My heart valve replacement surgery experience Part Two
With apologies to Paul Harvey, now for the rest of the story. Part one of my surgical experience can be read here.
Two things I forgot to mention in my first post was the coughing. Even when hugging a pillow it felt like I'd break a rib. Because of the pneumonia, I did plenty of coughing. Now I don't cough as often, I think I've done so around 10 times since my discharge on the 29th. It's still not a pleasant experience.
I also had a allergic reaction to the tape used for my dressings over the surgical site. Doctors were worried it was an infection, but it quickly became apparent it was only where the tape was. Benadryl was used to treat this, but other than the redness the allergy caused no discomfert.
Mid day the 18th- Me and my bed(Sometime while in ICU, I got transferred to a large size bed. I'm over 6' tall and the standard bed left my feet touching the end or going over it) got transferred to the CV unit or 3 South as its called at JFK.
My catheter was removed that evening, and this was when I first remember being able to sit up in a chair.
Aug 19- Setback time. I had heart arrhythmia issues that required more care than the CV unit could provide, so about 24 hours after arriving on the 3rd floor, I was sent back to the ICU. My arrival downstairs required my having the catheter re-inserted. The less said about this the better, except that I wished someone had hit over the head with a rubber tipped hammer beforehand.
Shortly after arriving back in ICU, I had a hot flash that seemed to never end. I ending up covered in sweat.
Aug 20-21- Getting sent back downstairs didn't help my mental state of mind at all. I overhearing one ICU nurse of mine describing me as 'lethargic'. Lethargic was about right.
I think the 20th was when I had my first 'accident'. Either spilling food or drink on myself or instead of urinating in a container, having it come out on myself. When not recuperating from surgery, I'm a bit of a klutz. This was magnified during my hospital stay.
One accident wasn't of my own making, but due to my night nurse Francis a few days before my discharge. When almost 90% through getting me set up and comfortable in bed before my going to sleep, he accidentally tipped over a cup of water into my bed. That necessitating a change of linen for the bed and gown for me. Francis I could tell was angry at himself for what happened, but didn't take it out on me.
The 21st was probably my turning point in my stay at JFK. Whether it was because of my having regular bowel movements from that point on till my discharge, my telling jokes to the nurses, that I began talking golf and discussing one of one online fiction stories with Leonita(Both subjects try her patience, but as I say she has Saintful quantities of it) or breaking out in song or all of the above is not known. All I know is it was then that the worst was behind me.
Aug 22nd- I got transferred back to the CVU around 2 pm. Again my large size bed coming with me, and a larger chair this time too. Beginning around the 21st Leonita or I would have to demonstrate to every new nurse of mine, how to get the chair leaning back or getting it stowed in place again. The chair didn't work like the normal hospital recliner.
This day was the first time I recall a Code Red(Fire alarm) being called over the intercom. Supposedly they are drills, my room door would be closed when they start, but the ones on the 22nd in CICU seemed for real. Each of the two code reds coming with a slight bang and shudder.
Sometime around 6 that night, I went for my first out of my room walk(A Physical therapist got me up out of bed while I was in ICU but I stayed in the room) with the aid of a walker. I think my journey was all of about 10 yards but it was a start. By the day of my discharge, I was able to do three laps around the CVU when up and around.
Aug 23rd- This was the last day I needed any oxygen. By then because of sleep apnea issues, I was only on a nose cannula at night.
I got feeling back in another finger this day. Leonita brought me a rubber ball to practice squeezing with my right hand sometime during my hospital stay. I still use it. Since I came home I have noticed my right arm is weak too, I feel uncomfortable lifting it beyond a certain point.
Aug 24th- The catheter finally comes out for good. By now I felt even the slightest tug on it or movement. My nurse Jean removed the foley in the process only causing me minimal discomfort. Thanks Jean. Now I only had the IV line left attached to me.
Sunday the 24th was when I got my first shower post-op. It felt so good.
