Here We Go Again, And Again...

Well, I made it about six and a half years not having to post to this damn blog...  This is the type of blog that the less you have to post, the better life is.  Just a refresher to catch you up.  Sarah is now almost 19 years old, a thriving freshman at St. Michael's College, majoring in Mathematics and Computer Science, made the Dean's List Fall semester during a COVID outbreak, avid skier and ski racer, and all around pretty decent kid.

She has had 2 previous aortic valve repair/replacement surgeries at ages 10 and 12 (see previous blog posts for the details).  At age 12, she got a bioprosthetic replacement valve - this was spec'd to be good for 7-10 years.  For various reason, her's fell a little short at 6.5 years, but she worked that valve hard putting it through adolescence, growth and an athletic lifestyle.  These valves just wear out like brakes or tires on your car.  How does one know it is failing?  Annual cardio check ups and ultimately symptoms (chest pain, shortness of breath during activity).  Last March her check up indicated maybe 2 more years life on the valve.  But then recently (early January) while skiing she was experiencing shortness of breath and deep chest pain.  She finally came to me and said dad, please call Boston, my heart is giving me problems.  So I did, and they arranged for us to go to UVM (shorter drive) to get a quick echo/ekg to see how it looked.  In short, it looked bad and the stenosis was in the 'severe' category.  That means lets get this fixed on the sooner side of later.

After many talks and consultations with her surgeon Dr. Emani and her cardiologist Dr. Brown, we came up with 2 options that would be suitable for this fix.  The goal is to minimize open heart surgeries - they just are not good to do on a regular basis.  There is also a fairly new procedure called trans-catheter aortic valve replacement (or TAVR, less invasive, catheter through an artery in the groin - way better than open heart).  This is not an ideal option now, but will be in the future.  Right now we considered 2 procedures:  1.  new bioprostheic valve called Resillia (maybe 10-12 years she could get), or 2.  The Ross procedure (bit more involved, grab her good pulmonary valve and pop it in the aortic position, and then put a homo-graft cadaver valve in her pulmonary position).  This has very promising long results on the aortic side, but is more upfront risk, 13 hr vs 8 hr procedure, potential pace maker needs, etc...  But she could get 20-30 years on the aortic side.  In general, it is a bit more Frankensteining than we like, and slightly higher risk.  Sarah (and us) was more comfortable with just getting the new Resillia valve and knowing that in 10-12 yrs that will need to be replaced, but can be via TAVR at that point (1 day in the hospital).  Most of the docs we spoke to put Ross as their #1, but that is likely just due to the longevity of the results IF all goes as planned.  We are taking the lower risk, higher predictable solution.  Literally made the final plan with Dr. Emani today on a Zoom call from our stay-cation condo at Burke Mountain this a.m.

So, we are here, as ready as you ever can be, COVID tested and well fed.  Sarah is a real trooper, almost stoic about the whole ordeal.  Imagine having to undergo 3 open-heart surgeries within an nine year period.  This a lot for an innocent (other than her goddam potty mouth) teenage girl.  On the upside we are in the most capable hands in the world (thank you Dr. Emani, Dr. Brown, and others!!) - we are blessed by that!  And a HUGE shout out to our unbelievable greater Danville/NEK people who have been bending over backwards to support Sarah, and Katie and Molly while we are gone.  You guys know who you are and we are humbled to be surrounded by so much love and selfless giving.  Seeing some early reports on the food deliveries for Katie and Molly, I dare say they may put on a little weight this week - they need it!!

Thanks to everyone for their prayers, well wishes and support.  I will do my best to keep you updated as we get updates through the day tomorrow.  Get real-time updates on Twitter @pmcalenney (https://twitter.com/pmcalenney).  Blog updates as I have time, hoping at least once a day.  So long for now, time to get my man pants on - big week starting now!