Saturday, February 13, 2016

A Followup on Eldy's Cardiac Bypass Surgery

Theresa and Eldy
Apologies for an extra long blog today, but there's lots to report! Eldy, of Where's Eldo? fame, (lol....) was scheduled for open heart/bypass surgery on February 3rd. His sister Theresa and her husband, Chuck, flew down to be with us having originally planned to spend the week vacationing with us anyway. Instead of enjoying breakfasts on the beach on Anna Maria Island, and taking side trips to explore our beautiful city some more, they spent a couple of days hanging out with us and boosted Eldy's spirits with wit and laughter. We had at least three days to spend with them before the day of the surgery. Eldy had pre-op blood work done, a chest Xray and some tests done two days before surgery just to make sure his body was ready for the big procedure.  We all had a wonderful meal the night before surgery at the fabulous Mattison's City Grille in downtown Sarasota. Sparky was trying hard not to think about this might be our last meal together but to think positive thoughts. Eldy was very quiet on the subject, trying not to think about it too much. He was scheduled for afternoon surgery on Wednesday, February 3rd but was required to report in at 7:30 AM that morning having had nothing to eat or drink since the night before, at least 12 hours before.

And so, the wait began...Here's how it went at Sarasota Memorial, one of the best cardiac care hospitals in the state of Florida.

7:30 AM...We reported in to the surgical waiting area...the waiting center nurse liaison gave Sparky a name tag identifying her as a family member. She explained how the morning would go, the different stages of surgery, how the surgery information board would show by color and doctor's name at what stage the patient would be in at each phase of the surgery from start to finish.

She gave us a web address for Sarasota Memorial for your phone where the patient is given a five digit code number and you can check on your phone as your family member moves through the different stages of open heart surgery...pre-op, surgery, intensive care, critical care, recovery room.
Not only that, but at each stage of open heart surgery, the family member is informed by a member of the cardiac care team directly when the patient is under anesthesia, hooked up to the heart bypass machine, when they come off the heart bypass machine, and when they are closed up and taken to the intensive care unit.

Wednesday, February 3

In good spirits 
10:30 AM....we were escorted to the next waiting area, the pre-op where Eldy had to get into the hospital gown, climb up onto a hospital bed and wait for awhile in an area where he was pre-prepped for surgery. This was where he had to get shaved by a very nice orderly/surgery assistant/?  The orderly and Sparky teased Eldy....and Eldy was able to joke back. We didn't get the man's name, but he was terrific in helping Eldy get his mind off what was about to happen. He was kind and gentle and very careful in his shaving procedure despite jokes about how he hadn't ever slipped, YET...Eldy was completely shorn of all his chest hair AND leg hair on both legs, in case they had to use either leg for the bypass. A line was inserted for the beginnings of drug administration.

The anesthesiologist  came in and asked all kinds of questions about previous surgical history, breathing patterns, and lots and lots of general health questions. He explained what would happen as he went into the operating room, that it would take an hour for them to prep Eldy for surgery in the actual surgical center. Lots of tubes and monitors to hook up before actually going under, and that the procedure would take about an hour.  Then the surgeon and came in and said that Eldy was good to go, and he wasn't going to repeat the previous office visit warnings as he didn't want to scare him right before surgery. The list he went over at the previous office consultation visit was VERY scary---heart attack, embolism, nerve damage, brain damage, stroke, kidney failure, pneumonia....and more. What are you going to do? Opt out of the procedure? hope and pray that all will go well.

1:00 PM..Time for Eldy to be wheeled to the surgery center....Sparky hugged and kissed him and off he went....Looking back on things, the afternoon seemed to go by quickly with Theresa and Chuck there beside Sparky to keep her company. At each stage, just as the hospital had promised, the liaison came out to speak to us directly to inform us at what stage he was at. They DON'T tell you if anything is wrong, that is the surgeon's call to tell you after the procedure. They told us when the operation started, when Eldy's heart was hooked up to the bypass machine,  when he was off the bypass machine, and when he went to intensive care.

