Bill Clifford
My heart story begins when I was 10 years old, although
I didn't really understand it at the time. My father, who
had been a professional athlete and football coach, died
suddenly at the age of 40 following his second heart
attack. I would find out later that almost all the men in
his family died of heart attacks. One by one I
watched his 4 brothers have fatal heart attacks, and even
a couple of my first cousins in their 20's. Like most
youngsters, my own mortality was not something I ever
thought about. It just wouldn't happen to me.
I had my first serious physical when I was about to get
married (to my wonderful wife, Cyd, of 32 years). The
doctor put the fear of God into me and gave me a full
course in Family Heart History 101. I realized then that I
would always need to watch for warning symptoms. For the
next decade my health was blissfully boring. Then in my
early 30's I discovered that my lipid levels were not
good. My good cholesterol (HDL) was low and the bad
cholesterol (LDL) was high. A few years later I had to go
on Blood Pressure medication, which I've been on ever
since. These things, along with a constant battle to lose
30 pounds, was all I had to worry about.
From age 40 I faithfully had annual physicals. I had
EKGs and the works and there was nothing abnormal about my
heart that showed up. At the wonderful age of
"50", however, things changed. I moved from San
Antonio to Houston and got a new family doctor. In October
of 1997, during my annual physical, the new doctor
listened to my heart and nonchalantly said, "So how
long have you had the Heart Murmur?" I did a
double-take and assured him he must be wrong, since no one
had ever said anything about a heart murmur before.
He convinced me to go for an echocardiogram just to be
safe, and said he'd let me know if there was anything to
be concerned about. I had the echo about 2 weeks later and
was thrilled that I heard nothing back from the
Doctor. I mean, what's the big deal with a
heart murmur? When my youngest son was born in 1980, they
discovered he had a heart murmur, and we thought it was
sort of like when babies are born with jaundice or
something. You put them under the special light and it
clears up, right? The truth was that I had no idea
whatsoever what a heart murmur was and what caused it.
I saw this doctor numerous times over the next 2 years.
He never mentioned the echo and never even listened to my
heart again. So by golly, all must be well. In
November of 1999 I changed family doctors and went in
for my physical. During the routine questioning about my
family history, I of course mentioned the heart problems
and also the murmur and echo I'd had two years earlier. So
the new doctor checked for the murmur and almost
fell off his stool when he heard it. He listened over and
over and grimaced and frowned and looked at me and said
that he didn't care what the other doctor did, ...I needed
to go in for another echo and do it fast. He said I had
the loudest murmur he'd ever heard. This was at
Thanksgiving and I decided that when the Holidays were
over I'd reluctantly schedule another echo just to prove
him wrong.
On March 21, 2000, I had the echo. The technician
made foreboding comments, like, "have you had a
high fever lately?" and "oh Lordy, what you've
got is so clear-cut" (those words will forever remain
in my memory). So I left there that day knowing that my
life would never be the same again. The next day I got the
bad news from the doctor that I had critical aortic
stenosis (94% gradient) and was a candidate for aortic
valve replacement. He said I needed to go to a
cardiologist immediately for an angiogram. Of course I
didn't have a cardiologist as I was still fairly new
to the area. He gave me several names to call and the
first new patient appointment I could get was 2 months
away. So I called my regular doctor back and he called a
buddy and got him to squeeze me in the next day for a
consult. The new cardiologist let me know that he was very
busy and only seeing me to return a favor to the other
doctor. Anyway, he said I needed a heart catheterization
(angiogram) and a TEE in order to be definitive in the
prognosis. We scheduled both for the following week.
I asked this cardiologist about names of heart surgeons. I
knew that Houston had a top-notch world-class Heart
facility, The Texas Heart Institute (at St. Luke's
Hospital). It was headed up by one of the pioneers in
heart procedures, Dr. Denton Cooley.
So on March 31, 2000, I did the heart cath and TEE and
got both good news and bad news. The good news was that I
didn't have coronary artery disease. My arteries were wide
open and unblocked, so there was no need for any type of
bypass. The bad news was that I indeed needed my aortic
valve replaced immediately. He said I was at risk for
Sudden Death. My wife got on the internet and we scrambled
to interview two potential surgeons for my procedure. The
first doctor told me that my only realistic option was the
Ross Procedure, because (and I quote) "coumadin is a
bad, bad drug". I asked him how many Ross Procedures
he had done, and he said probably 10 or so. He was so
eager to get another Ross Procedure under his belt with
me, and fortunately I recognized this right away.
The next day I met with the foremost heart surgeon
at the Texas Heart Institute, Dr. David Ott. He told me
that he would never suggest the Ross Procedure because it
took one bad valve and turned it into two bad valves. He
said there were frequently problems with the Pulmonary
Valve later, plus it increased the risk of surgery. Of
course he tried to talk me into a mechanical valve. In
Houston, that's pretty much what they all do. I told him I
was concerned about the coumadin and asked him about the
tissue valves. This man does nothing but bypass and valve
surgeries, and he had done a Homograph Valve the day
before our meeting. He told me he would not make the
decision for me, and to call him back with "my"
decision on what type of valve to use. So the next day,
after much thought and prayer, I called and scheduled my
surgery with him for April 10th... and I chose the
Homograph (human donor) valve. That was it. I never talked
again with any doctors, and simply showed up 6 days later
at 6AM for my AVR on April 10, 2000.
The surgery went perfectly. I went in at 8AM wide
awake, unsedated, while they inserted the blood pressure
catheter in my right arm and the aortic catheter in my
neck. I never knew when they were knocking me out. The
next thing I knew the recovery room nurse was waking me
and said my surgery was over and everything went well. The
surgery only lasted 2 hours. By 10:30AM they had me all
closed up and in recovery. At 1PM I was transferred
to ICU where I spent one night. The next day they took out
the wonderful chest tubes (ouch!) and I went to my private
room on the floor. It all seemed too easy. There wasn't
much pain, and it was over! I couldn't believe it. Three
days later I had a brief bout of Atrial Fibrillation. This
was quickly brought under control with a cardizem IV.
Three days later I went home. All wonderfully uneventful.
I spent the next 7 weeks at home doing what all heart
patients do. Religiously using the breathing tubes
(incentive spirometer), and walking, walking, walking. I
have a treadmill at home so this was an easy thing to do.
I was shocked at how zapped I was by the surgery. The
doctor told me I was anemic and that my blood was at about
75%. But one month of iron tablets took care of this, and
my energy slowly returned. On June 5th, I returned to
work.
I'm now 4 months post-op, and am doing very well. I
have had a few (not many) encounters with arrhythmias, but
nothing lasting and nothing serious. I experienced some
lightheadedness 2 months post-op, but they reduced the
amount of Atenolol I was taking and it went away
immediately. All in all I'm very pleased with the way it's
going. It's good to "get it fixed". And
even though I'm looking at a probable re-op 15-20 years
down the way, I'm still very glad I chose the Homograph
valve. I figure in 20 years they will have made wonderful
advances in medical technology.
So that's my story. Hope it helps someone along the
way. God Bless!
Bill Clifford
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