Good news and…bad? (07/08/04 archive)

Good news and … bad?

Date: 7/8/04 at 6:10AM

The good news: I have found an expert. He does a lot of mitral valve repairs.

The “bad” news: He’s 150 miles away and wants more data, which means getting a trans-esophogeal echocardiogram (known as a TEE); and he wants it done locally there.

He is taking a conservative approach and is looking at conflicting data from the procedures done so far: there is severe regurgitation, but the hemodynamics (heart functioning) are normal. He says I’m a borderline case as far as surgical repair goes.

The issue here is just how bad is it? Is it manageable (medication and monitoring), or do the risks of not repairing it outweigh the risks of surgery?

So he sent me to another cardiologist for assessment and a TEE, which is scheduled for next week.

I asked them both: What is the threshhold you’re looking for? Reduced heart function, increased pulmonary involvement, atrial or ventrical enlargement?

Each responded: Let’s wait until we see the TEE. It will give us a very accurate picture of the actual condition of the valve. which may leave no question about surgery.

Me: And what if the situataion is the same?

Them: Then we will have a long discussion

And that’s where it stands: two more doctors and another procedure scheduled. 150 miles away.

The TEE (07/15/04 archive)

The TEE

Date: 7/15/04 at 8:21PM

The TEE is done, and it went smoothly. The worst part (as the very nice nurses said) is the numbing of the throat. They told me to tilt my head back and open my mouth wide, then squirted a thick liquid in the back of my mouth and said, “try not to swallow.” That was O.K., but it tasted horrible, and because it was thick, it never really went away (of course, it wasn’t supposed to). But until my throat was numb it kept feeling like something was there.

The doctor warned me that one of the medicines would have an amnesiac effect. She was right. I didn’t remember anything. But I do remember what she said after it was over. The left atrium is enlarged. I asked which leaflets were involved, and she said both.

I left the hospital and slept the rest of the afternoon, which helped a lot. I’m staying at a friend’s house locally, and they’ve been wonderful. Feels just like home!

The cardiologist called after dinner and said they recommend surgery, so I’ll call the surgeon’s office tomorrow before I go home and see where we go from here.