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HCM-ers: Introduce yourself or just say hi
Hypertrophic Cardiomyopathy (HCM) | Last Active: Aug 26 9:56am | Replies (870)Comment receiving replies
I am trying to advocate for my mother-in-law who was diagnosed with hypertrophic obstructive cardiomyopathy several years ago. She recently had an echocardiogram because she was having pretty severe chest pain. Her first test came back with a gradient level of 160 (normal is 10) (I am not sure if this is how you explain these results correctly). They did another test a few days later and it came back at 60, still very high. She is very healthy and athletic, thin, eats clean, etc. Her cardiologist told her she has to have open heart surgery in the next two weeks at The Mayo Clinic. This was three weeks ago. My question is this- what is the protocol for surgery? Almost three weeks ago, when they caught this, her doctor told her that if she had gone on a trip she was scheduled to take today, she probably wouldn't have come back. However, they haven't done anything to monitor or move forward with next steps yet. She does not have a heart rate monitor or a defibrillator at home and has just been told not to leave her house or do anything that could cause her heart rate to rise. Everything that needs to happen has yet to happen. We know my father-in-law is not a good advocate because he is nervous and puts all of his trust in the medical system without questioning anything. To my husband and myself, this surgery should have happened or should be scheduled to happen now. With some pushing from us, she finally called them back instead of waiting for them to call her and they scheduled lab work for NEXT WEDNESDAY and a heart catheterization NEXT THURSDAY to be sent to Mayo. Then she said she is "hoping to have the surgery scheduled within two weeks." That is what she was told three weeks ago. What is she supposed to do in the meantime? What if something happens in the meantime and should that be a concern? Is this normal to wait this long and have such long gaps in care? She (my FIL) will not put our names on her records to share info so is there anything we can do from this position? We don't want to stress them out more but we also don't want them to be passive in her care. Thanks for any input.
Replies to "I am trying to advocate for my mother-in-law who was diagnosed with hypertrophic obstructive cardiomyopathy several..."
Do you have to take certain classes to do this kind of heart surgery? How would one of these surgeries go wrong and not be a successful surgery
Susan317- If I understand you correctly, as a patient, you do not have to attend classes. As a heart surgeon, you usually study under the watchful eye of an experienced surgeon. It goes without saying that the best outcomes come from hospitals with a high volume of myectomies (or other modality of treatments - such as Alcohol Ablation). As to "going wrong", well, you have a dozen forms to fill out prior to surgery where they tell you what can go wrong, but it boils down to less than 1 % actually die during surgery. The chief complaint I hear is that the surgery has to be redone later as the surgeon likely removed too little tissue. This is not the case at Mayo or other centers that do a high volume. I've seen this many times with patients who have had the surgery at their local medical center with a surgeon who - has done only a few of these.
I agree with Cynaburst. Please remember that doctors have to stress the negative - their lawyers dictate that. In all probability, nothing will go wrong (as nothing has really happened so far) by waiting. I always suggest that if a patient can, avoid surgery during the winter. I'm in CA and have the benefit of 80 degree days in January and if you couldn't guess by now, I avoid the snow like the Oprah avoids marrying Stedman.
The best part of post-op is getting outside and walking or riding a bike. They force you to get up and walk on DAY ONE post-op and continue this torture till its 3-times a day, each for longer periods. If you are older or "de-conditioned" they will put you in cardiac rehab where you learn to know your limits. The great thing is, you'll soon see a vast improvement in your ability. you'll be amazed at how fast the body heals.
Try not to worry - it not helpful for you or M-I-L. Its better to wait until she needs the surgery (Numbers don't apply to criteria - its more about managing symptoms) and they try to manage this through medication first.
Thank you! I had one done in April and then had to turn around in November and have another one done because I was still really sick when they did my echo from my first open heart surgery it looks like nothing had changed so that's when I went to Rochester Minnesota the Mayo Clinic which I call Hospital of Gods!!I feel like they saved my life I was just curious on how you can mess one of these surgeries up to make somebody go through another one don't they measure the muscle that they're supposed to take out I don't understand how they messed these up. So i had 2 in 1 year.. I had a really bad case..
WOW - Its not that uncommon when its its first done at a non-COE, but usually it takes a while to get discovered. 2 in a year is rough. Now you can put those behind you & move forward.
Yes i have thank you! But what is a non COE?
Ha Ha. Proud Minnesota girl here. I blew snow, six weeks after my myocardopathy surgery. Fresh crisp cold air didn't detour me at all.
Goodness! Hardy stock! The one thing I remember so vividly of my time there was how nice EVERYONE was. Not just the hospital folk, but locals, cabbies, shop keepers, waitresses, etc. Just kind, interested, concerned, honest folk.
Hi @susan317,
Welcome to Connect. Although successful septal myectomy can have excellent outcomes for patients with HCM, some patients can have recurrent left ventricular outflow tract obstruction (LVOTO) after septal myectomy and require reoperation. Here's an article written by Mayo Clinic experts that might interest you:
– https://www.sciencedirect.com/science/article/pii/S0022522314005686?via%3Dihub
How are you coping after the second myectomy?
Connect
@mollybo - your MIL is lucky to have you in her corner.
Myectomy is considered to be an elective surgery, and its purpose is to reduce symptoms and to eliminate the left ventricular outflow tract gradient that your MIL has. While she does have a significant gradient, people can live with these for a long time. It will just make you feel uncomfortable along the way.
It sounds like her current doctor is being a bit extreme and alarmist. Most people who have HCM and get proper treatment live a normal life span and have a normal quality of life. Though your MIL should be evaluated for her need for an implantable defibrillator, unless she has experienced a sudden cardiac arrest already, the likelihood that she will have one while waiting for her appointment is pretty low. I would not worry about that unless she is in extreme distress or collapses in which case it would, obviously, be an emergency.
Some things that might help you get a handle on the condition are:
A blog that I currently write called HCMBeat - http://www.hcmbeat.com
On that blog I have an entire page of resources for patients undergoing myectomy - http://www.hcmbeat.com/resources/resources-for-patients-about-myectomy. This includes several presentations by docs at Mayo about the surgery.
I also wrote a blog about my own myectomy at Mayo Clinic 12 years ago:
http://www.cynthiassummeradventure.blogspot.com
Another place you may want to visit is the Hypertrophic Cardiomyopathy Association: http://www.4hcm.org
The one thing that you should know is that Mayo Clinic is one of the best places in the world for treating this disease. Though her doctor does not seem too well versed in HCM, he did do the right thing by referring her to a place that is world class.
Wishing you and her the best. Feel free to send me a PM once you have had a chance to look over this info. if you have any questions.
Cynthia