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Greyg8r here

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Greyg8r here

Post by greyg8r on Sat Jan 18, 2014 12:46 am

A lot of you know me from CA, where I have been a member since 2007. As an update to old friends and an intro to new friends, here is a little bit about my personal life and my cardiac history.

On a personal note, I am 54, been married to the same woman since 1980, have three kids, older son 23, younger son 2, and daughter 19. Older son lives with us, younger son graduated from LSU in May, just completed an EMT program and will become a volunteer EMT probably in Tampa while he waits for decisions from medical schools (he applied to 12 and received two interviews thus far) and daughter is a sophomore at the University of Florida and a member of the marching band. I graduated from UF and have a master of scence degree from the University of South Florida. I am a scientist and schlep my science training classes across the country performing for spare change. I have done triathlons, a couple of marathons, halves, 10Ks and have shifted road cycling to more off road.

My cardiac history is complex. I had an episode of chest pains in Gary's home town of Columbus in November 2006 that turned out to be a 99% blocked RCA that was stented the day before Thanksgiving. I became officially a cardiac patient for life. In early 2008, my cardiologist noticed a new murmur. After an echo and CT scan, it was confirmed that I had a 6+ cm dilitated ascending aorta. I entered the Mayo Clinic in Jacksonville, FL, on April 5, 2008 (Friday) and had my aneurysmic aortic root replaced with a homograft (cadaver) that included the intact aortic valve. From the start, I had mild aortic insufficiency.

Fast forward to 2013. In June, my annual echo upgrades my aortic insufficiency from mild to mild/moderate. The cardiologist is not concerned and still believes I am on track for a 15-year aortic valve. Last year was a good work year, but I worked really hard and wasn't able to train as much as I had in earlier years and my fitness dropped off. My times were down from before which I attributed to fitness level. In early December, my fitness dropped way off. My heart would spike quickly and take 3 - 5 minutes to settle down after a modest effort. I was considering calling my cardiologist, but I had seen him just 6 weeks earlier. On the Saturday before Christmas, I was going to give a blood donation, but I couldn't because my diastolic was below 50. My bp was 122/45. I had him recheck it, and it was consistent. This really concerned me and I spent the whole weekend considering whether to call 911 and googling normal systole with low diastole. The lack of fitness, bp, and a scratchy throat I had for the last couple of weeks all pointed to severe aortic insufficiency. By the time I saw my cardiologist on Monday, I was mentally ready when my cardiologist told me I needed AVR surgery. Two days later, the echo removed the remaining .01% chance I didn't need a new AV.

I went to Tampa General Hospital last wednesday for prelims: cath, TEE, chest xrays, CT scan and ultrasound of the neck and had the surgery on Friday evening, which ended at midnight. I have a bovine AV.

While I was in prelims, my nurse had a particular insight to my surgeon, Dr. Cedric Sheffield, as he did the third AVR surgery for her husband, all of which were mechanicals. She is convinced that the surgeon finally fixed his problems. She gushed about Dr. Sheffield the way teenybopper girls gush about Justin Bieber. Dr. Sheffield doubts I'll ever need AVR surgery again, but if I do it will be in a couple of decades and will be a high tech process.

That about sums me up.


Last edited by greyg8r on Sat Jan 18, 2014 7:11 am; edited 1 time in total (Reason for editing : Remove names)

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Re: Greyg8r here

Post by RoadKillBill on Sat Jan 18, 2014 6:27 am

I suggest switching to a less adventurous lifestyle! OMG G8r, last week had to be nerve wracking, even for you. We're glad all is going as well as can be expected. You've joined LLJ in the prestigious two-timer AVR club.

It's great to see you on this forum, please keep us posted.

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Re: Greyg8r here

Post by Dave Tuttle on Sat Jan 18, 2014 9:28 am

Welcome to the forum Richard. Glad you're here although I wish the circumstances were different... It's good that your surgeon was one of the great ones. That makes all the difference.

Let us know how you're doing. I know how tough OHS recovery is but I also remember how amazingly well you came through the last one.

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Re: Greyg8r here

Post by echoguy on Sat Jan 18, 2014 10:26 am

greyg8r wrote:Dr. Sheffield doubts I'll ever need AVR surgery again, but if I do it will be in a couple of decades and will be a high tech process.

