Diet… Does Eating Suck Now?

Many people worry about this, and I’ll admit that I did, too.  I mean, who doesn’t like good food, right?  We can all breath a sigh of relief, it’s not quite as drastic as our fears led us to believe.  A couple friends of mine told me that, for the first month or so after surgery, food tastes terrible.  Not different or unrecognizable, per se, just bad.  Lucky for me, my experience wasn’t like that.  Food still tasted like it was supposed to, though maybe a little ‘dull’ for a short time.  In my case, food tasted fine and I was able to eat almost immediately.

The first day in ICU I was restricted to a solely liquid diet, but that soon after surgery I really didn’t want to eat anyway, so that was fine with me.  The first day and a half in the regular hospital room they fed me normal meals, but I wasn’t all that hungry so I ate only bits and portions.  One meal I didn’t eat at all because I simply wasn’t hungry.  After that I ate fine, and my appetite has been normal since.

And for what it’s worth the hospital food was actually pretty decent, even good at times… though the “pot roast” had the texture of something out of old Army C-rations.  There’s a not too fond memory I’d rather push back into the deep dark recesses of my brain.

The big change in my diet kind of surprised me.  Being diabetic and having everybody continually harp on me about blood sugar and carbs I was expecting a huge restriction there.  Not so.  Now don’t get me wrong, carb watching is still as important as ever.  I still have to keep them in check and do the right thing.  No, the big thing for me, at least for the foreseeable future, is sodium.  I need to keep my salt intake down and well-managed.  My hospital meals were specially designated as low-sodium, or possibly even no-sodium, I forget.  They also made it a point to provide packets of Mrs Dash for seasoning to replace the salt.  So the #1 dietary goal for me right now is reduce my sodium intake.  I can do that.

About 15-ish years ago I eliminated added table salt on all foods, except french fries, corn on the cob, and popcorn.  I did that for several years, but slowly backed away and started adding table salt to everything again.  Well, now I’m determined to go back to that goal… and add french fries to the no salt rule.  I even used Mrs Dash on some corn on the cob tonight and it was very good.  I still can’t envision unsalted popcorn, though.

I’m also making an effort to make more foods either from scratch, or at least simpler.  Packaged foods and mixes usually contain a bunch of sodium, for both taste and preservative purposes.  And here’s a fun fact:  Low-calorie, reduced-calorie, non-fat, and low-fat foods… basically anything packaged and marketed as an allegedly ‘healthier’ alternative… almost always have something increased to make up for what they took out, and very often that addition is a boatload of sodium.  For a few years now my position has been to eat the real thing, just watch portion control.

So, here’s my ‘new’ dietary regimen…

  • Reduce sodium greatly.
  • Keep watching my carbs.
  • Watch my portions… not easy for me, but I’ve been good so far.
  • Eat real food, not bastardized concoctions, just watch portions (there’s that theme again).

See, it’s really not all that bad.  Instead of ordering a meal and an appetizer, I pick one or the other, but not both.  If I go to fast food, instead of a value meal and another burger as a side… yes, I do that… just the value meal.  No more side burgers.  And guess what… it’s really not that bad.  I’m still satisfied when done.

Eat well, and bon appétit.  🙂

Rehabilitation

Physical Rehabilitation

Aka exercise.  Proper exercise and physical rehabilitation is crucial to a good recovery.  This is something that both the professionals and the people who have gone through this have told me, and it is stressed a lot.  Some people have told me about family members who blew off any physical aspect to recovery, and suffered for it.  They either had more medical problems or at least took far longer to recover.

The first thing you’re going to do is walk.  Three to four times a day in the hospital, even in ICU, and even as early as the next morning after the surgery.  It’s not going to be far at first.  It certainly won’t be fast.  Are you familiar with Tim Conway’s old man character on the Carol Burnett Show who shuffled along with 2″ steps?  Yeah, it’s going to be kind of like that.  In the beginning you will have an entourage of 2 to 3 nurses dealing with your various IVs and tubes, etc., plus to make sure you don’t fall.  A few days later you will get the regular physical rehabilitation people coming to see you 1 to 2 times a day, and they’re going to push you to go a little further, make sure you can do stairs, and so on.

