Wednesday, March 25, 2015

Illustration: Surgeon Draws Diagram Showing Work Done

I asked my surgeon, Dr, Grayson Wheatley at Temple University hospital in Philadelphia, to indicate where my dacron ascending aorta hemiarch graft was placed, and where he put the two CABG grafts. While I have no coronary artery blockage, the CABG grafts were necessary because my native coronary artery buttons were small and elliptical and he felt that there was inadequate perfusion through them. So I ended up with a new valve and dacron conduit extending up into the arch, plus four Bentall buttons: two native and two grafts.

Saturday, March 21, 2015

B4 And After Surgery

My sternal incision is nine inches long, and I have about a 2-1/2" scar where the four chest tubes exited from my belly. Then I have four incisions on my upper legs where the veins were harvested for my CABG grafts and a few puncture holes in my groin area and neck area. Quite a few cuts and holes but all healing well!

Friday, March 20, 2015

One Month Anniversary

My recovery is progressing. With the warmer weather the snow and ice has melted away. I am now able to walk outside. I can take a morning walk for about an hour and once again in the evening. I cannot cover as much distance yet, but it feels good to get the fresh air and sunshine. I am fine medically. I have no problems now related to my surgery. I still have to take too many pills and drugs, but I hope to be able to discontinue taking some of them very soon. This week I had appointments to see my surgeon and my cardiologist. These were the first follow-up appointments since I was released from the hospital. The sutures in my chest were removed and my incision is healing nicely. My cardiologist let me discontinue Metoprolol...and I immediately noticed more energy and pep and I felt better. Now it is all about regaining my strength and stamina. I am planning to attend the York TCA train meet in April. I usually go for a couple of days...Wednesday through Friday. I should be strong enough by then to enjoy the meet.

Sunday, March 8, 2015

The Difficulty: Getting Strength Back

It's been two weeks since my second of two trips within five days to the OR. Medically things seem OK, no issues with my new valve or all of my surgical repairs, heart rate or BP, etc. I just had no idea how weak I would be and how painfully slow and difficult getting any strength back at all would be. I haven't felt quite strong enough to go out of the house yet, but with all of the snow and ice and cold here in Philadelphia I couldn't go anyway, so I have a major dose of cabin fever. It's supposed to warm up this week and I have my first follow-up appointment on Tuesday so hopefully I'll feel better after i finally get out and get some fresh air.

Wednesday, March 4, 2015

My Surgery Saga Day By Day

Day 1: Surgery Day - February 16, 2015: After 11 years of waiting and watching the big day arrived. The night before I had to wipe myself down with special anti-bacterial wipes. I repeated the process in the morning before leaving for the hospital to check in for surgery.

When we got the the hospital at around 6 AM, Dan and I were placed in a cubicle in the pre-surgery area. Then it was time for yet another body wipe. There was the possibility that I would need to undergo DHCA (deep hypothermic circulatory arrest) with cerebral perfusion (they basically cool the body down and shut it down but keep the brain supplied with oxygen through arterial connections.) Therefore, I had electro-encephalagram contacts glued to my head. I really looked like a Franmkenstein creation.

Finally, I was ready, said godbye to Dan and I was wheeled into the OR for my procedure.

Day 2: Tuesday, February 17, 2015: I woke up in the ICU at about 2 AM, again at 4 AM and yet again at 6 AM. I was still on the ventilator. I would remain on the ventilator for 17 hours after waking up, until 7 PM in the evening.



Dan and our friend Stephen were bedside. I was awake much of the time and when I was I asked for pen and paper so that I could scribble questions and make requests. I was not in a great deal of pain, and my breathing was not encumbered by the ventilator tubes that were still deep in my throat.

My surgeon Dr. Grayson Wheatley at my bedside.

I had read somewhere that if you wake up post surgery and the vent tubes are still in, think of it like breathing through a scuba regulator. Since I am a scuba diver this worked well for me and I did not fight it or try to yank out the tubes. I couldn't have done that anyway since my arms were restrained. I was on the ventilator that long (17 houus) due to the length of my surgery (7 hours,) from 9 AM until 4 PM, and the complexity of the procedures performed resulted in the need for me to have an inter-aortic balloon pump installed to augment heart function post-surgery.

