JT's Blog

Things that interest me, things that happened to me, things that I like, even some things that I don't like...

My Final Surgical Blog Post

I've fallen way behind in blogging about my surgery, so this is going to be a short catchup post.

The first image from my open heart surgery to repair my mitral valve. I think this is before the repair.

In brief, I'm doing great.

Just saw my cardiologist, and like all the other health care workers I've seen, he's pleased and a bit amazed at how well I'm doing.

Last year when he first broached the subject of surgery, he thought I might not be able to take care of myself for about two weeks after the surgery, and it might take two to three months for a full recovery.

As it turned out I had two really awful days in the hospital, followed by three not so bad ones. Once I was released, I did pretty well, and full recovery came in about four weeks.

I even moved up my visit with the surgeon's office since I was feeling so good. They declared me fit as a fiddle, right as rain, and agreed that I no longer had to take that awful rat poison, uh, warfarin. They were even nice enough to give me a few photos of my heart during the surgery.

The second image from my open heart surgery to repair my mitral valve. I assume that white thing is the ring they placed around my mitral valve.

And I do seem to have developed some extra energy. I wasn't aware of it myself until the other day as I was walking home, I realized that I was sprinting to beat traffic lights and it wasn't tiring me out at all. When I arrived back at my apartment building, I took the three flights up the stairs without losing a beat. It was almost like I was 10 or 20 years younger.

I do have one lingering problem: what the medical community calls auras, and I call coruscating zigzag blobs, have been plaguing me ever since I was released from the hospital. But they are gradually diminishing, and I have every expectation they'll be back to their usual rare appearance before too long.

And I have one minor regret. When I consulted with the surgeon, I also signed up for a randomized clinical trial of atrial fibrillation remedies.

The third image from my open heart surgery to repair my mitral valve. I guess this is after the repair.

In brief, after my surgery I would be monitored for A-Fib, or irregular heartbeat, and I would be treated with one of several different medications, assigned randomly. I was looking forward to it.

The day after my surgery, Stephen, the young man who was in charge of the trial, came to see me in the ICU. He informed me that they had been monitoring my heart beat and had detected no irregular rhythms, so there had been no need for treatment yet. But, he assured me, they would continue to monitor me.

“So if I understand this correctly,” I began, “what you're telling me is that I got rhythm.”

Never saw him again after that.

Not Surgery Denied

Here I am demonstrating the incentive spirometer

“Just so I’m clear, you won't be following me through this whole procedure, will you?”

I was talking to the nurse at Penn Presbyterian who had just shaved my chest and abdomen in preparation for the open heart surgery, the day of the surgery having finally arrived.

“That’s right,” he replied. “I’m the cook prep nurse.” At least I think that’s what he said.

It wasn’t long before someone wheeled me into a quasi-waiting area. Several other nurses double checked my vital signs. Someone set up an IV in my right arm. Then a man introduced himself as an anesthesiologist; he said he was going to give me something that would make me feel like I had just consumed a glass of wine, because he needed to keep me conscious for a bit longer–

The next thing I remember is fighting a haze as I gradually became conscious. There was a vague memory of a dream where I was fighting off a whole team of people who were trying to stuff something down my throat...

There were several nurses around, fiddling with this and that, asking me how I felt. I gradually became aware that there were still a bunch of tubes and IVs sticking in me and I felt pretty awful.

They told me that the surgery had been completely successful and I was now in ICU; my mitral valve had been repaired, which was the desired outcome.

A familiar face appeared. “I remember you. You're the anesthesiologist,” I said, pronouncing each syllable very carefully.

“Oh, you remember me,” he replied, sounding surprised.

“Yes, you gave me wine.”

“You gave us quite a hard time when we tried to take out your breathing tube. You were fighting and flailing your arms. It took six of us to calm you down.”

“Oh, then that wasn’t a dream?”

The Nurses

There were several nurses who took great care of me in ICU. I remember Matt and Chris in particular, but there were at least a couple of others. Then once I got to my room, there were several more nurses who did great work. Again, I can only remember a few of their names, but here's a shout out to Bernadette, Christine, and Candace.

While most of the nurses were superb, there was one who was not. I don't recall her name, but it was during my stay in surgical ICU. As I said, I still had tubes and IVs sticking out of me, and I was in a lot of pain. I wasn’t feeling pain at my incision but in my back, my trapezius muscle to be exact; apparently while I was sedated, they didn't position me for my comfort but for the surgeon's convenience. So I was feeling quite a bit of back pain, and none of the medication they gave me seemed to help at all. Not even the morphine.

