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By Cranky Dog
[Trigger warning: Medical procedures, some concerning my digestive system, may be squick worthy.]
TLDR version at bottom.
Looks like I survived once more!
My brother posted this picture on Facebook.
So I wondered if I should also link a video of Gloria Gaynor's â€œI will surviveâ€ or Destiny's Child's â€œI'm a survivorâ€. Ultimately, it should be a YouTube cat video, because they have nine lives and I sure as heck used one of them this week.
So, to resume everything I've endured this month. I've had coronary angiograms (radioactive dye test + X-rays), CAT scans, MRIs, bone density scans, echocardiograms, electrocardiograms, chest X-rays, injections, countless blood samples, tons of pills, a pacemaker, a mechanical bi-leaflet heart valve, an ascending aorta replacement made of Dacron, a â€œMAZEâ€ heart ablation for atrial fibrillation. And after all this, I mostly feel like I strained my back the previous day and just a bit more tired.
Going back to last Sunday afternoon (August 16), I finally get the call to present myself at the hospital in preparation for my heart surgery on Monday at the end of the morning. So I pack my things and my mother drives me to the hospital. A bit later, I get told I'll be the first to get operated after all. Cool! No food/water after midnight (standard procedure). And then they have to shave my body hair almost fro head to toe. I shaved off my beard earlier in the day, knowing a catheter will go through my neck. Then they shave my chest, as expected. Part of the forearms, also expected for some other catheters and so they don't pull off as easily because of the hair. Then the groins area. Mostly expected, in case they need to pass a catheter through there in case the arms don't do. And finally the legs. Less expected. Normal for people with bypasses, as the go get some replacement veins directly in the shins. But technically, no bypasses are planned for me. So this is more of a precaution in case of an emergency bypass and they don't want to stop mid-procedure for a shaving.
I've also concluded that the orderly who shaved me is a man-hater. The way you use a hair clipper is not to dig the teeth in the chest as if you were scrapping crud off the bottom of a plate with a fork. Damn but those tiny teeth scratched something fierce. My brother used to be a sales rep for medical equipment. The way to use a hair clipper is to hold it like a pencil and glide over the skin. This wasn't what the orderly did. Hair kept getting pulled (remember the groin area? And that men also have nipples?). And of course she had to use the razor blade on my dry irritated skin as a finishing touch. At best I can accept that it was the evening, that she was in a hurry and wanted to rush me to the shower. Still a moment of Owies!
Monday morning comes by. The anaesthesiologistâ€™s team slowly prepare me with some injections, oxygen mask, saline solution, etc. So I'll be properly relaxed just moments before the knock me out for the surgeons. After this point, I have to trust what everyone else told me as I'm totally out. The surgery starts around 9am and ends before noon. During this time, I'm on an external respirator. And when I say I'm out cold, I literally mean that all autonomous biological functions cease. Heart stops beating. Lungs stop breathing on their own, no more digestion. EVERYTHING. IS. STOPPED. DEAD. COLD. My mother and one of my aunts (mom's sister) saw me as I exited the surgery. I wasn't breathing on my own, I was cold, and almost as green as the hospital gowns. A bit of background on my mother, she has been doing voluntary palliative care for over 22 years. So when she saw me, she saw all the signs of someone who just died. Now my aunt, who has no medical background, and confused the respirator's breathing with my own, thought everything was hunky dory and all positive. My mother who was still under the immediate shock of what she was seeing, just wanted her to shut up! Shut up! SHUT UP! Fortunately, the surgeons and nurses quickly reassured them that everything went as planned, that I was responding as expected.
So I get transferred to intensive care where I wake up mid-afternoon. First time I think of asking the time, it's just before 4pm. I still had tubes in my lungs, stomach, neck, a few spots on my chest. But I'm under so much morphine (or derivative) that I don't find them that uncomfortable. I had my full wits about me and had full understanding of what I just went through. During the evening, they make me stand up, and everything went fine. I got extubed on Tuesday, and to their credit, they have good techniques so it's neither difficult, nor painful. I've felt worse when suffering from the cold or flu.
I was surprised to learn I was going out of intensive care less than 24 hours after the surgery. I know they keep saying the whole surgery is far less painful than people imagine, but until you live it, you'd never believe it. They really know how to manage pain. You just have to remember that you're allowed to have more painkillers (up to a daily maximum) and that the staff aren't mind readers. They won't ask more often that needed. My real problem is that I was getting too many Tylenols and feeling hot is a side effect, and that I could've asked for more sleeping aids before midnight as one pill wasn't enough. And since we're going through a late summer and lived through a heat wave at the same time, I had many restless sleepless nights.
