Decision time

Well, here I am a few days after the July 4th holiday, and I am awaiting a big decision point in the treatment of my aortic stenosis.

As I have written about in previous posts, I have been pursuing the possibility of a TAVR procedure rather than open heart surgery to replace my aortic valve.  Most importantly, my history of chest radiation in the late 1980s puts me at potentially greater risk during open heart surgery, because the radiation may have caused damage that would be unknown until the operation begins.

On June 27th, I met with a surgeon, Dr. Tyner, for a second surgical opinion on whether I would be a candidate for TAVR.  His opinion was that TAVR should be my first option.

So a couple of days ago, I spent most of the day at Scripps Clinic in La Jolla, undergoing a battery of tests known as the "TAVR workup."  As I understand it, the tests are both a planning tool for the TAVR procedure, and a way of making sure there would be no impediments if I were to have the procedure.

The tests included a breathing or pulmonary test, in which I inhaled and exhaled into a mouthpiece to check my lung capacity; a "frailty" test which included a number of questions about my physical condition, a grip test and a walking test; a very extensive echocardiogram; and a CT scan of my heart.

Because the last two tests required contrast dye, I was turned into a human pincushion, getting three needle sticks for IVs.

But all of the tests went smoothly, and I was on my way home in the afternoon.

The next step is a meeting with Dr. Stinis, the interventional cardiologist, who would be the doctor performing the TAVR.  On Tuesday morning, a committee of doctors will review my case and determine if TAVR is the best course for me.  Later in the morning, I will meet with Dr. Stinis and his medical assistant, and learn which way the doctors want to go.  I am hopeful we will get the green light for the TAVR procedure, and maybe even set a date!

I have to say that I am a bit nervous right now, while trying to maintain an optimistic outlook that things will work out the way I hope and expect.

Either way, whether I end up having the TAVR or surgery, I am looking forward to having the valve replaced (and my coronary artery blockage treated) so I can feel better and return to my previous, more active, lifestyle.