A friend of mine and Leonita was admitted to the hospital on the 24th for chest pains. Terry having a room down the hallway from me(I was in 3005, she in 3012) but I never stopped by to say hello but we spoke on the phone. Misery likes company?
Leonita takes notice of a patient on the floor that day when out walking with me and the nurse. I made it a practice not to look in other patient rooms. First I like my privacy(I always told Nurses, doctors, PCAs and other hosp. personel to fully close my door when leaving. The room was quieter with the door closed too.) and I respect that of others.
It was either this day or Monday that I began receiving Heparin in order to raise my INR level. Before my surgery, I took cumadin because of my PE in 2005 and threat of another blood clot.
Leonita brought me Sunday communion on each of those days I was hospitalized. A Eucharistic Minister named Barbara brought me communion 2 or 3 weekdays also.
Aug 25-28- Now it was time to raise my INR in preparation for discharge. It was a slow process 1.4 to 1.5 to 1.7 to staying at 1.7 on the 28th. This made me think I'd spend labor day weekend in the hosp. Something I did not look forward to all.
On the 25th or 26th I began reading the newspaper or a book for the first time since being admitted. On the 26th Leonita brought me my laptop, I used this to send out a few email and post a message to friends at both a blog I write at and a forum where my online stories are posted.
Since I needed help to get the PC set up, I'd only use it when Leonita came to spend dinner time with me. In any case, using the PC was tiring and I didn't feel much like using it for more than 30 minutes at a time. 20 of those 30 minutes spent in either getting the PC to warm up and then make connection to the internet with AOL Dialup.
After 8-17, Leonita returned to work. She would bring me breakfast, visit at lunch, and come after her work day was over(4 pm). Visiting hours at the CVU are much less strict, family can come and go most anytime. Let me say it again, I got the most wonderful wife in the world. Leonita has the patience of a saint, something absolutely necessary to put up with me and my numerous shortcomings.
On 8-26, a close friend called me. Her name is Grace. I've known Grace and her husband Patrick via a melanoma support group for over a decade. We even met a few times in the late 90's when I used to travel to California for treatments. It was nice of Grace to call, as it was when a writing friend named Sephrena called also to see how I was doing.
By the 25th I would spend almost the entire day in my chair, only going back to bed at night, and for an afternoon nap around 130. Napping was easier in the afternoon than the morning, because during the later I'd see a steady procession of doctors and other visitors. It always seemed someone would come in the room after about 15 minutes.
My mobility was increasing. I could get out of the chair after counting 1...2...3. After a while I began getting up on 2, fooling my nurse or wife in the process. Getting in and out of bed was tougher and the physical therapist concentrated on teaching me how to do this. Now I can get in and out of bed without problems except for some physical discomfort in the chest area.
Sleep- Something not easy to do in a hospital. People go to a hospital to get healthy, and rest would seem to be essential for this. Then how do you rest when people come in your room every 2-3 hours even in the middle of the night? Its a catch 22 of course.
Most nights I'd ask my night nurse to get me in bed around 11. I'm accustomed to going pee at least one time a night. So I didn't want to get in bed too early or risk two bathroom trips. So I'd need to get up every night around 2-3 am. After this was through, I'd try going back to sleep.
Then shortly after your eyes close, a hosp worker comes in to give you a breathing treatment. Then after you doze off for a few minutes after your visitor leaves, the nurse or PCA comes in to take your vitals. Throw in a visit or two by the PCA to make a notation on the wall chart....well you see how impossible it is to sleep.
One night nurse named Jackilyn was good at getting her patients sleep time. She endeavoring to have your vitals taken around 1130 and then not again till 5 or 530.(I got IV antibiotics up to the day before discharge. These were done every 6 hours for 30 minutes. Therefore a nurse had to come in at least every 6 hours) In between you'd be allowed to rest. Thanks to Jackilyn it usually worked, though some hosp. workers would not get the memo once in a while.
