PVCs and Bicuspid Aortic Valve Fitness Questions

benjcbc

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PEB Forum Veteran
Registered Member
I am currently being evaluated for PVCs, and it was discovered that I have a bicuspid aortic valve with moderate-severe regurgitation. I am in the UK, so the off base cardiologists referred me to a valve specialist, as I will need my aortic valve replaced within 2 years; however, he said I won't have the appointment for at least 6 months. Despite having increased difficultly running, my PCM has determined that I need to take a full fitness test, which is due in 2 months. I feel like I'm essentially being forced to test and fail, in order to meet an MEB. I will add the the off base cardiologists says I should be able to meet the run standards; however, this is not the case. I have never had issues running (I have held above 90% PT scores my entire career), but I have increased low energy levels, and frequent PVCs. Also, I have been under evaluation since April 2018, and have not had a MET test. I am wondering if anyone has had similar issues before.
Thanks!
 
Hello,

I am in the PEB process now after having aortic valve replacement surgery in May.

I was diagnosed with a bicuspid valve about ten years ago. When I received my diagnosis I was in my early 20's and was told I wouldn't need surgery until I was in my 50s - 60s. Long story short, I had an episode where I felt faint and went to the ER. They told me I was fine (no heart attack and no stroke) and I was referred to cardiology to get checked. Other than the faint feeling, at this point I was asymptomatic. I had multiple ECGs, EKGs, TEEs, a CT scan, an angiogram, and an MRI - my valve leakage had become severe and heart had become weak so I was referred for surgery. This testing was over the course of about five months.

I received several opinions from cardiologists (civilian and military) as well as opinions from three cardio-thoracic surgeons. They all concurred that it was time for surgery. I noticed I was having some shortness of breath about 2-3 weeks leading up to my surgery. I chose to go with a mechanical valve which jeopardizes my ability to stay military due to the requirement to take blood thinners for life. I chose this because it is a long term fix as opposed to a biological valve (your surgeon should cover all this). I'm now 12 weeks post-op and I'm doing well. A downside to the mechanical valve is that I can hear my heartbeat now. Some people hear it and some don't. I'm getting used to it so it doesn't bother me anymore.

Like you, I never struggled with the PT test prior to my surgery. I was/am by no means a "gym rat" but I've always been active my whole life. You are your advocate when it comes to your care. If you don't feel well you need to you need to request a second opinion - you're entitled to that.

Sorry for the long response. I'm happy to answer any questions about surgery/recovery if you have any.

Take care.
 
Two cardiologist agree! But has anyone looked elsewhere; especially the lungs and kidneys? Perhaps a medical TDY to get a complete workup. Beats waiting months.
 
My appointment with the specialist got moved to next week, instead of March. I'm not sure if that's bad or good. As apprehensive as I am about the surgery, I'll still elect for the mechanical valve, when the time comes. I honestly have no faith in this UK hospital, and will do what I can to get a medical TDY in the US. Thank you for your inputs!
 
If you're Navy, I know you have a choice as to where you get the surgery done. The Navy was going to send me to Walter Reed at my request but I changed my mind and went with the military hospital local to me.

Just remember after your surgery you need to walk walk walk. The doctors will have you walking within 24hrs of your surgery and you have to walk to get better. No matter how much pain you're in, you have to get up and walk. There was another heart patient who I didn't see walk at all. He was there before me and was still there when I left. Also, I recommend you stay on top of pain management. When your meds wear off, it hurts to breath. I had the nurses waking me up every four hours to get my pain meds.

If you have anymore questions, I'm happy to answer them. Either post them here or PM me. I know exactly how you're feeling right now...
 
If you're Navy, I know you have a choice as to where you get the surgery done. The Navy was going to send me to Walter Reed at my request but I changed my mind and went with the military hospital local to me.

Just remember after your surgery you need to walk walk walk. The doctors will have you walking within 24hrs of your surgery and you have to walk to get better. No matter how much pain you're in, you have to get up and walk. There was another heart patient who I didn't see walk at all. He was there before me and was still there when I left. Also, I recommend you stay on top of pain management. When your meds wear off, it hurts to breath. I had the nurses waking me up every four hours to get my pain meds.

If you have anymore questions, I'm happy to answer them. Either post them here or PM me. I know exactly how you're feeling right now...

I'm in the Air Force. The medical group responsible for the coordination is terrible. I had to go in every day to complain about my off base cardiologist not addressing issues, and never got a second opinion. I would like to do the same, and have the procedure done closer to home. Do you know how straight forward the PEB/MEB is with a mechanical valve? I've been signed up to attend a PME course, and seem to be on track to stay in; however, I've already been non-depolyable for about 6 months now.
 
