is the worst part.

Anxiety and fears of mortality and such are very normal in situations like this. Keep getting it checked, follow up on your appointments and scans, take care of yourself as much as you can. Remember to keep a critical eye while reading any studies and such online, how much they might apply to your situation will vary significantly. If/when you need surgery, you'll get it, and you will be okay.
 
Hey Spookygal. I'm sorry to hear about the results and I totally understand your concern and anxiety over this. It's a big adjustment to accept that something is wrong with one's body that needs fixing. However, monitoring it and fixing it is the absolute number 1 most important thing to do so you can keep living and enjoying life.

People with BAV's aorta getting bigger over time is a fairly common occurence. This usually doesn't result in symptoms, but if left unchecked/untreated for a long time, is usually dangerous and can be life-threatening. When I was first told my aortic root was 4.2cm, I was so worried about dropping dead of a dissection. My cardiologist told me straight up, "at these dimensions you're not going to have a dissection." And he was right.

Many people here have had surgeries to replace or fix their aorta because of this condition. The procedure is safe and effective, and routine for cardiac surgeons.

Most likely, they will increase how often they check on it and if/when it reaches a certain threshold, they'll schedule you for surgery. You can read about many people's experiences with surgery here, it was really helpful for me to hear first hand accounts of what its like. And from what I can tell, it's usually very routine and you can get back to living life within a few weeks or months. Obviously, it doesn't feel so easy someone who is in the "waiting room" like us, so to speak. I honestly find the waiting is the worst part.

Anxiety and fears of mortality and such are very normal in situations like this. Keep getting it checked, follow up on your appointments and scans, take care of yourself as much as you can. Remember to keep a critical eye while reading any studies and such online, how much they might apply to your situation will vary significantly. If/when you need surgery, you'll get it, and you will be okay.
Hi Deidra,

I can’t thank you enough for your
Hi

well the reason we have follow ups is to see that's happening. So it could be argued that your followup did exactly what it was supposed to do; catch changes early.


firstly these things are not precise.
secondly its a long time ago that your ascending aorta was 3.6 and so that its moved a small amount to 4.15 (averaged) is an indication that its dilating and will eventually be repaired, probably sooner than later. All this depends on the growth rates (which will be determined by future readings)

That you know about this is a good thing.

I'm not good at understanding what I seem to not be pre-disposed to understand and which is illogical (yes I'm probably a bit autistic) but panic reactions have always seemed the worst and most pointless reactions. I say the worst because I've seen people killed by panic reactions. Hard to imagine worse than that.

So the usual process is to now increase monitoring. This is the current Australian guidelines, I expect the American ones are pretty similar.

https://www.racgp.org.au/afp/2013/june/aortic-aneurysms
The majority of AAAs detected with screening are below the threshold for elective repair. The management of patients with small AAA most importantly includes cardiovascular risk management with lifestyle advice, smoking cessation, pharmacotherapy (anti-hypertensives, statins, beta-blockers), and ongoing aneurysm surveillance. Suggested surveillance intervals are listed in Table 3, although local protocols may vary based on accessibility to imaging, patient preference and logistical factors.​
Table 3. Suggested AAA surveillance intervals
AAA diameter (cm)​
Surveillance interval (months)​
3.0–3.9​
24​
4.0–4.5​
12​
4.6–5.0​
6​
>5.0​
3​
While pharmacological interventions such as doxycycline, beta-blockers, statins and angiotensin pathway inhibitors to reduce AAA growth and rupture have been promising in animal models, these benefits have not been consistently reproduced in human studies.21,22 Optimal cardiovascular risk factor management should include smoking cessation, a statin, antiplatelet and antihypertensive agents to improve life expectancy by reducing cardiovascular mortality. In addition to preventing aneurysm related mortality, screening for AAA will identify patients with small aneurysms who are at increased risk of cardiovascular events and who will benefit from cardiovascular risk management.​

Ultimately be guided by your surgeon or cardiologist.

Do Not
do research to promote panic, do research to promote understanding. Do Not do searching like "how quickly will I die" because that's not a good research question. You can't be spoon fed by Google, because Google is not designed to answer your questions. You also need to ask wise questions if you want wise answers

My aneurysm was discovered at something like 5.6cm and I was operated on 3 months later.

