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I'm alive (Part Three) Return of the Cranky


Cranky Dog
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[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.

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So I wondered if I should also link a video of Gloria Gaynor's “I will survive†or Destiny's Child's “I'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 “MAZE†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 anaesthesiologist’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 “long term investment†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 Grâce 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 “fun†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.

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For those curious about life with a mechanical heart valve. It's... different.

 

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From the first day, it felt as if I had a wristwatch in my chest ticking along at its own beat. It really threw off my perception of time as I my mind expects a tick every second (or half-second), but this one is in synch with my heart rate at 70-80 bpm. Most of the time, I don't even feel it unless I'm laid back in a chair or on my back.

 

My sister is a nurse, and last weekend she brought her own stethoscope to hear my heart. She looked perplexed as she listened. She passed me the stethoscope, and I shared her confusion. I couldn't hear the heart valve the same way I was feeling it. The best we could figure out it that the thu-thump sounds a bit more dry and mechanical at the end of the “thumpâ€. But it feels like a pneumatic valve closing tight after a slight vacuum. Rather disappointed that I couldn't hear what I felt.

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Yeah, it is amazing how quickly folks recover from open heart surgery now a days.  My mother in law had a quad bypass and was walking around Spain on a trip to Europe 4 weeks later.  Her only complaint was stiffness in the leg incision from where they harvested the blood vessels.

 

Glad to hear you're finally on the road to recovery, and they let you out of the hospital.

 

Good luck with the recovery.  Especially the super itchiness of repopulating your pelt.

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glad you made it through CD.

I checked to see if you had made any updates on Saturday,  but you had said about a week, so I didn't worry  got distracted.

Is your painting table still accessible? 

 

RE: dreaming about Diggy Diggy hole - is that the new tetris dream ? 

My painting table is 1400km away, in another province, requiring air travel.

 

Would've been nice to have it nearby.

 

I'm at my mother's place (house I grew up in) for a few weeks.

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Hooray, today I climbed stairs! :rolleyes:

 

The feeling was weirder than I expected. Slightly tiring, which I expected with my low energy reserves and loss of muscle mass. But since my legs are still swollen (getting better), and I haven't had to do that kind of movement in ten days, it felt as if I had thick padding around the ankles, weighing me down.

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