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billr

Member
Joined
Aug 17, 2009
Messages
17
Location
Aiken, SC
Hi, my name is Bill (59 years old) from SC but most recently from NH although a native New Yorker.

This is an unbelievably great forum, in small measure due to all the info but in larger measure due to the intelligence, generosity and compassion of the members of this community.

I expect to be a regular contributor as I get ready to “climb the mountain” which will be very soon I think and certainly on my post-op experience.

I have been diagnosed with bicuspid aortic valve stenosis with some “minor” mitral valve regurgitation

I guess my surgery is a few weeks away. I had a cardiac cath. last Monday and am scheduled for a T.E.E. tomorrow AM (surgeon, whom I never met or talked to, ordered this test last Thursday.) More on this later…

Recent History:

I had an echo done in April of this year while I was asymptomatic. Follow-up echo was scheduled for November and was told by my cardiologist to expect to have my aorta valve replaced in one to two years. (valve opening measured 1.1 cmm, adjusted to 1.0 cmm). About a month ago, I started getting chest pains upon exertion, light headedness, strange momentary pains in my chest even when resting. As I also have Panic Anxiety Disorder (P.A.D., last 20 years) which is not the best thing to have when facing OHS. I sort of wrote SOME of this off as imagining the symptoms I was supposed to be on the look out for. I called my cardiologist’s office to schedule another echo, they pushed back a little but I prevailed and had the second cardio. Results: .8 cmm and pressure gradient of 95. These results prompted the cardiac cath. Which last Monday showed a .9 cmm aperture with a pressure gradient of 55. Cardiologist also noted mitral valve regurgitation which he felt the surgeon should repair this at the same time as the aortic valve replacement. Now for the TEE tomorrow... Any caveats or tips?

Any comments on these results? Seems I’m being fast tracked for surgery. Anyone know how long cath. and TEE results remain valid b4 the surgeon would like to to have them run again?

I am a recovering alcoholic (4 months now) with compensating liver function but good PT, PPT, INR and normal liver enzymes (now). I’ve been told by my GI MD, but not my cardiologist, that my liver condition may complicate the AVR but why this is so, I don’t know.

My Frame of Mind:

Despite what is probably imminent surgery, I am incredibly upbeat. I am physically (although wish a little more time would transpire between my last drink and OHS), mentally, psychologically ready for the surgery. This may be due to the fact that I nearly died (bled out) during my gall bladder removal operation 2 months ago ) INR was fine then, too.) Coming close to death is a real attitude changer, trust me. So, I am ready and just waiting to hear when the surgery will be scheduled. If you are a boxing fan (just lost half of my readership) you may be familiar with Michael Buffet’s pronouncement “Let’s get ready to ruuuuumble…!”, well that’s how I feel. On second thought, maybe “bring it on” would have been more appropriate given this audience.

My local cardiologist is great. My surgeon, Dr Chitwood (East Carolina Medical/Pitt Hospital in Greenville, NC is supposed to be a wizard. (Identical outcomes to CC.) I assume he will take me on since he was the one that actually ordered the TEE. I considered the Cleveland Clinic but quite a few people around here, including my cardiologist, recommended Dr. Chitwood.

I have searched this forum and found a few extremely favorable posts about his competence and overall attitude. He also supposedly had OHS. Anybody else have experience with Dr. Chitwood or Pitt Hospital in Greenville, NC.?

I am concerned about trip home and recovery. Five and a half hours normally by car, or a little shy of a total 2 1/2 hours flight time by plane with change in Charlotte followed by a one car drive. I had lined up a 6 seater Piper Aztec for a direct 1 ½ hour flight followed by a 20 minute car ride home but you have to get into the plane by climbing up onto the wing and sharply pivoting to the left then a deep knee bend to slide into the deep seat. This may be too much. Also cabin is not pressurized but we would be flying low, about 8,000 feet.

Any thoughts on travel home given the above? Any recommendations? (I have read most of the other posts on this forum regarding travel home.)

I am more concerned about the recovery than anything else. I guess I’ll just have to dust off my Nancy Reagan era tee shirt “Just say maybe to drugs”. Seriously, I am concerned about the duration of recovery not so much the pain. The gallstone attack, and recovery from the full stomach incision to stop the bleeding coupled with a hernia repair dine at the same time, set a new standard in pain for me. I got through it though pretty well though.

Looking forward to hearing anyone’s comments and contributing to this forum in the future.

Best regards to all—
Bill
 
Bill, you've got a lot on your plate, medically speaking! Oh, welcome to the forum, too!

Sounds like you have a good attitude, and that should help you through. Also, knowing about your anxiety problem, and how you react to stress, is not as bad as finding out about it now!

You don't say what your home situation is, but you will not be allowed to drive for a while (from 3 to 6 weeks after surgery), so you will need someone to drive you home, and it is a good idea if you can have some help for the first week or so, as bending and stretching are hard.

As to the travel, if you stay a day or two extra in a hotel after your OHS, would that knock you out financially? Some members (quite a few, actually) have done similar or longer drives just after OHS, and found it manageable with frequent walking breaks (hourly is recommended) and pain killers.

You seem to know about INR, I certanly didn't before my OHS, so you may be a jump or two ahead of the rest of the "newbie" gang in that regard!
 
Hi Jeanette--

Thanks for responding--

I plan on hanging out near the hospital post surgery for a day/two/three depending how I feel. I have no intention of driving myself as my wife or my wife's sister will be the designated driver(s) if we go ground.

For some reason, despite having P.A.D., I am not the least bit anxious about the surgery. Inexplicably, I am remarkably calm, collected, and pragmatic about the surgery.

