Surgical Consult Part 2

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Bryan B

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Jan 16, 2004
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Location
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I had a Ross Procedure in 2004 and have developed aortic root and ascending aorta dilation that have started to increase in progression at levels that lead my cardiologists to believe they will not stabilize but continue to increase. I had a surgical consult in August 09 but did not have insurance or any financial assistance at the time so they have been treating me with medication to try and slow down the progress. This therapy has only slowed the progress slightly. My cardios have me on a "no work" restriction so I have applied for SS disability. That has been a slow process. I think smashing my thumb with a hammer would be more enjoyable than dealing with the people at SS disability. The main contact I have been dealing with said he was waiting for my November 9 followup appointment before making a determination. Well after my cardio listened to my heart he immediately sent me to the echo lab (which was not planned for this appointment since I had one when I was in the hospital in July). After getting the results he said my dilation has once again increased as well my valve regurgitation. He has scheduled me for a surgical consult which I have November 19th.

I am hoping that this information will finally be enough proof for SS disability to approve my claim so that I can get this over with and get back to living my life. They will only do the surgery without insurance or financial assistance if my situation becomes emergent, and my cardiologists (I'm sure the surgeon will too) are all in agreement that they do not want to have to wait until I reach that point. My aortic root had increased to 4.7cm and my ascending aorta has increased to 5.7cm in the last 15 months even though I am taking Vasotec 10mg twice daily and Lopressor 50mg twice daily. My regurgitation has increased from mild-moderate to moderate in 3 months (although I'm pretty sure my MRI in July 09 already showed me as moderate). My cardio still thinks there is a reasonable chance of saving my autograft if I have the surgery soon but the odds will continue to diminish the longer we wait.
 
I read your thread .And I just got insurance through the Gov. No proublem for pre condition . My policy will be in effect Dec 1 and if need I can have surgery that day and its covered . So go to PCIP.gov It for folks like us. It is not cheep 600.00 a month . But a lot less then out of pocket! GOOD LUCK
 
Thank you for the information Ken I will definitely check that out. Duffey I will have it at Duke University Medical Center again but with a different surgeon. The surgeon I used last time has moved on to Children's Hospital in Denver, CO. The surgeon I have a consult with is the surgeon who took his position as Chief of Pediatric Cardiothoractic Surgery at Duke. One of his specialties is surgery on adults with congenital heart disease (me), valvular disease, and aorta disease. There is one other surgeon there that is even more specialized in disease of the aortic root and ascending aorta (me), aortic arch, and descending aorta. I think I may want to talk to him as well. Thank you for the good wishes Ottawagal.
 
Ken, is that suggestion of yours connected to the new "Obamacare" health-insurance reforms, or different?

I moved from the States to Canada a LONG time ago (36 years!), so I'm pretty ignorant about US details, but hasn't the new insurance kicked in yet to cover situations like Bryan's?
 
Normo,

I think most of (if not all of) the "Obamacare" health care reforms don't go into effect for 4 years from the time it was passed. I haven't checked out Ken's website yet but I have heard that there are state (and I guess federal) "high risk" insurance pools where you can pay a premium price and not be restricted by pre-existing conditions. I have applied for SS disability and I am waiting for their decision (they said they were waiting for my November 9 cardiology appointment which has resulted in a surgical consult). If I get denied my options would be hiring a lawyer and appealing the decision and/or waiting until my condition became emergent. But if I could get in a high risk insurance program like Ken is talking about 600.00 a month would be a deal because I am sure they would schedule me for surgery ASAP. I had a surgical consult 15 months ago and my surgeon (who is now gone) said the sooner the better in order to try and save my autograft valve. My aorta is also getting uncomfortably large at 5.7cm (dilated but no true aneurysm) and my aortic root is getting very close to the "go zone" for surgery at 4.7cm. Both numbers continue to rise every time I have an echo or MRI, and as they get bigger my valve leaks worse which lowers the chance of saving it.
 
Bryan,

Thoughts/prayers coming your way.....



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Just a quick update and a correction on some of the latest test results from my cardio appointment on 11/9 (and a question for anyone that might know).

As expected the surgeon I talked to recommended surgery as soon as possible...but...until I get financial aid I do not qualify for surgery unless I am considered an emergent case. I reported my aortic root as 4.7cm and my ascending aorta as 5.7cm. Actually my aortic root is 5.1cm and my ascending aorta is 5.4cm...I think. That is where the question comes in.

My surgeon was nice enough (without me requesting it) to send me his clinical report of our consultation. In the report it states, and I quote, that "his aortic root is significantly dilated and is now at least 5.4cm at the top of the aortic root and 5.1cm in the middle ascending aorta". BTW these number came from my 11/9 cardio appointment. Can this be right? For the last 15 months I've been told that the number for my ascending aorta has been higher than that of my aortic root. Did he transpose the numbers, was I misinformed, or did I just not understand what I was being told? Either way my aortic root is way larger than before. After the last two MRI's I've had I was told my root was 4.4 and 4.7cm respectively and my ascending aorta was 5.2cm and (I thought) 5.7cm but maybe it was really 5.4cm. I will contact the surgeon on Monday but was wondering if anyone had any insight about these measurements.

Any input would be appreciated and have a great weekend.
 

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