Tuesday, September 10, 2024

How Bad Could It Be?

 Worse than I imagined.  I did nor even get to count backward.  When I woke up, I had IVs in each arm, two in the left arm, one in the right arm, and one in the right jugular vein.  It appears that there might have been a cathether through the right femoral artery at some point.  When I woke up, I coul hear  Dr. Farivar explaining that it was 9:30 PM.  (Drug and trauma induced, i think.  He was done about 2:15.) We both had a long day. At least I did not have to stay awake for ir.  DIY open-heart surgery seems like it is not going to catch on.  I am impressed that the Johns Hopkins Medical School president self-appendectomy is not better known among surgeons.

He explained to my wife that once he got inside, the no longer neighing so well equine aortic valve had apparently ingrown into thc mitral valve.  I did not know that could be that ill-behaved.  This may require a transarterial addition of a clip later on.   That at least, is not a ribcage breaker.

Where he originally  believed that only the left anterior descending (LAD) artery needed a bypass, the ramus artery also needed it.  (When the mechanic gets your transmission apart and tells you that you need a left-handed feebleveetzer, you can at least ask to see the part first.)  They extracted some saphenous veins from my right leg to bypass the clogged arteries.  The saphenous veins cross-collaterize easily so you do need not them as originally installed.  John Hunter first discovered cross-collateralization of blood vessels in the late 18th century, by tying off an artery in a deer's horn.  The horn continued to grow, so he autopsied it and foumd the body had buillt a collalteral blood distrubution network.

Anyway, having done the grand tour of my heart, they closed me up, using steel wire to encourage bone regrowth.  Then, because my heart rate was only 30 bpm they decided that I needed a pacemaker.  They inserted that two days later, and it still hurts a bit.  

The battery is supposed to be good for ten years.  It comes with a  monitoring unit for when to buy some AAA batteries :-)  This is apparently a local anaethesthic replacement.   I rather doubt this will get two swaps.

So, I heard Dr. Farivar's disembodied voice but all I could see looked like a grating and I could feel the gag-inducing breathing tubes.  Days or possibly minutes later, the tubes came out and I could again see something.  Whatever it was, it was not interesting enough to overcome the pain killers.

When finally awake in the wee hours of Thursday morning, I was fuly aware that my ribs had been moved and were protesting.  The next few days were a blur of decreasing pain, Talmador, Tylenol, and muscle relaxants which was much of thc protests, I thimk.

Some time Saturday, I reached the stage I had leaned to fear in 2013, "The Ceremonial Torture of Chest Tube Drain Removal."  Back  then, the nurse said patients described removal as feeling "kind of funny."  In 2013, it hurt like hell for about two seconds.  This time it did feel funny and looked gross.  The tubes were about an inch long and a foot long.  They were covered in goo and blood.

Somewhere along the way, they removed the penile cathether.  This had actually been nice, not needing to use a urinal, which has oftten been less than wonderful in practice.

Throughout, continual injections of heparin to prevent clotting.

Something new that I learned is that major surgeries (and I guess this qualifies) heal faster at high insulin levels so I was getting insulin and regular insulin checks whenever I fell asleep.

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