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Home Sweet Home

It is now Tuesday July 2nd – and I am finally home. It has been a long, somewhat painful, and exhausting  six days since surgery. I went down around 8AM and happily, was able to say “see you later” (not goodbye lol) to my wife and daughter. Pre-op was all business, people dancing from cubicle to cubicle, each performing their specific mission-critical task. They shaved me (a lot), started an IV, and dripped in some Lalaland happy juice… and right around 9AM I was off.

I awoke, sort of, and struggled to figure out what was going on; I knew it had to ICU recovery, but hadn’t a clue of the time. I recall squinting at a digital clock and thinking it read 1:07, which made zero sense to since it was a six or seven hour operation. After a moment or two I realized it was 7:07. And that made sense. And then I realized that I could not speak – there was something in my mouth – actually my mouth and my throat: my breathing tube. I made some sort of motion or movement that helped them recognize that I wanted it out. After medically confirming that it actually was time to remove it, they extubated me – the first of a thousand tiny things that would provide me a measure of improved comfort and proof of progress, which is so mentally important.

In a nutshell, I was sent to ICU from surgery around five-ish, and my wife and daughter were allowed to see me a half hour later. I don’t recall them being there but was told I smiled when they spoke to me. I was, of course, still in Lalaland and intubated. I don’t recall much of that night, but do remember being helped to my feet around 5AM that next morning to be weighed (a daily morning routine). They told me I was doing so well that I would sent up to my room later that morning (my research had led me to expect one to two days in ICU), so there again another tiny proof of progress.

I was hoping for a Sunday discharge, which would be four days post-op, but one of the nurses told me that my surgeon never releases his patients until at least five days post-op. So my goal became a Monday discharge, one that I would not attain. Frankly I actually had a shot at a day five discharge, but a day four event would remove any chance of that….

They claim that days one through three post-op are an endless stream of baby steps and improvement that most people usually fail to notice: walking a little farther each of the many daily walks, feeling less light-headed upon standing, feeling less winded during the walk, needing less pain meds, and the like. And that proved true for me. My first time standing up I almost passed out. My first corridor walk was with a walker and left me somewhat winded. Literally baby steps!

They claim day four to be the corner most patients turn in their recovery. And that proved to be true, sort of. Walks were easier, no real discomfort or shortness of breath, pain was well managed and under control, and a good appetite. The chest tubes were still in which were unpleasant, but overall things were good. We were eating dinner when the EKG began to sound an alarm and within literal seconds people were pouring into the room. I was largely nonplussed as the various electronic devices in my room are subject to random, and seemingly innocuous alarms pretty much 24/7. But I did notice something odd or off with my heartbeat – something that would be quickly termed A-fib, or more specifically A-flutter. Apparently, it manifests itself in approx. 30% of the post-op bypass patients. Treatment was fairly easy, several IV’s were started and my pulse quickly returned to normal sinus rhythm. But supper, and that day-four corner turn, were blemished.

Another issue I was dealing with was low blood pressure coupled with a high heart rate, which was frustrating sine most my life my BP was far too high and my pulse was generally on the lower side. I believe we saw something in the range of 89/56 and typically in the 90’s over 50’s, which is just not right. And my pulse would sit at 90bpm at rest and would jump into the 120’s should I move suddenly (or as suddenly as an old man who just completed open heart surgery could lol).

At one point they decided to initiate an IV with albumin, a drug that helps boost BP. They chose an IV port in my right hand and started the pump. It immediately felt funny going in, but every drug and every IV has its own unique feel, I shrugged it off. After about a half hour my hand felt really tight, as did my wrist and forearm. I mentioned it to my wife and she came and uttered an “oh my God” and immediately left the room to grab a nurse.

When the two nurses came in, the very first thing they did was stop the IV pump. I commented it was a Led Zeppelin moment – “my hands felt just like two balloons” from Pink Floyd’s Comfortably Numb) – and happily they got the reference and laughed. One of them removed the IV from the port in my hand and we all marveled at the Pillsbury Doughboy ball of dough my hand had become.

Apparently the needle of the IV had either been forced deeper causing it to go through the other side of the vein, or pulled backwards slightly causing it to retreat from the vein, with either option resulting in almost the entire bag of albumin to enter my hand, rather than my blood system. No big deal (other than not getting the full efficacity of the drug, however it took three days for the swelling in my hand to completely recede.

Over time the meds began to do their job and my BP crept up into the 100’s over 60’s, which was gratifying to see; another of those thousand proofs of progress. But all that aside, my body has clearly begun the healing process, as evidenced by coming home six days after my heart was little more than a bloody paperweight, stilled and silenced for 124 minutes while the surgical team work their magic. I stayed alive because I had some machine doing that for me (a clumsy reference to Zager and Evans song “In the Year 2525”).