Anyway, I needed to change my position fairly often, probably at least once an hour, and with the pain and the tubes I wasn't able to move myself, so I had to ask for help. Now anyone who knows me knows that asking for help is not my strong suit, but I didn’t have any other choice.

Most of the ICU nurses were terrific, helping to position me whenever I needed help. But one time, after helping me into a slightly different position, Nurse Ratched asked me if that was better.

I answered honestly. “I’m not sure.”

This seemed to set her off, as she proceeded to lecture me on how fortunate I was to have so many nurses looking after me in ICU, that I shouldn’t expect that level of care once I got into a room, and that I better start showing some appreciation. I didn’t see her after that, probably it was the end of her shift.

Other than the back pain, which never responded to the pain meds, my biggest problem in ICU was the phlegm in my throat, which caused me to cough. A lot. Several times one of the nurses would stick a vacuum down my throat to try to remove the phlegm, but to little avail. Twice the coughing jags caused me to vomit profusely, at which point they stopped feeding me ice chips.

I Have a What in my Where?

My stay in the ICU was timeless; I really had no conception of time. At one point several of the nurses helped me onto a scale. They told me that I had probably gained ten pounds during the surgery because of all the fluids that had been pumped into me. I said that was unlikely, and I was right. I had gained twelve and a half pounds.

But that raised another question in my mind. I had been in ICU for a good number of hours and I'd probably have to pee at some point. Would I require a gang of nurses to help me to the toilet?

“Do you feel like you have to pee?” asked Chris.

“No, but I expect I’ll have to at some point.”

“Actually, they inserted a catheter in there and your urine is draining into that bag at your side.”

And for the first time I noticed a bag of amber-colored liquid at the side of the bed.

When it came time to release me from the ICU, the last thing Chris did was to remove the cath from my urethra.

I asked, “Are you a yanker?” If so, I guess that would have made me the yankee.

“No, I don’t yank. You’ll probably find it an odd experience.”

He was right about that. It wasn’t painful, it was odd. Actually, it felt like I had just peed on Chris. I felt I owed him an apology, but he denied it.

My Incentive Spirometer

The Incentive Spirometer

Before releasing me from ICU, Chris gave me my incentive spirometer.

This is a device that was supposed to keep me from getting pneumonia. There was still fluid in my lungs (and yes, I could feel it; it made taking a deep breath very unpleasant), and by inhaling through the incentive spirometer I could help get the fluid out of there.

In My Private Room

My surgery had taken place on Thursday morning; sometime around noon on Friday I was released to a private room. Chris wheeled me up there.

Given that I had not slept a wink on the night before the surgery, and not at all during my stay in ICU, I had now spent two nights without sleep. The pain meds were still doing nothing for the pain in my trapezius muscle.

The worst was still to come.

I pressed the button to call for help.

When Bernadette arrived, I said, “I’m feeling nauseated.”

“Oh, you’re nauseous, are you?”

I decided this was not the time to discuss the correct use of “nauseous”.

This was my lowest point. Apparently the nausea was a side effect of the anesthesia they had given me. But there was a solution. I think she called it Ativan. She administered it through my IV line; she said it would take effect immediately.

I don't think it worked quite as fast as she said it would, but eventually my nausea did go away. And the pain meds kicked in. And Friday night around 8 o’clock I fell into a blissful sleep that lasted until the following morning.

Well, it probably would have lasted that long, but one of the nurses interrupted during the wee hours of Saturday morning to check my blood and make sure everything else was as it should be. I fell right back to sleep.

Surgery Delayed

The phone rang.

I saw that it was the surgeon's office. Probably reminding me that my surgery is in two days.

“Hello.”

“This is Dr. F_______'s office. I'm calling to–”

“Remind me that my surgery is in two days. Yes, I remembered.”

“–your surgery has been cancelled.”

“What?”

“Dr. F_______ discovered that the hospital doesn't have all the equipment that he needs. He'll call you tomorrow to discuss your options.”

It was like a kick in the belly.

All my best laid plans to schedule the surgery over the Labor Day holiday so that I'd miss the damned Budweiser Made Deaf in America concert had gang aft agley.

The surgeon did call me the next day. He said he was referring me to another surgeon, as hard as that was for him to do, because after consulting with him, they had mutually agreed that the new surgeon had the facilities to guarantee a higher chance of a fully satisfactory outcome with a minimally invasive procedure.

He was also able to get me on the schedule in one week.

Of course, that meant I had to visit the surgeon and also see a new cardiologist because the venue had changed.

I won't dwell on that week. I'll just say that it was possibly the longest week I've ever lived through.