Good further reading more specific to Ascending Arch is here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497177/
also

https://www.jacc.org/doi/10.1016/j.jacc.2022.10.001
At centers with Multidisciplinary Aortic Teams and experienced surgeons, the threshold for surgical intervention for sporadic aortic root and ascending aortic aneurysms has been lowered from 5.5 to 5.0 cm in selected patients, and even lower in specific scenarios among patients with heritable thoracic aortic aneurysms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384009/
Finally, surgical repair may be performed at a lower threshold (ie, 5.0 cm) if the patient has low operative risk and the procedure is performed by an experienced operative team with established results.

There is a lot to read so I strongly advise taking your teams advice and don't panic.

Being hypochondriac or anxious is not something you want to keep as a personality trait, so I suggest strongly that you get good counselling and listen to it. I took this well known meme and altered it a bit
View attachment 889831

HTH
I will respond more later, but just know you are great. Thank you.
 
@spoookygal, pellicle provided some great publications for your review and there is a lot out there available. I encourage you to also listen to the presentation from Dr Elifteriades out of Yale New Haven. He has been active in thoracic aortic aneurysm for many years and has pulled together data on numerous factors to consider when deciding to have a TAA repaired. As you will see it isn't only the size of the aneurysm that drives the timing. This is from May 2022 and now incorporates some valuable genetic information that can be useful in determining the hinge point for surgery. I hope you find this helpful and we wish you good luck. As you will see in numerous presentation, this surgery is much more commonplace and therefore has excellent survival rates.

https://www.aats.org/resources/2162
 
It’s difficult to hear you need major surgery. I know exactly how that feels so you’re in the right place for sure.

From the moment I was told that I had a BAV to the moment I was told I needed surgery was a little over 2 years. This was after being told that I could potentially live with my BAV for the rest of my life. I was given false hope … and I kinda chose to hang my hat on that hope.

So, when hearing that I needed surgery, I was like “what?!”

After letting it sink in for a couple days, I actually became extremely grateful. Truly. We have the opportunity to live a long and full life. We are so blessed. If you backup to the 1950’s, this wouldn’t be possible and we wouldn’t make it. But now, wow!, we can live … and live … and live. And THAT is just super amazing.

You got this.

Tim
 
Hi Spookygal and welcome to the forum.

I'm sorry to hear about your diagnosis and that you are having such a hard time dealing with the referral to surgery. Like you, I was born with BAV. And like you, mine was discovered during follow up for a murmur. I was age 52 at the time and 20 months later I had surgery to replace my BAV and also my aortic root and part of my ascending aorta.

It is normal to feel shock and anxiety upon learning this news. I remember the week in 2019 when I learned of my bad news and how it turned my world upside down- at least for a while. I was taking my family to London, a trip we had been planning and looking forward to for about a year. On the day of departure, I got the first bad news- my advanced lipid panel discovered a genetic dyslipidemia, which most medical sites seemed to think was untreatable and which would increase my risk of heart attacks by about 300% as an independent risk factor. Over the next few days, while in London, more bad news kept coming. The next news was that my heart was enlarged; then the aortic stenosis diagnosis. The last place I wanted to be while I digested all this was overseas. It was a lot to swallow and I really would have much preferred to be home reading everything I could about my conditions for 12 hours a day, until I got my arms around things.

So, the trip really sucked for me, and I probably averaged about 3 hours of sleep per night. But, as I learned more and came to terms with the hand that I was dealt, I started to gradually shift from anxiety towards gratefulness. As others above have mentioned in this thread, our condition has a solution- one with a very high success rate. And, as long as we get it treated on time, we can go on to live very normal active lives, with normal lifespans. Facing the reality of open heart surgery is a tough pill to swallow, but these procedures have become routine in high volume hospitals and the outcomes are excellent.

You've indicated that your cardiologist is not a good communicator and in your post on Wednesday, you indicated that he said:

“if your aorta gets to 4cm we’ll be looking at surgery. Have a good day”

From what I can tell, the guidelines call for surgery once the aorta reaches 5.5cm, so one obvious question would be why he is using the 4.0cm threshold. It sounds like you have a surgical consultation coming up, so perhaps you can bring this up with the surgeon. They will operate at a lower diameter if they need to replace your aortic valve anyway, but you did not mention this as the reason for the surgical referral. You have mentioned symptoms, possibly from your regurgitation, so perhaps he has baked that into his timing for the referral.

