Shaken up after consultation

[JeffM]

So my surgeon tells me, in so many words, that I should have had AVR surgery at least a year ago. Despite my cardiologist insisting I was OK because a lot of that left ventricle enlargement was "due to my athleticism". Surgeon didn't agree. So now the LV is well into the 8s. Apparently, valve replacement surgery is indicated at 6.5. I know I'm in great hands, but everything I've been reading tells me the risk of a sudden death type heart attack is sigificantly increased once the heart begins it's accelerated deterioration at this point of the BAV/regurgitation cycle. I walked into his office concerned about how quickly I'd be able to resume and improve on my cycling performance and walked out needing a diaper. Hey, I know there are a at least a thousand things that are far worse than this news, but at the moment I'm feeling pretty ..... ehhhh...uhhhhh....scared. Not about the surgery any more, about how much good it'll do.

 

[Nancy]

Very first thing to do is to can your cardiologist. So use your adrenalin flow to search for a great one. No one needs that kind of inept care. These are the things I really hate to hear! It could have cost you your life.

Of course, surgery will do you good! What option is there, anyway?

Thank God for your surgeon!

 

[Dina]

So my surgeon tells me, in so many words, that I should have had AVR surgery at least a year ago. Despite my cardiologist insisting I was OK because a lot of that left ventricle enlargement was "due to my athleticism". Surgeon didn't agree. So now the LV is well into the 8s. Apparently, valve replacement surgery is indicated at 6.5. I know I'm in great hands, but everything I've been reading tells me the risk of a sudden death type heart attack is sigificantly increased once the heart begins it's accelerated deterioration at this point of the BAV/regurgitation cycle. I walked into his office concerned about how quickly I'd be able to resume and improve on my cycling performance and walked out needing a diaper. Hey, I know there are a at least a thousand things that are far worse than this news, but at the moment I'm feeling pretty ..... ehhhh...uhhhhh....scared. Not about the surgery any more, about how much good it'll do.

Same Here regarding the thought about how much it will make a difference.
And once you get the new valve in place not only will it prevent your
LV from worsening, but it can improve. My cardio gave me no
promises regarding this , but it is happening slowly. I do know that the
left side heals a little faster than the right.
My Best-Dina
There are alot of members here with your specific problem, I'm
sure they will give you more detail than I have.

 

[JeffM]

I agree with you Nancy. And I will line up a new cardiologist, whom I will hopefully be seeing for MANY yeasr to come.

Dina - thanks for sharing your experience and good news about your LV.

 

[hall]

You may try asking your surgeon who he might suggest for a cardio? You could call his office. Yep, your cardio has got to go! Good luck to you and let us know.

 

[vkernus]

Cardiologist

Cardiologist

Jeff,

If you want to stay in the area, I would recomend that you call Dr. Paul Obrien. His offices are located on Kenmore ave in Alexandria. In my opinion he and his staff are tops. He came highly recommended to me and I am extremly happy with his level of care and attention. He is a take no chances kind of Doctor. In addition, he is familiar with the surgeons in your group.

victor

 

[Superbob]

Jeff,

You will be fine but glad you are changing to a good cardiologist. The cardio needs to be very alert -- I know mine was and carefully monitored me right up to when I needed the surgery. Sounds like you are lined up with a good surgeon. As for being scared, we all were, but the odds are very much in favor of getting through this and going on with life at a high level of quality.

 

[ALCapshaw2]

It sounds like your Cardiologist is a member of the "Old School of Cardiology" where the prevailing attitude is to postpone surgery for as long as possible, then send the patient in when danger is imminent.

Did your surgeon send a letter to the Cardiologist with his assessment of your condition? I hope he did! Otherwise, how is this guy ever going to learn (and hopefully change)?

Bottom Line: It is still in your best interest to find a better cardiologist. It sounds like you already have one good recommendation. It wouldn't hurt to ask the surgeon for his (or his opinion of the one recommended here.)

'AL Capshaw'

 

[WayneGM]

My sentiment pretty much echos everything above. Despite the delay, I'm sure the surgery will do good for you in the long run. The main thing is that you are on the right track now.

