Quickie update

As I have said before, the farther I go out the less I’ll post, and there’s been nothing earth shattering to report, I feel like giving a quickie update, so here goes…

Sodium and Weight

The last week of May my Cardiologist put me on a much more serious dose of a new water pill, Torsemide, and off I went.  I was supposed to check in a few weeks later, but haven’t yet.  I will do so early this next week.

I still have the extra weight.  In fact, other than a couple short forays up to 268, I basically haven’t budged.  What HAS changed, and not for the better, is that now I am more achy, I am getting winded and getting tired easier.  Those aren’t good things.  Those are effects of the extra water weight.

We will get this worked out.

Scars & Body Image

A strange topic, but one that most people don’t talk about, so here I am.

My chest is looking very good, almost natural skin color.  You can still notice it if it peeks above my shirt collar, but it’s not bad.  There is no pain to this or any of the scars, which is good.  My arm scar is still not progressing as fast as the chest scar, but is itself moving along nicely and I have no issues with it.

Part of my left wrist is still constantly numb, and always will be.  Expected, warned, but just sayin’.  I hardly even notice, anymore, and I’ve always retained full functionality.

The only new development that I do not like is that I now have the beginnings of varicose veins.  On my inner left knee, next to where an incision was made to remove a vein for the surgery.  They’re small, but they’re still there.  I am NOT happy about this.  I have never had a varicose vein, until now.

Upcoming

I will have a major announcement in about three weeks, but don’t want to say anything just yet.  Not even hints.

Setback? Nah.

I really need to fix my header area.  But I digress, already.  *sigh*

Anyway, things have been going well.  Astonishingly well.  I feel good.  I feel better.  I can do more now than before the surgery.  That’s all good.  Then this past week I hit what I thought might be a speed bump.  Around last Monday I started having some chest… not pain, per se, but… discomfort.  It wasn’t bad, but I was a little concerned.  As the week went on it remained, but it lessened.  Ok, I thought, it’ll go away.  I spoke to some people at rehab about it on Monday, and we agreed it might be natural long-term side-effect of recovery, but to still keep it in mind to have it looked in to if I thought it necessary.

Fast forward to Thursday, and I’m home from work for another reason, but I’m really not feeling well, either.  The discomfort in my chest has suddenly increased, and is very uncomfortable.  It was in the center of my chest and my upper chest in front of my shoulders.  I describe the pressure as standing against a wall, trying to take in a deep breath, and feeling pressure on my chest because the wall will not give way.  I also felt pain/pressure when I would move suddenly and/or turn abruptly to either side.

But at the same time I don’t *know* what it is.  I’m also constantly told, “If you feel anything bad have it checked immediately.”, so I did.  Later in the afternoon, Missy and I headed down to the ER again.

I am again whisked into a room in the back… I later learn they have 36! rooms in the ER and that it’s not common, but not unusual, for them all to be occupied at the same time… and am asked a slew of question, the usual poking and prodding, and so on.  But because this is heart related they do an EKG, which came out fine.  The doctor was afraid of a possible blood clot, which is not unheard of for people after heart surgery, so they do an X-ray and a CT Scan.  Those both came back negative.  It is decided to have me stay overnight for observation… which I had kind of predicted would happen before I even went in… to do some more tests in the morning and to consult with the day’s cardiologist.

I felt gypped because, during my surgery, I had a very small broom closet-like room that was very sterile and cramped.  This time I had a very nice and spacious room that was actually comfortable.  But I digress, again.

The next day I have another EKG, an Echocardogram, and a treadmill stress test.  The EKG (which might have been the night before, I forget), was even better than the first time.  The Echo was fine.  The stress test was fine.  Interspersed between these tests is consultations with the Hospitalist (on-call doctor of the hospital), an on-call cardiologist and his nurse practitioner, pretty much everything heart-related is ruled out.

