Balancing Act

I blogged recently about my current pulmonary stenosis, or narrowed pulmonary artery, and how it's affecting me.  I've been feeling the same since then, enjoying a 20 mile bike ride this past weekend with friend Eric, averaging just over 11 miles an hour over a mostly-flat trip on trails around BWI airport.  I had to rest twice along the way, but that was mostly from some fun sprints.  With good conversation, comfortable temps, and plenty of sun, it felt great.

There isn't anything else new since my last post, except for me getting this time to write.  We are still waiting to determine when the next steps will happen, but for sure we are headed toward them.

The important thing to remember is that the stent I had inserted in 2009 had to strike a very fine balance.  If we chose too narrow of a stent, not enough blood gets to the lungs, I'm winded, and like I mentioned before, the heart ultimately gets unhealthy from overworking.  But the opposite is also true.  A stent with too large a diameter might deliver enough blood to the lungs, but more easily allows blood pumped to the lungs to flow back into the heart.  This backflow creates the same problem, requiring the heart to work harder to compensate, eventually enlarging the heart muscle and thickening its walls, resulting in reduced function.

Even if this balance had been maintained, however, it would not have been ideal.  I was still getting some of each side effect.  It's just that my current narrowing pushed me toward one extreme, moving me toward needing the pulmonary heart valve that God meant to be there in the first place.

So, what next?

In all likelihood, I'll be getting the cool new Medtronic Melody Transcatheter Pulmonary Valve in hopes of delaying another full-on open heart surgery.  The valve is attached to a stainless steel stent, which is actually a bit stronger one than the one I have today.  This means the new hardware eliminates the narrowing, provides the much needed missing valve, and reduces the likelihood of future stent fracture or bending.  Amazing.  If it goes as wonderfully as that did, I'll stay one night in the hospital and feel instantly better than I did before.

The deal, though, is that this amazing bit of technology doesn't last terribly long.  It is generally meant to get eldery people through so they never need a big surgery, or to get adolescents into adulthood when a big surgery is likely to be more effective.

For me, the Melody valve, or actually two of them in succession, should delay a big surgery somewhere between a few months and 15 years.  Yes, that's a big range, but the Melody is new and there simply isn't much data.  With luck, it'll be long enough so some new procedure or technology makes that big procedure simpler.  Make no mistake, however, in all likelihood I've gone from a hopeful 30% chance of resurgery in 30 years, to 100% in the next 15.

So, time and test results will tell us when we take the next steps.  In the meantime, I'm going to enjoy the great weather and preparing for the holidays, and will do the best I can balancing all the things that life requires :-)

Thanks for listening.