Heart mitral valve surgery

[Winston001]

Post the vid on youtube and do your own voiceover???? take it easy Winston.

Funny you should say that MM, there are videos on the net showing the operation and I studied them beforehand. If anyone wants to know more the Cleveland Clinic and the Mayo Clinic are the world leading heart specialists and have good info on their sites.

Anyway, open heart surgery is not a cakewalk. I may have appeared cheerful and no worries but underneath I was exceedingly nervous. So I fronted the surgeon. I pointed out to him that he proposed to crack my sternum, then crank it wide open with retractors which you can imagine comes as a bit of a shock to the ribs. After that he'd plunge his hands into my chest shoving aside the lungs and anything else in the way and grab my heart, at which point I was a dead man.

Not only that but the aeorta and vena cava would then be pierced so the perfusionist could artificially run my blood supply, while the anaethesist kept the body as close to death as he could manage. And to top it off the body would be cooled to slow metabolism down. The butcher....er surgeon then intended to cut my heart open, fiddle about with the mitral valve, cut pieces out of it, or if things were in a parlous state, replace it with a mechanical valve. After which he'd have a scotch, put in a few stitches, run some lacing wire through the sternum, hook me up to an electric fence and Voila - the Tui Moment - back to life.

Yeah right.....

He just grinned at me and said restarting the heart was the least of my worries. As it turned out, he was right.

[FJRider]

He just grinned at me and said restarting the heart was the least of my worries. As it turned out, he was right.

It's called "putting things into perspective" ... some butchers have a way with words ... eh !!!!

[Nasty]

He just grinned at me and said restarting the heart was the least of my worries. As it turned out, he was right.

I loved it when they told me for the SVT radio frequency ablation that signing the forms for a pacemaker were only a "precaution" in case something went wrong when they burned the electrical fault I had .... that gave me huge confidence

[Okey Dokey]

Geez, winston, this is riveting stuff. So very glad you are here to tell us yourself!

[Winston001]

So the big day arrived. I was admitted the night before and woken at 6:00 am for a shower with a special anti-bacterial sponge and instructed to shave my chest. I perked up when they offered a nurse to help but when I saw it was a guy.....never mind. So after that they stated putting lines into my veins with some happy juice and really everything following is vague. I said goodbye to my wife.

She tells me that later in recovery I would blurt out Monty Python lines while people were talking although I wasn't conscious. Its a 4-5 hour operation and everything went well. By the next morning I was awake and chipper, even managing a few steps around the recovery ward. In fact I felt pretty damn good.

When a medical expert tells you there is only a 2% risk factor with a procedure you tend to feel reassured. What it means is 98 people out of 100 recover and there are no complications. Risk however means that 2 people face death (at the extreme), damage to the heart, collapsed lung, stroke, infection etc. What you the patient don't realise is someone has to make up the 2%.

Suffice to say, I took one for the team. 99 of you reading this can relax.

[Winston001]

Later in the day the surgeon turned up and explained there had been a surprise. Not a surgical problem as such but a medical complication. In other words his job was completed and it was up to others to keep me alive..... Actually that's a bit harsh because he was certainly concerned.

The good news was the valve could be repaired instead of a mechanical valve being inserted. The bad news was that upon opening my heart he discovered evidence of bacterial inflamation and activity on the posterior mitral valve lobe. Exactly where he needed to operate. Oh dear....

There are two non-technical terms for this - a BAD THING and MEDICALLY INTERESTING. Trust me, you do not want to hear these words. Endocarditis is the proper name. The surgeon had only seen it once before in 20 years.

[Mom]

Endocarditis is the proper name. The surgeon had only seen it once before in 20 years.

I trained as a nurse at Greenlane Hospital when I left school. That once was the leading Heart hospital. Sir Brian Barret Boyes operated there and I can remember ward rounds with him

Endocarditis is no laughing matter, have nursed many cases of it. Gets on your heart valves apparently Not very nice either.

[Winston001]

I trained as a nurse at Greenlane Hospital when I left school. That once was the leading Heart hospital. Sir Brian Barret-Boyes operated there and I can remember ward rounds with him

Endocarditis is no laughing matter, have nursed many cases of it. Gets on your heart valves apparently Not very nice either.

I can second that. I have a couple of friends who are GPs and they have never seen endocarditis in a patient here although its not so unusual in poor countries. I should be accurate and explain the heart surgeon had certainly encountered endocarditis on the operating table but normally he already knew about it and was prepared. That was the reason for all the preliminary blood tests.

[Mom]

I can second that. I have a couple of friends who are GPs and they have never seen endocarditis in a patient here although its not so unusual in poor countries.

Once you have todl your story I will share one about a bloke I nursed.

[Winston001]

At this point I want to say that the heart surgery itself was far less painful than I ever expected. Modern medicine really is miraculous. The fact that I was feeling good and very much alive only 24 hours later says a lot. All things being equal I would have gone home after 5 days and it was all a surprisingly easy experience.