I would make a list of questions for the surgeon. I think this is also a situation in which a second opinion can often be valuable. Some people spend over a decade with their aorta above 4.0cm before needing surgery, so I would really encourage questions about why 4.0cm is being used in your case. Perhaps there is a good explaination, which your cardiologist failed to give you.

Whether your surgery date is soon, or at some point in the future, the good news is that your situation is being closely monitored. For those of us who are monitored and get their surgery on time, we can look forward to a bright future. Also, you're very young and young people tend to recover very well from valve surgery.

Below is a link to a thread which I started once I learned that my stenosis had become severe. I tried to give regular updates leading up to surgery, in the days spent in the hospital following surgery and during my recovery. I'm now about 3 years out of surgery and I live a very active, normal life. OHS is not a walk in the park, but you will get through this and should have every expectation to fully recover and go on to live a normal life. we can't control the hand that we were dealt, but we can control how we respond to it and the hand is really not as bad as it seems.

https://www.valvereplacement.org/th...to-severe-and-need-to-make-a-decision.887879/
 
IMO, the progression rate of an AA is highly variable. Case in point - mine:

First diagnosed at age 53 @ 4.7. Took 15 years to get to 5.0 and stayed at 5.0 for another 3 years until my BAV was the deciding factor to proceed with surgery. YMMV

Monitoring an AA with periodic testing is almost always safe and reliable and reduces the risk of failure to very low levels.

Lots of good info already posted here to help you sort your situation out.

Personal opinion: Job one is to replace that cardiologist. I had an excellent cardio who decided that monitoring the progression of my AA and BAV was not worth his time after a few years and wanted to refer me to his PA. Nope. Found another board certified cardio at a different clinic who was willing to help me with periodic testing and consults. When my condition deteriorated, he was right there assisting me on those all important decisions: When, where, Valve choice, etc. I am now seeing him 1X/year to monitor the surgical repairs and the condition of my heart.

While many cardios and surgeons have big egos and are not long on patience, some have a sincere interest in helping the patient understand their situation. There are world class options for cardio care in both Philadelphia and New York. No reason to settle for less than the very best care that you can find. Give yourself the very best chance.

HTH
 
Last edited:
IMO, the progression rate of an AA is highly variable. Case in point - mine:

First diagnosed at age 53 @ 4.7. Took 15 years to get to 5.0 and stayed at 5.0 for another 3 years until my BAV was the deciding factor to proceed with surgery. YMMV

Monitoring an AA with periodic testing is almost always safe and reliable and reduces the risk of failure to very low levels.

Lots of good info already posted here to help you sort your situation out.

Personal opinion: Job one is to replace that cardiologist. I had an excellent cardio who decided that monitoring the progression of my AA and BAV was not worth his time after a few years and wanted to refer me to his PA. Nope. Found another board certified cardio at a different clinic who was willing to help me with periodic testing and consults. When my condition deteriorated, he was right there assisting me on those all important decisions: When, where, Valve choice, etc. I am now seeing him 1X/year to monitor the surgical repairs and the condition of my heart.

While many cardios and surgeons have big egos and are not long on patience, some have a sincere interest in helping the patient understand their situation. There are world class options for cardio care in both Philadelphia and New York. No reason to settle for less than the very best care that you can find. Give yourself the very best chance.

HTH
I can’t believe you were in the waiting room for almost 20 years. That’s both probably a lot of dread but also ideal… mine seems to be dilating at a quicker pace which sucks. I hope it slows down.

I’m absolutely replacing my cardiologist, who is a PA btw. I’m absolutely trying to get in with the very best. I assume it’s going to be impossible to get an appointment but I’m going to try like hell.
 
Hi Spookygal and welcome to the forum.

I'm sorry to hear about your diagnosis and that you are having such a hard time dealing with the referral to surgery. Like you, I was born with BAV. And like you, mine was discovered during follow up for a murmur. I was age 52 at the time and 20 months later I had surgery to replace my BAV and also my aortic root and part of my ascending aorta.

