Well, it has been exactly one week since my surgery to replace my aortic valve. This is the second time I have had this open heart procedure... I am told I wore out the old valve with several of the activities that required long periods of high intensity heart effort. I am not all that inclined to agree... but it is easier than arguing from my weakened position.

So, here I am, seven days out and (typed while knocking on the wooden table) I feel wonderful. I haven't felt this good in many months. All of my body functions are in order with the exception of my hemoglobin... so I don't have the stamina back yet... but that is a matter of weeks (days if I choose to start eating lots of calves liver). I left the hospital on Sunday and have been walking a lot... stair climbing is already normal. So I can safely say that this recovery is much better than the last... perhaps I was already much sicker in 2001 and it took about a month to get where I am today.

My first replacement valve was made from a bull's heart tissue. I understand now that bovine tissue can be prone to calcification... and my hope for an 18 year valve was cut short by seven years. Of course, it isn't anticipated that an aortic valve prosthesis  is going to be worked as heard as I tend to make mine work. I do stand on my commitment that if one is in good health and shape when ultimately s/he gets sick, it is likely that recovery will go well. I will reduce my intensity and length of my cycling... but certainly will not stop.

My new valve is in fact a pig's aortic valve. It has been specially treated so that it will not be rejected by my immune system but it is roughly the same as a human valve. I can't feel it, but I do feel the difference the larger valve opening is making, especially to my mind. As the old valve was gradually shutting down, I wasn't getting the same profusion as I should have... it happened relatively slowly, so I wasn't noticing it... the surgery was abrupt, and I can clearly feel the improvement. Once my hemoglobin gets back to normal, I think my muscles will react the same way... I am looking forward to getting back into shape and rebuilding the strength/stamina to my best days.

I chose to come to Little Rock and the Arkansas Heart Hospital because I know the people who own the hospital, the physicians, nurses and others who make it work. They only work on the cardio-vascular system, and they do it incredibly well. I know that I could get the work done elsewhere, but I wanted to achieve the best heart function possible for the next 15 year window of Lynnda and my life. We have achieved that by coming here.

It is ironic that I have a pig valve now... and that I got it here in Arkansas. The University of Arkansas uses the Razorback Boar as its mascot... and the refrain "Go HOGS' is likely the most utilized in the state. They are a very successful university and the UAMS Hospital are awesome... I came here for my PET scan five years ago as well.

I believe could not have had the same work done in Canada. It is a failure of the system at home that there is no opportunity to be following the devolution of one's aortic valve, or any other vessel or organ, if you are asymptomatic. I was particularly concerned about my valve situation because there are essentially no perceptible symptoms... until sudden death... when the valve shuts down. I came to Little Rock each year to have an echo cardiogram done of the valve, because it is such a critical heart function.

For the first five years, there was no change in the valve's gradient... a key measurement. The heart was working well, and the blood velocity was normal. Four years ago we saw the first changes... about a 50% increase in the gradient, but no where near critical. It continued to increase and last summer it reached concerning levels, but still not critical. Some times as I was riding the bike I started wondering if this was my last ride, but I handled that by screaming down the other side of the hills... and all was well.

In December though, things had changed... and we scheduled the surgery. We were good to do it, since two of the three leaflets of the valve had fused and while the gradient was still less than critical... we got lucky because the valve was worse than anticipated. In this case, I am happy that it has turned out this way.

Here at the Heart Hospital I am one of 110 patients who occupied a bed each day. The numbers of patients that go through the cath labs and surgical suites is astounding. The hospital has heart failure, peripheral vascular, wound healing and diabetes clinics... all associated with integrated medicine... for a population roughly like that of Niagara and Hamilton. There are three other huge hospitals, all of which also have heart programs... but the AHH thrives through focus, excellence, research and having the best equipment and people available in the industry.

I am reminded of the Shouldice Clinic in Toronto. The excellence there is respected around the world... as is the excellence at the Arkansas Heart Hospital.


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