The doctor who did the angiogram indicated it will involve cutting me open and then wiring the sternum back together. This sounds absolutely awful.
I am home. It will be some weeks before surgery so everything I need to do for the cause needs to be done first.
"Pretend you have a broken wrist for a few days."
Hi Clayton:
ReplyDeleteSomehow this missive got messed up. I don't know how or why but I think everything's here.
Actually not as bad as you're making it out to be. I've had 2 CABGs (Coronary Artery Bypass Graft) 18 months apart, each for 2 different arteries including the big one on the back of the heart - the "widow maker". And I've learned a few things.
I've said it before - make sure you have a top notch surgeon. But nearly as important as that is to make sure his team is well established and has performed this surgery countless times.The surgery is about much more than the surgeon himself. It is truly a team effort.
Good luck Clayton. Relax as much as you can before the surgery. It's major surgery to be sure but it's not the end of the world and won't be the end of your life. You'll feel much better once you've recovered. You'll be surprised.
Keep us advised when you're scheduled for surgery. As I've said, I'll remember you and your family in my prayers.
God Bless.
John
Ask what their success rate is. That's not insulting to them - it's a perfectly reasonable question and you're entitled to the information.
Make sure you're scheduled for early in the morning. Don't accept surgery later in the day, i.e., afternoon or evening. Team members get tired just like everyone else. When they're tired they make mistakes and you don't need that to happen.
When you wake up in the recovery room chances are that you'll still be intubated (you don't feel it) and still have a breathing machine doing the work. Shortly after I regained consciousness the physician in charge of my recovery came to me and told me they were going to wean me off the breathing machine. Instead of
pushing air into my lungs at 100% of my need, they were going to reduce the machine's output to 75%.
You feel that lack of air and you have to suck in the rest of what you need. You have to expand your chest to allow air to flow into your lungs. Again, no pain but it is a strange feeling. Pretty soon it becomes natural again. Ultimately your breathing tube will be removed. They asked me to say something and I croaked out a hoarse "thank you" to a smiling physician. Don't be alarmed - your voice returns quickly.
When you're moved from the recovery room or the ICU (depending on your hospital's practices) up to you room they'll give you a small toy like object to blow into. VERY IMPORTANT that you blow into it as frequently as you can - you have to expand your lungs to their normal size and this little exercise accomplishes that.
I was told to breathe into the device in order to float small plastic balls above a certain line in a vertical tube. I was told to do that every commercial I saw on TV.
When you're discharged home you're told to cough frequently to expand your lungs and to continue using the small device. They sent me home with a firm heart shaped pillow to hold against my chest to minimize the discomfort coughing causes to your healing sternum - they cut it in half and use a rib spreader to push apart and open your chest to access your heart. That's what makes recovery painful. Not exquisite pain but you'll notice it.
When I got home after my first surgery I tried my best to follow the directions but the pain the coughing caused made me reluctant to follow directions. The second time I knew better.
Not coughing enough soon enough prolonged the pain caused by the coughing and I was miserable and fearful of pushing it. My recovery suffered.
After #2 I pushed the envelope and fairly quickly reached a point where it didn't hurt to cough. My breathing also improved with less soreness experienced too.
I never had a valve replaced so I can't speak to that. But I've learned the lesson to follow what my doctors tell me with a great deal of diligence. Fortunately I have not needed another CABG
Much of what you say applies to valve replacement. How about pain six months later?
DeleteAs I remember it the acute pain lasted perhaps 3-4 weeks after CABG #1 and half that after the 2nd procedure. After that time residual discomfort became less and less noticeable as time went by. At 3 months post surgery I can't say I was really bothered by the pain/discomfort. By 4-5 months it was completely gone. Just try to avoid any blows or pressure to your sternum.
DeleteThe only lasting symptom is itchiness over the surgical scar - and that's 15 years after the 1st surgery. Not all the time but once or twice a day I have to rub the area to lessen the feeling.
Shockingly to me, they had me up on my feet the morning after surgery! It felt wonderful to stand up and even better when my nurses pushed my frame into a nearly vertical position instead of being sort of hunched over.
I was walking short distances with two nurses holding my arms maybe 3-4 days after surgery. Pain meds took care of the pain. I just had to contend with stiffness and a noticeable lack of energy - surgery takes a lot out of you which is why recovery takes longer.
I was discharged to home both times after 5 days. I was told to walk every day as much as I could - I used a walker at the beginning to steady myself. Be around people when you do just for obvious safety reasons.