And now… let’s talk about the “insertions”. I had the 4 wires coming out of my chest, attached to an external pacemaker so they could manipulate by heart beating if needed (they were not needed happily). There was a drain coming out of left arm from the graft artery harvest site. And there were the chest tubes; three tubes coming out of my body approx. mid stomach. They drained into collectors so the medical staff could easily monitor the amount of blood and fluids being drained from me. They were intimidating to me – almost the diameter of my finger – and constantly uncomfortable. And it was endlessly disturbing to look at the blood sitting in the clear tubes between my body and the collectors.

Not only were they uncomfortable, they were limiting. How can you even think about getting out of bed and moving about with the IV’s and these massive tubes and collectors? They would hang them on my walker for my corridor strolls and frankly were the only reason I needed a walker – a required tool for my drains.

Now as time moved on, my concern over removing them grew exponentially. I asked a number of people about the whole removal process, I Googled constantly on how it feels to have chest drains removed, and fretted over it for a couple of days.

The first removal early on, was the bladder catheter. It went quickly and felt really weird, but not painful. Next came the removal of the wires out of my chest; again, felt incredibly odd but not painful. I had some concern over the arm drain because it often ached. The doctor came in and unwrapped the arm allowing me to see the massive incision running from wrist to elbow which was unsettling by itself. But seeing the tube coming out of my arm was really disturbing. It was probably 1/8” or 3/16” diameter and I wanted nothing more to see it gone. She had me count to three and then hum on three (this ensures you can’t inhale while it is coming out and end up with an embolism. It was a little uncomfortable but only for a second. But upon the end exiting my arm at a rapid speed, the bitter end flipped freely and sprayed blood all over my face! I laughed at her horrified face and said something like “it’s too early for Halloween decorations”. And just like that it was done. All that remained were the three chest tubes.

I continued to drain a fair amount of blood from them and in my mind, I knew this was impeding my progress. But at the same time, as long as they were in meant that I didn’t have to go through the removal process. But that night during the checkup they declared the tubes would almost certainly come out the next day. Ugh.

The next morning the doctor came in and said it was time. I immediately told him he could do what he wanted but I did not plan on being there for it. He laughed and then began the process of removing all the tape holding them in place. We went through the instructions, just like the arm drain a count to three and then a long loud hum. And on three I hummed and he yanked on all three at once and it was done. An incredibly odd feeling but not really painful. He quickly covered the three holes in my stomach and the deed was done.

I have to say, of all the pain and discomfort I felt over the post-op days, I never associated any of it to the chest drains. But once they were out, I came to realize that at least 80-90% of it was due to them. It turns out that apparently, they touch every nerve along every rib and any slight movement at all triggers discomfort. Once that were out my aches and pains were massively reduced. Amazing!

Now comes the painfully slow recovery process: the myriad of things I am not allowed to do topping that list. I can’t drive, probably for at least a month. I can’t pick up anything over 10lbs. I can’t reach or stretch. I can’t raise both arms above my head for any reason. I have to wear anti embolism stockings for at least four weeks (stunningly sexy in their smooth silky thigh high whiteness). So I can’t trim brush in the yard or mow the lawn, I can’t take the garbage to the dump, I can’t… I can’t do a million things. And that is simultaneously frustrating and depressing.

To top all the daily menial tasks I am denied from performing, there are the big projects that are now on hold. Withing the last few weeks, I had 5-yards of loam/compost delivered so I can continue to build up the bottom end of the yard that end up underwater during severe and prolonged rain events due to high groundwater table. Shovelful by shovelful into the wheelbarrow and then the long trek through the woods to dump the load and spread it, I was about halfway through that project when this all occurred.

In preparation of new storm windows, I had removed all my old ones in early June and was in the midst of repairing, cleaning, and painting the exterior sash and frames. I had also decided to paint the house over the summer and into the fall, now not likely to happen this year. Happily, I did a lot of cutting, splitting, and stacking so my winter firewood supply is basically all set and ready for burning.

There is the loss of fitness I had attained of the last year or two; I am at 23 hikes totaling 251 miles so far this year, averaging 10.9 miles per hike. And those values will not change for quite some time. Which means more from a fitness perspective than my personal records and stats. Some of my favorite hikes are the hot and muggy July/August hikes and grabbing ripe blueberries along the trail to combat thirst and hunger.

The fourth of July fireworks. For heaven knows how many years we have made the walk from our house to the town beach to watch the fireworks. The only thing that would stop us was the weather. I still recall sitting there just four days after my dad had died, feeling so terribly conflicted over the joy of the crowd and the splendor of the fireworks while feeling suffocated with the grief of his loss. This year, the weather will be ideal, my two local grandkids are at the perfect age to begin the annual tradition, and I will be here at home instead of there.

The loss of going out to dinner. We go out to eat twice a week and it will be at least August before we can likely do that again because of the driving restriction. So it has become an ever-growing list of losses day by day. But don’t get me wrong dear reader, my current status is infinitely better than the likely alternative had they not found and fixed my blocked coronary arteries. So, much like everything in life, there is both duality and balance in all this. Stay well reader, and if you smoke – stop; if you have high blood pressure – get meds; and if you have high cholesterol – get on a statin. Enjoy your 4th of July!!

This Post Has One Comment

  1. Vernie Vandervort

    Your passion for your niche is evident.

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