Surgery scheduled

[Johnny Stephens]

Nearly 2 months to the day after being told I have Aortic Stenosis, I met my surgeon Dr. Ed Verrier today. He is the chief of Cardiac Surgery at the University of Washington Medical Center. I walked out with a date of Tuesday, April 16th.

Over the past month, I had pretty much decided that I was going to push for a St. Judes mechanical, due to my history of radiation treatments for Hodgkin's disease. This radiation will possibly (likely?) make future surgeries more difficult, and I already don't relish the idea of reoperation.

It turns out that this was the only option he gave me, and didn't really think there were any other ways I should go. This was great news to me because it meant we were on the same page right off the bat.

I was really impressed with Dr. Verrier (who has done the surgery of a few others on this board) and his honest, straightforward manner. He took time to answer all of our questions truthfully, and didn't rush us even though he was about 90 minutes behind.

I met several of his staff who will be scheduling several meetings and tests. I don't yet have a date for the cardiac catheterization, but should find out tomorrow. One great piece of news for me: The TEE will be performed during surgery while I'm asleep. Yippeee! I was nearly obsessing with fear over this test.

I'm not over the mountain yet, but I can see it from here

-- Johnny

 

[mainframe]

Congradulations Johnny. The next 3 weeks will go by pretty quick. I am really happy having made the same decision and Dr. Verrier was recommended to me by our daughters doctor at Childrens Hospital (she also had Hodgkins). My PCP asked his buddies at the Polyclinic and also thought I had made a good decision. I was also impressed with the time he took and also he gave us much more information than anyone else had. I'm sure you won't be disappointed.

My cardiac cath was scheduled by my cardiologist a couple of weeks prior to surgery. The doctor who did mine was Dr. Dean, who is the head of the heart program at the UW. Be prepared to lay still for 6 hours after.

Overall I was very impressed with the care I received at the UW. I'm sure in the end, you'll be glad you've made the decision you did.

Let me know if I can help in anyway.

Chris.

 

[Ross]

Congratulations Johnny

I share your fear of the TEE and hope they do mine while I'm out. Heck, I don't like any test procedure, whether it is uncomfortable or not. You might say I'm allergic to Doctors.

I continue to hope they have a date set up for me when I see the Cardiologist on Monday, but these people seem to be moving at a snails pace, despite all my phone calls, etc.

I'll certainly keep you close in mind and prayer, and hope they don't change dates on you as the time approaches.

Ross

 

[Nancy]

Johnny-

That's good news. You're on your way to much better health. These next weeks will go fast. Just enough time to get last minute things ready and not too much time to dwell on the surgery.

So pack your bags, kiddo.

 

[Perrster]

Johnny's Date

Johnny's Date

Good luck to you, Johnny.

Your surgery date will be one-day short of my 2-year anniversary. And, welcome in adavnce, to the "click."

My Cardio said he recommends a TEE every 5-8 yrs. just to check up on those little titanium units. I don't mind the other regular maintenance tests (Echo, Stress), but that TEE is dreadful. My Cardio seriously said maybe they would have better technology by the time I would need it done. Being the head of the Cath lab I trust what he says to be more than just appeasing talk. Sure hope so.

Best of luck to you. I'll be thinking of you on your day.

 

[sylviayasgur]

hi johnny!
what great news! i'm so glad you got your "date". i also liked what you said about you and dr. verrier being on the same page with regard to your valve choice. i bet it gives you a great sense of security and confidence to know that.
the waiting is usually the worst part of this, but we'll all keep you company while you wait. i'm so glad that you are well on track here.

to all you others....
joey is scheduled to have a tee on april 5th and i wasn't totally worried about it, but now that you all talk about how dreadful it is, i'm getting scared. i can't stand the thought of him having any pain or fear (can you imagine how i did throughout his surgery?? ) please, somebody out there, tell me that in the right hands, with the proper sedation, that this test is doable and not the worst thing....
help!
-sylvia

 

[Ron K]

TEE not too bad

TEE not too bad

Sylvia and Joey,

I had a TEE done on Nov. 1st and I didn't think it was too awful. I was sadated somewhat in the beginning, but the Dr. wants you to be awake enough to follow his instructions as he goes along, up to a certain point. They start by explaining the procedure to you and then spray some numbing stuff into the back of your throat. (It tastes a little like bananas.) They do that two or three more times, about a couple of minutes apart, each time getting a little further down in the throat, but you don't feel anything different because of the earlier sprays.