As coincidence would have it, I already had an Echocardiogram scheduled for the next Monday, which I now no longer needed.  In talking with the on-call cardiologist, he wants to keep me for a second night of observation “juuuuust to be safe”… where have I heard that before?… and because my regular cardiologist was on-call the next day, but Missy and I quashed that pretty quickly, and he backed off, though I sensed grudgingly.  It was after this that the treadmill stress test was done.

The cardio nurse practitioner was present during my treadmill stress test, and afterward she saw that I was not suffering any heart ill-effects.  Bottom line, through an incredible series of process of elimination, it was determined that it was most likely just inflation in my chest cavity and/or around my lungs.  I have some anti-infamatory medication for the next 30 days and instructions to take ibuprofen as needed.  I’ve been out for two days and I feel much better.  In my non-medically trained opinion, the inflammation makes the most sense.  So here I am, telling another story, and I hope it helps someone down the line.  We shall see.

As a last point, I want to reiterate again what amazing and stellar care I was given by everyone at my local hospital, especially the nurses.  I said it before and I’ll say it again, the nurses make or break the entire experience.

Clearance!

Well, kinda.  I went to the doctor today.  Routine follow-up appointment with the heart surgeon.  Had an x-ray done first.  Went for the appointment, first met with his nurse, whom I had developed a special rapport with the last few months.  For example, she said she was going to put me in Room 11, so I said I didn’t want Room 11.  She, being the cool and sarcastic person that she is, instantly picked up on what I was doing and we shot back and forth humorously for a few minutes.  It’s pretty good when you can connect with a person like that in spite of seeing each other only half a dozen times.

Anyway, the doctor comes in, asks how my breathing and (lack of) pain is doing, tells me my x-rays look good, that my breast bone has completely healed, and… that I am cleared of all physical restrictions.  No more weight lifting limits.  Woohoo!

Ok, I do need to keep being mindful of things.  If something suddenly seems out of place, or suddenly hurts when it shouldn’t then give a call, but otherwise I don’t need to see him anymore.  I’m good with that.

Consciousnesses

I honestly consider myself very fortunate that everything has gone so well, regarding surgery and recovery. I do struggle with maintaining a proper diet, but I am doing better in a relative sense, so I’m telling myself that’s going in a positive direction.

I don’t remember if I mentioned this before, but in my rehab class I’m probably one of the better/best “in shape” people, which makes me feel good, but on the flip side I’m also clearly the youngest, which I do not consider to be a badge of honor.

You never know, though, just by looking at someone.  There was one guy, 79 years old and super nice, who could run circles around me and everyone else, but he’s done now.  He left early because his insurance wouldn’t pay for anymore and he could walk at home for free.  Can’t say that I blame him on that one, though I was sorry to see him go.

It’s interesting to me that there’s a couple guys in rehab that you can tell are concerned with their macho image. As part of our “cool down” at the end there’s a little weight training, just really minor. These guys will pick the biggest weights, and the way they work them you’d swear they think they’re on Venice Beach, or something, posing for the babes. 🙄

One of these guys, who finished just last week, I believe has had a couple minor “events” during his rehab workout. He always has the biggest weights, his treadmill was always set at the highest incline and a high speed, and so on. I felt like he was showing off as much as anything, but the “events” told me he needed to be smarter about it.

As for me, I’m quite content just doing my thing and working in a smooth and steady progression.  That’s fine by me.

Cruising Along

Almost three weeks have passed since my last post.  Time flies when you’re having fun, so the saying goes. It should be noted that things are beginning to wind down and normalize, so my posts will be a little less frequent from here on out, but they’ll still come.  I’m also working on a way to contact me with comments and/or questions, and should have that in place within the next day or two.

We have a few different things going on here, so I’ll do this as kind of a combo post and provide some updates.

Work:

I’m in my third week back to work.  The first day I was extremely sleepy, but the adjustment was very minor.  It was almost like I’d never left.  I sit at a desk all day, so physical requirements were minimal.

Rehab:

My cardio rehab is going very well.  I almost feel like the rehab people have become friends.  A couple in particular I feel like I have established a true bond with.  That’s a good thing.  I keep increasing my efforts each week, and have been able to keep up nicely.

