First Appointment with the Surgeon. More Tests. FH, How I Hate Thee ...

Today was the first official (I hope not the last) appointment with the surgeon. I really like him, he seems thorough and very empathetic, and very self-assured in his ability to give me a good life after this. He's also very open about the risks this surgery poses and those are all I can think of! 

In brief, this is the lowdown: 

- my mitral valve is fine; no surgery needed there.
- my aortic valve will be replaced.
- my aortic arch is so full of calcification that it will be replaced as well as the aortic root (which is between the valve and the actual arch).
- my LAD and OMB coronary arteries both have blockages and calcification in them, so they both have to be by-passed.
- he thinks potentially parts of my carotids will be also grafted - the CT scan I did today following his appointment will tell more. 

This will be a complex surgery, to say the least, but the piece that is the scariest for me is the aortic arch replacement. For this, he will use a technique called deep hypothermic circulatory arrest (https://en.wikipedia.org/wiki/Deep_hypothermic_circulatory_arrest), as well as he will use my venous system to feed my brain with oxygenated blood, so that he can buy himself some time during the hypothermia (the human brain cannot take more than 30 minutes of extreme hypothermia before it starts becoming damaged). If the cracking open of the chest was not scary enough, this just takes it to the next level. 

He also thinks we need to move the surgery up, and the original date I was shooting for (March 1) is too late. 

We spoke mostly about my FH history, how we got here, why we got here, and about the surgery itself. He is convinced that because of the FH, and if he is not replacing it now, my aortic arch will continue to deteriorate and I will have to have it replaced at some point in the future, but he would rather not open me up twice, if he can help it. My aortic aneurysm is not huge, but my arch calcification is significant, so he would like to replace the aorta now, with this surgery, even if this makes the surgery longer and more complex. 

As you can imagine, I am terrified, but what choice do I have? I am hoping that no brain damage nor death will occur with this surgery, but of course, there are no guarantees. The risk is about 15% for brain damage, in various degrees of severity and recover-ability.  Also, the surgery alone has a relatively high risk for stroke. Because of my FH, and my arteries being blocked in various parts of my system, the risk for stroke is higher. He will take precautions against all this, but there are risks, with everything.

After the appointment with the surgeon, I did get a CT scan of my chest, neck and base of my head vessels, so we can tell for sure of the amount of calcification in my carotids and other chest vessels. I will want to meet with him, again, face to face, before penciling in the date, just because I have so many more questions to ask ... I feel like if I know more, my morale would improve, although the more I know, honestly, the more I want to know less.

Although I have been reading about all these complications from FH all my life, this is all still surreal. I am still in shock as to how fast it all went downhill, after years of monitoring, dieting, drug therapy, etc ... 

I hope you all find this journey useful and learn something from what FH can do to us, 
eventually. 

To all, much health!