Feeling Good!

Here's a photo of me and Dan that was taken 25 years ago in top of the Eiffel Tower in Paris. It was our first overseas trip together. We started in Paris and then flew to Rome. Next month we'll be returning to Rome for the first time in 25 years. We'll see some sights then embark on a cruise to Egypt and the Greek Islands.

I'm feeling fine. I don't notice any increase in the intensity of any of my relatively minor symptoms. I walk three to four miles a day. My weight is not good but at age 60 at least I'm not obese and I'm still quite active.

My friend Jane had her surgery last week and she's doing well. That is good news!

Still Trying To Be As Active

Yesterday I walked five miles on the beach with Bradley, our dog. Last year I usually walked four or five miles a day on the beach and I'm hoping I can continue that pace this year. I've also been swimming in the ocean, although it's been a cool and rainy Spring with not much real beach weather.

As for symptoms, I continue to feel my heartbeats pulsing up into my throat. Five years ago I only felt this when I exercised. Now I can feel it when I'm resting. What is it? I think it is my enlarged aorta pressing against the esophagus or other throat structures that I'm feeling. When I have my next echo in six months I'll know if there has been any enlargement of the aneurysm.

PHOTO: a gargoyle in Lyon

Vacation And Status Update

Photo: The cloister at Moissac, France

Dan and I just returned from a great 2-1/2 week trip through Southern France. At the end of the trip we flew to Lisbon for a couple of days. I felt fine during the trip but a little more tired than I would have liked after we got back. It was probably just jet lag.

I'm now pretty much convinced that the pressure and tightness that I feel in my throat is due to the enlargement of the aorta pushing against the esophagus or other nearby structures. This started about a year after I first learned that I had a valve problem. At first I felt the pressure only when I really exerted myself like when I would jog for exercise. But now I feel this pressure even when I'm not doing anything strenuous. It feels like my heart is beating right up into my throat. That's about the best way I can describe it.

I've read some articles recently that help me to better understand the relationship between bicuspid aortic valve disease, aneurysms and aortic stenosis. Unfortunately, aortic stenosis combined with BAV and an aneurysm is sort of a triple whammy - not good! The stenosis (narrowing of the aortic valve) produces hemodynamic forces (a jet) that stress the aorta, according to one studay I read. There is a lot of debate about when to have surgery for an aortic aneurysm, i.e., at what size aneurysm. 5.0 is usually the trigger point for surgery except for Marfans patients. For those with Marfans, 4.5 seems to be the trigger size. Since bicuspid valve disease is in some ways similar to Marfans, there seems to be some who feel that 4.5 should be the trigger point for BAV patients. Then there is the whole body size calculation that figures in to the equation. Bigger people may have naturally larger aortas, so for them the surgery trigger size might be larger. However, there is a risk of rupture or dissection at just about any size. So the debate goes on. I'll find out if my aneurysm is growing and if so, at what rate, when I get tested in the Fall. If he aneurysm is stable (not enlarging,) that's one thing, but if it is growing at more tan .1 cm per year, that is of great concern.

Stable For Now

It's nice to be on hold for a while from tests and doctor's appointments. I read an article yesterday that indicated that aortic aneurysms grow slowly, at about 1 mm per year. If mine grows at that rate it wouldn't reach the critical 5 cm stage for seven more years. I also have some time hopefully before my aortic stenosis becomes critical. So the job is to stay healthy - I wish I could lose some weight - and stay on top of developments. My next appointment isn't until the Fall so I get to take the summer off.

Good Cardio Report

My cardio called today to tell me that the stress test was negative, good news. My symptoms are probably related to the AV stenosos. Finally, it's not time for surgery. So I will see him again in October and we'll take it from there. Incidentally, in the literature there are references to people with BAV to the effect that usually they do not get CAD. Works for me!

Walks By The Graff Memorial

The recently restored Frederick Graff memorial at the Fairmount Water Works here in Philadelphia. This is placed next to the trail where I do my afternoon walks every day.

NST Final

I completed the test yesterday and I think I did pretty well.. I did get that dull pressure in my throat and center chest that I have noticed for the past four years. Even hours after the test I could still feel it a little. I do feel encouraged to say the least that I can still do something like this at age 60 with a stenotic BAV and a dilated aorta. It pays to try to stay in condition. And as has been said many times, the body compensates for the AV disease.