Valve installation

… Continued from previous post…

The real adventure started the next day.  I woke up with a nasty migraine.  My normal migraine drugs could not be used because of possible complications, and there was not much they could do for me.  This did not turn out to be much of a problem, since they would put me under general anesthesia soon enough.

I was wheeled on my bed to a prep area.  After answering the same questions I had answered several times already, and getting hooked up to a few more hoses and “a little something in the I V to help you relax”… I don’t remember much after that.  Wife and Brother paid me a visit a little later, and they say I was talkative and apparently lucid, but I have no memory of it.  After their visit, I was wheeled into surgery. 

I started to wake up in the ICU with a breathing tube in my throat.  Brother and Wife were there, I think. 

It turned out that I was waking up at about 8:00, close to 13 hours after I had originally been put under general anesthesia.  The surgery went well, lasting from about 7:45 to 11:30.  The surgeon made the announcement to Wife and assembled family and friends.  He was excited to have been able to use a large valve (25 mm vs. the typical 21 or 23).  He also said that the old valve was in worse shape than anticipated; the opening was squeezed down to a small slit and the valve was heavily calcified (he said something about calcium deposits as big as marbles).  However, they did not save the old valve for me, so I don’t know what it really looked like; they probably just threw it to the OR dogs.

But I was still bleeding too much, so it was back into surgery.  A little direct pressure, a lot of cauterizing and about an hour later, I was back out of the operating room.  Wife had not been particularly nervous until then, but this bleeding thing got her pretty much terrified.  This process ended at about 3 PM, and they kept me under so that I would not get the bleeding started again.

We managed to get the breathing tube out in due course.  The removal was a very unpleasant moment, but after a few minutes, it felt great to get it out, and I could do a good Tom Waits imitation.  Other than that, I felt like I had been run over by a truck.

That night and the next day were spent in intensive care.  Since I had been entirely shut down and operated by machines for a while, the reset button had been pushed on most of my physiological systems and all were struggling to reestablish equilibrium, many with the assistance of drugs.  For example, I was getting hourly finger pricks to test for blood sugar, and I required some insulin for continued recovery.  The nurse told me that this was common.  If a patient were borderline diabetic, this experience might put him over the line, but most folks quickly get back to normal, as I did after a few days.

While in ICU, they started unplugging me from the various machines.  The first to go was the (surprisingly large) continuous-blood-pressure monitor in my wrist artery.  Just before I was taken to a regular room, the nurse removed my urinary catheter.  This thing was pretty useful, and I would recommend one for long car trips and meetings. 

 I stayed in the room in the cardiac observation unit until I was released.  The first night, I was helped out of the bed and sat in a chair for a while.  I walked 50 feet up the hall and back the following day, with people carrying an oxygen tank and the bottle that received the drainage from my chest.  Over the next few days, I did more walking, and they disconnected more stuff from me.  I had some further bouts with migraines, which was probably the most painful thing I experienced the whole time, though removing the chest tube was a close second.  And then there is coughing, which can be extremely painful.  They had a little trouble getting me to respond to the warfarin (couldn’t get my clotting tendency to go down, unlike a few days before when they couldn’t get me to stop bleeding) and kept me an extra night.  I was definitely ready to go home when they released me Monday.

I think I got pretty good care, all in all.  Some of the nurses were great; only a few seemed to just be putting in their time.  All of them seemed spread too thin.  The food was about what you would expect.

I am writing this two weeks after surgery.  Progress toward recovery continues, but not as quickly as it did at first, or so it seems.  My back hurts, I am getting two migraines a day, I still tire very quickly, and my mood is a bit down.  But I am also doing more things around the house.  I read an entire New Yorker today.  If it gets a little warmer, I can go outside for a walk tomorrow.  Bottom line is that the new valve is not yet showing any improvement over the old one.  I will give it a while.

My love goes out to all the family, friends, and neighbors who have given us support and Food over the last couple of weeks.  You all made this a whole lot easier for me and for Wife.

Footnote: I heard a few comments over my days in the hospital (especially while checking in) about identity theft, and every time I changed rooms, they asked my name and DOB.  This seemed a little paranoid to me, but it turns out that is something of big deal, as discussed on NPR this morning.

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