I was driving my car within 2 weeks and shortly after began to regularly walk around inside a shopping mall (due to the controlled environment and steady even floor) within a month. Slowly to be sure and pushing a feeling of exhaustion. Never collapsed but at the beginning it took effort to complete a lap, and then two laps, etc.
I preferred the 2nd floor of the mall because it had a railing I could touch to reassure myself. I went in the morning to avoid crowds.
About 10 years ago I had a series of 4 abdominal surgeries within a span of 8 months. Brutal. 1 was laproscopic which was gentle but 3 were midline incisions and they really wasted me. Seemed to take forever to recover back to a"normal" feeling. By comparison, the CABGs were a piece of cake compared to them.
I had 3 surgeries for orthopaedic injuries suffered when I was in the Navy back in 72-73. Although I was busted up pretty bad recovery was a lot quicker probably because I was in my 20s at the time. 48 and 50 for my CABGs, 56-57 when I started my 4 abdominal surgeries. You can compare.
Word of advice: Don't delay taking your pain meds - take them when your nurse appears on schhedule with the shot. The meds work great at keeping the pain away if you take them on schedule, but are really slow to get rid of any pain you're experiencing if you defer any and you suffer. Coming out of one of my later surgeries I was probably really doped up and declined probably the 1st IV dose for the pain saying I didn't want to become addicted to the pain meds. What a mistake. Within an hour I was crying for the shot and it took until the next dose 4 hours later for the meds to really work their magic.
Hope all this helps. Ask away if you have more questions.
Best,
John
What you describe is much like the recovery from the aortic valve replacement. When the chance came for morphine, I begged.
DeleteI am still seeking a minimally invasive procedure: Stanford, Mayo Clinic, Providence Hospital in Spokane and Stanford all do this robotic procedure through a couple keyhole cuts. The valve replacement is going to hurt, regardless.
Any help you need with the cause, let me know
ReplyDeleteI'm still praying for you Clayton.
ReplyDeleteThank you. Getting an answer as to whether Mr. Roboto can do my bypasses is the big problem. I hate to make phone calls because it exhausts me, but emails do not seem to get any response. I fear they are just going to say, "We need a referral."
DeleteHi Clayton - Old cardiac nurse here. When I was a student nurse I observed a valve replacement surgery. About a year later I was attending church with a friend and there was the patient sitting a couple rows away and I remember thinking - "Wow. I saw inside that guy while they worked on his heart!" And that was a couple decades ago. Things are even better now.
ReplyDeleteAs an RN I took care of CABG patients in the CV ICU and the vast majority of patients were up and out in a matter of a couple days. A friend in his 70s recently had CABG surgery and was surprised how quickly he was out and home (I got to have an "I told you so" moment!) I do need to point out that with a valve replacement there is no "minimally invasive" procedure. But as I mentioned I observed an aortic valve replacement more decades ago than I care to disclose, so they've figured out how to do it efficiently and effectively by now. Same with CABG. Abdominal surgeries are much more
prone to complications and pain (unless they are laparoscopic). Back in the day before laparscopic surgery was used for gall bladders our gall bladder patients spent more days in the hospital than the hearts did.
Assuming you have no complicating factors post surgery (most do not) they will get you up in a chair and have you coughing to keep your lungs clear. Breathe and bear it. Keeps pneumonia away. You should be visited by physical therapy to get you moving and they will walk you. Usually the most pain for this tends to show up 36-48 hours post op. When your vitals are stable (2 days in the unit?) you'll move out to the floor. I never saw anyone need a walker as they were mobilizing when and where I worked. If you were active before this getting moving should not be a problem, though anything like this will slow you down a bit as you recover and you will be sore. You certainly should not be having any pain at 6 months!
I agree that you want to see that your surgeon is a good one. Ask about expereince and check out reviews and "grades" online, (remembering that there is always those who are unhappy no matter what, so weigh that in.) I was really blessed to work with an amazing group of guys I would have trusted my mother with if she needed bypass. She actually had a stent placed by the cardiologist -- also a good group in my neck of the woods. So I am spoiled in that way. Usually their PAs are cracker jack also. As John said, do the breathing, hold the pillow and cough ... that's really important. You'll be surprised how those chest bones knit themselves back together. We are truly fearfully and wonderfully made. 🙂
I am coming to grips with the pain issue. Illogically, it sounds no worse than the aortic valve replacement in 2013, which was done through a hole about two inches long, in between my ribs.
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