So this is Jenn and I on a 5km run this evening, sadly I lost the details of the run on my watch as I forgot to save it.
This time last year I thought I had a bad chest cold that was causing me to be breathless going up the stairs at work and home.
A few months later I was under the knife having quadruple heart bypass surgery, what a difference.
So here we go, with an IV pole between by legs, a porter pushing and Jenn packing all my personal belongings, we headed up to the ward. This is the place I would be staying until my discharge, so you could say it was step on to discharge.
The Cardiac Ward is pretty large with various sized rooms, I hit it lucky and ended up in a semi private room with an older lady called, Pat, I have changed her name to protect her privacy. Pat was quite chatty and was looking forward, at that point, to the company as I knew Jenn has a fair amount of work to catch up on and would not be around all the time.
So Saturday March 3rd I went for my first walk after the surgery on February 28th, and it did not got well!
When you are on the ward you wear a mobile telemetry box which monitors your heart rate etc. being mobile it means they can monitor you when you are walking around, which is something they want you to do. So I asked Jenn to help me up and with my walker we set off got a short walk, just to get a feel for my new gadget.
As we passed the monitoring station my room we can see on the monitor that my heart rate was very high, around 150, my nurse, you are still assigned a nurse but she also has a number of other patients, anyhow she took me back to my room and got my to way down so she could take by blood pressure, which was very very high, so high I was seeing star Burts in my eye. They gave me some meds and told me no leaving my room for the rest of the day.
I was little upset by this as it was another setback, remember I still had the whole Afib going on as I was waiting to get another Carioversion, but Jenn calmed me down and we settled in for the rest of the day having a good chat with Pat, who was for sure in a worse way than me!
That night was my first night of sleep since the past Tuesday, and felt so good, Jenn showed up early as was told it was very unusual for visitors to arrive so early, I did not care, I wanted her around me as much I could.
I had not been allowed any food or drink after midnight as I was going for this Cardioversion at some point, we thought it would be in the morning again at last time, but 10am came and went, noon and lunches came and went, 2pm came and went and and around 3pm I was fit to be tied and said to Jenn I cannot do this, I need food as it was no close to 24 hours since I had had anything to eat or drink, aside from a little water for my pills in the morning. Then a little after 3pm I was told I was going down to get this done, as mentioned they do it in ICU, make sense they are going to shock your heart.
This time it felt like a whole procedure unlike the previous day where it felt like it was an ad-hoc thing, I am sure it was not, but that is how I felt, I the day before I had felt the whole thing, this just felt different.
The first scare was that they looked at the time I had gone into A-fib and they had to do some checking as it was more than 48 hours after I had done into this A-fib thing and it looked like I mat need a echocardiogram before they would do it, delaying it again, once again my rock calmed me down, but they came back and said nope we are good to go, the procedure was going to be performed by Brad and the rest of the nursing team, I really felt much more relaxed this time.
As the first Carioversion did not go well for me being awake they decided a bit of a stronger drug was needed to knock me out, so Ketamine it was, and boy did it work. As I came out I had a whole space themed trip with combo of Star Trek, Star Wars as well as, oddly, Star Wars Lego, I was floating around what seemed like lego ships and I was moving between them, they where mostly white, and sometimes behind them I could see a brick building that was white with white windows.
Slowly I start to come out of this an could see multiples of the same faces, these where nurses and Jenn, slowly everyone started to come into focus and Jenn was there with me again, soothing me and calming me as she let me know that it world this time and my heart was beating as it should. I actually as of now do not remember getting back to the ward from ICU.
I can see how people could get addicted to these drugs, they are powerful and can take you to a place that could be better then you are physically in at that time. WOW.
Eat, oh man did I eat when I got back, I was so hungry, they are saved some of my lunch and added some extras.
So heart now beating as it should it was time to starting with this walking with the goal of getting out a soon as I could, I was done and all I wanted was by own bed along with a decent nights sleep, as much as I wanted this, I knew I was still in the best place I needed to be at this time.
So today is the nitty gritty of the procedure, the Mazankowski, the hospital I will be in, has an amazing resource on what to expect before, during and the all important after. This post will not be for the squeamish, expect some pictures and detailed explanation of what they will be doing to this body of mine.
So first off I am not actually sure how many bypasses I will be getting, I think the least is a triple so that means a vein from my leg, and I have always been told I have great legs, well I guess I will have a war wound now!!
Although there are many slightly different slants on the surgery, in general they follow the same process.
Once in the OR the anesthesiologist will put me to sleep and slip and breathing tube down my throat so a machine will take over my breathing. For me this is probably the thing I am really worried about, I worry about coming around and feeling like I am choking, I have even told Jenn that she is to try and get them to take that out as soon as possible.
Once I am out they will start to harvest a vein, probably from my leg, called the saphenous vein, but it could be from my arm. The reason they need this vein is due to me needing more than a double bypass, they do this first so as to not have my chest open for to long.
After everything is ready my chest will be opened and my sternum cut with a special saw, well I hope it is special and not a Mastercraft special from Canadian Tire!!
The next part, I have read, is surgeon dependent and relates to being put on a heart bypass machine or not, often referred to on or off pump, some surgeons will choose to do the surgery with the heart still beating, while others not, hence the need for a machine. Right now I don’t know how mine will be done, I will let you know later.
A little more about the Saphenous vein, this vein is a vein and although it is the best one to use it still runs the risk of getting blocked down the road, this is where the healthy diet, exercise, statins and overall looking after oneself comes in to lower this risk.