Hey greyg8r!! Thanks for checking in and updating us. Glad that surgery went well and you are back on the "getting better" side of the curve!!

I am very interested in why Dr. Sheffield feels confident that this valve will last two decades. Does he have any concerns about excessive exercise? and...specifically what valve did you end up with?

Recover well!!

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Re: Greyg8r here

Post by greyg8r on Sat Jan 18, 2014 12:01 pm

echoguy wrote:
greyg8r wrote:Dr. Sheffield doubts I'll ever need AVR surgery again, but if I do it will be in a couple of decades and will be a high tech process.

Hey greyg8r!! Thanks for checking in and updating us. Glad that surgery went well and you are back on the "getting better" side of the curve!!

I am very interested in why Dr. Sheffield feels confident that this valve will last two decades. Does he have any concerns about excessive exercise? and...specifically what valve did you end up with?

Recover well!!

Brian, Dr. Sheffield refers to my prior surgery in 08 in the same context that an automotive engineer would refer to round stone wheels. He is just absolutely convinced that the current tissue valves are so much more durable and have better hemodynamic performance than those pleistocene valves they made way back in 2008. Calcification of tissue valves is their only problem that limits their durability and he says he sees remarkable resistance to that.

He is also very bullish on transcatheter aortic valve replacement which is in its infancy. Currently, it is only approved for stenosis, not insufficiency, and only for patients that cannot tolerate surgery. He says those things are becoming increasingly compact and will be the sole source in 20 years, maybe less. Very exciting stuff.

I chose a bovine valve. He said bovine valves are made from cow pericardium, rolled into sheets and cut into leaflets. He mentioned there were two variations of this, but I lost him at this point and told him to go with the one that will work best. Afterwards, he said he put in the largest valve he could and that I will like the hemodynamic performance, sort of like getting a PED  Very Happy 

As for exercise, my surgeon is no expert on that - he is probably 300#. My cardiologist gave me no exercise restrictions on my prior AV other than to use a minimum of 15 reps when lifting. He knows my attention to detail about controlling my heart rates during different events and I think feels comfortable that I am not going to over-rev my system. I'll have this conversation with him next week.

Thanks

Richard

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Re: Greyg8r here

Post by Rachel August on Sat Jan 18, 2014 12:44 pm

Richard - SO GOOD to hear from you - I've been thinking of you!!!!

Welcome to the HEART Forum and welcome to the "bovine club" - although I'm really sorry that you had to go through all this so soon after the first one!!!!

Heal well - looking forward to running with you again!

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Re: Greyg8r here

Post by DonSoule on Sat Jan 18, 2014 4:04 pm

Hi Richard - Wishing you the best with your new valve !   May it serve you well and be long lasting!  Very Happy   If you make it to Eagan this year, be sure and let me know so we can get together for a workout at the Y or on a trail again!

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Re: Greyg8r here

Post by twal on Sat Jan 18, 2014 5:13 pm

I'm happy you came through this all right.

Be sure to look me up if you come through Pennsylvania.

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Re: Greyg8r here

Post by Tom price on Sat Jan 18, 2014 7:07 pm

Welcome to the bovine club! Good luck in your "quick" recovery. I assume you have a Edwards bovine perdicardial tissue valve, just like mine....mine is 29mm, not that size matters. :-)
If you ever get a chance to be in Southern California, you need to plan a visit to the Edwards facility. They love seeing people who have their valves. When you contact them, they ask for your valves serial number....at the end of the visit you meet the very people who had a hand in making your valve! When I went, I gave each of them one of my Disney medals as a thank you....there was not a dry eye in the room.
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Re: Greyg8r here

Post by echoguy on Sat Jan 18, 2014 7:25 pm

Tom price wrote:Welcome to the bovine club!  Good luck in your "quick" recovery.  I assume you have a Edwards bovine perdicardial tissue valve, just like mine....mine is 29mm, not that size matters. :-)

My Edwards valve is 25mm, small, but I am told they made me cold during surgery and I am pretty sure there was shrinkage.  Embarassed 

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Re: Greyg8r here

Post by Rachel August on Sun Jan 19, 2014 9:54 am

My Edwards valve is also 25MM.....that's not small! I think that's a pretty good size.... I could say a few things here.....but I'm going to restrain myself and just walk away from the keyboard.....




