Hi all,
Got back from CCF last nite after a full day of tests yesterday for mom and then a meeting with Dr. Lytle. Not a whole lot on her echo has changed in 6 months (slightly higher PAP by a few mmHg but he said it's surgically not relevant given the small change), no worse on the regurg for the mitral and tricuspid so...... He said that they would do surgery if a.) they were trying to prevent a fib.... and said "the horse is out of the barn on that one" since she's been in very regular a fib for a lot of years and b.) if they were trying to address symptoms. Since she feels ok, does whatever she wants, can walk flat distances with no issues (uphills get her winded but she just takes a few moments pause and keeps going) he said he didn't think surgery would make her feel any better so at this time, he said no operation and to come back in a year. He also said that infections in a replacement valve are riskier to deal with than a native valve so he'd keep it in there as long as possible and that she has a risk of clot now that she's on ACT for and she'd have a risk of clot post surgery regardless of valve type and even more because of her permanent a fib so it's not like surgery would solve for that either.
I really cannot say enough about Dr. Lytle. He could have just read the tests, said "no surgery" and ended the conversation but he really took the time to explain reasons for and against surgery (he said "look, there are risks involved, they're small risks but let's face it, it's OHS") and really spent time discussing things. Told her what symptoms to keep an eye out for like leg/ankle swelling when it's not humid or she hasn't been on a long flight or on her feet all day (because he said swelling under those conditions is not abnormal, he looked at her ankles and was like "your ankles aren't the least bit swollen and you're not on lasix??") or shortness of breath when she didn't have it before or being more tired and needing to plan activities around rest. He said they will look at things again in a year and if she feels differently or tests show changed results, then yes, they can operate but he said there really is just no point in doing surgery just to do it. He said absolutely if she feels something has changed, call and they'll get her in within the week, otherwise, see you in a year.
It's so nice to know the head of the department still is that involved in patient care and takes the time with his patients to explain things. While we were waiting to see him (he was in surgery working on a woman's mitral valve), we talked to someone whose life he saved in 1999 and his wife who on Thursday is having Dr. Lytle do a replacement on the mitral and a repair or replace on the aortic and tricuspid. They said they wouldn't have anyone else do it. There are clearly tons of great doctors at CCF and if anyone ever finds themselves having the opportunity to use their facility, I say do it! Each time I go there I am more impressed with how well they coordinate things, how smoothly things run and in general how helpful and nice EVERYONE is. I love the folks in the red coats. The one guy that I asked how to get to the rooftop pavilion even told us about 2:30 cookie time. I mean how could you not like someone that tells you about cookie time???? LOL!
But seriously, I'm happy to know that surgery is on hold for now but am comfortable knowing we can go back there at any time should mom feel something has changed. She will follow up with her local cardio every 6 months as she does now but Dr. Hobbs (her cardio at CCF) and Dr. Lytle both will be in touch with her local cardio for their reports and said that he knows where to get them should he want to review anything with them.
I am going to continue to browse the boards so if anyone has any questions, please feel free to shoot me a note. Not being a patient, I don't have a lot of first hand experience but if there's any questions about getting around CCF, etc. I've gotten pretty good at the J building layout as well as the pulmonary labs in the Crile building.
I do have an ACT question so I'm going to post that over in the other section.
Got back from CCF last nite after a full day of tests yesterday for mom and then a meeting with Dr. Lytle. Not a whole lot on her echo has changed in 6 months (slightly higher PAP by a few mmHg but he said it's surgically not relevant given the small change), no worse on the regurg for the mitral and tricuspid so...... He said that they would do surgery if a.) they were trying to prevent a fib.... and said "the horse is out of the barn on that one" since she's been in very regular a fib for a lot of years and b.) if they were trying to address symptoms. Since she feels ok, does whatever she wants, can walk flat distances with no issues (uphills get her winded but she just takes a few moments pause and keeps going) he said he didn't think surgery would make her feel any better so at this time, he said no operation and to come back in a year. He also said that infections in a replacement valve are riskier to deal with than a native valve so he'd keep it in there as long as possible and that she has a risk of clot now that she's on ACT for and she'd have a risk of clot post surgery regardless of valve type and even more because of her permanent a fib so it's not like surgery would solve for that either.
I really cannot say enough about Dr. Lytle. He could have just read the tests, said "no surgery" and ended the conversation but he really took the time to explain reasons for and against surgery (he said "look, there are risks involved, they're small risks but let's face it, it's OHS") and really spent time discussing things. Told her what symptoms to keep an eye out for like leg/ankle swelling when it's not humid or she hasn't been on a long flight or on her feet all day (because he said swelling under those conditions is not abnormal, he looked at her ankles and was like "your ankles aren't the least bit swollen and you're not on lasix??") or shortness of breath when she didn't have it before or being more tired and needing to plan activities around rest. He said they will look at things again in a year and if she feels differently or tests show changed results, then yes, they can operate but he said there really is just no point in doing surgery just to do it. He said absolutely if she feels something has changed, call and they'll get her in within the week, otherwise, see you in a year.
It's so nice to know the head of the department still is that involved in patient care and takes the time with his patients to explain things. While we were waiting to see him (he was in surgery working on a woman's mitral valve), we talked to someone whose life he saved in 1999 and his wife who on Thursday is having Dr. Lytle do a replacement on the mitral and a repair or replace on the aortic and tricuspid. They said they wouldn't have anyone else do it. There are clearly tons of great doctors at CCF and if anyone ever finds themselves having the opportunity to use their facility, I say do it! Each time I go there I am more impressed with how well they coordinate things, how smoothly things run and in general how helpful and nice EVERYONE is. I love the folks in the red coats. The one guy that I asked how to get to the rooftop pavilion even told us about 2:30 cookie time. I mean how could you not like someone that tells you about cookie time???? LOL!
But seriously, I'm happy to know that surgery is on hold for now but am comfortable knowing we can go back there at any time should mom feel something has changed. She will follow up with her local cardio every 6 months as she does now but Dr. Hobbs (her cardio at CCF) and Dr. Lytle both will be in touch with her local cardio for their reports and said that he knows where to get them should he want to review anything with them.
I am going to continue to browse the boards so if anyone has any questions, please feel free to shoot me a note. Not being a patient, I don't have a lot of first hand experience but if there's any questions about getting around CCF, etc. I've gotten pretty good at the J building layout as well as the pulmonary labs in the Crile building.
I do have an ACT question so I'm going to post that over in the other section.
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