Monday, October 28, 2013

The Healing Home

*As usual, the following is written from my memory of the events.  Some things may be inaccurate due to faulty memories.  In any case, this is how I remember it: 

After a little over a week long stay in the hospital for surprise heart surgery, I was sent home to recover in as much comfort as one's own home can provide.  The release date had been changed twice due to complications with my disobedient heart.  But the day finally came and I was on my way home!

I was put in a wheelchair and sped at almost a running pace down to the valet parking area. You should have seen my husband trying to keep up with this guy; I swear he thought it was a race or something.  Once in the car, I sat in the front seat with my trusty heart pillow between my chest and the seatbelt.  Every little bump on the way home was a reminder of how fragile and uncomfortable I was.

Once home, I was excited to search for the "cherry" spot.  Everyone who has ever been sick or injured knows what I am talking about.  There is one spot in the house, be it a spot on the couch, your desk, bed, etc., that you find the most wondrously comfortable and will rarely leave until you are well again.  It took a little while, but I found that there isn't a cherry spot for me this time. My body has been through so much, and the fact hat I can't sit ( or lay) in one spot for very long makes it impossible to have just one good spot.  I found that there are several OK spots, but no cherry spot.

The half hour trip home, plus the flu shot they gave me just before I left the hospital, left me exhausted by time I got home.  I fell asleep on the couch, but not for long.  I can't sleep for more than two hours at a time since the surgery.  I get too achy and wake up and have to get up and move around.

One of the first things I swore I would do as soon as I got home was to take a real shower.  They told me I could as long as I didn't use hot water and I didn't spray directly on my incision sights.  And I had to be sure to dry the sights thoroughly.  I got all prepared and stepped into the shower only to find that the act of removing my clothing and stepping into the shower exhausted me too much to stand and bathe.  I have to wait for my mom to bring me a shower chair before I can take a real shower.  So I have been taking sponge baths (more thorough ones than at the hospital) in the mean time.

My daily routine is simple, I wake up, check my weight (they need me to do this so they can check for signs of water retention and other things), take my temperature (again to check for signs of bad things), check my blood sugar (diabetic), take my meds, eat breakfast, do my breathing exercises (that toy thing I talked about in previous posts), check the interwebs (Facebook, e-mail, twitter, blogger, etc.), then the rest of the day is pretty much a go-with-the-flow kind of thing.

Night time is the only time I don't look forward to.  I am so tired but I just can't sleep.  I lay on the bed and fall asleep for two hours or so, then wake up feeling achy and have to get up and move around.  I move to my desk chair with my legs up on the bed and sleep like that for an hour or two, then wake up with a numb booty and feet and have to get up and move around.  I move to the couch and sleep for a couple hours, then the cycle continues.  It is frustrating to say the least. And I feel so bad because my movement wakes up my husband, disturbing his rest.

Healing from heart surgery is serious business.  It will be months before I am anywhere near "back to normal".  They cut through a lot of muscle and bone to get to my heart, and then bypassed three arteries on my heart.  Then they sewed me all back together and I have to heal it all up.  This is why I have close to zero energy; every ounce of energy my body has is going to healing up my new arteries and the muscle and bone they cut through.  I am on all kinds of medication. Even though I am exhausted it is important that I get some exercise a few times a day (walking),  and even though it is difficult to stay asleep, I must try to get a good amount of rest. I have to check my incisions daily to make sure they are not becoming infected or healing too slowly. And I have to be aware of my overall health and how I feel.  If I were to catch a cold or get an infection of any kind right now, it could be devastating.

I have been home for four days now and am feeling a little better every day.  I do as the doctor has instructed and try not to over exert myself.  That is the hard part.  I am so independent that it is difficult to let others do simple things for me.  My mother-in-law comes over to help out and she is so nice to do so, but I just find myself feeling so weird letting her take my dishes to the kitchen or picking things up off the floor for me, or helping me to sit up from a laying position because I’m too damned weak to lift myself.  Well, that last part isn’t quite true, I am strong enough, but am under doctor’s orders to not use my arms or chest muscles, so it is very awkward to get up from a laying position without using your arms or chest.

I am sure very soon I will be feeling so much better and actually be able to sleep through the night.  I will be writing more updates as the weeks go by.

Sunday, October 27, 2013

The Racing Heart

 *As usual, the following is written from my memory of the events.  Some things may be inaccurate due to faulty memories.  In any case, this is how I remember it:

On Sunday, October 20th, 2013 I was sent from ICU to my own private room at Community Regional Medical Center Fresno. It was a relief to have some privacy.  Especially a bathroom and not just a toilet next to my bed (not that I used the toilet next to my bed in ICU...OK, I had to, once).