4:30PM... Eldy's surgery was completed and he was in intensive care. The entire bypass procedure had taken just a little over three hours. After Eldy was stabilized in intensive care, Sparky would  be able to see him.  At about 7:00 PM, the surgeon, Dr. Hoffberger, came out to see us. He had four bypasses instead of the six the cardiologist had predicted. He had a leg artery used from his left leg, and a mammary artery removed from his left chest area for the bypasses. There were no complications, and he did well.

8:00 PM....Sparky was allowed to see Eldy briefly. What was rather shocking and surprising to Sparky, she was able to walk right up to him in intensive care. She didn't have to put a mask on, nobody asked her to wash her hands or use hand sanitizer. With all the worries about hospital infections, that totally shocked her. Although the hand sanitizers were all over the place everywhere in the hospital, nobody was monitoring this in intensive care at this particular moment. At this moment, Sparky's heart almost stopped, unnerved by all the hardware, tubes and lines inserted all over.

He was completely covered up to his chin. His monitor screen looked like a space rocket console, and it was the size of a very big screen TV. Sparky had never seen so many tubes and lines and machines hooked up to one person. Not thinking, she put her hand gently on his chest and said,"Your pesky better half is here..." and the nurse immediately rebuked her! DON'T TOUCH HIM THERE! ---Sparky recoiled. OMG! WRONG SPOT! Eldy opened his eyes and smiled but became aware of the respirator tube and started trying to gag it out. The nurse quickly put him back to sleep so that he wouldn't get agitated with the tube in. He doesn't remember any of this, of course. Eldy remained in intensive care till the next morning, and was moved to the critical care unit. His breathing tube was removed by then.

Thursday, February 4th....Both our memories are fuzzy as to the time passage and the chain of events after the big surgery..... But he was on the road to recovery. Some of the things that we do remember and wanted to share....Eldy's blood sugar went haywire while under surgery. He became officially diabetic at the time of surgery and had to be put on insulin. He was getting injections and an insulin drip to manage the roller coaster sugar levels that had been triggered by the surgery. When you go through major surgery like that, the body may react in a lot of different ways...and Eldy's blood sugar was a surprising development. But that straightened out by the fourth day...He had no previous history of high blood sugar before that.

Eldy was so pumped full of fluids during surgery, he came out with elephant sized legs and puffy all over. You can gain as much as 40 pounds during a surgery like that from all the fluids that are pumped into you to keep you alive. Once you start recovering, they keep close track of your weight. Eldy was given diuretics to flush the fluids out, and potassium medication to replace the potassium lost. As soon as he took the diuretic pill, he had to pee and almost immediately, within just a few minutes. He had to go and often. He ended up having a container right beside the bed to pee in so he could use that since he couldn't always count on the nurse making it to him in time. The amount of fluid that came out of him was strictly monitored and measured. Gradually, the swelling of his legs and body came down.

Within one day he was up and sitting in a chair, but still hooked up to lines for insulin and IV drips for different things. It's hard to tell here, but his skin was ashy gray..Sparky was worried, but was told this was normal.

Within less than 48 hours, he was up and walking in a special walker. The walker is designed for cardiac patients not to put any pressure downwards. The chest and rib bones have been wired together and it is critical that there be no exertion of the chest muscles nor any kind of pull or push that might shift the wires to pull apart from each other until the bones have started to knit together. He has a six inch scar on his chest, and two incision areas on his leg, one down close to the ankle, and the other one near the knee on the left leg. Eldy will not be able to drive for six weeks and has to sit in the back of the car to avoid air bag pressure deployment in case of an accident. He will be using the heart pillow to cushion him from the seat belt. He will be sleeping in a recliner for the first week or so to keep him from shifting over on his side and moving the chest area. The goal for the hospital stay if all went well was predicted to be 4-6 days.
"Don't you dare take a picture of my backside!"
February 5th, two days after surgery...He's looking a LOT better...More tubes and lines have been removed...He's not getting much sleep as one night the nurses came in and checked his sugar with finger pricks every hour on the hour.  :-(

He was given a special breathing apparatus which is standard for heart surgery and other types of surgery patients. When you undergo surgery, the little sacs in your lungs collapse and they slowly recover afterwards and inflate back up with help from this portable device.

