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4A Daily News – Tuesday, November 5, 2013 Vitality health & fitness Fox's valve replacement a common procedure When Broncos coach John Fox went under the knife for aortic valve replacement surgery Monday, he had a procedure that more than 60,000 Americans undergo each year. It's a common surgery, with a high success rate, but that doesn't lessen the seriousness of what he faces. To explain what Fox has in front of him, The Denver Post spoke with Dr. Carlin S. Long, chief of cardiology at Denver Health Medical Center. Long hasn't treated the coach, but he was able to give a general breakdown of the procedure — and at what point it is deemed necessary. When Fox was taken to a hospital Saturday, he already knew he needed to have a procedure on what the team called in a statement a "defective aortic valve." Fox, 58, had chosen to delay medical treatment until after the Broncos' season concluded. Long said such an approach to a valve replacement is not uncommon; plenty of patients know they have a condition but can push back surgery if they aren't presenting the "buzzwords that worry us." Those buzzwords — which often prompt immediate surgery — are threefold: angina (chest pain), shortness of breath and syncope (a sudden loss of consciousness). When symp- toms such as these are present, patients are rushed to a hospital and usually have surgery soon after. Patients with aortic valve disease have the condition for one of two reasons: They were born with a congenital defect, or their valve has calcified and stiffened with time. Although Long does not know Fox's specifics, he said that a patient of Fox's age is more often one with a congenital defect. "When you have someone of Mr. Fox's age, the betting majority would say LASSEN MEDICAL FLU SHOT CLINICS Red Bluff Location November 9th 9am-1pm 2450 Sister Mary Columba Drive Red Bluff, Ca 96080 527-0414 Lassenmedical.com that he started out with an abnormal valve," Long said. "He was probably born with something called a bicuspid aortic valve, which means instead of having three (cusps), which is what you and I and the rest of the world have … he might have been born with two." When a patient has just two cusps in his aortic valve, the cusps are subject to more wear and tear over time. Patients therefore have more turbulent blood flow, which causes calcium deposition. "People with this bicuspid aortic valve typically will present in their 50s with symptoms that require valve replacement," Long said. "People with three leaflets that are normal that then have calcium deposition over time, those are the people that present in their 70s and 80s." Patients are almost always administered an electrocardiogram immediately upon arriving at the Red Bluff Businessman's Bible Study (RBBBS) Join us!! Network with other Christian Businessmen Next Meeting Monday, November 18th 7:00a - 8:00a FREE Coffee www.lassenmedial.com 331 Elm Street, Red Bluff RSVP 530-736-6775 hospital, Long said. From there, testing varies depending on the symptoms. Once doctors determine that valve replacement is necessary, most patients are put in a catheterization laboratory to determine whether there's additional blockage that might necessitate clearing concurrently with the valve replacement. "If they're going to go in and do a valve replacement, (doctors) want to know if there might be a reason to do a … coronary artery bypass at the same time," Long said. "You wouldn't want to just replace the valve and then find out a year later that he really needed a bypass, too." If such a bypass is necessary, Long said it takes the complexity of the surgery from "straightforward" to "a little more complicated." Aortic valve replacement surgery itself involves a few more decisions. Patients are usually implanted with either a bioprosthetic valve (usually made from a pig's aortic valve or another natural substance) or a mechanical valve (usually made of plastic). Bioprosthetic valves endure for five to 10 years, whereas mechanical valves are longer-lasting; the downside to mechanical valves is that patients must remain on blood-thinners, often for the rest of their lives. Long said that given a theoretical patient of Fox's age with a congenital defect and no other major medical conditions, a mechanical valve would be the most likely option. After aortic valve replacement, patients can be out of the hospital in as few as five days, Long said, after which they're required to return to the hospital for 2-4 weeks for cardiac rehabilitation. Only after that are they given a rehabilitation plan to continue on their own. Some patients then can return fully to work within 4-6 weeks. It'll be a long road ahead for Fox, and his family, over the next few weeks, but it should calm them — and Broncos fans — to know how commonplace the surgery is within the world of medicine. Hips and knees party planned Thursday St. Elizabeth Community Hospital will be hosting a Tailgate Party dedicated to the latest in hip and knee procedures. Two of the p r e m i e r orthopaedic surgeons in the region will be presenting the latest information about knee and hip injury and treatment options including minimally invasive tech- Dotson niques. Speaking on the latest in hip treatment options is Dr. Bradley Smith of the Dignity Health Medical Foundation, Red Bluff. Smith is a Board Certified Orthopedic Surgeon who is a graduate of Loma Linda University School of Medicine 1993 and completed his general surgery residency at the Smith Loma Linda University Medical Center in 1994. He completed his orthopedic surgical residency in 1998. Dr. Smith enjoys helping patients achieve practical ways to facilitate function and healing. Dr. Riico Dotson, Mayo Clinic trained, Board Certified Orthopedic surgeon is the Sports Medicine Medical Director for St. Elizabeth Community Hospital and has been practicing in Red Bluff since 2003. Dotson will be presenting on the common injuries of the knee and will explore minimally invasive surgical treatment for knee pain. Dotson has spent countless hours on the field or courtside supporting youth athletic teams and weekend warriors. He is the current St. Elizabeth Medical Staff Chief and the 2010 physician of the year. The Tailgate to Healthy Hips and Knees will provide educational and insightful information about hip and knee procedures with a tailgate theme providing catered snacks from Two Buds BBQ. At the conclusion of the seminar, an opportunity drawing for two tickets to the Dec. 8, San Francisco 49er vs. Seattle Seahawks game will be held. Pre-registration for the seminar is preferred by calling 888 628-1948 or online registration at www.redbluff.mercy.org/classes_and_events. www.redbluff.mercy.org redbluff.mercy.org Tailgate to healthy hips and knees November 7, 6-8 pm Red Bluff Community Center 888.628.1948 Community Diabetes Support Group redbluff.mercy.org/classes_and_events November 4, 6:30-8 pm Columba Room, Coyne Center Diabetes Education redbluff.mercy.org/classes_and_events November 6 & 20, 1-3 pm Columba Room, Coyne Center Type 1 diabetes symposium redding.mercy.org/classes_and_events November 9, 8-2 pm Gaia Hotel, Anderson 888.628.1948 Community Basic Life Support Redbluff.mercy.org/classes_and_events November 12, 6-10 pm Columba Room, Coyne Center Waterbirth Class redbluff.mercy.org/classes_and_events November 13, 6:30 pm-8:30 pm Columba Room, Coyne Center Type 1 and Type 2 Diabetes Medical Panel Discussion redding.mercy.org/classes_and_events November 14, 6-8 pm Mercy Oaks, Redding 888.628.1948 Auxiliary SOI Candle Sale November 15, 9-3 pm Hospital Main Hallway 530.736.1326 www.redbluff.mercy.org RANDAL S. 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Have you ever been embarrassed by a denture or a bridge? If you answered "yes" to one or more of these questions, call us today at (530) 527-6777 to schedule an evaluation appointment. We would be pleased to evaluate your oral health and discuss treatment options with you.