 

[Phyllis]

Don't despair- it sounds like you have a good surgeon and once you find a new cardio to care for you after surgery, you will be fine.

 

[Ross]

Jeff your not so damaged as to not recover some of it. Yours is at least caught somewhat early. Mine wasn't and I'll always have lifetime problems because of it. Don't let yours get to my point. Most of all, don't beat yourself up over it. Get fixed asap and things might well rebound for you.

 

[JeffM]

Just as expected, lots of supportive words and great suggestions. I will indeed get a new cardio and, Victor, I'll ask the group for someone who's based in Fairfax a little closer to where I live. If the best is O'Brien, I do know my way around Alexandria quite well.

 

[Illinois Al]

Most of all, don't beat yourself up over it. Get fixed asap and things might well rebound for you.

Ross has good advice. One of my favorite quotes that has helped me comes from the unlikely source of one of the TLOR movies:

"All you have to decide is what to do with the time that is given to you."

-Gandolf, The Lord of the Rings: Return of the King​

You can't go back and change history (we'd just mess it up worse if we could); we have to go forward making the best decisions we can.

 

[vkernus]

Jeff,

Don't let Alexandria be a barrier. He is very easy to get to, just off the Seminary Road exit of 395. My family doctor sent his wife to him when she needed a valve job. He comes very highly recomended. THat said, I would certainly check with your doctor to see whom he thinks is best. YOu are the one that needs to be confident in your choice. I personally believe that confidence in your doctor plays a large part in obtaining any peace of mind with this whole experience.

 

[JeffM]

"All you have to decide is what to do with the time that is given to you."


Can't argue with that.

Victor, you're right. I've been going to Arlington for the last 5 years.​

 

[Leeroy996]

Jeff, the 6.5cm is a level that surgeons use to determine if surgery is needed. Remember you don't necessarily fit the average person because of your fitness level. Get it all sorted right away.
For reference My LV dropped 2.5cm in size straight out of surgery.

 

[tobagotwo]

The LV will remodel (shrink). Almost all hearts do after valve surgery takes the unbearable load off of them. It's an accepted and expected recovery effect. The question is really how much. Because you have cycled and are athletic, there is a very good chance your LV will rebound much better than it would have if you were a couch potato (although there's no accounting for genes - some of those couch potatoes get away with a lot). I would think there is an excellent chance you can -return to - or very close to - the "normal" scale.

Cyclists are infamous for being taken off the track, into the emergency room, and directly tothe operating room. They seem to fail to have the symptoms until they faint one day. As such, they frequently are at a bad stage with their LV. But it also usually rebounds for them, due to their basic fitness.

A couple of questions: did you see the word "concentric" next to hypertrophy? Are any of your other valves, such as the mitral, leaking (regurgitation, isufficiency) at this point?

As for your cardiologist: he may be fine for other heart-related problems, but in terms of valve issues, he's just not competent. You need someone else. Words don't fail me, but printable ones do.

Quit the heavy exercising/cycling for now. Your heart isn't getting any rest. You're not helping it by working it out right now. If you need movement, walk (not power walk, no pedometer, just movement, not exercise).

Have the surgery. Really soon. You won't believe how much better you will feel. What you need now is to get that constant load off your heart. Then, after you recover, you can put the type of occasional, repetitive stress on it that will keep it fit.

Best wishes,

 

[CHDDoug]

Hang in there. My left ventricle was quite enlarged before I had my surgery (can't remember exactly how big, but it was big) and 5 months post op, I'm doing very well. Have been back working at a physically demanding job for 2 months, been doing cardio and lifting weights for 2 months, been playing golf for 3 months...all is well. You will be just fine.

 

[CHDDoug]

Oh, and as tobago mentioned, your left ventricle should shrink. Mine had already shrank (is that a word?) by my 4 week appointment (and quite significantly I might add).

 

[Superbob]

Jeff,

FYI: I had my surgery done by Dr. Alan Speir at Inova Fairfax. So did some others here. He is absolutely top-rate, one of the best. I also give Inova Fairfax's Heart Center an "A" from the experience of my five days there.