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John Nelson I wasn't sure if I should write about my open heart experience since I ultimately did not receive the Ross Procedure, but after some coaxing from a few of you I will relay my experiences as best as I can remember. I will say this. For those of you who are awaiting having open heart surgery done, don't fret it. It was remarkably a very painless procedure. With me, the most discomfort that I had was the result of a lung tube which is not normally inserted into an open heart patient unless they have a nemo-thorax (not sure if I spelled that correctly)- which is a hole in the lung. Day 1 (Operation Day) 6am: My wife, father and step-mom arrive at the hospital. Immediately they take me into the pre-op to get undressed and gowned. My wife and father joined me a few minutes later. They took my vital signs and took me to a gurney. My surgery was not scheduled until 7:45am. Most of the other patients were given sedatives and IV's almost right away. I was kinda getting worried since nothing was being done to me. 7:20am My anesthesiologist finally arrives and inserts the IV. I couldn't believe that it didn't even hurt. From watching others getting their IV I was freaking out from the size of the needle. The anesthesiologist gave me a bit of local anesthetic to numb my arm and I told him to let me know when he was going to insert the IV. He quickly told me that it was already in. About 5 minutes later he injected me with something to relax me. Relax me! hell it hit me almost immediately. From my previous surgery I don't remember having the relaxer hit so hard. My only wish was that my wife could have some as well -- she was a nervous wreck (I would have been too if the roles were reversed). After a few minutes they wheeled me into the operating room. I honestly don't remember much about the OR. I do remember them transferring me to the OR table and then stretching my arm out. After that, I remember squat. My next memory was waking up in ICU. I'm not sure what time it was but my entire operation was only 3 1/2 hours. So I am going to guess it was about 12:30 or so since I vaguely remember my wife and father coming to see me. I remember the tube down my throat and it was not that bad. I guess the words to remember is relax. As long as I was relaxing the tube was not a problem. After a while the tube started to bother me and I was trying to cough it back up. The ICU nurse (Mike) quickly inserted something down the tube to remove any excess fluid from my lungs (kinda like a mini vacuum) and then removed the tube. I'm not sure what they were doing but that is the best that I could describe. I don't remember being in much pain, but I was sore. 1:30pm: I remember the time here since I saw the clock and asked Mike what day it was. he thought that was kinda funny, but told me that it was still Monday. About this time my wife told me that they were unable to do the Ross and had to use a prosthetic valve and aortic root. I thought something was funny since I was able to hear a ticking in my ear. At first I was kinda upset, but I knew that I was alive and well and the doctors knew best. I guess the reason that they were unable to do the Ross was due to my Aortic Root being dilated and sorta described as having a sack around it. This caused the annulus to be dilated and unable to accept the Pulmonic valve. Also about this time I remember seeing my Cardiologist (Dr: Jerome Liebman) who described what had been done. I informed him that I was feeling really sore and they upped the Morphine that they were giving me. The rest of the day was sorta in and out. I really don't remember too much. That night was tough. More so that I was tired but I was unable to sleep (The ICU area was really noisy with all these old people who were a pain in the ass for the nurses. I would have killed them all! :) ). The ICU nurse was super, he let my wife stay in the ICU all night, which I guess is rare. I think they let her stay more because she was an incredible help to the nursing staff. That night I was given a sponge bath and my bedding was changed. This was kinda painful since they had to roll me on my side. That really hurt. The next morning I felt really good, until......... 11:30am Postop day 1: OK, so this is where the pain starts. A doctor on the Cardiothorasic (CT) surgery team informed me that I had an air leak in my lung and that they were going to have to insert a tube into my chest to apply suction to my lung. My only question was "Is this gonna hurt". I didn't like my answer. They gave me a huge dose of Morphine, and injected me with a local in the area where they were going to make the incision. The incision didn't hurt, but when Dr. Frankenstein applied his entire upper body weight to insert the tube through the outer lining of my lungs (plurum?) It hurt like hell, no two ways about it. Then they played with the damn thing until it was just right. All the meanwhile I was in agony (even with the morphine). 