|Bob in June, 2011|
He was skiing with a friend on Lolo Pass when his heart rate jumped and pain in his chest traveled down both arms. In those moments on the mountain, Bob first seriously realized he might not be Superman anymore - something had cut off his cape. He returned to the car, took aspirin as a precaution, and when everything went away, chalked it up to indigestion. All was good until six months later when his heart began to race again. This time they had finished skiing, and Bob was driving down from the Pass. They switched drivers, and that time too, it went away.
|Bob skiing again, the first winter after surgery|
Bob hadn't been in a hospital since he was born, and rarely had reason to see a doctor. As he stepped through the hospital door that day, that began to change. Ultimately he would seek several opinions, trying to understand what was happening in his chest. A whole battery of tests were performed. His heart murmur was brought up again, and he learned he had been born with a bicuspid aortic valve. The rapid heart beat episodes were given a name - "supraventricular tachycardia". With the tests and opinions, there were different solutions offered - an ablation for the rapid heart beat, surgery to bypass a blocked artery in his heart and replace his bicuspid aortic valve.
He kept researching his options, but life was difficult. Not knowing when his heart might begin to race, and the terrifying feeling when it did, made him very uneasy. When he visited his daughter in California, he would ask how far it was to the nearest ER. He began to feel like an emotional wreck.
In early 2010, he was desperately searching for answers and mentioned his BAV to a lifelong classmate and friend whose brother happened to be born with BAV - who pointed him to the Bicuspid Aortic Foundation. In March 2010, when Bob visited his daughter in southern California, he brought his test records and images with him, and a CT scan and office visit were arranged with Dr. Sharo Raissi. There it was confirmed that Bob did indeed have a BAV, but something else was explained that Bob had not been told despite multiple opinions. Bob's ascending aorta was bulging - he had an aneurysm in his chest. Fortunately, unlike many of those with BAV, Bob has low blood pressure, a good thing when there is weak aortic tissue.
It was explained to Bob that in one surgery, three things would be addressed: his bicuspid aortic valve, his aneurysm, and his rapid heart beat. His BAV would be replaced with a bovine tissue valve, his ascending aorta would be replaced with Dacron under total circulatory arrest, and his rapid heart beat would be corrected with a Maze procedure. It was confirmed by both a cardiologist as well as the surgeon that there was nothing of concern in the arteries of his heart - no bypass was needed.
|Back on his bike, September 2010|
The Fear is Gone
Bob had surgery in May 2010, and recovered at his daughter's home. Returning to Montana, he spent the summer in cardiac rehab, while gradually increasing his activity. He learned to listen to his body, to pace himself as it healed. He was especially happy to hear how well his heart looked electrically. The rehab staff raved about the perfect tracings on his EKG. No more fast heart beats! By September and his birthday, he was biking again, but not yet ready for strenuous paddling down the Missouri. But he had a goal to aim for - seeing the White Cliffs in 2011!
|Bob's first winter after surgery|
By the time there was snow in the mountains, Bob was back to cross country skiing! In his first winter after surgery, he totaled 296.4 miles on skis, travelling between 4 and 12 miles in a trip.
Information Made All the Difference
Today, Bob credits the information he received from the Bicuspid Aortic Foundation as the first step in finding the solution he needed. He did need: replacement of his calcified BAV, removal of his ascending aneurysm, treatment for his tachycardia. He did not need bypass surgery (or stenting) of his coronary artery.
|Bob fishing in 2011|
The View from Here . . .
Perhaps if Bob had died suddenly on that mountain, in the absence of an autopsy it would have been ruled a heart attack. It would have been a great tragedy for us, because Bob is very close, like a brother, to our family. The classmate that pointed him to the Foundation is my husband's brother. It would have been crushingly devastating if I had learned too late that Bob had a heart murmur due to a BAV, but had never been screened for an aneurysm. I would have wondered if his aorta dissected or ruptured, and if his calcified BAV contributed to his sudden death. Today, we are all very grateful that is not our fate. Tragically, it continues to be the fate of too many with BAV and other forms of thoracic aortic disease.
The Montana skies were never more beautiful, the cliffs more enchanting, than when Bob floated down the Missouri this September, past the beauty described by Lewis and Clark so long ago.