The Pig Might be Spared

Slight change of plans -- I think I'm going to go a different way with my surgery on Monday. After a last-minute consultation with my surgeon, I'm opting for the Ross Procedure instead of the pig valve.

Throughout my research of the last six months, I've read about the Ross Procedure (moving my pulmonary valve to replace my aortic valve, then using a human donor valve to replace my pulmonary valve). Somehow it never clicked with me (I was never aware of the benefits for a patient my age) and I was stuck thinking "why replace two when I only need one?".

This week at St Joe's I was given a booklet about heart valve surgeries (explaining the variety of procedures, hospital stay, recovery, etc). Wednesday night I was idly flipping through just reading random snippets - confident I knew all I needed to know after months of research and consultations. For some reason I stopped and read the two quick paragraphs describing the Ross Procedure -- how the repair lasts longer than pig valve replacements, also does not require blood thinners after recovery, and is a very good choice for young, healthy patients expecting a smooth recovery. "Particularly women of child-bearing age requiring aortic valve replacement." Ding ding ding -- a bell started to ring, and I mulled over the Ross Procedure for the next 24 hours. Last night I mentioned it to Tony and we did some quick research to reinforce what we already suspected -- that this might be exactly the surgery for me!

Today I called my surgeon's office and asked if he considers me a candidate, does he recommend the procedure for me, and can we still plan it for Monday? Yes, yes, yes were the responses! No final decisions yet, however, he's going to see what's the best he can do for me come Monday morning.

Sure, I'm a little disappointed that he hadn't tried to sell me on the Ross Procedure originally, or that he hadn't made sure I understood the benefits before I dismissed it as a possibility. But I guess this is why it's important that patients do their own research - not to second guess the docs, but more to be fully knowledgeable of their condition and possibilities for treatment. I'm glad I've done my research.

The surgery is a little riskier due to the replacement of two valves instead of just the one. However, now that I've got my mind wrapped around the need to have the surgery, I'm not so concerned about the risks of what he does while he's in there. Honestly, my concerns are more general - having the surgery at all, and going on and coming off the bypass machine with no problems. Beyond that, once he's in I don't care what he does and if he spends another hour Monday morning which buys me ten years on a redo - I say go for it!

Here's a little bit of info about the Ross procedure:
http://www.cts.usc.edu/rossprocedure.html

So yes, the pig may be spared ("Whew!" says the piggy). I am leaving the final decision in the capable hands of my surgeon - I told him I want to try the Ross Procedure but to do whatever he thinks is best when the time comes.

In the meantime, I'd like to give an enthusiastic, appreciative shout out to all of the organ donors and those considering organ donation -- THANK YOU! I'm not even remotely able to wrap my mind around this one right now (receiving a donor organ). But I do appreciate the opportunity it provides me.

All About Monday

I had my pre-surgery physical today at St Joe's. I think they are a little excited to have someone under the age of 70 to work with. :-) Two Physician Assistants (one experienced, one in training) came in and asked me the usual (although extensive) battery of "have you ever had/experienced (fill-in-the-medical malady)?" questions. I maintained an almost steady shaking of the head "No. No. Uh uh. No." They looked a little surprised - in their usual course of work they probably run into people with any range of health conditions other than the heart condition for which they are being treated (face it, you live long enough you acquire a laundry list of "yes, I have/had _____". My summary to them today was "nope, just the pesky heart defect".

I do have a CAT scan scheduled tomorrow morning (that came up late this afternoon so I haven't had a chance to mention it to my boss -- but his wife reads my blog, so he might be just about to find out). The CAT scan just gives the surgeon a little more information about what he'll find Monday morning. I'm all about him getting all the info he needs before he gets in there!

We learned more about next week's hospital stay and what to expect during the procedure and recovery. Lots of valuable information and it's nice to know as much as you can ahead of time, but there's a point where you just say "yeah, yeah, yeah, let's just do it already and get it over with!"

I'll be in the intensive care unit for 24 hours after surgery, which means Tuesday morning I'll be moved (by wheelchair even, not by gurney) to a regular recovery room (private, thankfully). My total hospital stay (I'm expecting a swift, smooth recovery with no complications) should have me home Friday or Saturday. I'm shooting for Friday.

Visiting hours are 11:00 a.m. through 8:00 p.m. Tony'll be pulling some long hours at my bedside so he would welcome some friendly faces, too, I'm sure. Here's where to find us:
http://www.sjmercyhealth.org/body.cfm?id=33

Wish us well and we look forward to seeing you soon.

Home stretch

Well, I'm in the home stretch leading up the my surgery and reality is setting in. Yesterday at home I started having what can only be described as sudden, violent mood swings. Poor Tony didn't know what was happening. I apologized and advised him that his best strategy for survival over the next week is to keep a very low profile and/or bow to my every whim. He seemed to understand and began obliging me.

Despite the aforementioned mood swings, it was actually a very nice weekend. We had friends over Friday for dinner and games. Saturday I met a dear friend in Ann Arbor for lunch, shopping, and catching up. The rest of the weekend was spent at home with Tony, watching tv and movies. Absolutely nothing was accomplished and I loved it!

At work this morning I sent my company-wide email informing everyone of my upcoming leave of absence. None of the gory details of why I was going to be gone -- I approached it strictly as the practical need to inform everyone of my absence. After the initial email, however, I sent some individual notes and responded to questions as they came. I definitely don't mind talking about my upcoming ordeal, but it seems so dramatic to just whip it out of the blue and say "oh, I won't be here Monday, I'm having open heart surgery".

This Wednesday I have my pre-surgery physical at my surgeon's office (he comes highly recommended, by the way - we've heard excellent things from other medical professionals, as well as former patients). After Wednesday, I'll have more information about my hospital stay. At that time I'll post information about visiting hours and directions, as I would LOVE to have visitors and see some friendly faces while I'm laid up.

Cow valve?! What the.....?

Tony and I went to St Joe's yesterday afternoon for office visits with my surgeon and my cardiologist. All went well - no new roadblocks, some questions answered, minimal poking and prodding, and no one made me feel like crying - generally good visits.

During the surgical consultation, my doctor asked what type of valve we are thinking about - I said a tissue/pig valve. Doc agreed with my reasoning in selecting the tissue over the mechanical valve at this time. Then he asked if I wanted a pig valve or a cow valve. Now, I was aware that cow valves are also in the pool of possible replacement parts, but most of the reading I've done was centered on pig valves. Apparently cow valves are equally popular as pig valves and offer a viable option.

Two things:
1 - My first thought was "Pig valve! It's gotta be the pig valve! Months worth of teasing and mockery have been endured with more to come -- we can't change tracks now!!"
2 - I can't imagine I'm going to notice the difference, and I have no criteria with which to make this decision (is one prettier than the other? does it clash with my aorta repair? which one is more slimming?).

I figure I'll leave the final decision to the doc, but here's hoping for the pig valve.

Missing!

My darling brother created this and presented me with a full-size copy (suitable for wall-hanging) at Christmas. It's very creative and a very entertaining read.

http://home.comcast.net/~gartrell/Arnold_is_Missing.pdf

There's nothing quite like a brother's love to help see you through.

Thanks, Rich.
:-)