Next comes a more rigorous rehabilitation, at the hospital three times a week.  Here you do things like a treadmill, exercise bicycle, stretching, etc.  I just started this week so my treadmill is at 15 minutes, but my goal is to work up to 30 minutes.  I will eventually do some strength training, but right now my focus is on aerobic exercises.  You wear a heart monitor the whole time, and they check your blood pressure several times before, during, and after.  It’s pretty thorough.  I also took a bunch of surveys the first day, which will be repeated for comparison purposes at the end.  It’s a twelve week program, so I will have to work something out at work once I return.

Incentive Spirometer

Another aspect, both before and after surgery, is the incentive spirometer.  This is a device intended to stretch and exercise your lungs.  Prior use was recommended by my surgeon, it is not ‘normal’.  The purpose for after surgery is that your lungs are negatively affected during surgery… “got lazy” is how one person explained it to me… and this contraption helps expand the lungs back into shape so they can be fully usable again.  This is a big deal, but I have struggled with it.  I can do it a few times then I start gagging, and I think the whole thing is mental.  You’re supposed to do this 10+ times an hour, every hour that you’re awake.

I was also given a set of four arm exercises, stretching type exercises.  These help stretch your body and muscles in your arms and upper chest back into shape, and it’s surprising how ‘closed in’, almost protective, your upper body becomes.  You are expected to do these 3 to 4 times a day.  For me it helped when I combined them with my walks, while in the hospital.  They’re easy in a ‘hurts so good’ way.  You do not have to do these anymore once you start the official rehabilitation.

Mental Rehabilitation

Doctors and medical people can tell you all about the physical recovery.  They can’t tell you much at all regarding what to expect emotionally and mentally.  Oh, they can give vague and generic suggestions, but not first-hand experience.

I’ve been fortunate, I’ve been very straight forward throughout this whole experience.  I’ve openly lifted my shirt and showed people my chest scar in public several times.  I’ve been very open about it, almost absurdly.  I haven’t really felt down or depressed, and I think things like this blog have contributed to my acceptance.

As I said in a previous post, while you are off work you’re going to have a lot of “extra” time on your hands.  First and foremost you need to rest and rehabilitate, but what about you mind and emotional state?  Be sure to keep your mind occupied.  Do some easy projects around the house.  You get a positive sense of accomplishment.  Read and/or study some topics that interest you, but you wouldn’t normally have time for.  Don’t be a couch potato mindlessly watching television every waking hour, but when you do watch tv include some mentally stimulating programs that will make you think and keep your mind occupied.

You will gain strength both physically and emotionally the farther you get from your surgery.  Take advantage of it.

What to do?

I’d been told by the surgeon and various doctors that I’d be out of work for around six to eight weeks, so up to two months.  Approximately.  Most likely.  So, what to do with all that spare time?  I mean, I work 40+ hours per week, normally.  I have a schedule.  I get up at a certain time, yada yada yada.  This was going to be thrown all out-of-whack.

In ICU right after the surgery wasn’t an issue.  Unless I was visiting with someone, or being poked and prodded by a nurse, I was sleeping.  Once we got into the regular room in the hospital the first couple days still involved a lot of sleeping, though with each day not as much.  I was also on somewhat of a regular schedule, sleep at night, up during the day, and so on.  My last couple days I was up more, and a little more restless.

Then I went home.

Prior to surgery I had all these grand plans for what I would accomplish during my time off.  I was going to clean my office, I was going to work on my blogs (I have four blogs now), and I was going to process more photos.  In the 19 or so days I’ve been home I have accomplished little of that.

My sleep schedule has been upended.  I’m naturally a night person.  If I could have my way, and I did this when I was self-employed doing contract work, I’d work all night and sleep all day.  I am pretty much back to doing that.  As I write this it is 4:30 am.  I went to bed at 2:00, couldn’t sleep for an hour, so I got back up and have been watching tv and pounding on the keyboard doing this and sending emails.  Between 4:00 and 6:00 has become my normal bedtime, though, and it’s starting to catch up to me.