Medications & Weight Gain:

About three weeks ago I started gaining weight rapidly.  Three or so pounds every couple days.  The rehab people were concerned and asked me a lot of questions… that I really didn’t know how to answer… but they called my cardiologist and gave them a head’s up for my upcoming check-up appointment.  My cardiologist confirmed that I was indeed retaining water.  I had ended my water pill a month earlier, so he had me start it up again.  This made a huge difference almost immediately.  I’m now back down to where I was before, my “normal” weight, and I’m not as achy in all my joints.  I can move around again.  A minor detour on my road to recovery.

And that’s it for today.  Just wanted to get a quickie update in.  We’ll talk in a few days.  Thanksgiving is coming up, and I’ve been learning a lot about eating and cooking a lower sodium diet… (It’s not as bad as you’d think)… and I think that’ll be my next topic.

“Are you ready to go back to work?”

“Are you ready to go back to work?”

That’s the most common question I’ve been getting the last couple weeks.  That, and “How are you feeling?”

My standard answer:  “Yes and no.”

Yes:  I like my job.  I like what I do.  I find it both challenging and rewarding.  I’m very proud of the projects I do, and get kind of giddy when I can point to something while driving and tell my companion, “I did that.”

I’m looking forward to getting back into something resembling a productive and reliable routine.  Read my Grump blog post from today to see what I mean.  Most people don’t realize it, but humans *need* structure.  It adds purpose, and we *need* purpose to balance our lives.  This is why many people who become long-term unemployed or retire and sit in a rocking chair seem to physically and mentally deteriorate quickly.  People need purpose.  I need purpose.

No:  I won’t lie, I kind of like having my time as my time.  I’ve been free to come and go as I please.  This is probably the biggest aspect I miss about being a self-employed consultant a few years ago… flexibility.  Having flexibility, not being so rigid that I feel hemmed in, is huge to me.  If I wanted to make an appointment at 10am on Tuesday, I’d check my calendar and schedule accordingly.  I never shirked responsibility or deadlines, but I had flexibility.  I will miss that.

“Are you ready to go back to work?”

Today is November 1st… the 26th anniversary of my Dad’s passing, but I digress… and I have medical clearance to go back to work on Monday the 5th, four days away.  I am excited and looking forward to it.  (Ask me again next Wednesday.  LOL!)  I am feeling so much better, in many ways better than before the surgery.  I’ve been warned that the long days will wear me out, but I work at a desk and should be ok.  If I do have some days that catch up to me, I suspect they’ll be few and will go away in a short time.

So, yes, I’m ready.  🙂

Stir Crazy

I’ve addressed this before, but what to do with all this ‘extra’ time?  It has been seven weeks today since my surgery.  I’ve been progressing well.  I keep feeling better and better.  Late last week I took what I feel is a remarkable turn… for the better.  All of a sudden I started what I would categorize as great.  I could move faster and easier than I have since, well… I can’t remember when.  Now, don’t get me wrong.  I still have my weight lifting restrictions, and if I forget I still get very clear reminders that I have other limitations, as well, but overall, I’m feeling really good.

With that, is my mental faculties.  I feel like my mind is engaging much better than it has.  Things seem clearer and my brain cells are more active.  I’m thinking like I used to, and that especially feels good.  But now with all this time, I’m starting to go stir crazy.  I was warned by my friends that this would happen, and they were right.

I went into work today for an optional employee meeting.  We have these once a month, “Lunch/Breakfast with Management” they call it.  It was presented to me as an option by my supervisor last week, and I jumped at it.  I have to say that I enjoyed it, too.  Not only was it something to do, it felt mentally stimulating, at east much more than I’ve been experiencing lately sitting at home.  I mean, one can watch only so many episodes of Forensic Files while surfing Facebook before they start to go stir crazy.