It is normal to feel shock and anxiety upon learning this news. I remember the week in 2019 when I learned of my bad news and how it turned my world upside down- at least for a while. I was taking my family to London, a trip we had been planning and looking forward to for about a year. On the day of departure, I got the first bad news- my advanced lipid panel discovered a genetic dyslipidemia, which most medical sites seemed to think was untreatable and which would increase my risk of heart attacks by about 300% as an independent risk factor. Over the next few days, while in London, more bad news kept coming. The next news was that my heart was enlarged; then the aortic stenosis diagnosis. The last place I wanted to be while I digested all this was overseas. It was a lot to swallow and I really would have much preferred to be home reading everything I could about my conditions for 12 hours a day, until I got my arms around things.

So, the trip really sucked for me, and I probably averaged about 3 hours of sleep per night. But, as I learned more and came to terms with the hand that I was dealt, I started to gradually shift from anxiety towards gratefulness. As others above have mentioned in this thread, our condition has a solution- one with a very high success rate. And, as long as we get it treated on time, we can go on to live very normal active lives, with normal lifespans. Facing the reality of open heart surgery is a tough pill to swallow, but these procedures have become routine in high volume hospitals and the outcomes are excellent.

You've indicated that your cardiologist is not a good communicator and in your post on Wednesday, you indicated that he said:

“if your aorta gets to 4cm we’ll be looking at surgery. Have a good day”

From what I can tell, the guidelines call for surgery once the aorta reaches 5.5cm, so one obvious question would be why he is using the 4.0cm threshold. It sounds like you have a surgical consultation coming up, so perhaps you can bring this up with the surgeon. They will operate at a lower diameter if they need to replace your aortic valve anyway, but you did not mention this as the reason for the surgical referral. You have mentioned symptoms, possibly from your regurgitation, so perhaps he has baked that into his timing for the referral.

I would make a list of questions for the surgeon. I think this is also a situation in which a second opinion can often be valuable. Some people spend over a decade with their aorta above 4.0cm before needing surgery, so I would really encourage questions about why 4.0cm is being used in your case. Perhaps there is a good explaination, which your cardiologist failed to give you.

Whether your surgery date is soon, or at some point in the future, the good news is that your situation is being closely monitored. For those of us who are monitored and get their surgery on time, we can look forward to a bright future. Also, you're very young and young people tend to recover very well from valve surgery.

Below is a link to a thread which I started once I learned that my stenosis had become severe. I tried to give regular updates leading up to surgery, in the days spent in the hospital following surgery and during my recovery. I'm now about 3 years out of surgery and I live a very active, normal life. OHS is not a walk in the park, but you will get through this and should have every expectation to fully recover and go on to live a normal life. we can't control the hand that we were dealt, but we can control how we respond to it and the hand is really not as bad as it seems.

https://www.valvereplacement.org/th...to-severe-and-need-to-make-a-decision.887879/
Thank you soooo much for this well thought out and probably time consuming reply. I’m going to read again everything said here and will reply with a better and though out response than this, just want to acknowledge and thank you.
 
It’s difficult to hear you need major surgery. I know exactly how that feels so you’re in the right place for sure.

From the moment I was told that I had a BAV to the moment I was told I needed surgery was a little over 2 years. This was after being told that I could potentially live with my BAV for the rest of my life. I was given false hope … and I kinda chose to hang my hat on that hope.

So, when hearing that I needed surgery, I was like “what?!”

After letting it sink in for a couple days, I actually became extremely grateful. Truly. We have the opportunity to live a long and full life. We are so blessed. If you backup to the 1950’s, this wouldn’t be possible and we wouldn’t make it. But now, wow!, we can live … and live … and live. And THAT is just super amazing.

You got this.

Tim
The false hope is what’s killing me I think. In April 2022 it was “you’ll probably never need it”. Safe to say I’m like ????????? Lol.

I’m anxiously awaiting the grateful part. I know I’ll get there but for now I’m definitely anxious and scared and in shock. All the things. I’m glad this isn’t some terminal diagnosis even though it seems like one. But either way I’m glad I’m here. Thanks again Tim!!
 
Hi

something else you said makes me feel that its ok to reply to this

The false hope is what’s killing me I think. In April 2022 it was “you’ll probably never need it”.
Myself I subscribe to the "Give it to me straight" philosophy and believe that "hope" is always going to let me down. So I'd agree with your assessment about false hope being the source of anxiety.
I'd say that as soon as you take the view that "surgery is only a case of when" that you'll feel better.

