I have been kicking around the idea of starting a blog, just so I can write down some of the stuff I obsess about and maybe make it stop whirling around in my head. I expected that it would mostly be a bike blog, you know, trips and events and projects, the usual stuff you can find on dozens or maybe hundreds of other blogs. Bikes are what I obsess about most, but maybe I’d throw in some politics, gardening , co-op governance and other random thoughts and features of my humdrum existence.
But life got in the way. I found out that I need heart surgery, so the content of my obsessions changed abruptly. For now, this will be a blog about my adventures in the American health care system.
So here is the story. I went in for a routine physical on Friday, August 14. I complained about feeling lethargic and about not responding to training – more distance or more intensity on made me tired rather than making me faster. The answer I expected was, “You are getting older and slower. Deal with it.” However, the doctor decided that we check out that heart murmur I had always had and sent me to get an echocardiogram, which was scheduled for August 26.
Sometime the next week, about the 19th, the office called and left me a message about the blood work that had been done as part of the physical. She said that everything looked good except that my thyroid was marginal. This is what I was hoping for, an easy fix, a pill every day and I would feel better.
During the echocardiogram I got to watch much of the echo process on the computer screen, which displayed the ghostly image of a heart from various perspectives, complete with valves flapping. The technician spent a considerable amount of time looking at the left side of my heart, but she shared no observations and I did not know what I was seeing. I still suspected no real problem.
About 3:30 the next day, a Friday, the doctor’s office called to tell me that I had a stenotic bicuspid aortic valve and that they had made an appointment for me to see a heart surgeon.
A little research on the web revealed that the valve is supposed to have three leaves; mine only had two, probably from birth. This defect and 53 years of pumping led to a narrowing of the passage around the valve. The stenosis was causing restriction of blood flow and the inefficiency of the valve was causing some backflow. The situation can lead to heart attack, stroke, damage to the heart muscle and aorta, and other general bad things. The only therapy is surgery, usually valve replacement. Tissue (cow or swine) is used on patients older than 60, but they wear out after a decade or two, so mechanical valves are used on younger subjects. The disadvantage of the mechanical valves is that they tend to cause blood clots, so a recipient takes blood thinners the rest of his life.
We finally got in to see the surgeon on September 10. A long discussion with him pretty much just confirmed what Rachel and I learned from our research. One new thing that we learned is that the blood thinner that is usually used is Coumadin, aka warfarin, aka rat poison, which did not make me feel warm and fuzzy.
The other thing we learned is that we sort of skipped a step. The surgeon does not make any decisions about the necessity of surgery or what exact surgery is required – we need to back up a step and see a cardiologist. The cardiologist will probably want to do a heart catheterization to confirm the results of the echo and check for other complicating factors. The cardiologist appointment is set for September 21.