Pellicle, I have been on this site for nearly 11 years and have regularly read your posts.if people like me who've had 3 OHS's and had a repair, then a homograft and finally a mechanical post something like that then we get called "tissue bashers"
I call it the votedown of truth.
I've found however that you can't really inform someone who isn't interested in being informed beyond the fulfilment of their confirmation bias goals of 'information' seeking
Then you should stop your selective reading and pay more attention, unless the truth of the matter is that you are actually only wanting to build a picture that confirms your binary simplistic view of me.Pellicle, I have been on this site for nearly 11 years and have regularly read your posts.
IMHO - you are inherently a "tissue basher" always have been and always will be.
Dear PellicleDear Mike
Then you should stop your selective reading and pay more attention, unless the truth of the matter is that you are actually only wanting to build a picture that confirms your binary simplistic view of me.
If you look you will find that I regularly suggest to people that their choice of a tissue valve is completely reasonable and perhaps the best bet; I say this when
These were once the universally recognised surgical guidelines and remain that way outside of the USA.
- they are over 65 and this is their first surgery
- they have complications which will make managing warfarin a hazzard
- they seem to be unwilling to properly manage warfarin
I suggest you have a cognitive bias to anyone (perhaps mainly me) suggesting what you are not ensconced in. So I'm saying you are tribal about this matter, you fail to see that its not a football game or a washing machine (where there is no harm in getting another if the one you bought failed in 10 years)
So I suppose from your taking the time to reply and call me out, that you are one of the handwringers who say "there is no wrong choice" am I right?
If so then you are dead wrong, there are choices which will lead to sub optimal outcomes, subjecting the person to further risks and harm.
The selection of the right choice (or the optimal choice) requires actually understanding the patient, their needs their critera (like age) and then thinking about stuff. Thinking about stuff is best had in also discussing ideas with others; preferably others with an open mind, so that new ideas or angles can be considered.
Most certainly the decision is complex and has many dimensions, but to simply throw up your hands, disengage and say "there is no wrong choice" is doing the poster a disservice. Many people can't think however, which is not a slight on them but simply the truth.
If you think telling a 20yo, a 30 or 40yo to have 3 surgeries is a good plan then I'd like to read your justifications. Due diligence requires assisting a person to make an informed choice. Informed means dispelling false ideas and explaining what they don't know. False ideas are such as:
- the many misconceptions about living on ACT
- the misconceptions that a tissue valve will last you over 20 years (in all cases)
- understanding what is in the literature about valves
I believe all commenters have the obligation to do due diligence in their replies, and not just push their own agenda. Show me you do due diligence in your replies not just say "get a tissue" or "there is no wrong choice".
On tribalism I'll say this; ust like the word terrific and the word gay have been twisted the word idiot has been lost to misunderstanding too, the truth about idiocy, which is that it is at once an ethical and a cognitive failure. The Greek idios means “private,” and an idiōtēs means a private person, as opposed to a person in their public role.
The public role is to be responsible to the asker, a responder being tribal is being idiotic because they fail to grasp their public role, which entails, or should, a relation of active concern to others. Typically here the pro tissue set remain not involved. It is not their problem, it worked for them (though they be over 60 at surgery and have made mistakes by believing opinions of one or two rather than the overall data.
could you clarify something- are you unhappy with your surgical choices in the past?
please open your mind and look beyond your singular binary thoughts and adopt a more inclusive way of thinking and accept both options give great outcomes depending on age, and other medical factors.
I can assure you by opening your mind, you will undoubtably enjoy life to the full.
indeed there is. There is also a place where one is better than the other and for good reasons. Aren't you the person who denied that SVD was related to the immune system? Seeking knowledge is part of why people come here. Some come here however to seek confirmation for their personal view (and think that is research).There is a place for both.
sure, and my answer is no. My answer is no because I am quite sure that I had the best possible choices available to me at the time, not all of them I had any say in.
When I was 10 they chose to not replace the valve but to repair it surgically. In 1974 there were not good options really for a 10 year old.
When I was 28 I was offered a homograft, which I was told "we wouldn't know how long it will last". I was told the other choice was a mechanical valve and warfarin. Despite being just out of a biochem degree I didn't really know much about that drug and really didn't have any negative views. I picked the homograft which as I've published before here was probably my best possible choice given:
So no, I'm very satisfied with the good advice I've been privy to and I would unequivocally say that my heart issues and the subsequent challenges it gave me have made me who I am today (and that's fairly healty and sufficiently fit for my age).
- its eventual durability (I would point you at this post I made for that data)
- at the time (1993) warfarin management was not as it is today, and point of care and self management was not available until nearly a decade later. The homograft gave me 20 years of trouble free life and were it not for the aneurysm may have been a bit longer.
- my choice on surgery #3 was quite plain to me, it was the mechanical valve. At 48 years of age and being quite active I knew that I'd be fronting up for surgery #4 by the time I was in my 60's perhaps earlier (seeing some posts here has clarified that for me). Given the complexity of my surgery (the aortic arch anatomy) and all the left over bits, scar tissue and what not I would expect that a 4th surgery would leave me alive (rather than dead) but facing an uphill battle to regain fitness and perhaps in the face of significant degredations in health (a pacemaker would not be a surprise with so many surgeries and scar tissue around the AV Node).
this comment has no basis in evidence ... and I assume it is just intended to be inflammatory and not in good spirit ... as indeed I've answered you in.
So, if you have lived life as fully and happily as I have then you have no reason to be the way you are. You can find quite a lot about my happy and full life, there have been difficulties and tragedies but among them is not being forced into a 4th and 5th surgery by some misguided person without clear access to the facts or apparently much experience.
At least I don't stoop to trolling people to elicit responses so you can then snidely attack them further. You have all of the genuine good faith of a politician.
You can find plenty of evidence to my quality of life here if only you were interested in learning about me and or even listening to anything I have to say.
Here is a thread with some of that evidence.
Clearly you are a very sensitive chappie and it leads me to wonder why you feel that way, and why you are so defensive in your comments and replies.
if you need any help - please DM me and I will do my best to assist wherever possible
Thanks for the info about the Trifecta. My surgery was 02-2015 at age 66. So far, so good.
I'm a tissue valver at 52 myself
I will need reintervention at some stage and warfarin won't be as big a concern in terms of my decision at that time.
I justxwish that so many don't always boil down into tissue vs mechanical face offs.
Anyway, all good