Surgery 9/26

[Travler]

Hello to all. This is my first post, however, I have been reading post here for a couple of days and they have been helpful.
This is all very new and sudden for me. My wife and I had returned from a wonderful adventure, whitewater rafting the Colorado River for the entire length of the Grand Canyon. This was an 11 day trip. The day after returning home I became ill, I thought I had picked up the flu. My temp ran over 101 for a couple of days. Then I noticed a red area on my lower leg. So decided I should go to see the Dr. She said I had cellulitis. She listened to my heart and and asked me if I had ever been told I had a murmurr? I said never. She asked if I had chest pain or shortness of breath? I said no. She was surprised, because she said this was a very loud murmurr. She then sent me to an internal medicine friend of hers. He did an EKG which was normal.
Then ordered an eco. When the results came back he said there was significant leakage of the mitral valve and wanted me to see a cariologist. This Dr did a TEE and said we then needed a heart cath to get the pressures and check tha arteries. This was done a week ago today. The result was: posterior leaflet of the mitral valve was severely abnormal and showed severe prolapse. A part of the posterior leaflet could not be excluded as a partial flail leaflet. There was a very eccentric jet of mitral regugitation. The ejection fraction is in the range of 60-65%. The coronary arteries had only minor, 20% luminal irregularities in the mid LAD. There was a severe, 3-4+ mitral regurgitation, but into a dilated left atrium. Right-heart cath showed PA pressures only in the mid 30's, but there were very large V waves.
The cariologist recommended surgery and said I could pick where to have it done. I asked him where he would have it done if it was him. He said he would use Dr Joe Craver at Emory.
So I have talked with his office. I am to have Pre-Op on Sept 18 and surgery on Sept 26.
My questions:
1. Does anyone else know if the test results indicate I should proceed with surgery?
2. Has anyone used Dr Craver, had surgery at Emory and have comments about them?
3. Since this is going so fast for me how do I get mentally ready for the surgery?

I think it is so great to have a forum like this where information is exchanged and such concern for each other is shown.
Hope I can encourage others myself.
Thanks John

 

[Ron K]

Welcome

Welcome

Hi John,

I'm about 2 years older than you and I had an aortic valve replacement 6 months ago. My situation was somewhat different from yours, but there were some similarities too. While I can't address your questions about Emory or Dr. Carver, I would like to offer a little help about preparing yourself for the surgery.

The shock of learning that you have a serious problem that requires open heart surgery is difficult to accept, expecially if you are relatively symptom free and living a normal, active life style. However, it's good that the doctors caught it before you had any severe symptoms or damaged the heart muscle. Shocking as the news has been, consider it a blessing!

Secondly, try to learn as much as you can about the procedure, the hospital and the surgeon. It's important that you realize that for people your age and in good health, other than the valve problem, the success rate for this type of surgery is 98 - 99%. The recovery period is usually 6 - 8 weeks before you are capable of returning to work and functioning fairly normally (driving a car, walking, doing just about anything that doesn't involve heavy lifting.)

Just about everyone at this site has been through it at least once, or is the spouse or significant other of someone who has had the surgery. We will all support you as much as you like during the process. Just ask.

Lastly, I recommend that you keep yourself in as positive frame of mind as you can. You'll have your doubts and fears, as we all did, but there's a very positive side that you need to keep in mind and emphasize. That is the number of healthy, productive years you will be adding to your life vs. what would have happened if the problem had not been discovered or if you choose to do nothing about it. These are extra years for you to spend with your family, to enjoy in retirement, to travel, to do the things you've always hoped you would have time to do, to contribute to the world in some constuctive way, and to enjoy life more fully.

The surgery itself isn't too bad. There is relatively little pain, and pain killers take care of that. The recovery period is uncomfortable and inconvenient, but manageable. The most difficult part of the whole procedure is the part that you are in now---waiting!

Others will be along shortly to give you additional advise. You're going to like it here, so keep posting.

Ron K

 

[Nancy]

Hi John-

Welcome to this great site. Sorry you find yourself in this position. Talk about getting hit with a ton of bricks!

Can't help you with if you need surgery or not. My husband's had 3 valve surgeries, and we always found that when the cardiologist said it was time, then it really was time. Doctors don't suggest surgery unless they see something in all of the numeric data from all your tests. One thing or another may be seem OK, but basically they look at the BIG picture to make a decision.

Your heart, the little marvelous bugger that it is, can enlarge to compensate for some of the inadequacies. That's why some folks don't feel too sick at first, but trust me when I tell you that if the cardiologist and surgeon say you should have this done right away, sooner or later, you will become very symptomatic. It's tough when that happens, because basically walking to the bathroom can be exhausting. You will not be able to breathe, and in my husband's case, when his mitral valve was not working well, he got very dizzy and actually spun around. I had to hold his hand to keep him from falling. He also did have some extremely serious blackouts.

So getting it done before it gets to that point is wonderful. Your recovery will be easier and you will feel a difference after the initial recovery period.

So hang with us for a while. We'll all work towards getting you mentally prepared. Use the site often and read as much as you can. Fears diminish when you learn more about your conditions.

Hope to see you here often.

