Hurry up and wait

Well, continuing the 'hurry up and wait' nature of my current medical fun and excitement, I visited with my cardiologist at the end of last week.  He seems very anxious to get the surgery scheduled as I appear to be having more and more difficulty doing the simplest of things without getting our of breath or tired.  The cardiologist's office called the surgeon and I've been given a date of December 1st for a consult with the surgeon.

Honestly, the 1st of December seems like months away from now (even though it's really only 3 weeks). Unfortunately we ran up against the Thanksgiving Holiday so that impacts availability.  If I were to be 100% honest, I'm not happy about another wait.  I can't drive.  I likely won't be able to drive for 6 months from my last episode of passing out. Just today, after attending the kids' soccer games, I came home and was so tired that I needed to lie down in bed for an hour.

My concern is that things seem to be changing rapidly.  The cardiologist said that people with my condition are "unlikely" to have any sort of heart attack type episode (but it's not out of the question).  I want to have this taken care of now.

I may have covered this in the past, but the main thing that we need to lay out with the cardiac surgeon is the type of surgery (and the type of replacement valve).  There are a few options that need to be considered.  For the procedure itself, the "traditional" approach is to have open heart surgery (pretty grueling procedure but is considered pretty routine, and the risks are well understood and normally well controlled). However, there are emerging treatments that allow for smaller incisions with more intricate tools to complete the valve replacement. Other options might be robotic surgery or valve replacement through catheters placed into your femoral artery.  The thing is, the newer treatments are less well-understood and are subject to more uncertainty.  The cardiologist told us a story about one of his patients who insisted on going to the Cleveland Clinic to have one of these newer procedures, but it went terribly wrong and caused lasting damage to the patient.  Let's face it, that doesn't sounds great either!!  

As for the type of valve, there are two main categories that are relevant for my situation.  The first is a big valve.  Yeah, where you get tissue from pigs that are grafted in during the procedure.  The drawback with this type of valve is that there is a limited life span.  A pig valve installed now would likely need to be replaced in 15-25 years. The advantage of this type of valve is that it requires no follow-on medication.  It's installed and then it works until it needs to be replaced.  The other type of valve is a mechanical valve.  This type of valve will last for the lifetime of the recipient. The drawback is that the valve tends to cause blood clots so the recipient needs to be on blood thinners for the rest of their lives (without any exception at all at any time).

My cardiologist is pretty clear on what his recommendation for me is based on my age: Open Heart Surgery with a Mechanical Valve.

These are the conversations that we will be having with the cardiac surgery.

I'm probably going to call the surgeon's office during the coming week to see if there are any openings before the Dec 1 time.

On an unrelated note, I need to cancel my scheduled colonoscopy and to cancel a visit to a genetic specialist about testing for a possible genetic condition from my Mom's side of the family.  Both of these appointments were scheduled for November but I'm not in any shape to be doing those things...