My heart valve replacement surgery experience Part One

I'm writing this post in order to help educate and prepare other men and women who are facing AVR surgery. AVR stands for Aortic Valve replacement. I also had repair of heart aneurysm on August 13th 2008.

Prelude- On July 30, 2008 I was admitted to the hospital with shortness of breath. The symptoms were like congestive heart failure, but not quite. I was suffering from aortic regurgitation as a result of a heart aneurysm. In the days ahead, I'd learn the heart valve I had was bicuspid rather than tricuspid. A cardiac catherization and cardiac echo gram confirmed all this. If there was good news, it was I had no heart blockages. My father twice required having heart bypass surgery.

The surgery I was facing was tricky, and I have other complications. The surgeon Dr. Lester has had limited experience in the surgery I needed, and was honest with the wife and I about this. Financial considerations kept me from travelling to places that do the surgery I needed. Gainesville Shands and Texas Heart were discussed. Considering I spent 16 days hospitalized, its probably good I stayed close to home.

I was discharged from the hosp. on August 6th, told to come back for pre-op on Aug. 11th, and told my surgery was scheduled for Aug 13th at 10 am. I'd have to report to the hospital at 6 am.

Before I had surgery, a ICU nurse at the hospital came to visit my wife Leonita and I. Her name is Zarah, and she's been our friend for a few years. Zarah gave me a good briefing on what I'd face after surgery, but there were still some surprises.

This is written all from memory. Neither Leonita or I took any notes. I was heavily medicated in the aftermath of AVR, so I'm sure there are many details I'm forgetting.

August 13th- I woke up at 430 that morning. Did a few last second things around the house before leaving around 5:40.

JFK Hosp is about 2 miles from my home. I was taken immediately into pre-op and went through all the preperations. It took two tries for a nurse to get IV in me or blood out of me. Don't really remember now. Around 7 am Leonita was shown in and stayed with me till I was wheeled down to the operating room at 8. I remember all the people in the room, and getting moved off the gurney to a table. Shortly after that I was off to la la land.

As I learned my surgery was complicated. Repair of the aneurysm and AVR. A St Jude mechanical valve was used. One problem- They had a tough time tubing me. That meant I had a tube down my throat for the first 24 hours. For the first 10 days or so after its removal, I couldn't eat certain foods(bread products for one) and needed the help of liquids to wash down the rest. Overall my appetite was good post-op. All those Outback Steakhouse commercials on American Movie Classics used to drive me insane.

My operation wasn't over till almost 6 pm. I was taken to CICU and my wife saw the surgeon. All I remember that night was Leonita saying goodbye(I couldn't open my eyes, but heard her voice), the tube and my inability to talk, being told I had a high temperature that got around 102 that night and that my nurse had just me for a patient. She spent most of the night seated at a table across from my bed.

Note- Zarah informed Leonita and I sometime during my hospital stay that in preparation for doing my surgery, Dr. Lester did no surgery for 48 hours before mine. That so he could be physically prepared.

And so began 9 out of my first 10 hospital days in the CICU. Both rooms I stayed in were right off the nurse's station and as a result noisy as hell.

As I began to wake up, I noticed the numbness in my right hand. It encompassing four of my five fingers at the time. I'm right-handed, and write for a living. This would be a major cause of depression the first few days for me. 5 weeks and 2 days post-op feeling is slowly coming back to my hand. It confined to three fingers now.

Aug 14- The tube was removed around 1030 am. My wife and her sister were with me then. I had some food an hour or so later.

That day I began to contract pneumonia, the main cause of my long CICU stay. My liquids needed to be restricted but at the same time I needed them to eat. Sort of a catch 22.

It was on the 14th I first remember getting hot flashes. They mostly involving my sweating profusely from the head. I'd continue to have them till almost the time of my discharge, though they gradually decreased after my transfer to the Cardiovascular unit.

Sometime on the 14th evening, I had something removed from me. That required me to be immobilized and my head tilted backwards. Maybe someone knows what this was, or I'm just dreaming from still being in la la land. All I know is I was struggling to breathe the night of the 14-15th. Before being put on a ventilator, I requested my wife be allowed to come to the CICU. JFK is pretty strict when it comes to ICU visiting hours, but your nurse can make exceptions. Leonita came and stayed with me till the ventilator came out late in the morning of the 15th. My nurse Tina sending her home for a rest.

Note- I liked Tina, who is from India, but used to call her Gina mostly. It was an incident mistake due to my meds and my health issues. Tina never seemed to mind.

My nurses and PCAs were almost always great during the time I was in the hosp. Ones that stood out were Gina, Jean, Jackilyn, Imelda and Mary Jane(members of the Filipina mafia like my wife), Evanna and others I forgot the name of. I even grew to like the one PCA who seemed to only annoy me on my first visit to JFK in late July.

I don't know what I would have done without Leonita. She's always had the patience of a saint, but it has been tough on her the last 2 months. I got the best wife.

Aug 15- I was taken off the ventilator. After a short time, the nurse ordered me lunch. Just my luck, it took 90 minutes for one inedible tuna sandwich to arrive(It was very dry and probably had little or no mayo).

Well I told Gina this, and asked if my wife Leonita could be called to bring me something. Then suddenly Gina bolted from the room. I'd learn later, her other patient tried to discharge himself and was walking out of the ICU!

I had my first bowel movement this day. On a commode, not in the bedpan fortunately.

Beginning Thursday or Friday, the night nurse would hand wash me in bed.

Aug 16-18- I got over the pneumonia but was generally feeling sluggish. All I remember is watching one Miami Dolphin pre-season football game, The movie Apollo 13 about 5 times, lots of the channel TNT and not much else. Leonita would bring me the newspaper in the morning, but other than wanting to know who won the last LPGA tournament, I showed little interest.

It was during this time, Leonita began to bring me breakfast daily. JFK's choices for this meal were either too hard to swallow or lacking in taste. Leonita would usually bring me scrambled eggs, but I ate a little French toast or English Muffin once my throat began getting better. These were all foods I was allowed to eat. Visiting hours at the ICU didn't begin till 10 am, but the nurses were kind enough to let Leonita come in around 630-645 to feed me. I was in no shape to feed myself with my right hand pretty useless. So my wife coming was helpful to the nurses. After feeding me, Leonita would leave before 730 and come back later.

That's about all I remember up through the 18th when I got sent upstairs around mid-day to the cardiovascular unit. I will continue my story in a post tomorrow.