I stayed in this room from Sunday evening, October 20th until Thursday, late morning, October 24th.  The daily routine was to check my blood-pressure, temperature, and oxygen levels about every four hours.  I was given medications in the morning and evening.  The medications included blood thinners, blood pressure, cholesterol, something to keep my heart rate down, baby aspirin to protect my heart, pain medication, stool softeners, and laxatives.  The first couple of days they forgot to give me my acid reflux medication, but after I was having some weird symptoms they realized it was from acid reflux and started giving the med again.

I was asked to go walking around the halls a couple of times a day.  It is amazing how fast you are up and walking around after major heart surgery.  It is very good to move around, although it is exhausting just to walk a few feet, it does help to keep blood-flow, and really helps to keep stiffness and soreness away.  By time the last day came around, I was taking 3-4 walks a day as well as getting up and moving around my room a lot.  What I mean by walks is that the floor I was roomed on is shaped like a field track, I would walk this track, I passed by maybe six or so patient rooms and three nurses stations on my route.  It wasn't a long walk, but by time I got back to my room I felt both exhausted and rejuvenated.

I was given a sponge bath each morning which felt good but inadequate at the same time.  Especially my hair, they make you use this leave-in shampoo that only proves to make your hair greasy and disgusting...but clean.  I couldn't shave and by time I left the hospital I felt like a yeti.

Whenever you have major surgery, it can take a while for all of your bodily functions to come back online at proper capacity. They measured my urine outtake which was more than adequate almost immediately after surgery. I was asked everyday if I had had a bowel movement.  It would be nearly a week after surgery before I had a bowel movement.  Part of the reason for this would be that I was not very active, part because I was not eating much, and part because of the trauma of surgery ( my body was so tense and sore from surgery that EVERY part of it was not wanting to move).

During my stay in my private room, family came to visit and it was nice to have the company and know so many people care.  I was sad to find out that children under 12 years old weren't allowed to visit, so two of my nieces and a nephew had to wait downstairs.  :(  it is understandable, though, I had just had open heart surgery and was at high risk for infection and had a lowered immune system and little children are notorious carriers of colds and flu, etc.

I watched more T.V. during my stay in the hospital than I have all year.  I paid very little attention to it, though.  I think I spent most of my time just staring out the window, thinking about everything and nothing all at once.  I had my cell phone and laptop with me and checked in on Facebook a couple times a day, but it only made me miss home so I kept that activity to a minimum.

Every four hours I had to do breathing treatments.  When you have major surgery, you are at high risk for blood-clots and fluid buildup in your lungs.  If you don't exercise your lungs and regain full capacity, you can develop pneumonia.  They gave me a breathing "toy" to keep with me at all times and use at least ten times every hour to exercise and strengthen my lungs.  In addition to the toy, a respiratory therapist would come to my room every four hours and give me a treatment to help open my lungs.  It was a mixture of medications used for asthma patients, delivered through a breathing machine.  I simply breathed in and out through this machine for seven minutes.  I hated these treatments solely because the medication left me feeling jittery for an hour or so after each treatment.

Every morning the surgical assistant would come by and talk to me about my progress.  On Monday he said I might go home on Tuesday.  On Tuesday, he was very concerned that my heart-rate was holding steady in the 110's (too high).  They decided to keep me another day and administer medication to bring down my heart-rate.  They also gave me I.V. fluids.  The next day my heart-rate was still high and I was feeling like I had a twenty pound weight on my chest.  They increased the medication and gave me more fluids and an EKG.

Wednesday evening my heart-rate had been normal for several hours.  I still had some heaviness on my chest and the feeling like I couldn't take a deep breath; not like suffocating but like I couldn't fully open my lungs.  The respiratory therapist came in and by chance we talked about my GERD (acid reflux) problem.  He deduced that it was inflammation from acid reflux that was giving me these weird symptoms.  He told the surgical assistant and I was put on heartburn meds.  By Thursday morning I felt so much better.

Thursday morning was a wonderful time.  I was told to go for a walk so they could make sure that my heart-rate was still under control. It was.  They removed the central line from my carotid artery, and took off the heart monitor, inspected my incision sights, gave me a flu vaccine, and went over all my home care instructions, medications, next doctor visit, etc.  I was on my way home before noon.

My next post will be about my first few days at home. 


Saturday, October 26, 2013

I Shall Pee On the Floor in Defiance!

*As usual, the following is written from my memory of the events.  Some things may be inaccurate due to faulty memories.  In any case, this is how I remember it: 

The first thing I want to say in mention of my stay at Community Regional Medical Center Fresno, is that there was not one employee I came in contact with that was not so very kind, compassionate, gentle, and professional.  Everyone from the nurses, CNA's, doctors, food servers, housekeeping, etc.; they were all wonderful and made my stay bearable.

I was in the hospital from Wednesday, October 16th, until Thursday, October 24, 2013.  This post will cover the time I spent in PreOp (Thursday, October 17th) and Critical Care. Friday, October 18th - Sunday, October 20).

