My Heart Story

I had open heart surgery in 2014. My aortic valve and mitral valve were replaced with mechanical valves and my aorta was repaired with a Dacron patch.
Timeline	• about 1980 — I needed a physical for high school track. Dr. John Goven noticed a heart murmur and advised me to eat lemon drops before I ran. • 1990 — I was about to receive my doctoral degree and decided to have a thorough physical before I left Northwestern University's student health plan. The physician heard the murmur, did more tests and discovered that my aorta was dilated. He suggested I had Marfan's Syndrome (No definitive test exists.) and handed me literature stating that life expectancy was 32. I didn't die in 1996, but I had annual echocardiograms from 1990 to 2014. They observed my dilated aorta, my mitral valve prolapse, my bicuspid aortic valve, and later, my enlarged left ventricle. • 1991 — My wife and I decided to join the Peace Corps. This had been a dream of mine for many years. After completing the lengthy application and interview process, the Peace Corps turned us down because of my heart condition. We asked them to return our file. “Laos couple” was handwritten on our application. • Summer, 2013 — My Aberdeen cardiologist, Dr. Larry Sidaway, noticed that my left ventricle was becoming enlarged because my valves were bad. He advised me to meet with a heart surgeon, Dr. Steven Feldhaus of Sioux Falls. • Christmas vacation, 2013 — I experienced shortness of breath while running through snow in winter boots and heavy clothes. • January, 2014 — I overexerted myself and collapsed on our driveway. • May, 2014 — My left ventricle and valves were worse. My cardiologist urged me to have surgery. • June, 2014 — I had surgery on my 50th birthday. (I was born in the morning and my surgery was in the morning!) The operating room was like MAS*H. People in scrubs moved quickly and purposefully in every direction. They sang "Happy Birthday" to me just before I went under. • July–September, 2014 — My right hand was numb and stiff from my pinky to my wrist. My ulnar nerve was probably compromised during surgery. (Patients are strapped to the surgical table and nerves can be pinched.) My neurologist assured me it would gradually improve. It did.
Close Call	My valves were much worse than anyone had foreseen. If my grandfather had been born with them, he probably would have died suddenly while pitching hay. After the operation, the surgeon told my wife that it was "a tough, tough surgery". To keep me motionless, I was under anesthesia for 24 hours. (Usually heart patients are awake a few hours after surgery.) The surgeon later told us that my aortic valve was one of the worst he has seen.
My Problems	Mitral Valve — Heart valves are like double doors. The leaflets open one way and blood flows, then they shut so blood doesn't flow back. Mitral valve prolapse is like a saloon door. The valve doesn't shut but goes a little farther and allows some blood to go backwards. My heart had to work harder to pump the same amount of blood. Aortic Valve — My aortic valve was like a door with rusty hinges. It was stiff and hardly opened at all. The technical term is calcification. My heart had to work harder to pump the same amount of blood. Left Ventricle — Blood flows into the left ventricle through the mitral valve and out through the aortic valve. My left ventricle became enlarged trying hard to pump blood with these lousy "doors". Aorta — Because the aortic valve allowed little blood to pass through, it squirted twice as fast as normal through the smaller opening. (Think of holding your thumb on a garden hose.) This was hard on my aorta, the main artery off the top of the heart.
CaringBridge	My wife and sister posted heart surgery and recovery updates at www.caringbridge.org/visit/billwieland. It is a great way to update family and friends.
Hospital	The Avera Heart Hospital in Sioux Falls, SD was absolutely excellent. Not only did my heart surgeon, Dr. Steven J. Feldhaus, save my life, he visited me every morning as did the endocrinologist. The nurses promptly answered the call button. They were very knowledgeable since it is a heart hospital—particularly the nurse practicioners. Furthermore, the hospital is connected to a hotel. We simply walked down the hall at 4:30 am the morning of my surgery. My wife, my sister and I stayed for just $50.
Engineering	My new aortic valve is the Carbomedics Top Hat and my new mitral valve is the Carbomedics Standard Mitral Valve. According to a Carbomedics brochure, “the leaflets of the artificial valves are made of a substrate of tungsten filled graphite coated with Pyrolite® Carbon...To further enhance structural stability, the housing is reinforced by a titanium stiffening band which makes it up to 30 times stronger than a valve without a stiffening element...”
Cost	The bills trickled in from several sources and my health care provider negotiated many prices, but the cost was well over $100,000. Fortunately, insurance paid most of my expenses.
TV	KSFY, the Sioux Falls ABC affiliate, broadcast an “Avera Medical Minute” interview with me about my surgery.
The Future	Because I have mechanical valves I must take a blood thinner the rest of my life to avoid clots. Vitamin K reacts with Warfarin, so I must limit my intake of dark, leafy vegetables! Otherwise I have recovered completely. I have slowed down because I am over 50, but I occasionally lift heavy objects or take strenuous hikes.