You breathe in slowly and try to keep the little ball on the right centered in its little space as you watch the indicator level rise. Eldy's goal started at 1500 and it is hoped he will be closer to 3000 as time goes on.

Deep breaths slowly in and out on this little device help those little lung capillaries inflate and keep pneumonia at bay. Eldy has done a fantastic job from day 1, surpassing his goals and religiously using it, 8-10 times a day, with a set of ten breaths at each practice.

February 6th...Three days....Lots of people coming and going...housekeeper, dietician, diabetes doctor, physician's assistant, nurse, nurse's assistant, and they are all really really nice, kind, and helpful, here at Sarasota Memorial, right down to the housekeeper, who asks us as family members, do we need anything? Can we get you anything?  Eldy continues to improve...walking a little more each day, today around the hallway, to the nurse's station and back. Pain is being managed well, but he definitely needs it regularly with a pain medication not quite so strong in between the require waiting time till the next dose. Today Eldy's white blood cell counts are a little elevated. Signs of a possible start to an infection. Antibiotics are administered quickly and he will have another blood check drawn tomorrow morning.  Nurse hears a little crackling in a lower lung lobe, possible signs of a little fluid buildup still there. Keep up the breathing treatments, Eldy, that will help take care of that. He does.

February 7th, Four days out....Target time for going home is tomorrow morning, Monday...Blood work comes back normal, the threat of infection has dissipated. The surgeon wants Eldy home as quickly as possible to keep from getting any infections in the hospital. Despite their best efforts to prevent that, it happens, so that's why the push to get patients home as quickly as possible. Eldy will be eligible for home health care, daily for at least the first week, Medicare will cover it if the doctor orders it. He does. The decision comes down from the power that be, that Eldy will be discharged tomorrow morning. Woo-hoo!

February 8th...Five days from surgery...time to go home! We sit and wait for SEVEN AND A HALF HOURS twiddling our thumbs to get cleared to go home. Paperwork has to be done elsewhere in the hospital. This is the only time we have gotten upset with the hospital. To have to sit and wait 7.5 hours for someone to say you can go home is ridiculous! Finally, the compulsory wheelchair arrives and we get out of Dodge.
The next time we see you, we will report on recovering at home....Until then...thank you to all of you who read us, and to those who read our Facebook postings, for all the good wishes and prayers through all of this....It was heartwarming :-) and encouraging to have so much support behind us.

Please remember that February is Heart Month. If you are among the boomer population, please get a stress test at some point. If you have family heart history, make sure you are getting your heart checked out regularly. Eldy had very few signs leading up to this, but we should have gone and gotten the stress test much sooner. He had shortness of breath over the years which he thought was related to his line of work, but the shortness of breath had increased quite a bit in the last year. He became more and more sedentary because he had so little energy and didn't feel like doing anything. The fatigue was much more pronounced. Sparky thought he was just sitting too much but it was a lot more than that. He started complaining about little pain twinges, but didn't think it was anything to bother the doctor with because they were so fleeting. His legs were bothering him a LOT. He had leg pain that would wake him up at night. Sparky thought he might have some blockages there but we never got as far as having a doctor say let's check that out. We now think that the blockages in the heart were causing some of these other symptoms. Sometimes people think a heart attack has to be the classic elephant-on-your -chest sign with left arm pain, but by that time, you probably ARE having a heart attack and the heart muscle is incurring damage as it's happening. Eldy was fortunate. He didn't have a heart attack. He had warning signs. His family doctor was caring enough to call him fortuitously one day after he had a particularly troubling episode of arm pain and twinges on the golf course, and the office said, "You know, we haven't seen you in awhile, we think you should come in." He relays the episode when he went in. They look at his family history again, then refer him to a cardiologist, and that's where the story began.....Please get your heart checked out if you have family history...Better to be checked too early than too late....The heart is a muscle, it doesn't regenerate tissue like some of your other organs can. Once it's damaged, you've lost part of it. Your life becomes more precious and shortened because of it.

Thanks for stopping by today...Eldo is on the mend and doing very well....We'll see you again soon!