Friday, May 8, 2009

Open Heart Surgery

Tuesday, April 28 to Friday, May 1: Live Through This

First thing Tuesday morning, I was at the cardiologist's office. He and one of his partners stood by while Kim, my favorite echocardiogram technician, showed them the areas they wanted to see. The echo showed that I had .5 L of fluid in the pericardium. Blessedly, the fluid had shifted more to one side and was no longer completely surrounding the heart and causing the cardiac tamponade.

The cardiologist was reluctant to send me to the hospital, given that they've almost killed me (and blew the most recent ER visit) AND the county had declared an emergency for swine flu. "You look like you're resting comfortably," he said. "Oh, yeah; as long as I stay lying down and don't do anything, I'm okay," I told him. I was all for avoiding the hospital for as long as I could.

He called the heart surgeon from the examination room and set up surgery for me for the next afternoon. "Go home and lie around eating bonbons!" he gave me strict orders. Okay, I'm making up the bonbon part. But I figured I could handle lying around doing nothing; I felt badly anyway. So that's what we decided to do, with me under orders to call 9-1-1 or head to ER if there were any problems.

That night, the fluid in the pericardium must've shifted, because suddenly I was feeling VERY VERY BAD, like I had the previous Thursday night before the syncope episode. Knowing the risk I was facing, we opted to get up and head for the hospital. I could barely make my body function; it was the most exhausted I've ever been (except the other times I've almost died). I can always tell when I'm on that path that leads to Death's door --- I have played ding-dong-ditch-it there more times than I ever thought possible. I always make it a point to try to get off that path immediately!

Thankfully, my prayers were answered when we were about 5 mi from home. The fluid shifted, and my heart could beat more properly again. Immediately I felt clearer-headed and could breathe easier again. We discussed our options and decided to head back home to get some sleep before surgery and ICU admittance the next afternoon.

I woke up---hey, that's always a good thing for which I give thanks. I do not take it for granted, even though I don't really worry or stress about it. Since surgery was scheduled for 5 pm, the hospital had told me I could eat a light breakfast as long as I was stopped eating and drinking by 9 am. I ate a couple egg yolks with toast and a few bites of bacon. I drank a few swallows of oj. At 9, I relinquished my plate but kept my orange juice. Between 9 and 10, I took a couple swigs of oj. Then I realized my mistake. I can't have the oj, either, after 9 am! I put the rest of the glass in the refrigerator.

And stupidly continued drinking water while I got ready to go. While I was being admitted in the hospital, I was drinking water. While I was getting prepped for surgery, I was drinking water. I am so used to doing imaging where you fast but drink lots of water that I had forgotten you can't have ANYTHING to eat OR DRINK, not even water, before surgery. I feel so brain-dead sometimes! I realized my error around 1 pm, after I had drunk ~half a liter of water.

Okay, this is not good. The nurses call to tell the surgeon what has happened and ask if we are going to postpone the surgery. While we are waiting for the response, someone comes to transport me on my gurney to the upstairs floor. When we get upstairs, he tells DH to say goodbye and shows him where he can wait. I'm being wheeled into surgery!

"Hey, wait a minute!" Even half dead, my brain will work and I can articulate what I need to save my own life. I explained that my surgery had been scheduled for 5 pm, not 1 pm--and that I'd not only had water that we were already questioning a need to postpone surgery, I'd had breakfast just 4 hr ago! I already had doubts I could survive general anesthesia, let's not stack the deck against me!

So seeing the problem, they left me in the hallway of the ORs area for a few hours, and I just napped on my gurney. I told the anesthesiologist I didn't think I could survive GA, but he assured me I would be okay. Sometime in the afternoon, I got wheeled into surgery. "Take good care of me," I told them as the anesthesia took effect.

I awoke still intubated on the OR table. And immediately started gagging and tried to sit up; this is a real-life nightmare for me! "Just a few minutes," the anesthesiologist said as he continued with his other work. AAAARRRRRGGGGGHHHHHH!!!!! I already have a horrible gag reflex; I've had a past BAD experience with intubation; this is a NIGHTMARE!!!!! My chest hurts hurts HURTS, especially since I tried to sit up. HELP! I focused everything I had on drifting back into the aftereffects of the anesthesia, relaxing, and not fighting the hugely wide tube impaling my body via my trachea. These are the times that try our souls...