I felt generally pretty well for just having awaken from surgery, and I was finally taken off of the ventilator and the tubes were removed at about 7 PM.

Day 3 and Day 4, February 18 & 19th, 2015: I remained in the cardiac intensive care unit. Whie I felt good the day after surgery, I began to feel worse during this time. I was unable to get out of bed. I had zero energy. I felt like I was in declinbe and I frequently voiced my concerns about exhaustion to my caregivers.

Day 5, February 20, 2015: At 6 Am my nurses decided to have me get out of bed finally and sit in a chair. I tried as hard as I could with their assistance but I only made a few steps in the direction of the chair when I passed out cold. I awoke surrounded by a team of nurses with one of them using a breathing bag on me. It was clear that something was amiss. I was scheduled for a heart catheterizaton later in the day. After the cath it was decided that I would require a return trip to the operating room. I went into surgery at about 7 PM that evening for a condition known as cardiac tamponade, where fluid a clots develop around the heart post-surgery and prevent it from functioning fuly. Thankfully the procedure was relatively short and it was succesful. I was returned to my room in the cardiac ICU.

March 2, 2015 Just completed a 30 minute walk in the house sans walker. It wasn't that long ago that I couldn't even get out of bed. I have some puffiness in the ankles, but other than that I have no complaints at all. I haven't taken a pain medication in a week. If I can continue to improve a little at a time like this I'm optimistic that I'll be walking outside soon...if Old Man Winter will give us a break here in the Northeast. Day 13: Discharge To Home! Journal posted on February 28, 2015 My stamina all of a sudden leaped to the point where I can walk a lot and even climb steps! I never thought I'd get back to this point. So the insurance denial doesn't matter...the hospital has cleared me to go home later today! Tears of happiness I gotta tell ya. Day 12: Cardiac Floor Journal posted on February 27, 2015 Waited all day today for insurance approval to enter acute rehab only to be denied. So the next option is to enter sub acute rehab at a different facility maybe as early as tomorrow. I am medically stable and feeling good just not strong enough to go home. Day 11: Cardiac Floor Journal posted on February 26, 2015 My Afib spontaneously converted to normal sinus rhythm last night so I didn't need the dc cardioversion. May enter acute rehab tomorrow or Saturday. It's been a long, tough haul. Day 10: Cardiac Care Journal posted on February 25, 2015 Spent some time with physical therapy today. Bowels are working finally. Afib and high heart rate are issues the doctors are working on. Will be making arrangements to go to a rehab facility upon discharge. Sorry I cannot be as actively supportive of everyone here but you are all in my thoughts. Day 9: ICU Journal posted on February 24, 2015 Well,.tubes are out and I am medically stable, I think. The Afib that I developed when they took me off Amiodarone due to liver concerns continues to rock the boat and is very noticeable. I have zero strength and get winded at any activity. I met with physical therapy today and they are recommending discharge to a rehab facility. I know I can't go home in my current state if extreme weakness. Thanks everyone for the continued love and support. I am glad this thing is not ad bad for most of you as it has been for me. Day 8: ICU Journal posted on February 23, 2015 Thanks everyone for all of the support. My numbers are improving. Two chest tubes were removed this morning...two remain. My swan neck arterial line from Fridays second surgery is supposed to be removed today also. No appetite and taking meds to get my bowels to move. But slow progress is being made I think. Patience is necessary. Update Sunday Feb 22 Journal posted on February 22, 2015 Still in ICU day 7...trying to get heart function improved...outlook trying to keep least one more day then maybe I can try to sit again...thanks for keeping me in your thoughts Journal posted on February 21, 2015 Still in the ICU since Monday. Had a second full steroenotomy Friday to relieve fluid backup behind heart Original surgery was 7 hours valve, root, ascending and two cabg...been a tough week...hope I have turned the corner