I have accomplished some things.  My blogs have been addressed, though not as up-to-date as I’d like.  I cleaned off my desk and a table in my office, but the rest still has to be done.  Not a single photo has been processed.  I started driving again less than a week after getting home, so that was good, and it’s allowed me to take myself to several follow-up medical appointments.  I’ve also started post-surgery cardio physical rehab, which is three times a week.

So it’s not like there’s nothing to do, but the maintenance you need to do is only a small fraction of what you are used to doing.  If you find yourself either with an upcoming heart surgery, or a just completed surgery, you might want to give some forethought as to what you will do with your “extra” time.  Keeping in mind, of course, that you will need to ease into it.  Your body will be stiff and sore, which will limit what you can do.  Also know that you will tire quickly and easily, which will bring on some unscheduled naps, which are very welcome when you can get them.  As you progress in your recovery your stamina will increase accordingly.  I will probably revisit this topic in a few weeks or a month and compare how things have changed.

Have something in mind to do, set a goal or two, but don’t worry if it doesn’t all get done as quickly as it normally would.  Things aren’t normal right now, so roll with it.

ICU from the Outside

After my first 10 minute visit I was a little shook but yet so relieved.  Shook because there was so much to take in and try to understand.  I sat in the waiting room with Vicki and we chatted and did our thing waiting until 2:30.  That was our next 10 minute visit time.  We went in to see him and I stepped up to hold his hand and say hello.  The breathing tube was still in.  He was looking good for a man who just had heart surgery.  Vicki came up to the bed and got in a short “chat” and got to see that her brother was going to be OK.

Back to the waiting room for an hour.  In that hour our son Matt showed up.  When the next visiting time came up Matt and I went in to see Ken.  Matt cautiously approached his dad.  It was hard to see him with all the tubes and lines, but so good to see him aware and good.  He STILL had the breathing tube in so we could only talk and hold his hand.  The nurse came in and said they would be taking the tube out soon.  A chance to hear his voice on our next visit.  We retreated to the waiting room and more time wasting.

For the next visit I only went long enough to hear his voice….say I love you.  Then left Matt to visit with his dad in private.  It was important that he knew his dad would be OK.  After that visit Matt headed home.  Vicki stayed until the next hour.  She went to see him but he was sleeping soundly.  She informed me that he needed his CPAP machine hooked up and that she was leaving.  I thanked her for being there.  I really appreciated her calm company.

I went to see how he was sleeping and talk to the nurse.  I could not find her.  I told the staff at the desk outside his room that Ken needed his CPAP hooked up ASAP.  I explained that I could see him having breathing issues as we spoke.  I was assured it would be done.  I believed them so much that I watched the time tick by and went back a half our later.  No CPAP.  I hunted down his nurse and told her I really thought it was important.  She agreed and said she would get to him very soon.  Next time I went back, a half hour later, he had it and was sleeping better.  He woke up and talked to me a few minutes.  Then I felt better leaving him to sleep.

I stayed for one more visit.  I decided to work on a puzzle in the waiting room on my last hour there.  It was very calming and time flew.  I then went down for my last visit before I went home to try for some sleep.  I got there and the night nurse told me I could stay as long as I wanted.  I sat for a visit and she also informed me that she was going to get him on his feet to stand next to his bed that night.  I was so excited!  When the time came, she helped him to “walk” his legs over the side.  Then he slowly stood next to his bed.  I was SO happy to see that!  It wore him out!  He got put back to bed and I helped settle him in before leaving.  Home for the night and back early for rounds.

Room move next!

Post-Surgery… ICU

Roughly four and a half hours later I came to in the Intensive Care Unit (ICU)… which is standard procedure after this type of surgery… in a dark room and with a bunch of tubes and hoses in me.  Very sore, very groggy, but I slowly woke up.  I was allowed limited visitors, and I made it very clear to my family beforehand that while I was in ICU I only wanted visits from three people: my wife Missy, my son Matt, and my sister Vicki.  I was willing to see anyone once I get into my regular room after ICU, but not in ICU.

