What are you waiting for?!

 

Is there a better spot to propose to my love?! Nope, Georgia Pass for the win!

Every day is one day closer to surgery and valve replacement. The anxiety these days is almost worse than the initial diagnosis. 

Knowledge and time are power, but they're also a curse. I know I'm better off with all the knowledge I'm gaining and the time I have to make decisions, but it's almost a burden to have so much time to think things over. There are no clear-cut decisions or answers and I'm burdened every day with the fear that I'll make the wrong choice or that I'll regret the decision(s) I've made for replacement.

As things sit right now (Feb 10th) I've made another appointment with Dr. Brants at Lutheran Hospital to further discuss replacement valves. *With all of the data I have now there is no disputing the fact that the valve must be replaced and a graft put in for the Aortic root. The sooner the better as I found out after my MRI last Thursday. The regurgitation rate is actually 48% and not 30% as originally estimated from the Echo (the MRI gives much better volumetric data)*  

The reason for another meeting with another doctor is to discuss the specifics of the On-X valve vs. the St Jude Regent valve and their respective benefits and shortcomings. I've come to the conclusion and understanding that a mechanical valve is the way to go for me. I have come to terms with the fact that I will have to life the rest of my life on blood thinners and anti-coagulants BUT with the chance I will NEVER have to have another open heart surgery, vs. a tissue valve that will 100% need replacing in the future. I'd rather adjust my lifestyle and habits slightly with a mechanical valve, than to go forward knowing for certain another sternotomy will happen sooner than later to replace a tissue valve.

Right now I'm trying to decide between the SJV Regent and the On-X valves as they are the 2 most respected replacement valves on the market. The SJV is the gold standard that most everyone else copies for their design, but the new(er) player in the game is On-X and with their valve the company claims a lower blood thinner dosage over the SJV and Dr. Brants at Lutheran has had great success with the On-X brand. I'm going to pick his brain for an hour and see what I come away with before making the decision.

The SJV mechanical valve

It all comes down to velocity and flow gradients when the blood is moving through the valve. On-X claims they have a wider/flared opening and smoother surfaces that allow better flow and surfaces that do not attract blood platelets to collect on them.

The OnX mechanical valve

That's what it's all about, blood clots. You see, when they heart receives a mechanical valve and the mechanical valve has pivots, hinges, edges and corners and otherwise non 'smooth' surfaces, blood has a tendency to stick to those surfaces. When enough of those little blood platelets stick to each other they form a large mass or clot and if that clot should break free and flow through the arteries leading to the brain a stroke can occur. Hence a life of controlled blood thinners to prevent a life threatening stroke.

There is a lot of negative information out there about blood thinners and the things you can and cannot do when you're on them. There is also a lot of talk about how you have to change your life when you're on them, but with the advancements in home testing and the ability to monitor remotely though online data collection I don't see it as much of a hinderance as I first thought.

It's funny the roller coaster of emotions, thoughts, feelings and general day-to-day conversations Kristen and I will have about all of this. I was pretty stubborn on the idea of my life being 'too' active for a mechanical valve and that I was going to push for a tissue valve, but after talking with surgeons and doing my own research I'd much rather take a few pills the rest of my life than go through another sternotomy. 

The sternotomy scares me the most! Ugh, cracking my chest open and knowing what that involves along with the recovery have me clenching my jaw and tensing up every time I think about it. Ready to get on with it!

The other major thing is that I've begun to stop accepting new custom work through JPaks in order to prepare for the shutdown.

Man, it's crazy to say that; shut down. It's got to happen as I'll be down for at least a month if not two, but after coming off last years momentum up until now, it pains me to no end that I have to turn away work in the busiest time of the season and that I have to shut the doors. I know I'll lose some business as not everyone can wait for me, but it AMAZES me the people who find out I'm closing for a bit and they're still willing to wait and support me after I get back into the shop! Stunning and humbling to think I've built a reputation for quality and style that will (hopefully) keep people coming back, even after a break.

I've wrapped my head around the surgery (I think) and closing up shop. I've been making preparations for as much as I can leading up to the date, which I'll be choosing next week after my consultation. Excited, nervous, scared to make that appointment, but like I said earlier, the anticipation is killing me! It's time to make some moves.

Headed to Arizona for a week of relaxation and hopefully leaving the worries of all of this here in Denver. I told myself to not make any decisions before talking with Dr. Brants and therefore I will make myself take my mind off things for a minute.

Love

-Joe