I haven’t had this officially confirmed with my surgeon yet, but I am eyeing Monday, November 5th, for getting a doctor’s release and going back to work full time.  That seems like a reasonable goal.  I have tentative plans to go to the Manchester office, where I used to work, and have lunch with friends next week.  I talked with my supervisor today, and we hashed out plans for me to continue my physical rehab after I return to work.  It will be three times a week until roughly Christmas, but I will be able to do it with minimal disruption to my work schedule or productivity.  That’s good.

I have to say, in spite of some feelings of stir craziness, I’m also feeling greatly encouraged and optimistic.  So many things make more sense now, in hindsight, for why I was feeling so poorly for so long.  I won’t say the surgery was the best thing to ever happen to me, but I am feeling good and encouraged and excited going forward.

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.  🙂

How Do I Feel?

How DO I feel?  Since tomorrow is the one month anniversary of my surgery I realized that I haven’t given the simplest of updates… how I’m feeling as I progress in my recovery.

I wouldn’t go so far as to say that I am fully recovered.  As I understand it, it can take up to roughly six month, on average, to be fully 100% (or better) yourself.  I understand that, and can live with that.  All things considered, though, I feel really good.  I feel like my recovery is going quite well.  Judging by comparing to others around me in rehab, and from what nurses tell me, I believe I am recovering faster and better than most people in the same situation.  My breathing exercises have been lacking, and I still have a small issue with lung congestion, which I am working on.  Even with that, I get the feeling that I was in better shape than most people going into a bypass surgery, which seems odd to me, but ok. I mean, I wasn’t exactly a pillar of physical strength and virility prior, if you know what I mean.  I’m certainly younger than pretty much all of them, which isn’t something to brag about, either.

I have virtually no pain whatsoever from the surgery itself, meaning the inside stuff.  I’m still short of breath and tire easier than pre-surgery, but that’s normal, and that and my stamina are steadily increasing with each day.  The day after I got home I got wore out and had to take a long nap after just unloading the dishwasher… which Missy chastised me for doing too much too soon.  Fast forward to today and I can do that and more, to the point that I feel like I’m actually accomplishing things.

My skin is… interesting.  The two incisions on my left leg are pretty much fully healed.  The two small incisions on my stomach from the drainage tubes are almost fully healed.  I am amazed at how well the 7″ chest incision is doing.  The scab portion is almost gone, only about an inch left.  The 9″ incision the length of the inside of my left forearm is taking longer.  It’s making progress, so I’m not worried, per se, but it is still about 80% scabbed with inflammation and redness.  Just in the last week has it started healing enough in places for the scab to disappear.  My skin on my forearm is forming some ‘pockets’ where the skin is pulling together unevenly.

Part of my left forearm and a portion of my left palm, in just the last 10 days or so, have developed some numbness and sensitivity.  I was warned up front that this would be perfectly normal and not to worry about it.  I have also since been told to ‘exercise’ it by stretching and working my hand and wrist from time to time.

My feet already had some very minor neuropathy from my diabetes prior to surgery, but now my feet and my upper chest, along with my left forearm, are all hyper-sensitive.  Something as simple as wearing a shirt can be painful.  My shirt will lightly brush against the incision areas and cause irritation, which turns to actual pain if it goes on for a few hours.

Part of my upper left chest will always be numb because they took out an artery that had some nerves attached for the bypass.  And… this surprised me… I will never again have a legitimate pulse in my left wrist.  The artery is gone from there, too, so there’s nothing to measure.  Makes sense now that I think about it.

Mentally and emotionally I feel fine.  I’ve been very open about this from Day One of being diagnosed.  That’s been very therapeutic.  I’ve been very stoic about it.  It just is what it is, let’s deal with it.  I feel like this blog has also been very helpful, keeping me in a good frame of mind.  As I have mentioned before my sleep schedule has been upended, but I’m getting enough sleep and it has been good sleep.  My appetite has been fine, though I’m consciously trying to eat smaller portions.  I’ve pretty much cut out table salt, and have tried to make some better choices, though I haven’t gone total health nut whack job, and doubt that I will.

So that’s it.  My health checklist, you might say.  I’ll revisit this a couple more times before I’m done.

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.