Paul's Heart

Happy TAVRsary To Me

The above photo is a replica of an artificial tissue aortic valve, and yes, actual size. The real valve, similar to which is pictured and actual size, is in my heart, officially four years today. This was third heart operation I have had (2nd in two years of each other) as a direct result of late side effects caused from my radiation and chemotherapy treatments for Hodgkin’s Lymphoma.

So by the numbers, I am in remission from my cancer now over thirty-five years. I had my first and only open heart surgery (and I am wording it that way on purpose) seventeen years ago to perform an emergency double bypass as I was dying from a “widow maker” level blockage of the left anterior descending artery (LAD), caused by my treatments nearly two decades earlier.

The number of years is important, 35 years in remission from cancer, 17 years since that open heart surgery, because over all of those years, I have lived to see progress in both cancer and heart disease in newer technologies, newer methods, better options to what otherwise would not have been available for me to have received that artificial valve.

You see, just a decade ago, this type of procedure was not an option for cancer survivors like me due to the conditions of our bodies from radiation scarring inside our chest cavities. And while this valve is only an option for the aortic valve, an option for the mitral valve (something I will need done in the future) is currently in clinical trials, as well as the other valves are being studied. If I were to need any of those other valves currently, I would need to have a second open heart surgery, which will not happen, at least by my decision.

Initially I was treated with 4000 rads of ionized radiation for my Hodgkin’s Lymphoma, a common amount back in the 1980’s. However at the time, I was never told the potential issues that could be ahead of me. Fortunately for newer patients today, they do not get treated with this level of radiation. Anyone who works in the nuclear industry or radiation will confirm, this is an ungodly level of exposure, way more than anyone should see in a lifetime, let alone thirty days.

Besides the risks of the development of issues, the risks of complications rise as well from performing any interventions. Surgeons have no idea what they are going to see upon opening up the chest cavity with those of us with our type of treatment history, damage and scarring over the years, and this will also possibly complicate any recovery. Having to crack the breast bone to perform my bypass, extra time would be needed to heal the breast bone due to the radiation history. Instead of three months for recover, I would be given six months. But perhaps the biggest risk explained to me, long before the breast bone healing, is the increased risk of bleeding out. I was unaware of this the first time I was cut open, but now that I am aware of this risk, have made a firm decision in the event of ever needing a second attempt at open heart surgery.

This is why research is so important, to find less toxic, less destructive, less invasive, safer ways to save a life. Had I needed my aortic valve replaced ten years ago, it would have meant another open heart surgery, and I do not know if I would be writing this. But progress, and finding the right cardiologist with this experience, I not only survived this surgery called “transcatheterization,” my recovery was literally less than a week, I was up and walking freely within less than 24 hours.

These fixes to my heart, and I still have three uncorrected issues, are not permanent fixes. There will come a time that they all will need to be done again, my bypass now seventeen years old, a stent placed in 2019, and this valve done in 2021. Heart studies show all are holding their own or minimum progression which means these repairs are likely a ways off yet. It is my hope that by the time that any or all three of the issues come up, science comes up with better options than what is available now.

Until then, I am just continuing to look forward to hopefully the many more milestones ahead of me, now witnessing the milestones of both my daughters. This is what drives my survivorship.