Thursday, October 17th was a day of calm and nerves.  I awoke that morning to the sound of my roommates daughter talking to the nurse.  She was sobbing and saying things like, "I understand."  "I know everyone has done everything they can."  My roommate was an elderly woman who, if I remember correctly, had COPD, had had a stroke, and had an infected bed sore that covered a large portion of her back.  She had stopped eating and this morning the nurse was telling the daughter, in so many words, that this was the beginning of the end.  The rest of the day was spent listening to the family cry and make arrangements to send their mother to hospice care.

As far as myself this day, I was subjected to EKG's, blood-work, an ultrasound of my carotid arteries, chest x-ray, and multiple people coming in and out to talk to me about different parts of the surgery: anesthesia, all the tubes and wires that would be hooked up to me, what the surgery entailed, what to expect after surgery, etc.  Several of my friends and family showed up to visit with me, for this I was so very grateful.  I was not very nervous yet, but I wanted the time to go by faster and having people to talk to and distract me was a good thing.  The last thing that happened before the lights went out for the night was a sponge bath.  For some reason they wouldn't allow me to take a regular shower.  This was my first sponge bath ever and it felt so weird to be bathing in a chair next to my bed.  It was one of those feelings of simply being out of place and discombobulated.

At some point, they took my roommate away and brought in a new one.  Another elderly lady, this one had just had a heart procedure done, stints, I think.  she spent several hours asleep.  It was when she woke up that things got interesting.  I don't know if she was having a strange reaction to the anesthesia, medication, or if she had dementia or Alzheimer's; but she was very confused and spent the entire night arguing with everyone, refusing to stay in bed, and peeing all over the place.  Yeah...

The morning of my surgery, I woke up to my roommate still fighting with everyone and peeing on the floor.  I had no concern about this however, my mind was on the surgery.  I was now feeling the fear.  My head refused to think about anything other than everything that could go wrong.  They were about to crack my chest open!  My heart was going to be handled by strangers hands!  I cried for a couple minutes in the bathroom while my roommate stood outside arguing with the nurses and her daughter about why there was a stranger in her bathroom.  When I came out, my husband was there and I cried in his arms.  All I could think was, "I want my mommy."  And she showed up, I cried in her arms.  Then they took me away to a very cold room, they told me what would happen and then I fell asleep.

When I woke up I was in ICU.  The few days I was in ICU, I felt wide awake but now that I try to remember this time, it is foggy. the first thing I remember is waking up to the nurse and respiratory guy discussing whether or not I should be put back on the breathing tube.  Breathing was difficult, it felt like I couldn't take in a full breath, but I tried hard and they decided I was OK on my own.  I remember my brother, Glenn, sitting in a chair next to my bed.

Doctors and nurses kept coming in to talk to me and do things.  Family and friends stopped by to visit.  They all said I looked so good for what I had just been through.  When I saw myself in a picture my husband took of me, I thought I looked like death.  I was up and sitting in a chair mere hours after  the surgery.  I had bad nausea from the pain medication and it took several tries with different meds to find one that didn't result in painful vomiting. I had no appetite, ate very little, and usually threw up after.  I slept a lot in ICU, but never for more than two hours at a time.  I kept being shocked awake, as if something was terribly wrong, and it was not a comfortable experience to have just had major heart surgery, so you can imagine how difficult it was to find even the most remote amount of comfort.

When I first arrived in ICU, I had an oxygen tube in my nose, two central lines in my carotid artery, a chest tube, an IV in the back of my hand, a heart monitor, a blood-pressure monitor, and one of those finger things that measure your oxygen saturation, and a catheter.  By time I left ICU, I had one central line in my carotid and the heart monitor.

I felt very little pain while in ICU and it wasn't just because of the pain medication.  The chest incision was totally numb and the leg incisions didn't hurt really either.  I think because of the numbness, my mind couldn't "feel" the pain so all I felt that told me I was in pain was stiffness and a heavy feeling on my chest.  The only real pain I felt while in ICU was when the doctor came in and yanked...yes, I mean YANKED the chest tube out of me.  OMG, it felt like he was disemboweling me. But it only lasted a few seconds and I felt tons of relief once that huge tube was gone.

At around nine in the evening on October 20th, I was moved from ICU to a private room.  I will write about this part of my stay later.

Friday, October 25, 2013

Surprise! Heart Surgery!

 *As usual, the following is written from my memory of the events.  Some things may be inaccurate due to faulty memories.  In any case, this is how I remember it:

I just got released from the hospital yesterday.  I had gone in last week for a routine angiogram and ended up having a triple bypass.  It's always fun when you hear those words, "Surprise! Heart surgery!".  Especially since I had no idea there was anything seriously wrong with my heart.

