On the other side

The surgery is over and I am back home now. It was a bit longer of a stay than I thought it would be, and I was only making real updates on my Facebook page and my wife's page. So in this post I just want to recap all that went on during my stay.

The surgery was Wednesday (Feb 6) morning. My wife and I rolled into downtown Grand Rapids and the Fred Meijer Heart Hospital around 6am after a tricky commute on icy roads. Around 8:00am, I was fully prepped for surgery and the anesthetist gave me the juice that put me under. I didn't even make it out of the room before I was completely under. Then, simply, 5 hours passed and I was woken up.

This was an open-heart procedure and so during the surgery I was on a heart-lung bypass machine which deflated my lungs and stopped my heart. It also involves pumping 10 pounds of fluid into my chest cavity to make the surgery work. And, I was on a lot of drugs. The surgery itself went off without any hitches. The first thing I remember was being helped to stand up --- I'm having to learn some new ways to do this, say tuned --- and being told that I did it well, whereupon I vomited all over the place. Actually dry heaving because I had stopped eating the night before, but still some pretty impressive nausea.

I stayed in the recovery room all night and most of the next day. The anesthetist came in around 8:00pm and said, "Not gonna lie, this is gonna be a rough night." And he was right. Incredible soreness in my sternum area because they had, you know, split my sternum in two for the procedure. With this procedure you cannot do anything but lie on your back, and you cannot just move the way you want. You have to avoid any movement that puts separating pressure on the sternum or the incision area. Think about those kinds of movements when you go to bed tonight --- it turns out this is what we do constantly in bed. It was also painful to breathe deeply. So pretty much everything about going to bed that night was waking me up with throbbing pain, despite getting some major league painkillers.

The pain from my sternum was and still is an aching pain rather than a sharp pain. Those of you who have experienced broken bones before -- that's kind of what it is, because they did break a bone to accomplish the surgery, along with cutting through muscles and deep tissue.

So I counted the hours that night until around 9:00am on the 7th. Not much whatsoever happened on the 7th, just hanging around in the recovery room. My wife came in to sit with me and talk, and my 15-year old made it in as well. Doctors and nurses were checking in on me, and good progress was made. I should have been moved up to the 7th floor of the hospital where the individual patient rooms are located, but there were no beds available so I just had to wait until enough people were discharged.

That happened later on that night, and I was moved to a private room with a bed, chair, and TV. I managed to sleep 4-5 hours that night which isn't bad considering how painful it was to go into REM sleep and deep breathing.

Then exciting stuff started to happen.

On the morning of the 8th, as I was eating breakfast (the first food I'd had since the night before surgery) I suddenly felt my heart accelerate and stay there, and I started to sweat buckets. Within 30 seconds, nurses were through the door and attending to me. I was having atrial fibrillation or "a-fib". According to the nurses my pulse rate spiked to 180 beats per minute, which sounds like this. Additionally my blood pressure bottomed out which concerned the nurses more than the pulse rate. Thanks to quick action and some meds I was immediately put on, there was no damage of any kind and I was brought back to a normal heart rate within an hour.

But up until that point, everything had been going textbook and it was looking like my post-surgery hospital stay was going to be unusually short. I was hoping to come in, conquer the surgery, nail the recovery, and head home to sit in my new recliner and watch movies for two months. The a-fib changed all that, and it was scary. If that kind of thing happened once, it could happen twice, and what if it sets itself off when I'm out of the hospital? About 1/3 of patients who have my procedure end up having a-fib, some chronically. So this wasn't unusual, but it was a setback.

As a somewhat funny side note, during this whole a-fib scenario, a volunteer Eucharistic minister showed up to offer me Communion. It was just their normal rounds for the day and they were visiting every Catholic on the floor. But here I am, pulse rate through the roof, sweating buckets, nurses obviously concerned and this random person shows up telling me to say the Our Father and take Communion. I didn't think that's what they did when you're dying, I thought, but what do I know?

Things got better each day from there.

Later that day I got out into the hallway for a walk and this made a huge difference in my attitude and belief that I was going to be OK. Into and through the weekend, the day had a discernible routine:

  • Wake up usually around 6:00 and have a nurse come in and take my vitals, and accompany me to the bathroom to pee. Wash hands, brush teeth, then into the reclining chair in the room.
  • Take pain meds for the morning and settle in either to watch a movie on my phone, watch soccer on TV, or try to read (hard thanks to the mind-altering effects of the painkillers).
  • Interrupt for walks -- they had me doing 4 walks each day of 300 to 500 feet, just a loop around the floor.
  • Order lunch from room service at noon, and have my vitals checked again while waiting for it. I'd also usually talk with a nurse practitioner or doctor about bigger stuff, especially the a-fib. Smaller a-fib episodes kept happening both during the day and overnight as I slept and my blood pressure was still too low.
  • Move movies or books, punctuated by walks.
  • Visitors usually, often just my wife but I had a few wonderful visits from work colleagues and from my priest.
  • Move to the bed around 9:00 and try to get to sleep by 10:00.

On Sunday night we finally hit a breakthrough when I flipped back into a normal heart rhythm and stayed in rhythm. I had been taking IV drugs to help with this with the idea that we'd eventually switch to oral drugs that, if a-fib kept happening, I could take home with me along with blood thinner to prevent a clot and then hope for better later. But the heart rhythm I had switched into was so textbook the doctors decided to just take me off all those meds and see what would happen. Nothing happened and that's exactly what we'd hoped.

So this morning (after a truly terrible night of no sleep thanks to a deepening sternum/backache) the nurse practitioner declared she was going to send me home. And now, here I am.

It's wonderful to be home but also a little scary, since in the hospital I had 24/7 world-class care literally steps from my room, whereas now I have to figure things out on my own should something go bad. I have to keep track of my meds and exercise and be careful not to put strain on the incision, as opposed to having nurses do that for me. But it's the start of long recovery period and I am glad to be on that road.

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