12:30pm They transfer me up to the cardiac floor. I was really sore from the tube in my lungs and everytime I would breath I would hurt like hell. At least I had the Morphine to take the edge off of it. 2:30pm I go into shock from pain. For the last 45 minutes I have been begging the nurses to give me some sort of pain killer. They gave me Darvocet when I came on the floor but it hadn't even phased the pain. The nurse informed me that the resident doctor said that the Darvocet would be fine and I could have another dose in six hours. I promptly told her that they were giving me 8cc or mg (can't remember) of Morphine every hour and my doctor had ordered the pain meds to keep me comfortable. She said she would run it by the resident Dr. He told her he was too busy to research what they were giving me in the ICU. Meanwhile I was about ready to lose consciousness from the pain. My Dad sensing this jumped on the phone, tracked down my Cardiologist, and he got on the case. About 5 minutes later the Surgeon was in my room chewing the resident CT doctor (who was one of his students) why the hell he didn't give me something for my pain. Shortly thereafter I had an IV drip of morphine that I could hit if I needed anything. Minimum I would get 1cc of morphine, max 8cc. The next few days were fairly unevetful. I had a low grade fever the first few nights, that scared my wife quite a bit. The tube stayed in me almost the entire time that I was in the hospital. This was most of my discomfort. I also had a hard time closing the hole in my lung. Every day they would come, clamp the tube that was coming out of my chest and wait a few hours. After a few hours, they would release it, and take an x-ray. The first few times that they would release the tube, I would feel the air rush out of my lungs, just like it did when they inserted the tube. I'm not sure what that signified, I know it wasn't good, and it sure didn't feel good. Postop Day 5 (6th day in the hospital) Finally the tube came out, my lung stayed inflated and it was almost time for me to go home. The only thing left to do was remove the wires that connected the temp pacemaker (The tubes had all been removed in the ICU except for the lung tube). I will say this. The one thing that stressed me out the most was the removal of tubes and wires while I was in the hospital. Someone said that the tubes would not hurt. I guess they didn't but they sure didn't tickle either. The Foley catheter and the pacemaker wires were the worst. The wires kinda burned when the nurse yanked them out. The tube felt kinda funny, not sure how I can describe those. The catheter, shit that stung! But I guess a tube coming out of your private parts is supposed to hurt a little. One word of advice. The foley didn't hurt when it was in as long as you didn't let anyone trip over it or move it too fast. The male nurses that I had were great about making sure I was not in any discomfort from the Foley, the female nurses on the other had just man handled the tube. If I could have hit them at the time I would have. Finally all the tubes and wires are out. They made me lay in bed for an hour after the pacemaker wires were out. Something about them wanting to monitor the heart after the wires were out. I'm Home!! My first few days at home were fairly good. I think I was more scared to get in the shower for some reason than anything. I guess because they wouldn't let me take one in the hospital. I guess I figured my incision would soften up and my guts would start falling out of me. Who knows. I know the hardest part of coming home was mobility. In the hospital they made me walk around a bit, but it was not as much. At home, I was getting pooped really quick. The other hard part of coming home was getting off the narcotic drugs for the pain. In the hospital they were giving me large doses of Morphine and then the second to last day that I was there I asked them to start giving me something less potent, since I didn't like what the Morphine was doing to me. So they placed me on Darvocet. At times at home I would get the chills and then start sweating like crazy. I guess it was drug withdrawal. Thank God my wife was patient and understanding. Without her I never would have made it though those fits. After a day or so, I weaned myself off the Darvocet and was just taking Tylenol. I can truly say that I am not in much pain now. If I move to fast or try and lift something it will hurt for a bit. I remember one night when I tried to roll onto my stomach and almost flew through the roof of our bedroom, now that hurt! Today makes the 14th day after surgery. I can truly say that I feel great. I do get tired fairly easy, but my surgeon tells me this is your body's normal reaction to this stressful of a situation. I had my first appointment with my cardiologist last week and everything was fine. With the mechanical valve, I can hear it fairly loud at times. It drives my wife nuts at night since it is clearly audible. I try and go to sleep at night with a pillow on my chest. After the surgery, I can feel a difference. I no longer get exhausted like I used to. I'm no longer out of breath, and no longer just want to go to sleep. Yes I get tired, but it's a different type of tiredness. I did notice this, my tastes have changed. I used to love hot and spicy foods, now I can't tolerate them. I hope that changes real fast. Well, that's mostly it. I guess I will update you in a few months as to how I feel, but if I was told I had to have it done again, I think I would. It was not fun, nor painless, but I feel so much better now. As my doctor said before, "After they saw the sack around the aortic root, we knew you were a walking time-bomb". I asked my cardiologist if he knew about the sack before the surgery. He told me he did, but didn't want to concern me. I'm glad he didn't tell me.
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