Schedule is set

Health, Heart 2 Minutes

This is the old good news, bad news routine.

Good news – my heart surgery is scheduled. Bad News – it will be the open heart variety that is invasive, not the TAVR that would have been minimally invasive.

The date is Sept 21. Why not?  I’ll be 54 by then. So in thirteen years, I’ll be 69 when I need maintenance if this new valve lasts as long as the last one. And then, I’ll be older and the TAVR will probably be the magic bullet. So instead of waiting until my almost 70 to have a sternotomy, I’ll do it now.

The other upside is that I will get the maximum size valve now allowing for even more room in the future and good ejection rate now.

The downside is that the surgery is rough and a long recovery. I’ve waited about 3 months for something to happen so I’m glad something is happening.

On May 26, my original surgery for May 27 was cancelled. The insurance company, Premera, denied coverage for that surgery. Since then, I have been going through an appeal process. This has been tough but in the end, unsuccessful.

Because this TAVR procedure has been performed mainly in people in the upper age range. (average age is 86), the results are a bit skewed. They don’t really know how long the valve will last (called a performance characteristic). So the questions of cost, how long the valve lasts, the recovery time in the hospital (apparently this is a large chunk of the costs), this is all more heavily influenced by the older population receiving the valve.
In the older population, the average stay for TAVR is 5 days; The average stay for SAVR (so-called open heart) is 7. Not that different. So the cost doesn’t turn out to be that different. In my case, the stay would be 1 night with the TAVR barring complications. But no one really wants decisions based on one case. Otherwise that works for the insurance companies too. They could force you to have the cheaper option. What’s good for the goose is good for the gander.
The net result is Premera will pay for a sternotomy (crack the chest) surgery SAVR and not the TAVR.
Most likely that will also mean that future TAVR valves will be a no brainer option. They will advance in 15 years and the technique will become the norm. Plus, if I’m lucky enough to be alive then, I’ll be older. I’ll be chasing down the population in which the valve is the preferred option.

I had accepted this possibility a couple weeks ago when we were sent the official denial letter. It seemed inevitable that I would have the big surgery. But hearing it from the doctor was very different and a little bit tough. However, I’m glad I won’t wait to long. They said, “how bout next week?” Which was kind of amazing but also a bit too soon.

I hope to be out of the hospital by around Monday, Sept 26th. I can’t lift anything heavy for 6 to 8 weeks, including a tuba. Around Thanksgiving I’ll be back to being more like myself.

After I get out, I’ll let everyone know that I lived.

Published by franla1917

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