Category: Recovery

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.

Pain & pain meds

Pain

‘Does it hurt?’  ‘How long until the pain goes away?’

Those are common questions that I often hear, and that I had myself.  I can say that results have not met expectations… in a good way.  Right out of surgery you would think it would hurt like hell.  You would think the pain would be constant.  It really didn’t.  I was sore, very sore, but not really in pain, per se.  Of course there were some really good pain meds being pumped into me via the IV, so I’m sure that had something to do with it.

It did hurt when I would try to sit up, or twist my upper body.  Getting in and out of bed was a chore, and in the first few days I really needed help doing it.  This was tough for me.  I’m someone who always prided them self on being independent.  I’m a big boy, I could get up and go to the bathroom on my own, right?  Well, no, I couldn’t.  I needed help.  At first from nurses, two in ICU, one in the regular room, but later as I improved Missy was able to help me alone.  Then, once back in bed I wouldn’t be up high enough so two nurses would have to ‘adjust’ me.  One on each side, they’d grab the sides of a pad that I was laying on, 1… 2… 3… *heave!*, and that would work.  My bed could be adjusted up now and I could go back to sleep.

It hurt when I coughed, which I was warned about from everyone, but not as bad as I had been warned.  A local charity gave me a heart pillow that would become my ‘security pillow’ for the foreseeable future.  Coughing is a big deal.  You hold this tightly to your chest when you cough, it helps manage the immediate pain somewhat, and you’re encouraged to cough often to clear your lungs of stuff so you don’t get pneumonia.    Breathing clearly is one of everybody’s foremost concerns in your recovery for this reason.

What does hurt, and what no one had really warned me about, is sneezing.  One person did warn me, after I mentioned it to them, to “let it fly” and not hold it in, and now I know why.  When you hold it in it creates a great pressure and strain on your lungs and chest, and they don’t need that right now.

By the time I came home, there was virtually no pain at all, except for coughing and sneezing.  The soreness lasts quite awhile, and you move slowly everywhere and for everything.  Two days after I got home I unloaded the dishwasher, and that single effort wiped me out and left me in some pain and soreness, so I took a nap.

As I sit here writing this almost three weeks later my chest is still sore, but much of that is the skin around the incision tightening as it heals, which it is doing quickly.  Last couple days I have had a few instances where it felt like my heart ‘jumped’, and would sometimes cause a reflex in my arm and/or leg.  This is new.  Some internet research indicated that it might be AFib (Atrial Fibrillation), which is fairly common after heart by-pass surgery.  I am on meds to prevent blood clots, and AFib usually goes away fairly quickly in this case.  I have a doctor appointment with my surgeon for a check-up later today and will ask about it.

The two very small incisions in my left leg have been fine.  The long incision on my inner left arm has been the most problematic.  It’s appeared more inflamed, but my cardiologist said it was fine.  It gets sore as well, partially for the same stretching reasons, but also partly because it keeps rubbing against things, primarily my stubbly chest and stomach hair as it grows back in.

Both my chest and arm incisions are hypersensitive, though.  I do not enjoy not wearing a shirt, but have had to go shirtless a lot here at home because a shirt brushing up against an incision is quite irritating, and if it goes on for too long they do begin to hurt.

Pain Medications

Prior to surgery I was given some kind of medication to take on a daily basis that I call “mini nitroglycerine”.  If I remember correctly this was to expand my arteries, or something like that.  It gave me severe headaches, which I had been warned was a possibility, so I stopped taking it after about 3 days.

I do not remember what pain med they gave me through the IV after surgery.  I was taking Oxycodone and Tylenol in pill form after surgery.  The Oxycodone was interesting.  I had some strange dreams on that stuff.  One while in the hospital had me dreaming of scrolling Facebook on my phone, and I somehow knew my hand was up near my face actually making scrolling motions.  I told myself to stop doing that, but I kept doing it.  I would have thought nothing of it, but Missy told me about it the next morning, and confirmed that not only did she see my hand making the scrolling motion, but my legs were moving, too, kind of like how a dog runs in its sleep.

The second day after I got home I started getting sick.  Discharge instructions said to call the nurse’s station if any issues so I did.  They said call my family doctor, so I did.  They said call my surgeon’s office, so I did.  They initially didn’t want to deal with it, but when I explained more she went and consulted with my surgeon and he said to discontinue my two anti-biotics and the Oxycodone, as either were known to potentially cause this.  I did so, and I stopped getting sick.  Before we ended the call, though, I was instructed that any other questions should go to my family doctor.  😐  Thanks.

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!