I've suffered from GERD fro two years now and had thought that all this chest pain was just uncontrolled heartburn (the symptoms are extremely similar).  when my doctor couldn't figure out why the diet and medicines weren't working, she sent me to a GI specialist who in turn sent me to a cardiologist because I had told him the only time I get heartburn now is when I am physically active.

My first visit with he cardiologist was routine.  They ran an EKG which came out abnormal but "not bad", and he listened to my heart and examined me and we talked about my history and symptoms, etc.  At this time, he figured there was a problem but that it wasn't anything to be overly concerned about.  I think he was thinking this because of my young age, I'm 34.  He scheduled me for a stress test.

One week later, I returned to the cardiologist and they ran the stress test.  What they do is hook you up to a heart monitor and do an ultrasound of your heart while you are resting.  Then they make you run on a treadmill for a few minutes while increasing the incline and speed every two-three minutes.  The test lasts as long as is takes to get your heart rate up to max.  So the less healthy you are, the shorter the test will be. Mine lasted six minutes. When your heart-rate is to max then they lay you on the table again and ultrasound your heart while it is at full capacity.  At this point, the doctor found, "a narrowing".  He scheduled me for an angiogram.

The very next morning, I was at Community Regional Medical Center in Fresno for my angiogram.  An angiogram is when they go in through either your groin artery or wrist artery and shoot dye into your heart to get a good image of the blood flow. It is a mildly painful and uncomfortable procedure, but it doesn't last long. They had not even finished the procedure when the doctor got on the phone to schedule surgery for me.  This was when I became concerned.

I went in for the angiogram on Wednesday morning.  My bypass surgery was scheduled for Friday morning.  So I sat in a bed all of Wednesday and Thursday with nothing else to do but think.  The doctor said that one of my arteries was 100% blocked and one was 70% blocked.  I would need either a single or double bypass, depending on what they found when they got in there.  I was very calm and good spirited (worried more about my cat missing me at home than the looming surgery) up until the thirty minutes before the surgery.  My husband came into he room and I just broke down crying.  Let me tell you, it is very true that in times of pure fright and crisis, everyone calls out for their mommy.  When she showed up, I hugged her so hard and cried so loud.  I was frightened.

I know you are wondering how a 34 year old woman could end up needing coronary bypass surgery.  I was diagnosed with type I diabetes at age nine.  I have never had the disease under perfect control.  Part of this was the fact that I am bull headed and do what I want; part of this is because I had no health insurance for a large chunk of my twenties and early thirties and therefore could not monitor the disease accurately.  Diabetes, when not controlled, will kill you, it will ruin your heart, kidneys, eyes, circulation, stomach, everything!

When the surgery finally came, it went very well.  It was supposed to last 3-6 hours but was over in under three.  They ended up doing a triple bypass because they found a "ghost artery" when they got in there.  A ghost artery is an artery that no longer works and has sprouted a ton of tiny veins to try to bypass itself.

I plan to post several spots on my recovery in the months to come.  I hope my experience is interesting and can help others who are going through the same thing, or just need a little information.

Tuesday, October 15, 2013

Playing Doctor Pinball Pays Off

I have written in the past about my ongoing troubles with GERD.  For those of you who don't want to travel back through my previous posts, I have GERD and up until today, I thought all of my pain was attributed to this terribly uncomfortable heartburn problem.  I was wrong...well, not all wrong, I did suspect that there was possibly something else.  About that, I was right.

My primary care doctor, a few weeks ago, sent me to a GI specialist to try to figure out why my heartburn was not being successfully controlled by medication and diet.  The GI specialist ordered an endoscopy.  Let me go off track here for a moment and tell you the wonderful story of how the endoscopy went.  They give you an IV and through that they give you nice drugs that relax you and help you doze off a bit.  My IV either punctured through the vein or was not in it at all.  All those wonderful drugs filled a nice lump in my arm, NOT getting into my bloodstream and therefore NOT making me relax or sleepy. Needless to say, I felt every moment and millimeter of the endoscopy.  Not a comfortable experience, but not terribly painful.  Thank goodness it only lasts a few minutes.  After the endoscopy was done, I would say about 30 minutes to an hour later, the drugs finally hit me and I slept like a baby for several hours.

OK, back to the story at hand.  The GI specialist, after hearing me explain that I don't get heartburn from foods, or when resting, and not too often when lying down anymore; but I do get it real bad whenever I try to engage in any physical activity, with no relief from medication, suspected I might have a heart problem in addition to the GERD.  He referred me to a cardiologist.

The cardiologist checked me out, did an EKG and a stress test with ultrasound and found an abnormality, "a narrowing".  So, now I get to go in and have an angiogram to find out the extent of this issue.

At least I know what the source of the pain is now and can move forward to get it resolved.

If you'll excuse me, I need to go shave my groin now.