"Okay!" he said brightly as he pulled the tube out. Thank God. I was briskly wheeled to recovery, a room full of gurneys and people with no walls or even curtains. Groan. Every bit of my torso hurt. I focused on resting and tuning everything out.

And came to being wheeled again, this time from recovery to ICU. Someone was squeezing my hand; I turned to see DH smiling at me and the pastor smiling at me right behind him. What a happy sight!

I got checked into ICU and that's where I stayed for the next couple days. I was just one hurting unit. My nurses took very good care of me, though. I used a pillow against my stitches, but coughing was horrible. And I still couldn't breathe right. But fortunately, I was able to get some sleep somewhere in the wee hours of morning.

I woke up Thursday morning to learn I was supposed to suck on my lung device to at least 1250 cc today. I've never had a lick of trouble doing that after any of my previous surgeries, but this time I couldn't really move it past 500 cc -- and boy, did even that really hurt my lungs and chest to do!

Then, my vitals alarm kept going off. It seems my saturated oxygen was running as low as 83%. So I had to be on oxygen. I kept waking up every time I fell asleep, feeling like I wasn't getting enough oxygen. But the nurses watched me while I slept, and with the oxygen I was staying in the low 90s. Since I couldn't breathe without oxygen, I had to remain in ICU. But I did start getting up and getting myself to the bathroom, at least.

Sometime around 11:30 at night, another doctor showed up. My oncologist had asked a pulmonologist colleague if he would stop in at the hospital and see me. So he did, at the end of a very long day for him. Isn't that cool? And they rolled a portable machine right up to my ICU bed to get a chest x-ray---all I had to do was sit forward for a second. Trust me, it hurt to even do that little!

The pulmonologist felt there was a strong possibility that the lower lobes of my lungs had collapsed during the surgery, and that they were probably inflamed. So he ordered an intramuscular injection of a drug for me to reduce the inflammation and pain. There must've been something about the drug that wired me, for I did not get any sleep till well after 4 a.m, when the lab showed up for my blood draw. And the ICU ward that night/morning was not a pretty place to be; lots of people were struggling all around me just to keep breathing and keep their hearts beating. It was hellish. I just kept waiting for my body to stop hurting so much.

I woke up again a bit before 9:30 a.m., just in time for my very first breathing treatment with a nebulizer! I've heard about them from my mom friends with asthmatic children, but have never seen (let alone used) one. I could already tell the difference when I woke up; I was better able to breathe and could inhale the nebulizer's medicated steam without any trouble. I checked my lungs: I had no trouble reaching past 1250cc (yesterday's goal). My peak was 1750. Yep, the lungs are working again! And the nurses noted my saturated oxygen level was higher on room air than it had been the whole day yesterday while I was on oxygen!

But the medicine was also making me cough up the fluid and congestion in my lungs. OOOOWwwwwccchh!!! All I could do was press the pillow to my incision and deal with the hurt. But they heard me say Ouch on that ICU ward!

I spent the day clearing the lungs by coughing, plus worked on getting myself out of bed (successfully). Yay; I could do it! Now let me out of this place!

The oncologist and the cardiologist released me; we waited for the pulmonologist to release me. He came by around dinner time and told me that the radiologist thought the chest x-ray showed pneumonia , but that he thought it did not. To err on the side of caution, he wrote me a prescription for a week's antibiotics.

And with that, I was sprung from ICU and the hospital! The nurse helped me package up my dinner and I was OUTTA THERE!!!

And you know, as happy as I was to see Home and my awesomely comfortable bed, what made me happiest was crawling into my roomy garden tub and enjoying a good long soak. My 3-in incision is covered with superglue (since I spit back every kind of stitch put in me, including dissolving ones) and is surrounded by swelling and bruising from the spreader the surgeon used. I've never worried about any of the scars; I figure I've earned every last one of them. I definitely feel I earned this one!

So that's my ~11th surgery (counting the minor ones) since getting on the cancer bus; open heart surgery, to save my life once again. God Bless All My Doctors!!!

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