Then they sadate you a little more and ask you to open wide and try to swallow a tube that the echo instrument eventually goes through. That's managable at that point because the patient is pretty well out of it.

That's about all I remember until I woke up a while later and everything was done. The cardiologist came in and interpreted the results to me and my wife, but I really didn't remember or understand much of what was being said. As you know, sedatives knock me for a loop!

My wife drove us home and I rested a couple of hours. Everything was okay then and I didn't even have a sore throat.

I'm sure you'll do fine. Don't fight the test and don't go in too apprehensive. A good Dr. will handle it without much discomfort for you.

I hope your TEE goes as well as mine did.

Ron K.

 

[Perrster]

Sorry about that

Sorry about that

Hey Sylvia,

I didn't mean to scare you about the TEE. It really wasn't all THAT bad! I actually wanted to see the digital camera they were going to stick down my throat, but the sedative apparently kicked in and I missed my opportunity. There were three people involved in the test and I never doubted for a minute that wasn't in good hands for the whole procedure.

Ron, your lucky to have gotten banana flavored stuff. They never offered me a flavor and I remember it was pretty yucky tasting.

 

[carbomedic]

Alright Johnny!
The time will go fast. You have a key element to make is easier, trust in who and what and where. You can put it on auto-pilot, they will take care of it.
Here they wanted the cath 7 to 10 days before the surgery to make sure there no surprises when they go in.
I don't recall having a TEE, but others on the floor did and all had it right before the surgery, same day. You are out for the surgery already.
carbo

 

[sylviayasgur]

thanks for the pep talk fellas!!
i feel a bit better about the tee now...
thanks for all your support and caring; this site it a godsend!
God bless,
sylvia

 

[Nancy]

Sylvia-

The doctor is the key to the comfortable outcome of this procedure. With the experienced ones and the use of the proper numbing and slight sedation it's not bad at all. The test shows so much that's important. Joey will be just fine. It doesn't take very long. Think about this, what's 30 minutes or so out of your life to find out so much.

Thinking good thoughts your way.

 

[OldNick]

I've had my St. Judes for over 8 years now, so my memories of a couple of TEEs are not too vivid. However, I don't recall any real pain from the process. The worst thing was opening up wide for them to apply the numbing spray to my throat. After that, it was just doing what I was told, until it was all over. It helps to schedule them early in the day when the staff is fresh and ready to get it over with.

 

[jade45]

That TEE thing!!!!!!!!

That TEE thing!!!!!!!!

OK Guys I have read what you have posted about this TEE thing I have to have one done Wednesday at 11:30 what's this about doing early so they in a good mood HA HA
I do have a very serious question though, I have severe panic attacks that seem to deal with my throat, when I start to get one
my throat seems well to go away and I can't swallow , I mean at all, so how does it feel in your throat when they spay the nummy thing ,do you still feel it is it hard to swallow can you feel yourself swallow,this is really bugging me out cause I don't want to go into a pain attack with a tube down my throat.

Someone answer soon please!!!!!!!

-----------------------
jade
this don't sound good

 

[ALCapshaw]

TEE experience

TEE experience

WHOA ! The TEE (Transesophagael Echogram) procedure is NOT the horrible experience so many posters seem be dreading. I've had two (and several endoscopy's...looking at your esophagas with a scope swallowed down your throat). I know it sounds awful but to my mind the worst part is swallowing the bitter tasting numbing medication. Conscious sedation (Versed and Demerol) is used, just as in a catheterization. If you are nervous or just don't want to remember the experience, just tell the doctor and they can / will increase the dose to where you are unaware of the procedure.

As a precaution, you could ask your doctor to check your esophagas for narrowing (strictures) using an endoscope before they insert the TEE. You DO want to be sure they spray your throat well and that you swallow the excess. This medication suppresses the 'gag' reflex. Gaging on the hose is not pleasant, but not the end of the world (it happened to me once during an endoscopy, when I wasn't properly sprayed). Ever since, I just let them sedate me to where I don't
remember a thing

Having experienced more medical procedures than I care to remember, I have learned that the BEST approach is to relax, or at least relax the part of your body that is being 'invaded', and that will minimize the discomfort. Clench your fist or any other part of your body, but not the part being worked on Talking with the nurses and support staff helps me to relax and seems to result in better treatment as a bonus.