I would advise you that digging into searching all manner of things are unneeded and personally I've done pretty much nothing to 'prepare' for my surgeries. I ask what I need to do, then just do that. I waste no time on further analysis or research.
When I found out about OHS#3 I just asked what's next and then waited for that. I had other things to do (like keep my job, renovate a house and stuff like that). I literally gave no thought to it past the appointments in my calendar.
Even though I knew I would be on warfarin this time I made zero effort to read anything about that in advance because I strongly believed "when the time comes I'll learn it" (and I did).

Perhaps because I don't want spoilers for movies or ask about "what happens next" and just live in the now and only plan for what is reasonable to require planning (like a camping trip) I believe I enjoy my life more because I'm rooted in the now as best I can be.
3128-1704412652838.png


I did look into valves a bit because I was given a choice of mechanical valve so I looked into it. I'm rather glad that my surgeon took the view of doing what was best for me (NB a pre-attached graft version of the On-X was not available and would lengthen time on the cross clamp, so because that's an indicator for mortality he picked the one with the pre-attached graph which was the ATS).

Just before surgery I wrote this:
https://cjeastwd.blogspot.com/2011/11/heart-of-matter.html
My apology if this has gone off "to one side of the proper target"

Best Wishes
 
I’m kind of glad my aneurysm was already of operable size (6cm) when it was first discovered. I only waited 6 weeks for the surgeon to line everything up for my surgery. He participated in a round table of surgeons at Stanford and told me their opinions on whether they would give me mechanical or tissue valve was 50/50.
He chose porcine for me. I was 34 and clueless in 1989, so I gave him the option of valve choice. If I had to do it over, knowing now that I would end up with 3 surgeries in 20 years, I would’ve asked for mechanical. I didn’t have BAV, just the aneurysm which was stretching my aortic valve. My aorta (surgery notes said it was 7cm),fell apart in the surgeon’s hands when he went to work with it. He was hoping to wrap it around the Dacron graft, but had to cut it out.
Sorry you have to deal with the unknown of when, but I guess we all do after even having one OHS.
 
Last edited:
Hi

something else you said makes me feel that its ok to reply to this


Myself I subscribe to the "Give it to me straight" philosophy and believe that "hope" is always going to let me down. So I'd agree with your assessment about false hope being the source of anxiety.
I'd say that as soon as you take the view that "surgery is only a case of when" that you'll feel better.

I would advise you that digging into searching all manner of things are unneeded and personally I've done pretty much nothing to 'prepare' for my surgeries. I ask what I need to do, then just do that. I waste no time on further analysis or research.
When I found out about OHS#3 I just asked what's next and then waited for that. I had other things to do (like keep my job, renovate a house and stuff like that). I literally gave no thought to it past the appointments in my calendar.
Even though I knew I would be on warfarin this time I made zero effort to read anything about that in advance because I strongly believed "when the time comes I'll learn it" (and I did).

Perhaps because I don't want spoilers for movies or ask about "what happens next" and just live in the now and only plan for what is reasonable to require planning (like a camping trip) I believe I enjoy my life more because I'm rooted in the now as best I can be.
3128-1704412652838.png


I did look into valves a bit because I was given a choice of mechanical valve so I looked into it. I'm rather glad that my surgeon took the view of doing what was best for me (NB a pre-attached graft version of the On-X was not available and would lengthen time on the cross clamp, so because that's an indicator for mortality he picked the one with the pre-attached graph which was the ATS).

Just before surgery I wrote this:
https://cjeastwd.blogspot.com/2011/11/heart-of-matter.html
My apology if this has gone off "to one side of the proper target"

Best Wishes
You can reply to anything I write! I definitely see you’re well versed and respected around these parts so I’m glad for whatever input. I really do think I need to stop googling. It’s driving me insane lol. Surgery is certainly the case of when and once I subscribe to that narrative I’m sure I’ll feel better. I’m just so scared currently. Ugh.
 
Hi
You can reply to anything I write!
I'm more concerned that what I write may not be something you wanted to hear. That was my slant.

I definitely see you’re well versed and respected around these parts so I’m glad for whatever input.
I'd be cautious about the universality of "well respected" around here ... I know some people like me but equally some hate me ... ¯\_(ツ)_/¯ however it bothers me not because I can't control what others think about me...

1706646134447.png


so I don't try to.

I really do think I need to stop googling. It’s driving me insane lol.

