I did do research before deciding on the path forward.
@VeeEnn
As a breast cancer survivor with silicone implants which may eventually fail I will almost certainly need surgery in the future. That ruled out mechanical valves which need daily anti-coagulant.
The question was whether I should have TAVR or open-heart surgery. There is some research on valve problems due to a poor seat which results in blood bypassing the outside of the implanted valve seat. This is called a paravalvular leak (PVL) or paravalvular regurgitation (PVR). This is very common, reported in around 30% to 36% of patients in recent low-risk trials, significantly higher than with surgical valve replacement. While sometimes considered benign, even mild PVL can be associated with an increased risk of long-term mortality.
My situation was uniquely bad. I had a bicuspid valve which was heavily calcified. My cardiologist told me that the opening was so small that only a small (19 mm) valve could be implanted by TAVR which would leave no space for a future insert when the valve failed in 10 years.
He didn’t mention paravalvular leak but I could see that the shape of the hard, calcified opening wasn’t circular and wouldn’t fit the implanted valve. That would almost guarantee a paravalvular leak later.
In addition to needing the aortic aneurysm replaced, that paravalvular leak decided me. I got open-heart surgery to cut out the defective, hardened valve and provide a nice, round valve seat for the new valve. The new valve is 25 mm which is the largest size manufactured and actually designed to accept a newer valve inside it when it fails. By that time I would be 80 years old (if I live that long) and would get TAVR instead of open-heart surgery.
I’m almost done with the cardiac rehab program and feeling pretty much back to my old self again. I have an appointment scheduled with my cardiologist in September. I will ask him if he wants me to get an ultrasound before the visit (which is simple) and/ or angiogram (which isn’t). I’m taking small doses of aspirin and metoprolol and he will probably want to continue them.
Thank you for sharing your husband’s experience. I hope that he wasn’t as terribly weak for a long time as I was.
Pretty sure he must’ve been. I suspect he expected something like, since so many of his patients have gone through a liver transplant. I think this has to be worse…and I think the “orthopedic” healing had to be the real drain on the body resources. The rib cages vs the soft tissue (as important as those tissues are). Follow up for that was for a year…a joint appointment with the intervention cardiologist IIRC with a Zoom meeting in between.
In the way that husbands oftentimes are without adult supervision, I recall I went out to do some shopping at about the 4 week mark with strict instructions not to do anything daft. He was getting up and pottering about at this point so no issues with bathroom requirements etc. I got home to see a neighbor’s car in our driveway.
He’d decided to go to the mailbox to pick up the rubbish it usually contains. This is just over 100yds from our house, I’d say so he didn’t have too bad a time going. Coming back a different proposition. That part of our street has about a 3-4% grade (just about the flattest part!) he had to come uphill on the way back. He got halfway and eas poleaxed! Fortunately that house has a decorative bench out front and he sat thete, intending to wait for me for the remainder (yes, he was that poleaxed!) A neighbor came by shortly after so he thumbed a ride hoping to keep his STOOPID a secret. Mildly amusing to think about now but potentially serious.
He’s the sort of person to muscle his way through stuff as a rule, but I think the potential for blowing the valve concentrated his mind a bit!
That seems so so bad that there was no interlock, preventing anyone, other than maybe the operator to enter the room… So basic a thing, if it’s on, nobody should have access that hasn’t been cleared… What a mess… OSHA? or it’s equivalent?
Obviously, I wasn’t there. I don’t know what the technician did, or didn’t do. I can only speak about my experiences with MRI (yes…I’ve had probably 10 of them).
No family is allowed past the waiting room. Not even as far as the lockers, which they have for patients to put all their belongings (often -but not always- having to strip everything and change into a gown). Even though the records show I’ve had several MRIs, they always ask about metal implants or devices.
That this guy was even in a place that he could hear/see the MRI room is weird. The facility I usually go to has at least two doors between the waiting room (where family must stay) and the MRI area and lockers. Then there’s the door to the actual MRI room. If I were to need assistance, there are techs that will do it. Which sometimes I do if it’s a longer scan with and without contrast (i.e. they do it twice). Longs scans of about 30 minutes seem to make me dizzy. Don’t know why. Ten minutes is no problem.
Ok. I know y’all are all gym-rats, but, me? I was non-plussed.
I’ve never “heard” of a “weight training necklace chain”.
Google shows this image advertisement:
Other links suggest chains weighting 20-100+lbs, and various uses n configurations.
Tragic as it is, I learned something from the situation.
I HAVE heard of pitbull owners staking their pit to a stake with a “log” chain, forcing the animal to drag the chain around as it moves … Building muscle.
ralph tries to learn something every day.
Sometimes it’s even useful learning.
I had an MRI that lasted 2 hours because it was a brand-new machine and the radiologist was figuring out how to operate it. I had to stay perfectly still because the lesions he was targeting (for needle biopsy) were only 8 mm across and buried deep in tissue.
I found that yoga deep breathing is the way to keep calm.
Wendy
It’s also difficult to imagine it even being permitted in the facility at all. It is something that the clinics and hospitals where I live would consider a potential weapon. Also, why didn’t he leave this chain in the car or at home? Was he rushing from the gym and just couldn’t leave it somewhere else?
I hate to blame the victim and the guy did die after all. But I can’t help but feel that there is a point when people have to be held accountable for their own foolishness.
If you are qualified to vote or own a gun, then you should be held solely responsible for going into a room with an active MRI machine and a big warning sign on the door while wearing a gigantic metal chain around your neck.
You are correct. Even in an emergency, it takes time to spin-down. It’s not like flipping on a light switch. The magnets are always active, except when spun-down for maintenance. So even if not doing an active scan, you don’t want metal near it.
I agree with you and btresist…it was the guy’s fault. If I was on a jury, I wouldn’t award the widow anything for her husband being stupid. (Yeah, that sounds harsh, but as you say: personal responsibility.)
My theory is that she knew he walks around with those chains on and set the whole thing up and started shouting just to get rid of him. The perfect murder.
OTOH, I may have been watching too many of those true crime shows.
I’d have told them to practice on someone else!
I’m somewhat claustrophobic and I can’t imagine (or can all to easily imagine) lying in an MRI tube for 2 hours.
Would have to be major sedation involved.
Well, yes, doors, with interlocks, hopefully. He must have been in an area without anything like controls, either in with the techs, or somebody never saw him… Dumb move in any case…
If the technician actually called him in, that would be negligence. I could see that one. However, you’d have to prove to me that happened. A radiology technician would know that is a bad idea. As I said, the places I’ve been, they don’t allow family past the waiting room. If the facility was really that incompetent, you’d have to prove it to me. If you could, yes…I would award the widow.
MRIs aren’t cheap, so I can’t imagine this was a fly-by-night operation.
I don’t buy that the wife was calling him in. Those things are loud. But, if she did, and he could hear her, that would be “team stupid”. No dice.
I get your point. But sometimes the victim really is to blame. He’s not so much a victim as a Darwin Award nominee.
As a safety manager I’ve often said that I’m in a constant battle against natural selection. The more successful I am, the more difficult the job becomes for future generations…
That said, there are often safety improvements that can and should be made, even when someone does something stupid.
