outsdr: (Dalek Longcat)
Here are some pictures I took during my hospital stay. I'm putting them behind a cut because they're obviously explicitly showing wounds, etc. There is no nudity or flowing blood, nor is there gaping wounds, etc.

2015-01-14 22.22.41

Shortly after leaving surgery. Hurray! The wrist guard is to protect the arterial IV from any damage or pulling.
Squicky pictures through here ... )
outsdr: (Dalek Longcat)

The surgery to repair my sternum on January 14th went off without a hitch. Not only do I feel better than when I went in, but the pain and discomfort is tremendously less than I experienced after the surgery in October.

A few interesting tidbits:

The original wires did not break. Instead, the wires actually pulled through the bone. No wonder it hurt so badly!

Before this surgery, not only was I able to feel my heart through the gaps in my sternum, but I could actually see it beating beneath the skin. As the surgery date neared, I was puzzled, because it was lower than I expected my heart to be. Also, it had developed into a baseball-sized lump pressing against my skin. After the surgery I learned that what I had been seeing was actually the build up of fluid around my heart. A tube was kept in place in my chest to drain away this fluid until Friday the 16th. (And it was a really weird feeling when they pulled that out!)

My cardiologist said it was a mess in there when he opened me up. Sadly, even though I told him it was ok, no pictures were taken.

All of the old wires were removed, and new wires were put in place, as well as three sternal plates. They're shaped like a butterfly bandage, and are place vertically on my sternum. It's hard to get an idea of their size from the x-ray I saw, but at a guess I'd say they're 1"x2.5".

I had an IV placed in the jugular vein on the right side of my neck. It caused a great deal of pain in the muscles in my neck and across the back of my skull; however, in addition to being able to accept IV fluids, it also allowed blood draws. And there were many. Without the IV, the blood would have been collected by needle puncture every time. So it was worth the pain. When it was removed, it also felt very strange and painful ... because the IV lead went all the way to my heart!

I had an arterial IV placed in my left forearm. It had a sensor inserted that was able to measure my blood pressure. Pretty cool.

The catheter was really convenient; I was almost sad to see it go.

Not only is my pain level significantly lower this time, but there has also not been any mental fogginess or confusion, or memory loss. I spoke with the anesthesiologist before the surgery about the amnesiac drugs I was given last time, intending to ask for a lower dose in hopes of not losing so much temporal memory. He said that I didn't need to have them at all if I didn't want them! So that's what we did, and I am able to remember right up to the moment he started gassing me on the OR table, and then nothing until I came to in the Cardiac Critical Care unit.

I'm also recovering my strength and mobility much more quickly as well. For the first few days, I was given a walker to use while making laps around the hospital unit. After the catheter, arterial IV, and chest tube were removed, I used the IV pole to support me as I walked. Now, I'm not using anything. I have my cane handy just in case, but I feel so good I'm going to try to walk a mile this afternoon.

One of the best feelings I have is that this should be the end - this time my recovery is going to end in being recovered- six to eight weeks from now, I'll be returning to work and my old life.

When I was discharged, the hospital insisted on wheeling me out in a chair, of course. The elevator was empty when we got in at the 7th floor, but quickly filled as we descended. One man and his family cheerfully said to me that I must be very happy I was leaving, the other occupants smiling and nodding as they gazed down at me, as I managed a tired but grateful smile in return ...

The look on their faces when I quietly said, "They're sending me home to die," was simply priceless.

(Don't worry, I quickly let them off the hook, but it was awesome!)**

The kitties are happy to see me again, but I do have to be wary of Akoya, as she doesn't realize she can't pounce on my chest like she loves to do, and I have to watch her closely when she even walks across me, light as she is. Last night, she stepped on the bandage over the wound from the chest tube, and I nearly screamed in pain (I settled instead for a manly bellow.)

The well-wishes and kind thoughts I received, as well as the number of people praying for me*, were very much appreciated, and really did help me feel better. I thank every one of you.

*No, I do not believe in the power or point of prayer. However, the person praying does, and as such, it means they are, in their own way, keeping me in their thoughts and hoping for the best for me. Why would I ever want to turn that kindness away? (Granted, it's a little annoying when they think their prayers were answered and it was their God that healed me, but whatever gets them through their life. It causes me no harm.)***

**That I was able to come up with this instantly on the spot really gives me hope that I'll soon be able to write my columns again soon. It's also nice to see my wit was survived and returned.

