Severe Aortic Valve Insufficiency & Lifting Weights/working out & many other ?'s

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Severe Aortic Valve Insufficiency & Lifting Weights/working out & many other ?'s

Okay I'm 45 a former college swimmer and water polo player still in great shape. As a matter of fact, I was going through a mid life 'poor me I'm turning 45' crisis so throughout the spring and summer I was killing it working out- lifting, high intensity interval training, sprint swimming workouts, 5 mile runs, etc. Felt no symptoms. A Dr. thought he heard a murmur on my routine physical l almost skipped and recommended a cardiologist which I almost blew off but went. An Echocardiogram showed my aortic valve leaking big time. My Dr. said I was already in the SEVERE range and he ordered a transesophageal echocardiogram, angiogram and an MRI. They all concluded the same thing. I have a severe Aortic Valve Insufficiency with an enlarged left ventricle and enlarged aortic root. My Cardiologist said open heart surgery was the only way. I spent the next month scouring the internets looking for any info that would prove my Dr. wrong. I found none and recently met with the Surgeon he recommended. The surgeon was cool and said he could do a less evasive open heart surgery on me and not crack my whole sternum just half and my recovery would be 4-6 weeks. Both the Surgeon and Cardiologist said I could't wait 6 months to do the surgery.

My echocardiogram was 8/1 and the other tests were done a week and a half later. Here's the thing, I've had no symptoms until now maybe... The Dr's told me to cut back all working out. So I quit swimming workouts and high intensity interval workouts. I started jogging slow (still going 5 miles) I quit lifting for a month but resumed with lighter weight. My Dr. recommended I just don't lift but if I had to, to use light weight. I'm sure he and I have different views on what light weight is. Anyway, long story short, I got work commitments I need to accomplish and want to get my surgery the first week of December so I can hopefully be well enough to work 1/5 (4 weeks).

I apologize for my long drawn out grammatically incorrect backstory, but wanted to lay out some of it before I asked some questions.

QUESTIONS:

1) SYMPTOMS I noticed while lifting about two weeks ago I felt some pain around my heart area. I guess it would be called chest pain. It went away but has came back usually during a weight workout. I've been using lighter weights but the meathead in me is still probably overdoing it. SHOULD I BE WORRIED??? Other than that I have no real symptoms other than my slow runs seems harder than I would think being that I'm purposely going slow.

2) VALVE SELECTION - I'm a light sleeper and will tear out a wall to find a cricket that's making noise because I won't be able to sleep and I hate ticking noises i.e. MECHANICAL VALVES- I heard and read on here and there internets sites that some people hear it and some don't. MY Cardiologist was like you gotta get MECHANICAL you're young and you take like 5-6 supplements a day what's one extra blood thinner pill? I was like yeah I can handle that until I started researching and heard about the clicking noise. When I met with Surgeon he said you should think about tissue valve because in 15-20 years they may be able to do non evasive through the groin, etc. aortic valve replacement to swap it out. I asked about clicking noise and he said well some hear it, some don't but we aren't taking it out once it's in because of a clicking noise. So there's my dilemma. I'm leaning toward tissue because taking a blood thinner rest of my life is one thing, but a god damned clicking noise too- F that!

RECOVERY - What's chances I'll actually be able to do a job 4 weeks after surgery. It's just 4 days and it would be giving a few speeches each day like 4 15-20 min speeches. My plan is to be able to do it. Now if after 2-3 weeks I feel I can't I will cancel it, but want to give the old college try (I failed out of college after a year but you probably already guessed I wasn't a product of higher learning if you read this whole thing)

Any advice or comments would be greatly appreciated. I'm really wigged out as of recent because I wanna be able to do surgery in beginning of December as planned but fear I could be placing myself in danger. So I'm conflicted, stubborn, scared and clearly mildly to severely ignorant. Thanks!

 

[pellicle]

Hi

welcome to the waiting room

Okay I'm 45 a former college swimmer and water polo player still in great shape...

QUESTIONS:
...
2) VALVE SELECTION - I'm a light sleeper and will tear out a wall to find a cricket that's making noise because I won't be able to sleep and I hate ticking noises i.e. MECHANICAL VALVES-

being stubborn is not a trait that's good unless it pertains to survial. Winding yourself up is not a survival trait. Myself I have learned to adjust to dripping taps (long long before my valve went mechanical) and while I do hear something, I don't hear a ticking - I hear my heart beat.

A ticking clock is an external thing, my heart beat is about as internal as it gets. Over the years I've always wanted to be more aware of my heart beat because (especially in training) knowing it is useful (I even have a HR monitor).

I like that I can hear my heart beat (sometimes it shits me) because it gives me feedback - such as "why am I getting anxious about this" as I observe my HR go up before I normally would.

I agree with your cardio btw ... if you get a tissue prosthetic your lifestyle will see you back here in less than 9 years (maybe less than 2) having essentially chewed through it.

