The heart is the substance.

Friday, July 24, 2009

the surgery and the afterglow

Yes, it's the update you've all been waiting for! Just kidding. I am pretty sure no one is sitting on the edge of their seats to hear how the surgery really went.

First of all, the surgery went very well. My surgeon was able to repair the heart valve through the minimally invasive surgery! Good news, great news... yes. I am currently at home recovering which includes walking a few times a day, keeping up with meds, generally resting, spending time with mom, and watching some movies along the way. It is very hard to be still and be a patient, when there are times you want to do things. The first few days were pretty lazy, because I was still very sore and did not feel well. I see my cardiologist on Tuesday and we will see how she thinks things are progressing.

July 13th revisited:

I arrived at pre-op at 7:30am. They were running a tight ship and I was immediately taken back for vitals and the deadly finger prick! (seriously, I bruised) After the rest of the blood work, I was sent to get a chest X-ray. Unfortunately, this proved to be a little bit of a longer wait, because their computers went down and they skipped me on accident. After the chest X-ray, which they conduct somewhat like an assembly line... or herding cattle, or something strange and impersonal. Then I met with the nurse who gave me a big book from the heart center... you know, just a little light reading. She explained everything about pre-op stuff, including how to properly shower with the little scrubber things that docs use to scrub-in with. Believe it or not, you have to take 2 showers! We met with the anesthesiologist coordinator who answered our questions about being "put under." After that, I requested a notary to complete my Advance Directive paperwork, so that everyone knows what decisions I would like in case I cannot answer for myself. The paperwork also includes a healthcare power of attorney, which officially appoints one individual to make healthcare decisions for you if you cannot speak for yourself. After all of this was completed, we went to the cardio-thoracic surgery clinic to speak with my doctor. I actually spoke with one of the fellows, but he was nice and it only took about 10 minutes. After five hours of clinic time (mostly waiting in chairs), I was free for the afternoon. Mom, Dad, and I went to lunch which was really fun. I took an afternoon nap and then met the pastor at my new church for dinner. He drove all the way from Newport News, VA for my surgery. Talk about an awesome person.

A little bit about July 14th and the following days:

We arrived at the hospital at 5am. By 5:30 I was in pre-op answering questions. Just as they were putting on my ID bracelet, a nurse came by to let me know that my surgery would be postponed for an emergency double lung transplant. I trotted out of to the waiting area to let the fam know. We were all a little dissappointed, but we were happy for the recipient of 2 matching lungs! This began the long wait. I was finally paged to surgery somewhere between 1:30 and 2:30. Special thanks to S, P, D, R, and D who made visits that broke up those 8 hours for me! The worst part about it was that I couldn't have any water... but I made it!

The questions went fast and pretty soon, I was meeting my anesthesia fellows who would take care of me. They whisked me off to another area and began placing my IV. I got a little scared at this point, because everything was moving so fast and the room was really small. But as soon as they sent that first med through my blood... I was asleep.

I woke up in the ICU, with a tube in my throat. At first, I just remember snapshots. People were trying to tell me to stay awake, because you have to be awake enough for them to take the tube out. All I can really say, was that this is not a pleasant experience in the least. It is pretty much like being choked and not being able to do anything about it. Luckily they figured out that I was not going to pull on the tube, so I did not have to be restrained for too long. The second worst thing, other than waking up intubated, was a lovely thing called chest tubes. I had two large chest tubes and one drain (Which stayed in until discharge). One tube goes in front of the right rib-cage and the other goes behind the rib-cage. Both of these help to drain fluid from you body after surgery. Eventually they removed the two large tubes, which again, is very painful. While my primary experience in the ICU is one of pain and discomfort, I also sat in a chair and walked about 30 feet. And when you think about it... that is pretty impressive. By noon on the 15th, I was ready to go to step-down.

The afternoon went well. The first night awake was a pretty awful experience. My goal is not to belabor the experience of pain, but is more for those who are facing this surgery and are reading this blog. My greatest advice is to work hard on communicating with your nurse about pain. Know how they interpret the pain scale, what they are hearing from you. Make them repeat information... some of them don't listen. Also, when you are on pain medicine, it is harder to articulate complex types of pain, so keep trying. Be assured that they can call the doctor and order you more pain meds- I promise. If a nurse tells you, "that's all we can give you," have them call the doctor. While my pain was not well managed on my first day, I am thankful to those nurses who helped me and for my mom for putting up with my moaning (literally, not figuratively). All of this to say... pain management is a HUGE issue, and everyone uses different language to talk about pain, so try to communicate well and often.

The next couple of days went much better. Thanks to all who visited me in the hospital, sent flowers, cards, and wrote notes on facebook. While I did not have the energy to respond, I was very grateful for your thoughts, prayers, and encouragement. You'll never know how special it made me feel.

My days in the hospital usually included (starting at 4am)- bloodwork, chest x-ray, meds, breakfast, walk, sit up in chair, lunch, walk, nap, dinner, walk. Sounds fun, huh? I did eventually get a couple of spit baths too, which always makes you feel better. God knew what God was doing with that whole water thing.

Heart surgery accessories:
Incentive Spirometer: a plastic tube-like device that looks somewhat like a nebulizer. The idea is to suck air into your lungs to help expand them and encourage deep breathing. This helps with- not getting pneumonia and increasing stamina.
Heart pillow: a firm pillow that you can hold to do deep breathing and coughing that acts a splint so that it does not hurt as much. I have also found this pillow useful for laughing, since that can hurt a little too.

Now, my incisions are looking good and by tomorrow, I should be able to take off all of the tape, gauze, etc. There are 5-8, depending on how you count them. It looks like there will not be bad scars, but I will update you on that once all of the tape is gone.

I am pretty certain you are tired of reading this post by now. I just needed to get my update in, before my blog became a pre-op only account.

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