Randy Martin: Let me, because I want to hone in, and your message is great and your style and your passion is fabulous. What would be, just off the top of your head, what would be the five things that you would tell? So if a patient has been told by the cardiologist or doctors I need a mitral operation, I need an aortic operation, what’s the five things you would tell them out of the gate that would be the top five things to think about.
Adam Pick: It’s a great question. And what’s interesting is it’s a little different for every patient.
Martin: Ok.
Pick: Because they bring to the mix a whole set of schemas and ideas that brought them to that point in their lives. So it’s hard to say there’s a predefined set of 5. The first thing I can tell you and it’s everything I do is, maybe I won’t get to five, is that message of hope. You go through this, odds are statistically very favorable for you. I think the Society of Thoracic Surgeons suggest that both aortic and mitral valve surgery the mortality rate is about 1.7% when you combine the two. That means that, I’m not great at math, but 98.3%, they make it through.
Martin: Right.
Pick: Right. The second thing is not just can you make it through, but can you thrive afterwards? The inspirational stories that are out there will bring anybody to tears. Veronica Meyer, from Switzerland, climbing Mount Everest after she had a heart valve surgery. Brilliant. David Watkins doing the Iron Man triathlon. Brilliant. So empowerment, hope. Third is, I would really encourage people to welcome love. And what I mean by that is that we are all surrounded by people who love us. And the family, in this situation, and your friends, your support group, if you want to call it that, open your eyes to them, open your ears to them, and most importantly, open your mount to them. You know, a lot of people aren’t big Oprah fans, you know they’re not Dr. Phil disciples. It’s hard to share what’s going on in their life because it can be such an isolating situation. By getting that out it helps with the catharsis and the processing of what they’re about to go through, which I can tell you, after talking with thousands of patients, it can be a rollercoaster.
Martin: I can imagine.
Pick: It can be an emotional and physical rollercoaster.
Martin: Well, you went in a different direction than I thought, but excellent, excellent points and I’m not demeaning that, and I liked your message. I think that’s very important. Really, family, friends, being honest, getting encouragement, all that stuff is critical. I mean, we are human, emotional people. I also loved your concept of really empowering the patient to try to find out as much as they can, or get people who can, not only about the process that they have, but a second opinion. So that you’re telling me that when you went in to have your surgery you were confident that you were going to have the right procedure by the right surgeon and you had the surrounding envelope of love and support, is that correct?
Pick: I’m telling you I had all of those things, but I still was on the rollercoaster. And I would even say that I had a train wreck. Because while I had a great surgical result, what I found was that my expectations that were set to me in this process didn’t meet up with the reality of time.
Martin: You’re talking about the postoperative time now.
Pick: Exactly.
Martin: I tell people, and I’ve not had it done, it’s sort of being run over by an 18 wheeler. Is that a bad statement to make?
Pick: You know, what I’d say again, it’s about the patient. Right? Everybody has different experiences. I’m just getting off the phone yesterday, Denise Ring, who just had a mitral valve surgery down in Florida by Dr. Kevin Acola. A week and a half postop, she’s doing fantastic, not complaining of any major pain. At the same time there are folks like me: I came out of surgery, my chest was very sensitive and sore. I ended up becoming addicted to Vicodin in the process, which put me down a very dark tunnel, which resulted in cardiac depression. So while on one hand I had all of those great things I talked about, I didn’t have the framework for understand what the expectations were going to be.
Martin: What the process was.
Pick: Yeah, and how I was going to be unique to that process.
Martin: I understand.
Pick: A great example is the expectation for driving after surgery. You’re told, most people are told you’re going to be able to drive 4-6 weeks afterward.
Martin: Absolutely.
Pick: What happened with me was, 6 weeks after when I got in the car, I was scared for my life, and for the passenger.
Martin: Isn’t that interesting?
Pick: Because of all the pressure and the tension in my chest, it was still sensitive. So, and that’s where cardiac depression sat in, and that’s where I got a whole lot of learning about probably what I’d say is point 4 in your list of 5 requests, is cardiac rehabilitation.
Martin: Now you’ve obviously struck a sensitive nerve. And it’s interesting to me that we in medicine, and I’m doing a generic “we”, don’t, we really don’t discuss with patients where they live. And obviously your story, your book, really has struck a nerve, because it’s very popular, the book is, if I get 20 copies sent to me by patients, and your blog sites are popular. So it’s instructive to us as physicians isn’t it? From what you’ve learned? Is there a different way we should approach patients?
Pick: Well you have just brought about what I think is the fundamental essence of what this little book, turned into a website, turned into a mission, there’s philanthropy attached to it, but the concept of the perspective and, what I would consider to be, the contribution from the community. What I’m trying to do, while I originally started with the focus on the patient, the education, the research and the data, it comes from the clinicians and it comes from the medical device manufactures as well. So while I think there are some learnings for the surgeons and how to work with patients and manage expectations, I think it’s a two way street. That’s why in the new edition of the book, we are actually now taking in contributions from some of the leading valve surgeons, to help us understand certain things for more of a clinical point of view, so that at the end of the day this, hopefully, transforms and evolves to really what I want it to be, which is a community based project. Which is why we’ve launched certain things like Heart Valve Journals and it’s heartvalvejournals.com and it’s similar to a Facebook, but for heart valve patients. So we can get them together on-line, from all over the world, thousands of people helping each other and the stories there again are beyond touching. And strangely enough I never expected it, but every once in a while, we’ll see a surgeon up there leaving little comments and notes of encouragements for their patients. So it’s really a beautiful thing to see that.
Martin: Little did you know that congenital aortic stenosis would have led you on this path where you’ve helped make a major difference in people’s lives and will continue to do that. Those of us in the medical field appreciate that. Thanks very much for visiting with us.
Pick: That means a lot. Thank you for all that you do. I appreciate being here with you and getting to know you. It’s been a great time.
Martin: Thank you. It’s been my pleasure. Thanks very much.
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