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Re: Greyg8r here

Post by Tom price on Sun Jan 19, 2014 10:28 am

Shrinkage ! Good one! And thanks for backing away from the keyboard Rachel! I guess this just shows I have a big heart.....no comments Rachel!
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Re: Greyg8r here

Post by kodi30 on Sun Jan 19, 2014 4:43 pm

Gee, I have an Edwards too and it's only 21mm. Probably because I was older and there was more calcification. They told me they put in the maximum they can under the circumstances. Well at least it has kept me alive. Tom thanks for the info on visiting them in SoCal. Where are they located...not that I can't find out on my own. Smile

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Re: Greyg8r here

Post by Tom price on Sun Jan 19, 2014 8:17 pm

Edwards is in Irvine. I visited them when I went out to run Disneyland half. It is not too far away
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Re: Greyg8r here

Post by Dave Tuttle on Mon Jan 20, 2014 11:39 am

Shrinkage! LMAO... I hope the Gator has his hug pillow handy when he reads that one.

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Re: Greyg8r here

Post by Gary E on Tue Jan 21, 2014 9:55 pm

For those unfortunate enough to have never met the Gator, I was going to post the photo you staged in Baltimore at our gathering there. It is currently inacessible somewhere in my computer, but if any of you have that iconic photo, please let the others share that humorous moment.

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Re: Greyg8r here

Post by Rachel August on Wed Jan 22, 2014 10:02 am

Gary E wrote:For those unfortunate enough to have never met the Gator, I was going to post the photo you staged in Baltimore at our gathering there. It is currently inacessible somewhere in my computer, but if any of you have that iconic photo, please let the others share that humorous moment.  


Oh - that was a GREAT photo!!!! I don't think I saved it....but I'll check mine at home - I laughed so hard when I saw it!

I hope someone has it!!!!

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Re: Greyg8r here

Post by Sumorunner on Wed Jan 22, 2014 6:32 pm

Not me. I have about a dozen photos from Baltimore and the only ones with Richard are the group shots.

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Re: Greyg8r here

Post by mikenall on Wed Jan 22, 2014 9:35 pm

Gary,
Is that the picture I used after you lost a bet?

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Re: Greyg8r here

Post by Gary E on Wed Jan 22, 2014 11:01 pm

mikenall wrote:Gary,
Is that the picture I used after you lost a bet?

Refresh my memory, Mike, I loose so many bets that I can't keep track!!!

The one I had in mind was taken in the bar of the hotel, and involved a few empty glasses and one tired dude.
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Re: Greyg8r here

Post by Rachel August on Thu Jan 23, 2014 8:13 am

\"Gary E wrote:

The one I had in mind was taken in the bar of the hotel, and involved a few empty glasses and one tired dude.

That's the one!!! After taking it - Richard called me to tell me that he stayed out too late and wouldn't be able to run his leg (we were on the same relay team) - Cracked me up!!!! Character!!!

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Re: Greyg8r here

Post by greyg8r on Thu Jan 30, 2014 10:49 am

Update on health: I started having coughing issues in early December, about the time I noticed exercise intolerance. The coughing was from fluid retention in the lungs and pleural cavity, which is common with severe aortic insufficiency. After being on a diuretic for 18 days and losing almost 10 pounds, mostly water, I think my lungs have finally dried out. I have not coughed in 2 days, although I still have occasional cough desires while speaking. I think I will be fine by Monday when I do my next class in Birmingham next week.

In early December, I was dropped like third period French while mountain-biking with my neighbor, his wife, and his friend. The neighbor is a strong rider, who I usually go to head to head with, so being dropped by him was no big deal, but I am way stronger than his 45yo wife and 28yo pudgy rookie friend. Once I am cleared to ride again, I will stay off anything technical, but judgment day will come!

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Re: Greyg8r here

Post by Tom price on Thu Jan 30, 2014 11:14 am

Thanks for the update....have a smooth ride on that road to recovery.....
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Re: Greyg8r here

Post by Dave Tuttle on Fri Jan 31, 2014 5:24 am

Back to travel and teaching Monday... You ARE tough Richard. Glad to hear you're doing well.

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Re: Greyg8r here

Post by twal on Fri Jan 31, 2014 8:57 am

Great to hear that you're coming back strong.

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