Living with a Mechanical Heart Valve..Click..Whoosh..Thump..LubDub..

OK. Life was not meant to be easy - so they say! The first thing I noticed with my new heart valve (My aortic valve was also shredded during my aortic dissection and had to be replaced (see my earlier blog) after things calmed down and I went home from hospital was the 'whooshing' and 'thump thump thump'/'click click click' noises coming from inside me..

As time progressed and I learnt to live with this (and my wife also!) A lot of information had to be gathered and assessed however on this. And - don't rely on the medical profession for answers! in all my time with this I have never yet met a doctor or medical professional who has had an aortic dissection repair or a heart valve replacement! A heart specialist told me last month during my annual check up that he thought over 10,000 mechanical heart valves a year were implanted in the UK.

I cannot substantiate this but the last figures I could find online from the UK Heart Valve Registry (in 1995!) show 6,000 mechanical valves a year implanted. Fast forward this by 14 years and add the fact that 70 years of age is now the 'new 60' - and many older people are fitter and living a lot longer - 10,000 mechanical valves a year implanted in the UK is quite feasible.

Firstly - the noise. I can only relate to this regarding a mechanical heart valve as that is what I recieved, and from anectdotal evidence and 'rubbery' statistics this is the main valve of choice for heart valve replacement due to its ability to last a lifetime, unlike prosthetic tissue valves which can have a definitive lifespan and could require replacing within the lifetime of the recipient. But - I'm not buying into that argument! For your follow up checks after your operation you are constantly told by the doctors and the booklets etc that you 'will get used to the noise' Nope. Sorry. You dont!

You do however get used to the noise in the daytime but now and again in a quiet room or at my computer I can sometimes hear my heart thumping away -but not ticking! Other's however hear it quite clearly as a ticking. Hey - I can live with that though...it just takes a long long time (years) for you not to get petrified everytime you hear you heart thumping..! Actually I have a theory about the 'thump thump' vibrations I feel in my chest...one that I cannot get confirmed but - I think it is valid - as a couple of friends who are doctors (GP's) privately agree with me.

When you are operated on - especially if it is train wreck like I was - the focus is on getting to the heart immediately and getting the problem fixed. You heart is encased in a tough membrane called the pericardium which holds your heart tightly back towards your spine. It is cut open in the operation to get at the heart. In most cases once your heart is repaired the pericardium is NOT - I think - sewn back up.

It is not actually critical that it repaired (the pericardium) and in some cases people are actually born without it. I believe that without this to hold your heart firmly, your heart moves forward a little against your breastbone and this causes the thumping and vibration that you feel (or at least I do!) But as I said once you get used to it (the thumping) it is not a problem. Anyway that's my theory - and I would LOVE to be proved wrong by a knowledgeable medical expert!

Bed and sleep is the REAL issue. When you lay down - (particulary on your back!) the sound is magnified 10 fold! Thump Thump (!!) (and a LOUD "tick tick" to your partner!) Coupled with that it seems that the noise of the blood flow through the dacron aorta hemishield implant is magnifed as well! Aghh!! In desperation we tried many things, however that did NOT include drinking a bottle of red wine a night - as one husband of a young lady with a mechanical valve told me he did to get to sleep when I was getting a blood test at the hospital!

We finally have a reasonable compromise in that I now sleep nearly always on my side. We purchased a thick memory foam top for the bed which dampens the noise/vibrations. (And yes - we measured the noise before this and the tick/thump did vibrate though the bed!). Finally I sleep with a wheat bag against my chest which muffles the sound - nearly completely.

Maybe others don't have this issue with the noise but if they do - the above works! Other things to watch are that when laying down it is best NOT to put your arms above your head (and especially when standing up as I find this this puts a lot of strain on your new plumbing!) and when getting up in the night - do it sloooowly..as the sudden change in blood pressure with going from horizontal to vertical means your heart has to immediately move up a couple of gears and start pumping a lot harder than it does when your are horizontal and laying down.

Elementary physics - but remember whilst your mechanical valve is a marvel of engineering it is not - and never will be - as good as your late departed real valve! Happy snoozing! Next Up - Living with your Warfarin Regime: INR Levels (International Normalised Ratio) Blood Thinning for your Mechanical Heart Valve...

Cheers
Graeme Archer
Founder: Mechanical Heart Valve Forum UK