The other bypass parts can come from within the chest cavity, the left internal mammary artery (LIMA) also the right internal mammary artery (RIMA) may also be used as a graft.
So all this can take up anywhere from 3 to to 6 hours depending on how complicated it is as well as the number of bypasses.
Once the bypass grafts have been completed it is time to reassemble by chest start with the sternum.
Now I have read on the Mazankowski they they are use a serious of wires to hold the sternum together while it grafts itself together, but just this morning I read that some surgeons have started to used plates and screws as they are more stable, it will be for sure question for my surgeon as to what he uses. I hope he is a good stitcher, kinda like my mom who was amazing at knitting things.
The one on the right would be my preference as it seems more stable, but I have to trust what my surgeon says is best for me.
Once they have stitched the rest of me up and I will be moved to the ICU for a day or two, here I will have a full time nurse watching over me and giving me pain med as required, They say on the pain scale of 1-10 once it reaches 4 ask for medication as it is easier to treat pain as it is building than when it reaches its peak.
In ICU I will be hooked up to all the cool expensive monitors as well as have some chest tubes in and maybe still the breathing tube. I am not sure what they look for when the are looking at moving you out of ICU guess at least breathing on my own.
Once out of ICU I will probably still have my drainage tubes for a day but once they are out it is all about keeping moving and more and more each day.
I am determined to walk hard when I am in the hospital, following all the directions of the professionals who will be looking after me, yes even the physio. This is the best way for me to get out of there as fast as the goal is getting out of hospital get home, they say it can be anywhere from 4 to 8 days from surgery, I suspect not 4 and I hope not 8, so we shall see.
So there we have it, the process, obviously a little more than what I have posted, but it gives you and idea of what I will be going through starting on Wednesday.
Tomorrow the last day of work.
So today was all about the pre-clinic, a time to meet lots of people and lots of new information to take in.
We arrived a little early and struggled to find the place we needed to go, but eventually found the registration desk where we gave info and was given a restaurant like coaster they give you when they are full.
Eventually it flashed and we went to the clinic where the barrage of info started.
First in the anesthesiologist, not one I will have, but a good chatty guys who explained everything that would happen are part of his team tomorrow. He reassured me about the breathing tube and said it would be a none issue. He also explained what will happen when I arrive in the that I will be given a sedative, basically what I am on now for sleeping, but double…yay.
Next up respiratory therapist as they need to check my lung capacity and they then can they see how I am doing afterwards, well he was socked as basically I have a 120% lung capacity, go figure, guess it explains the loud sneezing.
The the nurse came in, who was amazing, she made us totally at ease, showed us a video, and basically reviewed all my info and totally explained what will happen and where we need to me and when.
We then met Dr. Lam she is the chief resident in the cardiac unit who went through the surgery bit and explained what they would be doing with various arteries and leg veins where they would be attached etc. Looks like a triple will be gong on, although she did say that does it always happen due to what it is like when they get in there.
She was very good at explaining the risks and it seems I have .9% change of not making it, pretty good odds I say, she also talked about resuscitation and if I wanted it, that was a no brainer, also would I want bloods products, another no brainer, I also used to be a blood donor until they imposed restrictions on who, and because i lived in the UK between 1980 and 1986, so they think I may have mad cow.
Nurse was now back with more info before we headed off to have some blood work done and head back to meet Dr Moon my heart surgeon.
Dr. Moon was great, basically saying that his job was to get me back to what I was doing before this all went down. He said if you goal is to run 10k, then there was no reason why I could not, travel, back to work etc. He was saying in 4 weeks if I want to start to get faster on the treadmill, then go for it. Just see this as a fix to improve quality of life and extend my life.
Next the nurse brought in a selection of chest binders, these help stabilize my chest to allow the sternum to heal, started off with a small, but I needed a medium.
All done, we decided we needed to find out where we needed to go tomorrow, eventually found it after a wander around the hospital.
By the time all this we where starving so we came back to our suite and then headed out to O’Byrnes for a beer and a snack, non alcoholic for me.
So tomorrow is the big day, BUT they did say it could be postponed and considering Dr Moon is on call tonight, we are crossing everything.
So today I started a regime of ointment up my nose today, something I was prescribed when I got my surgery date, the ointment is called Tara-Mupirocin and upon doing some research found it is to protect against getting a post operative infection, here is a good article that explains it. So anything that can help me be protected after surgery I am totally in for.
This is an addition to my other meds right now, never taken so many in my whole life, and I am sure they will change after the surgery, I am actually hopping not as I am coping well on these and if anything I would love to get rid of the Beta Blocker but on reading about other people it seems to be a lifer.
This is my last weekend that I can pretty much do what I want to a while now, so plan to make the most of it by cleaning the house, something that I will not be able to do for at least a good 4 weeks after surgery.
Up till now I have been more nervous about post surgery and the lifestyle change that is a head of me, although I am sure that even that will not be as bad as it is in my head, but my focus has started to think more about the surgery and the days after.
The last time I was in hospital as an inpatient, colonoscopy does not count as that was a day job, was when I broke my arm when I was around 9/10 years old, I know I was still at Boaler Street as I have memories of being at that school with a broken arm, So I think I have done pretty well, but man what a way to jump back in.
So I have been doing some reading on the surgery and I plan to make that a post for tomorrow, sounds like TV eh.? Post a tidbit to get you to come back.
The Retired Dude 