I would agree. General googling is literally harmful and like talking to an AI that's designed to keep you talking (they call it "on platform" I call it making money from you).

https://www.euronews.com/next/2023/...ged-him-to-sacrifice-himself-to-stop-climate-
Surgery is certainly the case of when and once I subscribe to that narrative I’m sure I’ll feel better.

decide and it is done ... simple.

I’m just so scared currently.
so perhaps examine what you are scared of, go through that in a meditative and reflective way and keep being like a child asking "but why".

Best Wishes
 
Hi

I'm more concerned that what I write may not be something you wanted to hear. That was my slant.


I'd be cautious about the universality of "well respected" around here ... I know some people like me but equally some hate me ... ¯\_(ツ)_/¯ however it bothers me not because I can't control what others think about me...

View attachment 889850

so I don't try to.



I would agree. General googling is literally harmful and like talking to an AI that's designed to keep you talking (they call it "on platform" I call it making money from you).

https://www.euronews.com/next/2023/...ged-him-to-sacrifice-himself-to-stop-climate-


decide and it is done ... simple.


so perhaps examine what you are scared of, go through that in a meditative and reflective way and keep being like a child asking "but why".

Best Wishes
Well spoken, as usual.

What am I scared of? Dying of course 😋
 
What am I scared of? Dying of course 😋
now, take this in the mindset of "I know you probably know all of this but ..."

I think its just like the first time you have a serious motor accident and you actually see "I could die doing this" (says the guy who got vertebrae damage being head on hit by a car turning infront of me on my bicycle back in the 80's who still rides a bicycycle and a motorbike now too). Yes the C1 and C2 surface damage is making itself known to me now that I'm 60.

But there are things worse than death (to my mind) and mentalities around them too
1706649374603.png

(from the Washington Post)

This is the blog of a guy who I sort of became friends with (he's in Toronto, I'm in Australia, but we both have interest in using old lenses on micro43rds cameras) and he's sadly now quadriplegic because of an accident quite like mine riding to work
https://oldlenses.blogspot.com/

I won't say accepting such things is easy for him, but he has (I think two) lovely daughters and a lovely wife.

So perhaps the actual fear is caused by us living such utterly sheltered lives that the very thought of a risk of adversity terrifies us ...

HTH
 
a perspective
https://jamanetwork.com/journals/ja...tom-performing groups) remained statistically
(edited for brevity and relevance)
On Kaplan-Meier analyses, both 90-day survival (99% vs 97% vs 93% for SAVR in the top-, middle-, and bottom-performing groups) and 1-year survival (96% vs 94% vs 90% for SAVR...)​

and
https://www.iihs.org/topics/fatalit...08 fatal motor,per 100 million miles traveled
There were 39,508 fatal motor vehicle crashes in the United States in 2021 in which 42,939 deaths occurred. This resulted in 12.9 deaths per 100,000 people

so both about 99% survival rates

Best Wishes
 
a perspective
https://jamanetwork.com/journals/ja...tom-performing groups) remained statistically
(edited for brevity and relevance)
On Kaplan-Meier analyses, both 90-day survival (99% vs 97% vs 93% for SAVR in the top-, middle-, and bottom-performing groups) and 1-year survival (96% vs 94% vs 90% for SAVR...)​

and
https://www.iihs.org/topics/fatalit...08 fatal motor,per 100 million miles traveled
There were 39,508 fatal motor vehicle crashes in the United States in 2021 in which 42,939 deaths occurred. This resulted in 12.9 deaths per 100,000 people

so both about 99% survival rates

Best Wibut what about like 10 years. 20 years. 30 years lol
a perspective
https://jamanetwork.com/journals/ja...tom-performing groups) remained statistically
(edited for brevity and relevance)
On Kaplan-Meier analyses, both 90-day survival (99% vs 97% vs 93% for SAVR in the top-, middle-, and bottom-performing groups) and 1-year survival (96% vs 94% vs 90% for SAVR...)​

and
https://www.iihs.org/topics/fatalit...08 fatal motor,per 100 million miles traveled
There were 39,508 fatal motor vehicle crashes in the United States in 2021 in which 42,939 deaths occurred. This resulted in 12.9 deaths per 100,000 people

so both about 99% survival rates

Best Wishes
great info !!!! That’s good. I’m seeing some weird stats for the long term of cardiac surgery patients as a whole. It doesn’t seem very long term. Ugh.
 

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