'AL'

 

[ALCapshaw]

Re: Surgery scheduled

Originally posted by Johnny Stephens

Over the past month, I had pretty much decided that I was going to push for a St. Judes mechanical, due to my history of radiation treatments for Hodgkin's disease. This radiation will possibly (likely?) make future surgeries more difficult, and I already don't relish the idea of reoperation.

-- Johnny [/B]

Johnny,

Please expand on the effects of Radical Radiation Therapy (which I've also had) on the heart and heart surgery. What effects does radiation have on coronary arteries? How does it complicate surgery?

'AL'

 

[ALCapshaw]

Bovine Pericardial Valve

Bovine Pericardial Valve

Ron K -

I see that you have a Bovine Pericardial Valve.

That is the direction I am leaning so I'm wondering how you decided on that valve. If you don't mind, would you tell me your age?

'AL' (age 58)

 

[Johnny Stephens]

Radiation

Radiation

Al, as it has been explained to me, radiation to the central chest can cause "scarring" in the tissues around the heart, as well as calcification of the valves, primarily those on the left side of the heart. My cardio and surgeon both say the degree of damage (if any) isn't fully known until a person is opened up. My surgeon says this may make my procedure "a little trickier" than normal, much like a 2nd operation can be. He still downplayed and doesn't anticipate any problems.

There is remarkably little information about this, so far as I have been able to find. Here are a couple of links:

http://www.lymphomainfo.net/therapy/radiotherapy/late-effects.html

http://www.acor.org/ped-onc/survivors/cardio/radia.html

 

[ALCapshaw]

WOW ! Thanks for the links to radiation effects Johnny.
That explains a LOT.

'AL'

 

[Perrster]

Johnny/Sylvia:

Al's right. Just try to relax. Talking to the nurses helps, especially if you get a real pretty nurse (and sure, a handsome specimen for the female patients!). That REALLY helps take one's mind off things!

Best of luck to you both.

 

[Ron K]

response to Al

response to Al

Hi Al,

The decision to go with a bovine valve was partly mine and partly the surgeon's. Interestingly, the cardiologist seemed to be leaning toward the artifical valve when I met with him just before meeting with the surgeon.

After reading a lot about various options, I decided that I would like to avoid being on coumadin, if at all possible. I learned from this site that many people have been on coumadin for a long time and have managed very well. Also, the home testing machine that is now available takes a lot of the anxiety out of controling the INR. Hower, I would be the kind of person who always had this on his mind and worried about blood clots and strokes or serious bleeding, especially internal bleeding after a fall or an accident. (My wife would worry even more and try to limit my life style (i.e. no more climbing ladders,, etc.)

I'm 59 years old, so I'm not young, but I'm not old either. The surgeon said I was on the brink as far as valve replacement goes. I could go either way. However, the bovine valve, which he said was the valve of choice in his opinion, would last 15 to 18 years or so, and then have to be replaced again. He said that 88% of the bovine valves that were used in the last 18 years were still going fine.

The chances of a successful surgery for someone my age were 99% or better. The chances of successful surgery at age 75 only dropped to 98%. So even if I do require another AVR at 75, I decided that the risk to me was preferable to being on coumadin.

However, since my mitral valve was also leaking, wheither I got the bovine valve or the artificial valve depended on his ability to repair the mitral valve. If that had to be replaced, he recommended going with two artificial valves.

Well, the catherization showed that the damage to the mitral valve was not very serious and it was leaking primarily because the aortic valve was leaking severely and putting more stress and pressure on the mitral. It turned out that he didn't have to do anything with the mitral valve and therefore was able to use the bovine aortic valve.

I have an echo schedule in mid-May which will show what the mitral valve is doing now.

The final decision was the surgeon's and was made after he openned me up. Fortunately, things went my way. However, I was prepared and positive about whatever type of valve or valves I got. I knew I could live with coumadin, but it just wasn't my first choice.

I am hoping that medical technology will continue to improve and I may not need another AVR, or if I do, it will be through some minimally invasive method.

My advise is that you discuss your options throughly with your surgeon and that you decide what seems right for you. This is what seemed right for me and so far, I have no complaints.

Let me know if you have any more questions, and good luck making this difficult decision. Don't forget, waiting for the surgery is the hardest part of this preocess.