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Monday, July 29, 2013

Cardiothoracic Resort Vacation

After doing everything I could come up with to avoid it, it was finally time for my open heart coronary bypass surgery. Well, except according to one person, I could just put some kind of chelation suppositories up my butt instead, and I have to admit I didn't give that a full and thorough hearing. I also have friends who think they're really going to get to the bottom of what's going on at Area 51 and expose it to the world, which is all good fun at a cocktail party but nothing I'd want to hang life and death decisions on.

So they got is there at the ass-crack of dawn all ready to rock and roll last Tuesday. Monday morning was spent getting registered, tested, inspected, educated and so on as far as surgery prep. That idea I had to shave my chest in advance, I found out Monday they would have canceled the surgery because they don't trust my razor and whatnot to be sanitary and nick-free. They gave me a special cleanser for in the shower both the night before and morning off the surgery, and so on.

There were some German Brethren hanging out in the lobby where my family was camped out to see me off across the River Styx. They create a bit of an Amish impression, though not quite as extreme in dress. Turns out my future neighbor was their relative, an older guy who'd been in for a couple of weeks to have the same operation as me plus maybe some more. In recovery, I'd be able to hear them sing hymns from the other room periodically, and see members of the family come and go. What makes their dress striking, I think, besides its 19th Century feel and long beards, is little boys and girls dress like miniatures of the adults, same dress, same bonnet, same pants, same suspenders. It's the effect of a mother wearing the bear midriff look of her daughter down to the jewelry and eye makeup except from the other direction and starting in Victorian times.

Corinna and I joke that we're half Amish, what with our TV-less home and doing so much cycling for transportation, but these folks were the real thing (not actually Amish but an Anabaptist theological cousin to them). Me, with my purple mohawk and goatee, I was getting at least as many long looks as they were, but I suppose the impulses and ethics behind my appearance were quite a bit different.

We had quite a wait which surprised me. The trains seem to run on time with Mid-America Cardiology, and with KU Med in general, from what I've experienced so far. I was supposed to be first case, too, so there shouldn't be much way for the doctor to get backed up. Except, it turns out, when someone comes in the ER feet first and needs emergency heart surgery.

When they finally took me back, got me changed and so on, they got to doing that shave job I was supposed to leave to the professionals. I'm ticklish, esepcially my legs and butt, but really everywhere on my body. Always have been. And these trimmers vibrated. And they were trying to deforest a zone from my clavicle to my ankles. It was ugly.

I suggested that since it's hard to tickle yourself, maybe they could hand me the trimmers for the trickier regions of my body, but the one doing the trimming didn't think she was allowed to do that. I guess I should have snatched them from her and just done it myself, but instead I focused on not jumping off the table as those trimmers came at me again and again. They acted like nobody had squealed and squirmed as much as me, ever, but I don't believe it. My oldest daughter is at least as ticklish as me, so I know I'm not some singularity. They've had others, I'm sure, and told them they were the record setters for screaming like a girl and giggling with tears in their eyes.

I think next time, I'll have to insist on anesthetic before shaving, no joke.

From there was the nerve-racking wait to go in to the OR. The 'love you's' and 'see you in a bits' from my family and I was off. My Dad said, 'Welcome to the club.' He's a bypass patient as is my uncle. Both my grandfathers died of heart disease before unpleasant procedures to extend life had been developed. In case I want to whine about what I have to go through, there's that.

I came to, I guess, with the tubes still in my throat and chest, not able to talk. Unable to communicate discomfort. I guess I squeezed Corinna's hand though I have no memory of this. By the time the tubes came out, about ten at night I think, my family was long gone. I didn't remember the post-visit so I thought they'd waited around all day for nothing and got sent away, I can't remember the complication that delayed my breathing tube coming out. I was allowed Sprite and oxycodone, I think the first time I've had that particular painkiller. I'm pretty impressed with it, gets the majority of the pain without making me feel high or dopey. Which surprises me, given its reputation as a street drug, but they told me if you have actual pain, the receptors for that get the drug and the euphoria thing doesn't happen.

Before my transition from ICU, they wanted my chest tubes out. In the process of pulling them I got a huge cramp in the wall of my chest that went basically from the shoulder to the diaphragm over the left half of my body. They'd been asking me to rate my pain on a ten point scale but that one was a twelve, minimum. They left in a couple of pace-making wires hooked to a box. "This is not the nurse call box!" one nurse told me as she tucked the pace box into a side of the bed.

Food was served as room service when I got up to the CTP recovery room I was in the rest of the time. Cardiac, low-sodium menu, but you could pick from quite a bit of stuff and Corinna was able to add a guest tray for six bucks. The room was fashioned as a suite, hotellish, with a desk and settee, several chairs and so on. Corinna commented more than once that it seemed posh, and I kept thinking what a lousy theme resort.

After my finger a couple of years ago, I was braced for a lot of post-op pain. That pain was intense, so I was surprised when my chest and arm (where they harvested my radial artery) weren't as bad as that. Not nothing, mind you, I'm still eating oxy to keep it at bay, but there must be more nerves in the finger or my finger surgeon must have been a clod.

They gave me devices for breathing exercises and sent in respiratory therapists to help me use them. I say the pain isn't as intense as my finger was, but you breath all the time, and getting your sternum split makes that breathing pretty damned uncomfortable. They also set me up with a Heart Hugger, a harness I wear to clutch closed when I cough or move in ways that strain my sternum while it's healing.

The first night out of ICU, I was awakened hourly to check my vitals, blood sugar, etc. I was on an insulin drip, SOP I'm told because the stress of heart surgery sends everyone's blood sugar out of control and that hampers healing.

Corinna didn't spend the night that night, but she did visit. She hadn't figured out the settee so she started arranging chairs to ice her head (she's been fighting back from a nasty concussion), and of course I doubted she could get the chairs arranged and get in there that way. So she proved me wrong.

When my nephew visited Friday, my brother warned me not to show him my full scars. 'He still worries about this scar,' he said, showing me his laproscopic hernia operation scar, perhaps 3/16" long. I've had cat scratches more impressive looking than that scar, and here I am with the marks from three IVs, including one in the throat, plus an eight in zipper on my arm, one of similar length on my breastbone and a couple of wires sticking out my belly. My nephew is three, so this is a freakshow.

Turns out he never even noticed my scars, just the purple hair. He wanted to see the dragons on my phone (Fort Conquer), wanted to play Fruit Ninja on Corinna's phone, wanted to explore the rest of the cardiothoracic surgery floor, but never even asked about the wounds that showed on me.

All the while these things are transpiring, I'm getting used to the constant monitoring. Peeing in a measuring thing so they can see how much I'm letting off, that sort of thing. They keep asking me if I've had a bowel movement and no, just a lot of farts. Almost from the first I came out of anesthesia and they say this is good, means things are processing at least. But they keep bringing me meds that include 'stool softener' in the list. Anesthesia and pain meds constipate, they explain, and you don't want to get backed up. They added the stuff we have to give our mighty hunter, Jello, Miralax. They hint that suppositories are in the arsenal if I can't produce.

When it finally happened, they asked if I'd had a bowl movement and Corinna said, 'More like a revolution!'

1 comment:

Sharon said...

Great post Rod, great writing as usual. Thanks for sharing.