***That being said, there was one woman that I came close to snapping at during my original recovery. Shortly after being revived from sedation, I was on one of my difficult walks around the unit, when yet another hospital employee came up to me and gushed excitedly how happy she was to see my recovering when she thought I was going to die, and how I really must have someone watching over me. I thanked her, but said that my recovery was all due to my surgeon and the staff caring for me. She shook her head no, and as I tried to reiterate that I felt my surgeon deserved the credit, she said I was definitely being watched over, while casting her gaze upwards and clutching at my hands. She had the vapid look of a true believer, so I just thanked her again and returned to my walk.)

Frustrating

Dec. 7th, 2014 06:46 pm
outsdr: (Dalek Longcat)
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.

But.

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
effusion identified.

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.
outsdr: (Dalek Longcat)

So, I met with the hematologist yesterday. He was a little hard to understand, but he told me I tested positive for Lupus-Like Inhibitor, explaining that the antibodies in my blood are attacking the blood vessel walls, making them rough and causing blood to stick to them and clot. There's no cure, and I'll be on blood thinners for life.

Good news though is that this should never happen again, he said. _Should_.

What I forgot to ask him was why it happened in the first place. I'm scheduled for another blood test in February that's going to be done to make sure this is what is really going on. I'll try to remember to ask him then what triggered this after never having any clotting problems before.

He said there's no test for this, unfortunately. It's not hereditary, but it is genetic (that seems contraindicative). He also referred me to a Coumadin clinic in December.

The hematologist said I had the worst case of blood clots he has ever seen.

I told him I wasn't sure if that should make me happy or not.

Annoyingly, these test results are dated October 2nd. So apparently they've known all along what was causing the clotting and just didn't bother to tell me. Granted, it's possible the information was buried so deeply in my chart that it was missed.

He also very soberly told me how very serious this had been and that people die from blood clots all the time, and that this really should have killed me as well. He is glad I'm doing as well as I am.

And to be honest, I almost feel like I'm back to my old self again, at least mentally (There's still some memory issues.) Once my chest finishes healing, I think I'll be fine (It still hurts, a lot at times, but not like it did before. Sneezing and coughing still terrifies me though, because it feels like I'm splitting in half every time.) Especially once I get some more cardiac rehab sessions done as well, and my strength and stamina return to normal.

He told me that I'm still restricted on the weight I can lift, because my sternum is still somewhat soft. I think I made the right decision to wait to return to work until January. I want to be as close to 100% recovered as possible when I go back, especially since I know that I'll end up pushing myself to show that I can still do the job just as well as, if not better than, I did before the surgery. And I definitely don't want to be coddled.

So that's that. Looks like I have some lifestyle changes to consider, but if the only thing I need to do to treat this is taking one pill a day, I can live with that. Well, I have to, I guess. But I know it could have been a lot worse.

*This is the title of an actual movie shown to us in school. It was from the fifties, but showed an impressive mix of live action and animation. As well as cigarette smoking doctors! And bible passages!

(And it turns out it's totally on YouTube.)

outsdr: (Dalek Longcat)
Hello!

I continue to improve. I'm doing cardiac rehab now (gentle exercises to strengthen my heart and lungs) which is going well, although it's frustrating how much they suck away my energy.

I'm hoping to return to work beginning of January. I don't want to go back until I'm as close to 100% as possible, because I know I'll end up driving myself hard to show everyone that I can still do the job just as well or even better than I did before the surgery.

Speaking off, here is a picture that was taken of the blood clot that was removed from my heart. I'm putting it behind a cut, because it is kinda gross.
Icky )

Honestly, it's mind boggling to me that this came out of my heart; that I had open heart surgery; that I needed open heart surgery. It feels like it happened to someone else.

I'm also doing something I didn't think I was going to do: I'm writing down all my false memories of events that ocurred during my nearly two weeks of sedation. Writing them down is helping me work through them, and is helping me accept that they are not real, because a lot of them still feel very real. It's interesting that I'm noticeing a few corelations between things I remember and things that I'm told ocurred in the real world.

Update

Nov. 9th, 2014 10:20 am
outsdr: (Dalek Longcat)
I'm at home now, and have been since Monday.

Two Thursdays ago, while I was still in the nursing home, the UTI that I knew I had kicked me hard with its ugly little feet. I was out walking to halls, working on building my strength, when I got the chills and started shivering so badly I didn't think I'd be able to make it back to my room. Somehow, I managed, and went to bed to warm up. I had known I had a UTI since I arrived, but the first test supposedly never made it to the lab (found this out after six days) and the results of the second test hadn't come back yet.

Read more... )
outsdr: (Default)
First off, here are two images of my spine; my chin is pointing to the left.The story continues ... )
outsdr: (Default)
First off, here are two images of my spine; my chin is pointing to the left.The story continues ... )

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