I would STRONGLY recommend you actually read the stuff posted here (time and time again) about the warfarin issues (which are largely overblown and figments of imagination or myths) and educate yourself on what the actual issues are with warfarin.

Ask questions and from that position of knowledge make your decision as to what valve a properly informed one (not a misinformed one).

Best Wishes

 

[knotguilty]

I did not recognize any symptoms when I was diagnosed during a routine physical, when he heard a murmur. That set things in motion for me too. The thing I had was a cold feeling in my chest when I ran, like you would feel during a run when it is cold out. But in my opinion, I just don't get a feel for how long tissue valves last. There are people who have had them replaced to go mechanical but there is no one on this web site with a tissue valve longer than 11 years, that I know of. Not saying they are dead but maybe they just went on with their life, don't know. The people on here with mechanical valves are more in touch because they medicate every day. And there are people on here who have had their mechanical valves a very long time, and doing just fine. As far as I know they don't usually recommend a tissue valve to someone of your age, not that they don't do it. But if it were me, I would have to think very carefully about a mechanical valve. I would think there is a very good chance of having to have another surgery if you go with a tissue valve in your lifetime. It is a hard personal decision, but only one you can make, and live with. Either way, if they can go with a minimally invasive, you could be up in a couple weeks, and exercising within a month. I love the gym and I don't lift as much as I used to but you will be surprised at what you will accomplish. Good luck in your decision.

 

[epstns]

I don't have the state at hand, but the average lifespan of the second generation (we're now on third gen valves, "expected" to last longer) is said to be somewhere around 12-13 years. That must mean that some are longer, some are shorter. The one thing that is known, though, is that in younger patients (and at 45 I call you young. . .) tissue valves do not last as long as they do in older patients. That said, the age at which major centers like Cleveland Clinic are recommending tissue (aortic) valves to patients has been going down. Initially I think it was 65, then 60, and now they favor tissue valves in patients as young as 50's.

If I was in your place, though, and even though I have a tissue valve and haven't looked back on the choice, I would strongly advise you to consider the mechanical valve options. At 45 now, if you opt for a tissue valve, you will (if you live long enough) need another replacement. I'd bet that after you do it once, you won't want to volunteer to do it again. Yes, they may promise that by the time you need another valve they will be implanting them through the femoral artery in your groin, but there is no guarantee that this will be the standard in our lifetimes.

 

[dick0236]

Okay I'm 45 .....

QUESTIONS:

1) SYMPTOMS I noticed while lifting about two weeks ago I felt some pain around my heart area. I guess it would be called chest pain. It went away but has came back usually during a weight workout. I've been using lighter weights but the meathead in me is still probably overdoing it. SHOULD I BE WORRIED??? Other than that I have no real symptoms other than my slow runs seems harder than I would think being that I'm purposely going slow.

2) VALVE SELECTION - I'm a light sleeper and will tear out a wall to find a cricket that's making noise because I won't be able to sleep and I hate ticking noises i.e. MECHANICAL VALVES- I heard and read on here and there internets sites that some people hear it and some don't. MY Cardiologist was like you gotta get MECHANICAL you're young and you take like 5-6 supplements a day what's one extra blood thinner pill? I was like yeah I can handle that until I started researching and heard about the clicking noise. When I met with Surgeon he said you should think about tissue valve because in 15-20 years they may be able to do non evasive through the groin, etc. aortic valve replacement to swap it out. I asked about clicking noise and he said well some hear it, some don't but we aren't taking it out once it's in because of a clicking noise. So there's my dilemma. I'm leaning toward tissue because taking a blood thinner rest of my life is one thing, but a god damned clicking noise too- F that!

RECOVERY - What's chances I'll actually be able to do a job 4 weeks after surgery. It's just 4 days and it would be giving a few speeches each day like 4 15-20 min speeches. My plan is to be able to do it. Now if after 2-3 weeks I feel I can't I will cancel it, but want to give the old college try (I failed out of college after a year but you probably already guessed I wasn't a product of higher learning if you read this whole thing)

1. I had no symptoms altho the docs told me I had a "one in four chance of sudden death" until I had the surgery. I waited 8 months.....with my fingers crossed.

2. A mechanical valve will probably last your lifetime. The majority of people with mechanical valves do not complain of a "noise" problem after a few weeks or months out of surgery. I have a model "T" Ford valve clickin' away in my chest and I haven't heard it for years....and years....and years. However, apparently some folks can't get used to their valve noise.

3. I had just graduated from college when I had the surgery and I went to work in accounting four weeks, to the day, after discharge from the hospital......and passing their pre-employment physical exam.

 

[AZ Don]

Welcome to the forum,
Re. exercise. Your Dr's are advising you to avoid working out to avoid damaging your heart, not your pinky toe! If you really like working out I suggest that you take their advise so that you don't cause damage. That you are having pain while working out should be a warning. Following surgery & recovery you should be able to return to any level of activity you want. The healthier you are going into surgery the better your prognosis is following. I expect walking is fine, beyond that you are probably taking risks. Re. waiting until December, that is less than 6 months from August and only a month and a half from now - I had to wait over a month just to fit in all the tests and scheduling - but I would defer to your Dr's on this.

