Facing one’s own mortality is strange. When I was young, I thought I would live fast and die young; age 30-35 would be plenty. I didn’t live fast, I am still here and I don’t want to die young.
But what are these histrionics all about, really? Let’s look at some numbers.
Up until this point, my life expectancy is the same as the general population (assuming we knew nothing about my heart). So, being reasonable, that’s about 80 years plus/minus.
Now we all know that without the op, the outlook is fairly grim. Would I have preferred to be none the wiser, to continue thinking I would live to 80 but pop it at 40 or 45? Hell no. We are all on a timeline, but I guess mine is just a little bit more defined than most.
So, ignoring the above, the moment the surgeon says “scalpel” my life expectancy changes from that of the general population to that of an exclusive club of Ross Procedure patients, of which there is little in the way of long-term data available. I’ve been looking at some studies (with my B.Sc hat on) to gain greater understanding. Although I have found no studies tracking patients longer than 20 years, the data is:
- Chances of dying during surgery – c. 1% (I thought this was higher initially so that’s a win). All the surgeons I’ve met are very keen to point out how they have never killed anyone. But….
- Perioperatively (after) – the risk increases, particularly in the next 30 days (i.e nothing to do with the surgeon – or so they say) to approx 3-5%, although younger people fare far better.
The fix is expected to last 15-20 years before further – “intervention” i.e more life-changing surgery and another blog 🙂
- At 10 years – most studies suggest c. 93% of people are still knocking about.
- At 20 years – its down to 80-85%.
- By 20 years – 30% need some form of re-operation and further new valves.
- Beyond that – *shrugs shoulders and looks blankly around the room*
This data does not include deaths from non-valvular related issues. They have to control variables, you see. The rates can be compared to those of the general population at 37 years’ old: 2.5% and 8% within 10 and 20 years respectively,
Here are some other fun ways to die and their odds (American statistics)
- Unintentional poisoning – 1 in 70 (Illegal opioids – 1 in 109)
- Car accidents – 1 in 102
- Accidental fall – 1 in 119
- Gun assault – 1 in 285
- Drowning – 1 in 1,086
- Fire or smoke exposure – 1 in 1,506
- Choking on food – 1 in 3,138
- Biking accidents – 1 in 4,050
- Accidental shooting – 1 in 8,305 – Again, the stats are American.
15-20 years. 52-57. With another operation, maybe it’s longer, another 10? More? Less? I think it’s safe to say at 37, I am likely halfway there or more by now, on a good day.
How does one manage this, my answer is…..you can’t. It just is. Accept it, don’t accept it, fight, argue, be angry, whatever you like. It simply is, take what you have and work with it.
I can make plans. Thoughts about boring things like life insurance (I can’t get any, other than a company policy), pensions, mortgages etc, and I can plan things. I have made plans to a certain extent, but as usual, it will never be enough.
Of course, there is room for optimism; the extra cyborg implant, may work to improve the timelines. There are no answers today, as I will be one of the people in the studies that tells us if it works…….or not.
The longest surviving heart valve replacement patient to date is about 45 years, which for me would mean 82 ish – a good innings. I could do this. I like this idea.
Will all this give me a new lease of life, where I only do happy and good deeds, dedicate myself to charity or retire to a monastery in Ladakh to contemplate Nirvana? Will I live my life to the fullest and appreciate every day, or some other hyperbole that people come out with after major surgery. Probably not. I would like to say yes, but we all know that it would be a lie. I will come out with the same joie de vivre that I went in with (which is lots, of course).
If I do pop it, remember that I will: haunt you / look down / up / sideways / rot in the ground near you / absolutely nothing* (delete as applicable per your current beliefs).
One last thing though, and jokes aside. Children – a simple one, really. All this shit started going down for real when Candice was already pregnant, so that one was a fait accompli. The midwives and doctors like to say “see you in two years” when they discharge you, what do they know?. Would I like another kid? Maybe. Whether we will or not though is definitely a question for another day, especially if the main thing that you are for your kids……….is to be there when they need you.
I want to be there for her. I have to see this through for her. Presumption though, it’s a bummer.
Every day right now is a blessing and all that, sure. I am just a little clearer on how many of those blessings I have left (statistically speaking of course) than other people.
In summary, then: I might die. I might not. I might haunt you. I might not. I might live to be a hundred.
How are you? You know what. Actually, I’m doing quite well.
What about the motorbikes? I liked the picture, that’s all.
Howard
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Howard’s happy heart surgery blog 