Sunday, May 24, 2015

headed home

The doctors were unable to determine why I had two recent small strokes, one of which was asymptomatic, but they narrowed it down to:

1. There seems to be a small growth on the end of the aortic valve which is either a clot or growth that causes clots (it looks like a guitar pick from the side, but I don't eat guitar picks, so...).  This was determined with a procedure that makes colonoscopy seem pleasant.

2. I have a heart defect called a PFO which is a small opening between left and right atria.  After birth blood goes from right ventricle to right atrium, then to the lungs then back to left atrium, then to left ventricle then to body.  Before birth, the heart doesn't bother sending blood through the lungs, so the PFO is an efficiency gain.  About 30% of Americans fail to have the PFO close after birth, and blood (and clots) from elsewhere in the body can pass through the PFO causing strokes.  (The lungs filter out clots if you don't have a PFO.)  Coughing and straining on the toilet can increase the amount of blood passing the the PFO. My PFO is small enough not to justify surgery, and might explain why only small clots are going to my brain.

3.  It is possible that I have an irregular heart rhythm called atrial fibrillation (also quite common) which throws clots to the brain.

As I said earlier, not as neat as an episode of House in terms of puzzle solving.  But the solution to all these is warfarin, a blood clot preventer, and less coughing and straining.



  1. Great!

    Hopefully everything will work itself out.

  2. But the solution to all these is warfarin, a blood clot preventer, and less coughing and straining.

    Rat poison!

    My paternal grandfather had to have a heart valve replacement in his 60s, and had to take that for the rest of his life. But he got an artificial valve.

    Good luck with it, and hope you get better.

  3. Praying you'll meet with a full recovery.

  4. No Xarelto?


  5. Inline Fuel filters in the Carotid arteries.... :-)

  6. Ahh, the good old transesophageal sonogram. The only reason that a colonoscopy is more pleasant is that they gave you much more Versed for the colonoscopy, so you don't remember it. Gotta be awake to "keep swallowing, keep swallowing".

    Hope you don't love spinach. :-) I wasn't on the stuff long enough (just after the valve repair) to worry about it, but keep an eye out; there are non-rat poison anti-coagulant drugs that are in development and testing. The constant testing and diet restrictions are much lessened with other drugs (although I know of none approved at present for stroke prevention).

    Heart surgery is certainly not trivial, but I survived it quite well, and I was a few years older than you are now, so if it looks like a good option, grab it.