Re. Choice of valves. The general guidance says that older than something like 60 years should opt for tissue valve since they may not need to replace it, and younger should opt for mechanical so that it doesn't have to be replaced, but there are many different perspectives from experts in the field so you really can't make a "wrong" choice. My perspective is that I would rather be in control of medication than be subject to future heart surgeries that are outside my control ... but I don't mind ticking. I should mention that some that have aneurysm repair "feel" their heart beat following surgery. It's not so common but it's something that I live with every time I take a deep breath. It's been over 3 years now and I still notice it sometimes, but it doesn't bother me... anymore.

Re. Recovery. With OHS I would say giving speeches at 4 weeks might be difficult, but with a less invasive surgery it might not be so difficult. I expect you will know based on how you are doing at 2-3 weeks.

Good luck!

 

[almost_hectic]

Even if you can swap out a tissue valve through your groin, that replacement won't last you your lifetime. So unless you dont plan on growing old, that would still mean you'd have to have open heart surgery again when your a very old man. They dont actually swap the valve out, they put a valve inside a valve. But to date that can only be done once. They can't put a valve inside a valve, inside a valve. Im 46 and got my mechanical last year. My surgeon said a mechanical was in his opinion my very best option, he's my same age roughly and said thats what he would get. I can hear my tick very softly sometimes. Other times not at all. Depends on other noise inside or outside. Doesn't phase me any more.

 

[DachsieMom]

Knotguilty, your post was interesting. I, too, had a heart murmur and also described the feeling in my chest as the feeling you get in your lungs when running in zero degrees (which I have done). I had no other words to describe it. It also felt like a mild burning sensation. Not at all typical of aneurysm. You are the only other person who described it in the same manner. I had a thoracic aortic aneurysm and sinus of valsalva aneurysm. Surgery last year at age 42. I went with mechanical.

 

[DachsieMom]

To the OP - I am a very light sleeper. The noise does not bother me at all - in fact, it's reassuring (except at the beginning, when it skipped occasionally if I pushed too hard). I was answering emails, etc. at 4 weeks. You may be able to do short speeches if there are plenty of opportunities for rest in between. No you don't have to travel much to get there. I was still very tired at that time.

 

[zee112]

There's no guarantee that replacing your aortic valve through the groin will become the standard in decades to come. There is a guarantee that you will need a second replacement. Save yourself the risks that come with OHS by having it done once with a mechanical valve (Chances are it should last a lifetime).

Scar tissue becomes a nuisance with every subsequent OHS and so do the risks. Warfarin isn't an issue at all, trust me I thought the same and was hesitant in getting it. The clicking noise doesn't scare me, it provides me with the peace of mind that my valve is still working and ticking away. Oh and did I say it will never degrade like a tissue valve will?, which means no heart damage that comes with a failing valve! Win win situation.

 

[Superman]

Should add, that even with mechanical - there's no guarantee you won't need a second surgery either. Had to go in again for my aneurysm.

If I had a crystal ball (and the option), I might have gone tissue the first time, if I could have timed my aneurysm perfectly with the deterioration of the tissue valve, then gone mechanical for the rest of the trip.

I do tell everyone my valve had a lifetime guarantee.

Should it ever fail, the guarantee is up!

 

[pellicle]

If I had a crystal ball (and the option),

say, if ever you get that crystal ball going, let me know as there is a trifecta out there just waiting for my name (and the detials of the horses ;-)

 

[Superman]

say, if ever you get that crystal ball going, let me know as there is a trifecta out there just waiting for my name (and the detials of the horses ;-)

I did win $50 on a $2 play one time. Had a free wager that came with a party package. My wife and I picked a random horse based on the name. Race was half over when we realized they put the wrong horse down. We went up to see about fixing it, but by the time we got there, their mistake turned into our win.

Rather be lucky than good I suppose. First and last time I did anything at a track. The extent of my gambling is putting money in the bank and betting it'll still be there when I need it.

 

[Agian]

There's no guarantee that replacing your aortic valve through the groin will become the standard in decades to come. There is a guarantee that you will need a second replacement. Save yourself the risks that come with OHS by having it done once with a mechanical valve (Chances are it should last a lifetime).

Scar tissue becomes a nuisance with every subsequent OHS and so do the risks. Warfarin isn't an issue at all, trust me I thought the same and was hesitant in getting it. The clicking noise doesn't scare me, it provides me with the peace of mind that my valve is still working and ticking away. Oh and did I say it will never degrade like a tissue valve will?, which means no heart damage that comes with a failing valve! Win win situation.

You watched Pellicle's video backwards, didn't you?

 

[pellicle]

... The extent of my gambling is putting money in the bank and betting it'll still be there when I need it.

not as certain as it once was (google "bank Bail in")