While taking a shower with Leonita's help on the 28th, we talk about the surgeon Dr. Lester. Guess who sticks his head in the bathroom door? Dr. Lester.
Finally got around on the 28th to shaving for the first time since admittance. I had postponing this, because by the time I got to the floor my beard was already out of control. Shaving me would require cleaning my electric razor multiple times. So I put it off, till finally I couldn't let it go no more.
Something I haven't mentioned- My blood sugars. My primary care doc has me on diabetes meds. However I've always been marginal in my blood sugar numbers. My wife has diabetes and tests herself every morning. She would sometimes test me too, and I'd wake up with a number in the 60's about twice as often as one over 100, and the ones over 100 would make it by the slimmest of margins.
This continued when I was in the hosp for AVR. I had blood sugars as low as 56 and 58. The nurse would bring me OJ then. Twice when Leonita was there, she gave me a little chocolate fudge cake she brought up from the cafeteria for herself.(After I ate some, Leonita stored the rest in a drawer. The next day my number was low again, so Leonita got the cake out again) After eating, they want your blood sugar under 150. I think I crossed that number three times, but barely. One time they gave me insulin, and my sugar dropped like a rock into the 70's. Another time I get my prescribed glucotrol pill after my blood sugar registers in the 70's.
Since coming home my blood sugars continue to be low sometimes. Like today, I woke up with a number of 63 and before eating lunch leonita measured me. It was 60.
It was on the 26th or 27th that the night PCA Suzette mistakes my 35-year-old sister-in-law named Leonette for my and Leonita's daughter. Leonita and I were 46 and 47 at the time but my wife has turned 47 since. Leonette has a baby face and looks ten years younger than she is but still......
Aug 29th- Jackilyn takes blood from me at about 3 am. She tells me if my INR gets to 1.9 or higher, the heparin will be stopped. After 5 am, Jackilyn is back to give me the results. Its 2.3, the heparin is stopped. I'm going home! The heparin is stopped and for the first time since 8-13 I'm not receiving anything by IV. When Leonita comes to bring me breakfast, she begins packing my stuff. She takes about 80% of it home before leaving JFK around 730.
Not so fast on my going home yet. The doctors have to see me before signing off on the discharge. They all come and go by 10 am. I'm growing increasingly antsy and restless. Nothing seems to make me rest, I just want to get out of the place. I have a nurse named Judy that day, but she's never had me as a patient before. She has other patients, and needs to get my discharge papers together. When Judy arrives to take out the now unused IV pics, I ask if noon would be a good time for Leonita to come, Judy says yes.
It isn't till past 1230 that Judy comes to read Leonita and I my discharge instructions. When this is through, judy calls for a volunteer to come with a wheelchair to bring me downstairs. I'm going home.
Not so fast again. A few minutes after 1 pm, a frail elderly volunteer(who looks as if I should be pushing her out of the hosp. rather than vice versa) who weighs about 30-40% of my total weight arrives in the room without a wheelchair. Instead the volunteer comes with a story about the large wheelchair being locked up, and I'd have to wait for security to free it. Who knows how long this will take . One large wheelchair in an entire hosp. I'm itching to get out of Dodge, and ask Judy if I can just walk downstairs. I can do 3 laps around the floor, why not just walk to the front entrance and wait there as Leonita gets the car?
Judy says fine, but she'd have to go downstairs with me. Except she's got to take care of another patient then. Judy leaves, Leonita and I wait 10-15 minutes, Judy is still busy. So with Leonita carrying my last bag of possessions, we set off for the elevator by ourselves. A few minutes later, I'm standing outside breathing fresh air for the first time in over 2 weeks. A few minutes before or after 1:30 I climb in the car with Leonita's help. Finally I'm going home!
By the time of discharge, I'd lost a little under 20 pounds since being first admitted in July. That Salisbury steak diet does wonders.
I may write a post homecoming post at a later date.
Labels: Personal Stuff