Until I cut down on the Tylenols, my mind was doing funny things during those nights. The dwarves of the Diggy Diggy Hole music video were having side-adventures with my memories. And on another night, one massive weird dream was mixing some movies that may or may not have ever existed. But Michael J. Fox's Doc Hollywood character was there, an Appalachian backwater town that smelled of cigarette butts (coinciding with real life some lung secretions) where the starring family's prized â€œlong term investmentâ€ was the completed VHS collection of an 80s action TV show that featured weekly car chases with the hero's white Lamborghini in Miami weather. There are several more details, but I'm trying to forget them, thank you very much. Even with the fan my mother brought pointed directly at my head, I was sweating bullets. These were quite unpleasant nights. I had a stiff neck/back as I couldn't really sleep in any other position than on my back, but as long as I stayed still, the pain was quite bearable and more pleasant than the dreams.
It's when they took off the bandages over my chest on Thursday that I finally saw the incision. A nice, nearly straight 10 inch slice in the middle of my thorax. In D&D 3.x/Pathfinder terms, the surgeon rolled a natural 20, x3 damage, with a scalpel of mercy (non-lethal damage). OK, technically I was helpless so it was a Coup de GrÃ¢ce and auto-damage. But it's a clean cut, very fine stitches, though I suspect much larger ones below the skin, especially considering that metal wires are used to close the ribcage. It's a bit tight, but no really irritating, save for the regrowing chest hair.
Equally, since my digestive system was on hold, and I had a urinary catheter, they had to give me meds to start everything up again as I was retaining liquid because of the heat and meds, quickly gaining weight, and they wanted samples of everything. There were no problems removing the urinary catheter, and I learned that a small bubble keeps it in place inside the urinary tract. But one problem, though not uncommon for people under morphine was that I suffered from oral thrush. The mouth dries, and a fungal infection sets in, wrecking your sense of taste and making the tongue sensitive to heat, ruining my appetite. A special mouthwash fixes in a few days, but the timing was bad as I was supposed to be gaining strength again. But that's not all! To encourage bowel movement, glycerin and stool softening suppositories were given to me. I couldn't really keep them in for much more than an hour. So they gave me more stool softeners in pill form later at bed time.
This... complicated things on Friday morning. I was getting stomach cramps and so many bowel movements that I had to reschedule an echocardiogram. And I ain't even finished with the â€œfunâ€ news! For now the staff believed I was having too many bowel movements, liquid or not. Those who know me, also know I've had many bowel movements every single day of my life. And if you give me strong stool softeners, cream of celery at suppertime, don't be surprised if there are explosive results. But since the medical staff don't know me personally, they saw it as potential symptoms of C. Difficile! And the standard protocol is to put me in isolation. In my own bedroom. My semi-private bedroom, shared with another heart valve patient, and shared toilet with another room. But because of the isolation, I have to use a portable toilet that's one size too small, in plastic bag, with scratchy toilet paper, with a curtain as the only form of privacy in a room with constant hustle and bustle from the staff. And the staff didn't seem in a real hurry to change the bag when it was used. If I wanted to walk in the hallway for exercise, I had to don a yellow oversized disposable hospital gown and surgical gloves. Anyways, even the evening staff quickly realized I probably had nothing from the few samples they took, but it takes two days to get the lab results. And we're already late Friday afternoon right before the weekend, so I'm not expecting any shortcuts.
Ultimately Saturday morning comes by, and the floor surgeons grants me my leave of the hospital, and I'm back at my mother's place before lunchtime. Finally, real coffee, real food, real beds, real air conditioning, real internet. Life begins again! We go to the pharmacy in the afternoon and it's quite a haul. Some of them are only for the next couple of days, some are iron/vitamin supplements to get my system back on track. A few Tylenols, and sleeping aids that I only take if required (haven't yet). And then comes the more permanent ones. Beta blockers to slow heart activity, baby aspirin and warfarin/Coumadin for blood thinning. These will be for the rest of my life (or next medical breakthroughs). I don't even feel that tired over all. A bit sore and stiff yes, low reserves of energy. Though I knew I wouldn't be anywhere near my 100%, I never expected I'd be over 50% from the get go. But to give me every chance possible, we've moved most of my things on the ground floor. I'll be using my mother's bedroom (she'll be in the guest room) in the meanwhile. I'm expecting a rather quick recovery, but it can still take up to three months. When I find that I can climb a flight of stairs in one go without feeling faint, I'll know I'm on the right track.
TLDR: Had final open heart surgeries. A bit sore and tired, but mostly fine.
By Cranky Dog
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 90Â° 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.
In a different thread Vince put out a call for terrain assistance the night before ReaperCon. He needed a big hill. (A table was planned that called for a graveyard on a hill.) A link to that thread.
I saw the thread and a few PMs and text messages later it was determined that there was a hill hiding in my rather disheveled workshop room that might do.
It looked like this:
It was an unfinished slab of pink foam (the top had a basecoat on it). This shot was originally sent via phones to [give] Vince an idea of how big it was. That is a Storm Giant from the KS 1 batch along with a paint bottle for scale (I lack a copy of Sir Forscale).