This is not going to be an easy Christmas.
Some background; I've been going to a cardiologist for the last several years as he's been watching a situation that I have with one of my heart valves. Now this was a known issue that I've had for years but it was something that I could live with as long as it didn't get any worse. It never really caused any problems other then being noticed as a slight murmur for the last 10 years or so and in fact, up though last year, my doctors have said that if nothing changes that I could leave things as they were. Well, it appears that something has changed.
This past September I started to experience shortness-of-breath and lightheadedness. At first it was just this one instance while walking around a mall where we were out shopping. A few weeks later it happened again while I was out for my daily walk around the neighborhood. Then just before we left for Thanksgiving in Michigan it started to be a daily thing. I got an appointment with my cardiologist and he did an EKG and checked me as much as he could on short notice. He did schedule me for my annual cardio stress-echo test that I usually have every December anyway, for when we got back.
The one thing that had changed about the time I started to have these problems was a new diabetes medication (I'm marginally type II diabetic) so he recommended that i go back to my old medicine and see what happens as we were leaving for Michigan the next day. Well nothing changed and in fact the day before we were to fly home (a week ago Monday) I had an attack that felt like a heart attack (which I had never experienced before even with my recent problems). Anyway, my wife rushed me to the local ER and they checked everything out and determined that it was NOT a heart attack but a severe case of acid re-flux, something I had never before experienced in my life and so I had no idea what that felt like. I have to admit that in retrospect, this was self-inflicted as we had gone to dinner the night before at a Chinese Buffet and I just ate way too much as well as trying some items that turned out to be much spicier than I normally eat. So after six hours in the ER I was released with some medication for the acid re-flux, which cleared-up quickly. Anyway, we caught our flight home and I immediately went in to my family doctor as I was told to by the ER doctor. Since I've never had a history of stomach problems he figured it was a one time incident but did say that I needed to have that stress-echo since we needed to find out what was causing the shortness-of-breath and lightheadedness.
So yesterday I had my stress-echo and it was not good. That heart valve that was being watched, well it has basically blown-out. Now I can live like this for a while yet, as long as I avoid lifting anything heavy or any other strenuous effort. But Thursday I'm going in for a coronary angiogram to see if there are any blocked arteries. Now my cardiologist does not think this will be an issue as I've never really had a problem with cholesterol and the stress echo, while it showed that my heart valve had deteriorated since last year's test, the heart muscles themselves were still strong and appeared to be undamaged. However, before they proceed with a plan to fix/replace my heart valve they have to rule-out any serious damage to the heart such as blocked arteries. If the angiogram is clean it gives us more options as to what to do next.
So if all goes well Thursday, which my doctor is expecting, we will then decide when and what type of valve procedure to perform. Ideally he would like to use a 'bovine/porcine' valve as that's the least invasive procedure and there are very few post-operative complications. Now they could replace my valve with a mechanical one, but that's a more complicated surgery and it would also require that I take anti-coagulant drugs the rest of my life. The only real advantage of using a mechanical valve is that they never wear out, while tissue-based, or 'bovine/porcine', valves last for only 15-20 years but the risk of post surgical blood clotting is virtually nonexistent and they can be 'installed' without having to actually remove the old valve as this it more like a 'retread' procedure. Note that this is one of the procedures which are now being done using surgical robots which are used to make miniature sutures as well as perform other precision tasks.
So by the end of the week we should know when and what the next steps will be. I would like to think we could get this done before Christmas. If not, we'll have to wait until January as my doctor says that you do NOT want to have anything like this done over the holidays themselves since that's never a good time to be in a hospital.
As for where the surgery will be done, whatever approach is taken, my doctor has recommend Ceder Sinai Hospital up in Los Angeles, as they've done the most valve replacement operations in the world and this is one procedure that you want done by people who have done a lot of them.
So I'll keep you all up-to-date and that I ask you all to pray for me and my family in the mean time.
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