I've been doing a LOT better. I've been going to cardiac rehab for over two weeks now, and it really made a difference. My progression has even surprised me. And I don't have nearly as much pain now ... I haven't needed any painkillers for over two weeks as well! That inculdes otc painkillers. I've been really, really happy about it. My stamina has increased, and I was looking forward to returning back to work at the start of the new year.
Last week, I think, as I was laying in bed, I rolled over and just happened to have my left hand on my chest when I did. As I rolled over, I felt things move. Things that aren't supposed to move. I did it again, and distinctly felt one side of my sternum left upwards from my chest, and the other side sunk in. Lying still, there was also a distinct gap between the two pieces.
I had a feeling that this may not be a good thing. It didn't hurt though, and I looked up online and read many posts from people saying that it can take six months for a sternum to fuse together, not to worry, etc.
On Monday, I casually mentioned it to my physical therapist during cardiac rehab. She was concerned, and told me that I should bring it up with my cardiologist, even if it didn't hurt. I promised I would.
Tuesday, I remembered that I forgot to have my bloodwork done on Monday, so off to the lab I went. I ran a few other errands and went home. I hadn't been home for long when my cardiologist's office called me. Convenient.
The levels of coumadin, the bloodthinner I take that keeps me from clotting and therefore enables me to continue living, was much lower than it should be. She adjusted my medication, and I mentioned my sternum to her. She also seemed concerned, and said she wanted me to come in to have it looked at. She'd make an appointment and call me back. I didn't hear from her for the rest of the day.
Wednesday, when I arrived for cardia rehab, it was also time for an evaluation by their doctor. My therpist and I mentioned my sternum to her, and I lifted my shirt. By then, it was noticeable under the skin visually when I turned left and right. Her eyes got big when she saw it, and told me that this was definitely something that needed to be looked at, and under no circumstances was I to do any exercise with my arms (which I hadn't been, but was due to start in the upcoming week.)
Thursday morning, I called my cardiologist's office, since I had yet to hear from them, and arranged to come in within an hour.
My operating doctor didn't examine me, but on of his associates did. She took all of 5 seconds to determine that something was badly wrong, and that I needed a CT scan right away. Even without the CT scan, she told me that most likely I was going to need more surgery that will either re-wire my sternum, or fix it with a titanium plate. (I kinda like the plate idea!)
She told me that they would take good care of me. If surgery is necessary, I'll need to be admitted to the hospital a few days prior, so that they can take me off my bloodthinner while monitoring me for clots. Otherwise, there's a distinct danger of bleeding out during surgery.
Sadly, she also told me that I won't be able to return to work in January.
The CT scan only took a few minutes, and I was on my way home.
Surprisingly, my CT results appeared in my records that afternoon:
TECHNIQUE: Chest CT performed without contrast with sagittal and
coronal 2-D reconstructions.
FINDINGS: There has been a previous median sternotomy. The sternotomy
wires do not cross the sternotomy. There is a gap with soft tissue
attenuation at the site of the sternotomy with the gap measuring at
2.3 cm. There is some resorption of the margins of the sternotomy.
Without intravenous contrast, it is difficult to determine if there
is abscess although I do not see significant fluid attenuation at the
sternotomy site. There are degenerative changes of the
sternoclavicular joints. There is some stranding within the
prevascular fat. Subcentimeter lymph nodes are seen in the
mediastinum. There are coronary artery calcifications. There is a
mild pericardial thickening without definite pericardial effusion.
There is a linear area of subsegmental atelectasis seen at the
periphery of the left lower lobe. Right lung is clear. No pleural
Imaging through the upper abdomen is notable for some fatty
infiltration of the liver. Adrenal glands are not enlarged.
Gallbladder, pancreas, and spleen are unremarkable in the visualized
areas. There are some degenerative changes to the thoracic spine with
mild thoracic kyphosis.
I'm not a cardiologist, but these results did not look good to me, especially the nearly one inch gap between the two halves of my sternum! If someone were to give me a sharp finger to the chest, it's probably hit my heart and kill me. I'm also concerned that there's no sign of the wires that were there in the first place. I don't think that my body would absorb them (although I wouldn't put it past my super liver to make the attempt) so where the hell are they? (Actually, it only says that the wires don't cross the gap, I guess. So maybe they're just hanging there.)
So I'm pretty certain that I will indeed need surgery. In fact, I spent Friday morning preparing to be called in and admitted to the hospital. I expect that the edges of the sternum cut will need to be re-opened so they can heal together. At least I already have a scar that easily marks where they need to cut!
I never did get the call, so probably someone decided I should at least have the weekend before being readmitted. I'm glad, because even though I don't remember being frightened by the big surgery in October, for whatever reason this surgery is worrying me. I'm not sure if it's the surgery that frightens me, or knowing that I may end up inside that strange parallel universe inside my head again. That's not a fun place to go. (I've almost finished writing down my recollections of that time. Fourteen pages and counting.)
So I'm frustrated. Mighty frustrated. Because this means I'm nearly back to square one. All the pain I had to deal with for eight weeks is going to start all over again. Not being able to lift myself out of bed. Not being able to cough or sneeze without excrutiating pain. Not being able to lift anything over five pounds. Not being able to shower myself, or use the bathroom without help, or walk easily, or any of those other little things that I've taken for granted for 40 years.
And my chest hair was just starting to be noticeable again.
Hopefully, since there's no surgery on my organs this time, my recovery will be easier and quicker. I don't see why I'd need to be put on a respirator and kept sedated again, for instance. But this means missing two more months of work, at the very least. I have no idea how long I'll be hospitalized. I have no idea if I'll need to be transferred to an inpatient rehab facility again.
It's a frustrating set back.