Attitude is Everything!

They say attitude is everything, and for Tom Laue attitude is everything. Attitude helped him face valve surgery with healthy anticipation, and it’s sustained him in recovering from a dual valve replacement procedure. Just ask Tom how he approached surgery and he’ll tell you, “I focused on the benefits.” Then ask how his recovery progressed and he’ll say, “I thought of it as a much needed vacation.”

Tom’s valve problems were congenital: his aortic valve had two cusps, instead of three, and his mitral valve was severely prolapsed. Doctors detected a heart murmur early on; however, Tom remained virtually symptom-free until he contracted pneumonia at age 51. After a slow recovery, the heart murmur Tom’s family practitioner heard raised concern. His doctor referred Tom to a cardiologist. When Tom told the cardiologist, “I’m tired all the time,” the cardiologist responded, “That’s good, because that’s what your ECHO (echocardiogram) shows.” It was time to see a surgeon.

The time between pneumonia and valve surgery was stressful for Tom. He’s a busy guy. He teaches Biochemistry at the University of New Hampshire (UNH) in Durham, New Hampshire USA; he’s Chair of the Faculty Senate there; he’s Director of both The Center to Advance Molecular Interaction Science and the Biomolecular Interaction Technologies Center at UNH; he has a handful of grad students working with him at any given time, and he designs instruments for biochemical researchers. Add a significant dose of travel to an already full academic life and most people would find it exhausting. But if your heart function is compromised—well—Tom reached a point where he’d return from a business trip and spend the next day “recovering.”

It was time for surgery. Tom viewed surgery as a means to an end: in the end, Tom would have his energy. “I knew things weren’t going to get any better for me, so I looked forward to getting my energy back,” he revealed. He freed his schedule; he was ready to do what he needed to feel better.

The surgeon explained that he would attempt to repair Tom’s mitral valve, replacing it if repair was not feasible. The aortic valve was clearly in need of replacement. After discussing the merits of tissue vs. mechanical, Tom and his surgeon settled on mechanical, primarily due to Tom’s relatively young age (generally mechanical valves last longer than tissue valves). The prospect of life-long anticoagulation therapy didn’t upset Tom because he has researched how warfarin works. (Some of Tom’s research is focused on learning more about the effects of warfarin on proteins in the body.) Additionally, Tom knows the drug has been used successfully for decades. On October 7, 2004, Tom Laue approached surgery, anticipating a more energetic life. He received not one, but two St. Jude Medical® mechanical heart valves including a SJM Regent® valve and a SJM® Masters Series mechanical heart valve.

Tom’s in-hospital stay was uneventful. In six days, he was home. He views his recovery as just that: a time to recover his health. His wife, Janet, and younger daughter, Hannah, are there for support, as they were for the surgery. (Read Tom Laue’s personal valve surgery and recovery recommendations.) He calls into work for a brief time each morning . . . to discuss the essentials with his administrative assistant. Then he spends time reading; watching movies; working on a computer program; talking online afternoons with his older daughter, Erica, who is a freshman at McGill University in Montreal, Québec, Canada; and exercising per his doctor’s orders.

Tom’s diet has remained the same. He and Janet are vegetarians, which means they eat lots of leafy vegetables and soy products—both are rich in vitamin K. (Vitamin K helps the blood form clots when needed for healing.) Given Tom’s diet and dual valve implant status, the cardiologist has Tom on a higher dose of warfarin than is typical. But Tom is comfortable with this because he understands warfarin. He understands that both a person’s body chemistry and diet affect how warfarin works. “Warfarin has a narrow range of efficacy,” he explained. “The trick is finding the dose that will keep my blood anticoagulated, without overthinning it.” Tom is part of a patient self-testing program that is used for testing anticoagulation levels at home. So far, there have been only minor dose adjustments to bring Tom up to therapeutic level.

Tom Laue's Personal Valve Surgery & Recovery Recommendations

• Have a positive attitude and focus on the end goal: reclaiming your health
• Enlist the support of your family
• Establish good communication with hospital staff (make sure they prepare the family for how you will look when coming out of the surgery with IVs, a chest tube, and catheter in place, etc.)
• Don't be afraid of pain because there is really very little, if any pain (except when coughing—a good reason to stop smoking)
• Stop smoking as soon as feasible before surgery (coughing is painful after surgery because it stresses the sternum)
• Accept that there will be glitches in your recovery. For example, some patients recover more quickly than others. Some patients have blue days. And some patients on warfarin or other medications may need to work with their doctors to make adjustments in their medication levels.
• Free your schedule and think of your recovery as a vacation. Commit 100% of your time and energy after surgery to reclaiming your health. Keep in mind too that recovery takes time; your strength and energy will return gradually.
• Follow your doctor's orders
• Avoid lifting, which stresses the sternum and sternal incision
• Exercise a little more each day (per your doctor's instructions)

Tom is easing into work gradually and pacing himself. He’s eagerly anticipating the full return of his energy and every day, he feels a little stronger.

Working with college students has been gratifying for Tom, in fact, the most rewarding part of his work is helping students focus and giving them perspective. “I tell students that their undergrad time is their last chance to discover academic interests,” he explains. “Grad school is where they start making professional decisions.” One might call that advice focus; another perspective. We’ll call it attitude. After all, attitude is everything!

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