 

[Bill Hall]

John - Welcome to this heart valve web site. Just a few comments.
1 - Your EF looks very good.
2 - Just because you don't have symptoms doesn't mean you don't need surgery.
3 - The 3-4+ is significant, but I had 4+ and they told me to have surgery within 6 months. Your situation might be different.
4 - I would believe you need the surgery, however that doesn't mean you can't get a second opinion. It might help you get mentally ready.
5 - You should ask questions about the procedure and recovery. I think it made me feel good to know the details and how long things would take before I was well again.

Good luck with this. Send me an e-mail at [email protected] and I can tell you more or ask questions in this section.

 

[Mara]

Hi John

No one on here should be giving medical advice to anyone else. All we can speak of is our own experiences. If your doc said you need surgery and you don't like that, get a second opinion, or a third or a fourth.

I don't want to pick on Bill, but, unless he's an MD, a cardiologist who has seen your tests, and knows your medical history, telling you that some of your tests look good might not be real good advice. Everyone is different, so comparing echo's and tests really means nothing. Everyone has other things going on or not going on that indicate surgery is needed.

The best thing is to ask the doc. He works for you.

We can give you moral support and tell you that the surgery is not too terrible and the best way to get ready for it is too think about feeling better when it's all over. Ask specific questions and learn all you can about the surgery. Education and knowledge take out a lot of the fear factor. You'll do great.

 

[ALCapshaw]

Hi John,

I'm glad to see you listened to your doctors and had the important tests. Valve disease is pretty much a mechanical / plumbing phenomena and the tests are indeed definitive. When the doctors say it's time for surgery, believe them. You do NOT want to wait until you have serious symptoms which may lead to irreversible permanent damage to the heart.

If you want a second opinion, ask your cardiologist for your test results (Echo, TEE, and Cath) which can be put on a CD. These are the standard tests for Valve evaluation.

Hospital ratings by procedure can be found at www.healthgrades.com There are several very good heart hospitals in the mid-South such as Duke, UAB, St. Thomas (Nashville). I'm not familiar with Emory but know it by reputation.

The GOOD NEWS is that success rates are very good, especially for
people in otherwise good health and not too advanced in age.

For mental preparation, I suggest reviewing some of the posts in the PRE-SURGERY Forum. Most of us experience anxiety among other feelings going into this decision. A positive mental attitude goes a long way towards a successful outcome.

Best wishes,

'AL'

 

[sonya489]

Hey,
Isn't it odd how the little red spot and not feeling well got you to the Dr. It makes you wonder about stuff like that. So they found all your major damage with the heart catherization and the TEE correct?

C-YA
Sonya

 

[Travler]

I appreciate the encouragement from those who have responded.
It truly is interesting how I found out I had any heart problem.
If I had not had the fever and the red spot on my leg, I would not have gone to the Dr. I have never been good to go even on a regular check up basis, certainly if nothing major was wrong.
So as my GP said, we were just lucky I had something that took me in. Perhaps it was more than luck! I am grateful to find a problem that can be repaired before major damage was done.
The TEE and heart cath were the tests that gave all the answers we have at this time.
Since the date of the surgery has been set, and reading the posts here, I have been a lot less anxious.
Thanks
John

 

[ALCapshaw]

Hi John,

Sounds like you are doing all the right things to prepare for your surgery and get in a good frame of mind.

While waiting for my surgery, I 'finally' got around to writing a Will, Power of Attorney, and Medical Power of Attorney. Fortunately, I came through surgery OK, but it was reassuring to know that everything would be handled as I wanted, 'just in case'.

You may want to read over some of the POST SURGERY posts to learn some of the 'tricks' in achieving a smooth recovery such as sleeping in a recliner or using 'body pillows' for support, having 24 hour help for the first week (or two) after you get home, using the Incentive Spirometer (breathing exercises) to prevent pneumonia, and WALKing to restore your muscle tone and energy.

As one member put it, WALK, WALK, WALK, ... BREATHE, BREATHE, BREATHE, and NAP, NAP, NAP.

Your body will tell you when you have the strength to get up and move and when you need to rest.

You were blessed to discover your condition when you did and wise to follow through on getting proper treatment.

Best wishes for an uneventful surgery and recovery.

'AL'

 

[John Cochran]

Hi John,
When major surgery is recommended, getting a second opinion is always a good idea; however, do not delay in getting it. If even you feel pretty good now, delays can result in irreversible damage to your heart.

Welcome to our "family" and ask as many questions as you want...folks here will go out of their way to be helpful!

Best,
--John

 

[McCln]

John

John

I know so many John's in this world. Well, you should listen to everyone here that says that if you are feeling incomfortable able the doctors diagnosis, get another opinion. But keep in mind that all PCP doctors are not trained to hear heart murmurs, but should have heard something, a swushing sound to indicate a problem. I was born with congetial heart murmur, but had surgery to replace it. I knew since I was nine years old, so no regrets now. If you feel that surgery is the answer, get educated. And come here and ask questions as well as you should as your doctor. Get other opinions if you need them. You will do what is right for you. You have to feel comfortable with the doctor and the diagnosis and treatment. Take care and keep us informed. We are here for you.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve