Travis's Guestbook

Hey Travis. Thought I'd check in with you and see how you're doing. Sounds like a mixed bag what with the pain episodes and the Navy deal. Well, they don't know what they're missing out on. Anyone who can face the challenges you had and add to it the physical conditioning regime you are on and then on top of that working through the pain episodes is the elite of the elite. Yeah, elite of the elite of the elite even. I really hope that it works out getting to the bottom of the pain episodes. Keep pushing them to figure it out. Maybe consult with a place that's done even more thousands and thousands of MV repairs? Hopefully somebody has seen it before. Hey, but I know you are unique! So, a 6 out of 10. Can I convert that to a 2 out of 4? That's not so bad. The important thing is to keep track of it. Athletes as a matter of course have more regurgitation than average according to the stats. It's partly because athlete hearts are beefier in the muscle, but conditioning does not enlarge the valves along with the muscle. That pulls the bases of the valves apart a bit so they don't meet as well in the middle anymore. You have an annuloplasty ring, right? That's supposed to stabilize the valve circumference and keep the leaflets at the right separation so they meet properly (coapt) on the ventricular beat. That means something else is going on. Here's my (un)educated guess: You mentioned numbers below that suggest your heart has remodeled significantly post surgery. So, and I'm just free wheeling here without any real expertise - take it with a grain of salt - when your valve was repaired they moved the chords around on the leaflets as part of the repair. Then they check for leakage and coaptation to be sure they've got them in the right place so the leaflets properly meet before finishing up. That all happened when your heart was still enlarged. At that time the chords were just the right length. Now after remodeling, your heart has gotten smaller because it doesn't have to fill 140 ml to pump 60 ml anymore (or whatever the numbers are). It only has to fill 80-90 ml or so now that half the blood isn't going the wrong way. Being smaller means the distance from the papillary muscles where the chords are rooted to the valve leaflets is shorter. But the chords are the same length. So there's some room now for the valve to prolapse. Maybe they compensate for this effect in the surgery, but if so, I imagine it's hard to get just right. Or maybe I'm totally off base, engaging in pure and idle speculation, or just plain wronger than wrong. In any case there should be some details in the surgery report about what was moved, trimmed, and added. Whatever is going on should be apparent in your echo. In my journal I have a piece about afterload reduction, which has been shown to slow down the progression of MR using common, safe drugs. They basically lower your blood pressure through a variety of means to promote more prograde rather than retrograde flow. You might want to see if this is a viable approach for you. It's my journal entry "An ACE up your sleeve: from October 28, 2012. As usual since I'm not a medical doctor these are just talking points you might want to use with your cardiologist to stoke a conversation that might end up with some good ideas. OK buddy, time to book. May your beat be strong and long!

Hi,Travis..Very important data,I know the meaning of this numbers.....Thank you very much for it...About Italian method,I think that you didn`t get the idea of the method..It is not especially for elongated chords ...The idea is other : just to prevent leaflet of the valve to bulge back..because your chords may be OK as length,but they are elastic and doesn't prevent leaflet to bulge back in atria...these artificial chords are much more tight and STOP leaflet to bulge back deeply,keeping leaflets in one contact line ...the traditional repair surgery as I can see is based on completely different idea - they cut part of the tissue and make the mitral valve to close completely..but when surgery is done,blood flow put a pressure to leaflets and even not so loose,they again (in some cases) bulge back in small or bigger extent...the Italian method,as I can see,just restrict leaflet from opening further from some level,i.e. more then some length....nevertheless of blood flow and BP..remember the bungy jump - rope prevent the jumper from touching the ground....after some level it is like a break ...this direct counter - force,acting in opposite direction of BP,is much more stable,then the repaired tissue ..I think this is precious in this Italian idea..of course,only animation now,but very smart..more over these artificial cords are stronger they original mitral chords/tissue and will not elongated because of BP as mitral tissue do..ok,may be it is not "tight seal" because of not perfect leaflet's contact line,but MR will be just several drops of blood (as typical for normal valve),but not a "backflow"...keep in mind,that if this Italian method become reality ,no necessity of stopping heart,no such a long recovery period,no opened heart,but only one hole...and the most important - you decide problem forever and forget about second OHS..no artificial valves needs,no risk of new mitral valve loosening because of permanent BP...just technically new approach ...you actually don't have sick heart,but just mechanical problem with mitral "door"....problem is the location of the "door" and difficult surgery access to that "door"...look again video...look and schemes of mitral valve..and you will appreciate the new idea and its defence against blood back flow...But my general idea for the very moment is other : Do not be in hurry for second OHS...just try all these lifestyle changes,we are talking about to postpone OHS as much as possible...you see- new technologies are close...and they probably will solve MVP problem in entirely new way,and this way will be stable and life-long..and if you again will be declined by SEAL Navy will be not because of your heart this time,but only because of your age - you will not be young enough for them:) Even with mitral valve much more tight,than nature give to healthy people...you will agree that artificial cords are stronger than natural ones,right?...your enemy now is BP and everything which stretch in mechanical way your valve (too strenuous exercises,salt,weight, endurance running/swimming, etc.)...your MR/MVP in my opinion is not result of age degeneration or cellular disorder,but mechanical problem in the valve caused by extra physical efforts.I am neither expert,not a prophet,but I think that you have the chance to be one of those men who first in the medical history get STABLE,LIFELONG and SATISFYING decision for MVP.

Hi,Travis...Of course,I a can promise that this is right,but I think that should be like that...I used to do fitness,but was not able to gain enough kg...I was,with a lot of eating about 86 kg...After that I start really hard workouts,with proteins and supplements...I become 96 kg....and I think this may be the reason for me,because nobody in my family and relatives has MVP ...Just this extra 10 kg. cause the heart to work more,increase BP and stretch the valve..Now I cut meat,I lost weight and my BP is 120-125/75-80 kg...I start to run moderately and to walk much..and my cardiologist said that my left atria - for 6-7 month become smaller...and MR is 24 ml...I do not know if it is truth or just inaccurate diagnostic,but I think that it is logically ....I tried to convince a friend of mine to make the same changes (he is active in fitness and has MVP),but unfortunately he is not willing to lose weight,and have no way to check this theory with him....But if you search internet you will see,that MR is more common among sportsman as average percent (10 %),than among rest people ( 3-4 %)...But the sportsmen are usually healthy people ...That`s why I think that in the very begging strenuous sport could trigger MR..And,after that this MR 'work for itself" and deepen the problem....And my idea is ; if somebody with this condition,make the above mention changes,may be some reversion could happen ...even to the harmless point....because if your heart is so strong for these strenuous exercises,probably MR is not because of natural (cellular) reasons,but self-induced...Filipides - ancient Greek run 42 km.,after Marathon battle,and after that collapse and die....Obviously this healthy man died because of extra efforts - hearth attack...I mean-even perfectly healthy person,could pass away just because of one extreme physical effort... If so,why are not permanent physical efforts able to induce these changes in mitral valve?...Doctors dont know what cause MVP/MR,but in the same time they always look for "pathological" reason on cellular level..OK,but if the reason is not "pathological"? And we are healthy as mitral valve tissue,but just because of increased heart activity cause this ?...Also,see your case - you did surgery - may be not 100 % perfect,but probably good enough to stop the MR..your valve WAS MADE tightened...but something again loosen your valve...and probably this is your own heart,because it used to work with extra force and extra pressure...if the reason was on cellular level,I think 2 years is too small time...Also,you said - possible bad surgery and doesn't hold up...If it was bad surgery,probably it would fail earlier,after some month and weeks...Doctors usually take decisions,based on your present condition...and doesn`t try to find out what cause this condition...Once they see my BP,they says - should take pills..but I didn`t take pills,and try alternatives,and think they work...Could you tell me your left atria numbers and cholesterol levels? My idea is - my ones,was a little bit higher...but it is possible because of sport (athlete hearth) and meat (if somebody do fitness usually eat more meat and this rise cholesterol)...about chest pain episode : I never have it ,before to understand of MR..after that I has almost one year - I was so depressed and scared..not only chest,but and shooting back pains...Stress produces adrenalin and other chemicals,which can destroy your nerve systems and heart rhythm..After I calm down this pains goes away...About your chest pains,it is possible to be result NOT from the heart,but because of injuries of muscle nerves during the OHS...and because you start too early with exercises it is possible to cause them additional irritation..I dont know if you are under stress (you wrote you manage it),but I knew for me,that stress could cause physical pains,not only emotional depression.