[Winston001]

Anyway I ended up with a staphylococci infection in my heart. Harmful bacteria have no business being in the pericardium (heart space) so science is interested in how they got there. 10% of infections can be traced to dental disease but 90% is not understood. Thus I found myself under the curious gaze of an infectious diseases expert some days later. This type of thing is meat and veg for research papers and I should have felt honoured to contribute but somehow......

After 2 days being stabilised in Mercy Hospital I was moved to Dunedin Public Hospital for intensive anti-biotic treatment and was starting to feel really sick. The medicine was 5 million units of penicillin 4 hours intravenously day and night plus 60mg of Gentamicin every 8 hours. That is a powerful lot of poison. Plus blood tests every 12 hours to check inflammatory markers and other things I lost track of. Gentamicin for example can cause hearing and liver damage.

6 days after the operation I was ready to say goodbye because I felt like I'd be in a coma next day. Guess that was the low point because strangely I was a lot better next morning. Crisis averted but it was a chillingly mortal moment.

[Winston001]

After a few days they put in a PICC line which is a semi-permanent IV tube running close to the heart so that the anti-biotics were delivered on site. The good thing about this was that I could walk away from the IV drip stand for 3 hours at a time. Initially I was told I'd be on a 6 week course in hospital which was a bummer piece of news. To be tied to 4 hourly treatments when I was beginning to feel well and just wanted to go home felt so frustrating.

You have to make your own fun to pass the time. As a teaching hospital there were a lot of trainee nurses and doctors so when a new one turned up to take blood I would scream at the crucial moment. This was guaranteed to produce panic. Ahhh the laughs we had......

You can't assess your own state of health in hospital. Its warm and safe and you feel better than you are. Once the PICC line was in I was free of the IV stand so naturally I escaped. Walked a block down the street to a mall and supermarket which sounds easy enough eh. Not. It was 5pm with a cold southerly wind blowing and I could see the hospital from the supermarket.....and wondered if I could make it back. One block. Farrrgggg! Imagine having to call an ambulance.

Somehow I got back to the ward where I was spotted by the nurses and my card was marked. Next morning the cardiologist whom I'd developed a good rapport with called on his rounds. He talked about releasing me to Southland Hospital but then mused that could be a problem because there were no supermarkets nearby......bastard.

[Winston001]

This is pretty much the end of my tale. Shrek came to visit me which was damned decent of him because he lives in Central Otago. I was sent to Invercargill then discharged home for daily doses administered by a District Nuse. After 6 weeks the line was taken out and life has returned to normal. I'm on Warfarin for a couple of months and still get pain in my chest if I try anything physical but that isn't surprising. It takes the sternum about a year to completely heal and the baling wire stays inside.

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

[jim.cox]

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

Yeah right

Stay away from Hospitals and Butchers...

[Mom]

I hope this story will be of reassurance to anyone facing heart surgery. The medical care was simply excellent and pollyanna as it sounds, I feel really fortunate to have been looked after so well.

The advances that have been made in medicine in a few short years is amazing.

Like I said I trained in NZs heart hospital, some of the most pioneering surgery was performed there, it was a world leading hospital for the treatment of heart disease. Probably still is before I get told off

I saw some truely incredible things during my time there and a few have stuck in my mind. One is a man I nursed with Endocarditis, it is a story I have retold many times over the years. My children benefited from it more times than strictly required for the message to sink in, but you can't be too careful when raising babies I think.

This was 1977, the years of long hair and loud music, and Bob* was admitted to my ward. He was one very, very sick puppy. Tall and thin, on the methadone programe, long hair, a once attractive man who had obviously lived a bit. He had these most incredible track marks on his arms and legs. Honestly I had read about them, and seen pictures but to actually see them and feel them was a truely shocking thing for a young gal out of school. He was in his mid 30's and not expected to live much past the next few months.

He was philosophic about how his life had panned out and was full of advice and sage words of wisdom gleaned from the lofty position of "dying from his lifestyle choices" hindsight. His heart was giving up, his mitral valve was completely stuffed, and he was not eligible for surgery as he was too sick. There was not enough time to get him well enough for surgery, before his body gave up. Mind you we still tried.

He had endocarditis on his mitral valve. He likened the growths to cauliflowers that were preventing his valve from closing properly. The reason for his? Injected drugs of the illegal variety. He was a heroin addict who would inject about anything into his veins to get his fix. He told of dealers cutting the stuff with talcum powder, cornflour, you name it they used it, and he just shot it up his arms and legs. Powerful thing meeting Bob. Over 30 years and I can recall him to my mind as if I saw him yesterday.

Back then it was weeks and weeks of hospital and IV antibiotics and a very long slow and often futile excercise to get rid of. Amazing they found yours and were able to treat it sucessfully. There is the advances for you. I reckon it will have come from your teeth, or a really bad throat (not that I have any idea really )

May your recovery be unremarkable and your repaired valve perform better than the original.

Thank you for sharing your story.

* not his real name