Not looking forward to the TEE tomorrow though even though it should be no biggie. But I have an extremely strong gag reflex and my cardiologist isn't big on anesthesia, or at least he wasn't for my cardiac catherization. He may change his mind after my bite block bounces off his forehead a few times....

Best regards--
Bill
 
Hi Jacqui--

Thanks for the welcome.

I forgot to mention in my original post that I'm going with a xenograph (non-mechanical) valve.

Best--
Bill
 
Bill, welcome and congratulations on your sobriety. My father died at the age of 43 from alcoholism, so I know first hand what that does to your body as well as how it affects all of those around you. That's a great first step towards giving your body a fighting chance. They may be concerned about your liver function due to the amount of drugs they give you and your liver needing to clear them from your system. That is only a guess on my part, hopefully someone who knows more will come along.

I think you'll be surprised at the pain level. Although there have been a few on here who have had unmanageable pain, I think the majority are somewhat surprised at the low pain level in your actual sternum. Your back and shoulders may be a different story, but still, very manageable.

I was one of the ones who travelled after surgery from Rochester MN to Charlotte NC. I think I was 9 days post op (it is all a blur!). It really wasn't a big deal. My total travel time was probably about what you are looking at. I took a pain pill before I got on the plane and I was absolutely fine. The weekend following that, I travelled by car to Asheville and back to watch my son play soccer. Again, no issue. If you do the drive, just be sure you stop every once in a while and stretch.

I don't know anything about your Dr., however, I do think I have read of others who have had experience with him. I'm sure if you ask to meet him before hand, it won't be an issue.

Best of luck to you.

Kim
 
Hi Bill, and welcome!
I'm a NC native who had AVR for bicuspid valve at age 60. (That's background for my opinions on some of your concerns.)
How long test results are good--I was told 30 days, but the more time you spend on the forum, the more you'll realize that nothing is standard everywhere.
In your situation, I'd opt for the car trip. Once you factor in getting to the airport, security lines, waiting in Charlotte (where changing gates can be quite a trek), there may not be that much time savings. If you decide to fly, request a wheelchair.
As Kim said, pain may not be a big consideration. But you will probably find you tire very easily. The sternal cut does not involve muscles as abdominal surgery does, so is likely less painful.
It sounds like you have a great attitude and a good medical team.

Best wishes,

Debby
 
Welcome Bill from another newbie and another native New Yorker (now living in NJ - I didn't stray as far as you)! My husband will be having AVR most likely this Friday (we are meeting with the surgeon tomorrow).

You sound like you are in a really good frame of mind. Good luck with the TEE tomorrow. You will do great. Glad you found this forum. I feel so fortunate to have found it too.

Nadine
 
Hi, Bill!:)
Push the cardio for more "happy juice" before the procedure tomorrow. They can be real cautious with the juice, and it usually works to your detriment.
The squeaky wheel does get the oil, or in your situation, the versed.;)
 
It sounds like you have a Positive Attitude facing surgery which is Key ingredient to a good recovery.

As a BAV patient, I would want to know how much experience your Surgeon has dealing with BAV and the often associated Connective Tissue Disorder(s) (CTD) that can result in Aortic Aneurisms. FYI, there are several Levels in increasing complexity in Heart Surgery with Surgery of the Aorta being the most complex.

I would also want to be checked for aneurisms. The 'gold standard' tests are either a Chest CT or Chest MRI. Ask your surgeon if you have any signs of CTD and about his experience dealing with CTD and Surgery of the Aorta. I'm not trying to be negative, just thorough to ensure that all issues have been checked and the surgeon can handle anything that may show up.

'AL Capshaw'
 
I can not add to anything said except maybe that the TEE was a non issue for me as far as gagging or discomfort.

My after surgery pain was really in my left shoulder.

Want to say "welcome" and do keep us posted.

Marie
 
Hi ALCapshaw2--

I do not have all the answers to the questions you posed but of course will ask. My position is, and my cardiologist is in agreement, is that if there are KNOWN and significant complexities to the surgery, I would change the venue to Cleveland Clinic. Of course, the operative word is "known" at time of admittance.

Although Dr. Chitwood is perhaps best known for his international pioneering work in minimally invasive surgical techniques, and specifically, mitral valve repair using robotics, he is exceptionally regarded (so I've been told) in all aspects of cardio thoracic surgery. Maybe if you have the time (and curiousity) you might want to take a look at his CV at www.mitralvalvesurgery.com and let me know what you think. ( I know, CVs aren't always completely accurate ... mine reads pretty well as well.)

Thanks for your response and input--

Best regards-
Bill
 
Hi Bill,

Just wanted to wish you a warm welcome to this fantastic forum. Good luck with the TEE tomorrow. I echo what others have said. You have a great attitude which is half the battle. All the very best.
 
Another Welcome to VR.com, Bill.

Happy you found us.

Congratulations on your sobriety and best wishes as you go forward through this OHS journey.

Don't fret the TEE. It really is painless and very easy on most of us. Yes, there have been a few who had it a bit harder but most of us report no problem. It's an excellent test that gives a lot of info.
 
Welcome! What a great attitude you have!! That is a good part of the battle so I'm told, so keep that going strong. Congratulations on your 4 months sobriety. That takes true determination and it sounds like you have it in spades. I am still climbing the mountain, so can't contribute much else other than a hardy hello and best of luck on the TEE.

Rhena
 
Hi Bill,
Thanks for sharing your story. Sounds like you have been thru alot in a short period of time. I would read the "sticky" section at the top of the forum on the subject of what to ask doctors. Make darn sure this doctor you like does these on a daily basis...and has done MANY of them. Best wishes.
 
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