I'm in the Air Force. The medical group responsible for the coordination is terrible. I had to go in every day to complain about my off base cardiologist not addressing issues, and never got a second opinion. I would like to do the same, and have the procedure done closer to home. Do you know how straight forward the PEB/MEB is with a mechanical valve? I've been signed up to attend a PME course, and seem to be on track to stay in; however, I've already been non-depolyable for about 6 months now.


I would imagine no matter the service, they should be sending you to a U.S. doctor for an exam/opinion. I would continue to push that... In fact, it is always your right as a patient to request a second opinion. The first cardiologist to tell me I needed surgery was a civilian doctor. When that info got to TRICARE they required me to see a military doc and then I consulted with a second military doc after that.

In the Navy when you're suffering from a major medical condition, you're enrolled in the Navy Wounded Warrior/Safe Harbor program. You're assigned an advocate to assist you through the recovery process. Also, separately, you're assigned a nurse case manager to assist you in getting appointments, prescriptions, medical device(s), etc. When I was considering having the procedure done at Walter Reed, my Navy Safe Harbor advocate was coordinating a little apartment-type place for myself and a caretaker to stay until I was safe to fly. It was going to be at no cost to me. There has to be some sort of equivalent for the Air Force.

As far as the MEB/PEB, I had my surgery done in the end of May. I returned to work in the end of June. I requested my PCM initiate the MEB/PEB immediately because I want to know what the future looks like for me as far as my career goes. If I'm able to stay, great. If not, then I want to make the transition into the next phase of life. Anyway, my board was initiated in early July. I met with my PEBLO and consulted with the military disability attorney by mid-July. I had my VA rep appointment to go over all of my ailments and to submit my VA claim in late-July. My C&P exams were about a week ago. Thats where I currently stand... The next step is for my PEBLO to receive my packet from the VA. Once they get it, they'll send that package, my non-medical assessment from my command, and the narrative summary from my PCM to the PEB in DC. Then it's a waiting game for the fit/unfit decision. During this process, you can't go TDY or on leave that takes you away from your permanent duty station area.

I've been told by several docs the mechanical valve was the right choice due to my age (early 30s), but that I pretty much guaranteed an "unfit" decision from the PEB. To me that's ok. I would rather make the best choice for my health and be here to see my child grow up.

If you have anymore questions, let me know. If not, I'll post updates about my PEB here so you can see.
 
I would imagine no matter the service, they should be sending you to a U.S. doctor for an exam/opinion. I would continue to push that... In fact, it is always your right as a patient to request a second opinion. The first cardiologist to tell me I needed surgery was a civilian doctor. When that info got to TRICARE they required me to see a military doc and then I consulted with a second military doc after that.

In the Navy when you're suffering from a major medical condition, you're enrolled in the Navy Wounded Warrior/Safe Harbor program. You're assigned an advocate to assist you through the recovery process. Also, separately, you're assigned a nurse case manager to assist you in getting appointments, prescriptions, medical device(s), etc. When I was considering having the procedure done at Walter Reed, my Navy Safe Harbor advocate was coordinating a little apartment-type place for myself and a caretaker to stay until I was safe to fly. It was going to be at no cost to me. There has to be some sort of equivalent for the Air Force.

As far as the MEB/PEB, I had my surgery done in the end of May. I returned to work in the end of June. I requested my PCM initiate the MEB/PEB immediately because I want to know what the future looks like for me as far as my career goes. If I'm able to stay, great. If not, then I want to make the transition into the next phase of life. Anyway, my board was initiated in early July. I met with my PEBLO and consulted with the military disability attorney by mid-July. I had my VA rep appointment to go over all of my ailments and to submit my VA claim in late-July. My C&P exams were about a week ago. Thats where I currently stand... The next step is for my PEBLO to receive my packet from the VA. Once they get it, they'll send that package, my non-medical assessment from my command, and the narrative summary from my PCM to the PEB in DC. Then it's a waiting game for the fit/unfit decision. During this process, you can't go TDY or on leave that takes you away from your permanent duty station area.

I've been told by several docs the mechanical valve was the right choice due to my age (early 30s), but that I pretty much guaranteed an "unfit" decision from the PEB. To me that's ok. I would rather make the best choice for my health and be here to see my child grow up.

If you have anymore questions, let me know. If not, I'll post updates about my PEB here so you can see.

I just received my VA exam information, and waiting for the IPEB to state, hopefully, I'll know my fit/unfit decision soon. I agree that I would rather get out, if it's what's best. I've been dealing with this for years, and Medical Group is refusing to treat my symptoms.
 
What I know, as of now, is the MET rating (3 - 5), when symptoms occur. I'm wondering if it is safe to compare these against the disability charts on Military Disability Ratings for Heart Conditions, in order to estimate a DOD percentage? I understand that valve issues are congenital, but I've also been in for nearly 10 years, so I'm trying to guess how this will play out. Thanks!
 
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