Superior's Goss makes quick return from heart surgery

On April 12, Superior resident Jim Goss accomplished his first substantial trek of the year.

He said, “Four of us hiked Bald Hill two days ago, and I felt strong the whole way. It's 2,400 feet of vertical, so it is considered a moderate to strenuous climb.”

For this avid hiker and organizer of the local hiking group in Mineral County, the ascent up Bald Hill was easy. Easy considering Goss had just had heart surgery one month earlier.

As a healthy 61-year-old, Goss has had very few medical encounters in his lifetime.

The only thing in his daily pill box are calcium supplements. So, when he discovered two years ago that he had a heart murmur, Goss shared, “My family does not have any consistent history of heart issues, so it was a bit of a surprise to me, and took a while for me to process.”

Along with three million other Americans each year, Goss was diagnosed with Barlow syndrome also known as mitral valve prolapse. This is when there is an improper closure of the valve between the heart's upper and lower left chambers.

A fairly common heart condition the Mayo Clinic stated that Mitral valve prolapse can develop at any age. It can also run in families and may be linked to other conditions, such as infection and connective tissue disease.

Symptoms may include an irregular heartbeat, palpitations, and shortness of breath. Most people don't require treatment, but some cases may need medication or surgery.

Initial diagnosis simply requires a stethoscope to listen to the heart. Goss said, “A murmur was first noticed about two years ago, but at my most recent physical exam it was loud enough a level three on a scale of one to six, to warrant an echocardiogram.”

Even after these findings and being labeled as having moderate to severe regurgitation, or mitral insufficiency, Goss was told he could continue most of his normal activities including skiing, and hiking.

He explained, “There was no immediate sense of urgency, but the heart does start working hard to accommodate the faulty valve, which eventually leads to an enlarged heart and ultimately congestive heart failure. There were many visits for tests, each more increasingly invasive, starting with a transthoracic echo which confirmed my murmur was not innocent, then a transesophageal echo that allows for better imaging for the surgeon.”

Next his doctors needed to evaluate the health of his coronary arteries prior to surgery. This precaution is in case there is a serious blockage in any of arteries. If one is present, then they can do a bypass at the same time they do the valve repair.

During his coronary CT, doctors found a suspicious area. Goss noted, “So then I needed a coronary catheterization which confirmed I had a 40% blockage in one of my coronary arteries. Apparently, a blockage has to be 70% or greater for them to intervene with a stent or bypass, but it did mean that I am now on Lipitor and baby aspirin for the rest of my life to hopefully halt the progression.”

“So, in essence I have dodged two bullets,” shared Goss.

In all, it took around three months to complete necessary testing and schedule his annuloplasty, during which a ring is inserted around the mitral valve. The operation is described as a minimally invasive open-heart surgery, where the surgeon's incision is three to four inches long on the right side of the chest.

This creates access to the heart for their surgical instruments between two ribs. Not having the sternum cut makes for a much quicker and less painful recovery time. Goss said, “It's amazing to me that this is now how most of these types of surgeries are done.”

On average the hospital stay for this type of procedure is four days, then two to three weeks afterwards of no driving, light duty, and a restriction on lifting.

Goss detailed, “In my case, I was in the hospital six days, because they found I had fluid accumulating in my chest cavity, which necessitated the reinsertion of a chest tube to drain it off.”

After returning home his recovery went smoothly.

“I could take short walks immediately, and within three weeks I was hiking the Vista Trail and skiing four weeks out. I feel near 100% five weeks out from surgery,” expressed Goss.

In Goss’ case, some surgical intervention and the insertion of a plastic ring around the mitral valve will probably last him a lifetime. He said, “I will need to take echocardiograms on a once per year basis to make sure the repair holds, but otherwise I have no restrictions on my activities and my prognosis is excellent.”

Goss added, “I am also lucky that my condition could be resolved as a valve repair as opposed to a valve replacement. Tissue valves or mechanical valves either don't last long enough or require taking blood thinners, like coumadin for a lifetime.”

Although it’s a challenge to face any sort of health condition Goss was grateful for his experience. He shared, “I feel that we as a country do a pretty poor job making sure everyone has access to health care and affordable insurance. I am lucky that the Affordable Care Act gave me access to affordable health.”

Generally, he’s been diligent about taking advantage of healthcare clinics like the free blood draws at St. Pat's to monitor his cholesterol.

But only in the last few years he’s become consistent with going for physicals.

Goss stated, “My situation is one where the healthcare system did work the way it should, but I know there are many people who fall through the cracks. My condition, if left undiagnosed, was insidious and would have caused irreversible damage to my heart.”

Since his heart valve repair at St. Patrick’s Hospital in Missoula March 4, Goss has made a strong recovery. “I have steadily increased my walking to the point that I'm now able to hike the Vista Trail at a reasonable pace, and my dogs are very happy. The weather has been perfect in assisting me regain aerobic capacity.

“It has a high success rate, will hopefully last a lifetime, and there should be no restrictions on my activity,” noted Goss. Which is a very good thing, considering Goss has a full calendar of hikes to take part in this summer all around the county. If you’re interested in joining him and other fellow hikers on the trail in the coming months feel free to contact him at jgossorcreich@blackfoot.net.

While you’re trekking along, he’ll probably give you an update on his recovery himself.