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  1. They got me again! I knew it was coming, but this time they were much sneakier about it. [TLDR at bottom] I was told in late May that my heart valve was due to get replaced. I knew that day would come, being born with a faulty valve, but didn't expect till later. Eventually got the referrals by my cardiologist to get the tests and surgery, but everything takes many weeks, if not months. Meanwhile, I'm on short term disability, and slowly feeling more exhaustion with activity. So I fly down to Quebec City from St.John's to enjoy a big family reunion (59 relatives altogether) during the first week of August. On the following Monday (August 3rd) I had a follow up echo-cardiogram for my slowly degenerating heart valve. I'm secretly hoping it will accelerate the process for me to get the heart valve surgery since I'm waiting for a call for a coronary angiogram (the radioactive dye + X-ray to see your blood vessels) for the following week. It worked a bit too well. When some of the research personnel saw my echo results, they told me they'll show them to one of the cardiologist and maybe expect a phone call. Well right before lunch, they call me and tell me to present myself to the emergency ward as soon as possible. So I finish my lunch, pack several belongings for a stay in the hospital and my mother drives me to the ER waiting room. Again, the same hospital as last time with absolutely no internet access for patients. Within the hour, I'm screened, admitted to the ER, measurements are taken, I get scheduled MRI (they're still as noisy and claustrophobic inducing as I remembered them), and soon get my room to spend the night there. They tell me I'll be getting my angiogram ASAP and the heart surgery likely the following week. Next day (August 4th), they give me the documents concerning angiograms. Uhuh, catheter through wrists veins... otherwise through groin... local anasthetic... awake during procedure... groin area shaven (dangit!). All in all, it goes well! They were able to go through my right wrist, I have excellent arteries, no blockages, no need for bypasses and using veins from my legs. About catheters that go through major veins/arteries. Since these are large blood vessels, to stop the bleeding, much pressure must applied, the basis of a tourniquet, to form a blood clot at the point of incision. And when they say MUCH pressure, they mean it! For my wrist, they had to put a sort of foam cylinder tied down tight with a plastic wrist band. How tight was it? Literally lost all feeling in my fingers for the whole hour I had it on at that extreme tightness. I wasn't allowed to make a fist otherwise blood would flow into the hand, but not out (like putting a rubber band too tight around a finger). So I was only allowed to move my fingers. Weird feeling to have to physically look at my hand to confirm that finger movement has occurred. After an hour, the nurse confirmed there was only light bleeding, so she was authorized to loosen the band, but still leave the whole apparatus there for another hour. At least I could feel my fingers again. After two hours, a simple bandage was enough. I was lucky, because another lady on the same floor had to wait for two hours before getting her wrist band loosened. Rest of the week is minor tests, I'm on a wireless heart monitor for a few days until they notice that my heart rate goes unusually low, mostly at night and that the signal is "off". So they stop my heart meds that controlled my hear arrhythmia that brought me there three months ago, put me on a fully wired heart monitor and in a semi-intensive care bedroom where there is a nurse's office right next to several beds. It's on Friday morning (August 7) that they tell me I'll be getting a pacemaker. WTF?! It ain't just the heart meds? They keep me monitored during the whole weekend and I see myself the results. My heart rate could drop to 36-38 bpm and up to 60 bpm when still on the effects of the meds, and as my body slowly evacuated them, my heart rate rose from low 60s to 100s when active (with exhausted sensation due to failing heart valve, but I knew that part already). Still need the pacemaker because the calcification that's killing my heart valve is also affecting the central heart nerve that sends the signal down the heart. The signal is still getting there, but it's not taking the path it should, hence the pacemaker. And my pacemaker will be programmed to keep my heart rate at a minimum of 60bpm. If it's above that rate, it stays in standby. Battery should last 8-10 years, with checkups every 6 months. Did I mention the dentist in all of this? Looks like people getting heart valve surgery are at much higher risks of viral infection to the heart if they have cavities. So I get to see the dentist. I curiously have a very anatomically schoolbook perfect dentition. The dentist was commenting to the assistant "look at the typical cusp on , notice the channels on the incisor". Oh yeah, one of my wisdom teeth has cavities below the gum line and we'll have to take it out, and HAS to be done before the heart valve surgery. So the following Monday, dentist is ready, but since there might be an opening for the pacemaker surgery, we'll do the wisdom teeth right after. Turns out I don't get called for the pacemaker until nearly 2pm, and still wait for an hour on the stretcher in the block. And just as they're finishing their setup, THEN the surgeon asks me "You're right handed, yes?". I'm left handed, and pacemakers are usually installed on the opposing side. So they have to remove everything installed, move the equipment around, and start again. The surgery itself isn't really painful. Local anesthetic, mild sedative. I felt mostly they way you feel just before you wake up when you're half-awake and half-dreaming. I could feel movement in my shoulder, and feel them stitching my should back. Then it was back to my bedroom without moving for several hours. The pain was bearable with the right medication (Tylenol and codeine), but my right arm movement was limited. Not allowed to raise it over 90° for at least a week (don't worry, I'm in no mood for that), and no lifting with it for a month. The shoulder muscle *was* sliced open after all. As I write this, it's four days since the surgery, I can lift my arm without discomfort, somewhat limited shoulder movement, but the area near the incision is still sensitive and with a bandage. For those curious, pacemakers are about the size of a pack of matches, but twice as thick, and are typically placed in the upper shoulder area, just below the collar bone. I always thought it would be closer to the breast area, but a vein that goes directly to the heart is conveniently near the shoulder articulation. Then wires are placed in the right are of the heart and "screwed" into place. Screw to far and you puncture the heart (and nasty internal bleeding). More the reason to not do any heavy lifting until all of the internal punctures and cut muscle tissues fully heal over a month. Now since everything took longer than expected, it was too late for the dentist. And the hospital dentist only operates on Mon-Wed-Fri. So on Tuesday (Aug 11), I spend the day just enduring the pain of the pacemaker incision. It took me a while to remember that I *can* ask for more meds to control the pain. Tylenol doesn't do much for me, but codeine works nicely. Luckily I'm not allergic to it like my mother and brother (gives them horrible nausea). On Tuesday, they take out the heart monitor telemetry, first time I don't have sticky pads on my body in over a week! I can finally rest without risking a wire coming off, sticky pad unsticking, or accidental hair removal. I and finally SLEPT. Genuine, unconscious, sheep counting, lala-land SLEEP instead of prolonged naps. Wednesday (Aug 12), get to see the dentist. I already told them I take an unusually long time to get numb. So they do the injections, we wait a bit. Time to go to the rest room. Come back. Numb enough. And then the wisdom too comes out amazingly fast. Didn't even take 15 minutes by my estimate. First time I had a wisdom tooth out, it took a long time. First time it required specialized vices, extra injections to make me numb, three people working on my face and a nurse having to climb on my chest. This time, a simple fulcrum-lever system, a few gauze pads to bite on, and I was on my merry way. On my way back, it was also getting pretty clear I wouldn't be getting my heart valve surgery this week as several emergencies came in during that time. On the plus side, I may have temporary leave from the hospital until the next week, but they want me ta have a fixed scheduled date, otherwise I might get bumped off the list if I leave the hospital. So this morning (Thursday, Aug 13), I got my appointment for Monday August 17, *and* temporary leave until then. I'll get a call during the weekend for further details. My mother lives within a 15 minute drive, and I feel sturdy enough to wait until then. As long as my heaviest activity is climbing stairs, I'll be fine. TLDR: Spent ten days at the hospital for an unexpected pacemaker heart surgery. Still a bit sore. In a surprisingly good mood. Back there next week.
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