My memories of visits initially are vague.  I do remember Missy coming in, vaguely, I think she was first, and I’m not sure if I reacted or not.  I think I did.  I remember Matt coming in, not sure for how long, but I do remember grasping his hand right before he left.  I was aware enough for that, and I sensed that it was something that both he and I needed.  I also know that Vicki visited, but she was unlucky enough that I was usually sleeping when she did.  At first, visits were limited to one person at  a time.

In me were a breathing tube, a catheter, a large drain tube from my stomach, a small drain tube from my stomach, a heart monitor (which would stay on to the very end), an IV in a large vein in my neck, and either two or three IVs in my right arm.  Throughout this entire blog this is the only thing that I am going to rail about:  the breathing tube.  I had been told by everybody… doctors, nurses, people who had had this surgery before, experiences I’d read online… that you generally don’t even know it’s there.  It’s removed prior to you waking up, as soon as you’re able to breath on your own without outside assistance.

That didn’t happen with me.  In my ICU room was a clock on the wall right in front of me, and I was aware and coherent enough that I was able to count the time.  I was awake and aware of the breathing tube for three hours.  THREE  HOURS!!!  Because it disrupts your vocal chords you can’t speak or even make grunting noises.  Because my hands were secured to the bed… so people don’t remove the breathing tube themselves, which people apparently do when given the chance, and now I know why… I couldn’t even signal anybody to ‘ask’ that it be removed.  Three hours I laid there staring at the clock watching the time slowly tick by.  I was livid.

I have been since told that I wasn’t breathing well enough on my own for the anesthesiologist’s satisfaction.  I didn’t care.  They should have put me back out, or something.  Once they finally told me they were going to remove it, I started planning in my mind all the invectives I was going to let loose with.  “It’s about fucking time!  What the fuck is wrong with you people?!?”  Once it did come out, however, all I did say was a solid, “It’s about time!”.  I even said it twice to make sure they heard it.

Moving on, I was recovering very fast, they said.  I stood by the side of my bed later that afternoon, which I was told is unusually fantastic.  The next morning, roughly 18 hours after surgery, I took my first walk around the nurses station.  Everyone was impressed with how soon and how well I was doing.  Because of my plethora of tubes and such still in me I had three nurses accompanying me, both to carry the tubes and stuff, and to make sure I was steady and didn’t fall down.  They said I walked them, I did so well and so fast.

My web server had a major implosion and was down for five days, hence the delay in this post, so I forget a couple of the details, but my memory tells me that no tubes other than the breathing tube came out the first day.  The next morning some of the tubes started coming out… not necessarily in order, both stomach drain tubes, the catheter, the neck IV (which required the nurse holding pressure for roughly 15 minutes so I wouldn’t bleed to death), and one or two arm IVs.  By the time I was transferred out of ICU and to my “regular” room around mid-day I only had one arm IV and the heart monitor.  I am told that my recovery was going much faster than average and very well.  Impressively well.

Surprisingly, as major as this surgery is supposed to be, I didn’t feel all that bad.  Sore, sure, but not any real pain.  Of course I did have some good pain medicine coming into me via an IV, but even after that stopped I never did have real outright pain.  The vast majority of pain medication in my regular room was simple acetaminophen (Tylenol).

Before I headed off to my regular room I distinctly recall a nurse practitioner rip my two nurses a new one because one of them cancelled a particular medication that she had ordered.  Kind of reminded me of Army basic training the way she spoke to them.  She was tough!  I did kind of chuckle because, before she started chastising them, she pulled the curtain to my room closed as if that might preclude me from hearing.

One aspect that intrigues me is that the nurses on the recovery floor were absolutely awesome, but the ICU nurses… while certainly capable and good… were a little sketchy by comparison.  The whole ICU seemed to be a tad less coordinated than the recovery floor, which is where we’re heading next.