Rehabilitation

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.

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.

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.

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.

Room 330

“Boardrow, 6/10/68″*

That’s the identifying information, name and birth date, everyone asks when they come to see you. And I mean everyone. There’s no way around it. It’s a ubiquitous part of your very existence in a hospital. (Yes, I know why they do it, but it still gets old quick.)

It was time for me to leave ICU. Surgery was the 11th, and it was the next day, the 12th, roughly 11am…-ish. I was put in a wooden wheelchair that reminded of some old sadistic psychiatric hospital in an old Hitchcock film, and wheeled up to the third floor to my home for the next few days. The trip was pretty uneventful. Missy was with me and the nurse and we chatted on the way up about nothing in particular. If I remember correctly, my newly assigned nurse came down to get me.

“Boardrow, 6/10/68”

I was taken to Room 330, a small and sparse sterile-looking room. When I was in overnight a few weeks before for observation I stayed in Room 436, which was a corner room with two windows and comparatively nice views. For a hospital it looked and felt almost like an apartment. So when we were in the “orientation” a week prior to surgery we ‘requested’ room 336, right below with the same set-up. Allegedly these two are the only rooms with a decent view in the entire hospital. My room, 330, had a view of the roof… the window washers were a surprise… and building expansions from when the hospital has been expanded haphazardly in fits and starts.

So we get into the room and begin to get settled. I think it’s hot and stuffy. I find out the next day that the room has an individual thermostat, so we set the temperature down to 68. I think it’s still a bit warm, but Missy’s cold. I also requested a fan so we could get the air circulating, and that was delivered right away. The fan was a huge help. At this point the room was reasonably comfortable, and it would be home for the next few days.

By this time the only things attached to me are the heart monitor and a single IV in the back of my right hand. They used IV for some pain meds and other stuff the first day, but after that nothing was connected to it, though it was left in “just in case” they’d need it. I was fully unattached now, so I could do things by myself like walk and go to the bathroom. This is huge.

Edit: Missy reminded that the small drainage tube from my stomach was still in, and had a bulb at the end that caught body fluids, which the nurses would have to empty 1 to 2 times a day.

“Boardrow, 6/10/68”

I had a plethora of nurses, nurse techs, nurse’s aids, and others, throughout my stay. Pretty much down to every one, they were all absolutely awesome. Caring, concerned, knowledgeable, helpful, anything you would want. There’s a couple that stick out to me as exceptionally fantastic, Torry and Ande, but really they were all good. All but one were women, and I’d say that probably all but one were most likely under 30. Which, to me, makes it even more impressive that they have such a young staff that is both capable and dedicated. They ran on 12 hour shifts, and I never had the same one twice, except Torry and Fifi.

I can say unequivocally that I left with a whole new respect and admiration for nurses. These are the people on the ‘front lines’, so to speak. These are the people that make or break your recovery, your comfort, your whole experience. Even if you’re feeling cranky, be nice to your nurse.

The other downside to the ‘regular’ room experience was that there would be times where one person after another would come in wanting to do something to me… one would check my vitals (“Boardrow, 6/10/68”), two minutes after they left one would check my blood sugar (“Boardrow, 6/10/68”), 10 minutes after they left someone would come in to take my order for lunch (“Boardrow, 6/10/68”), 5 minutes after they left the doctor and/or their nurse’s practitioner would come in for their daily visit(“Boardrow, 6/10/68”) … and on (“Boardrow, 6/10/68”) and on(“Boardrow, 6/10/68”) , for sometimes three hours straight. I wanted to put a “Do Not Disturb” sign on the door. It was impossible to get any sleep.

“Boardrow, 6/10/68”

My walks increased in both frequency and length. I would go a little farther and a different route each time. My minimum goal was 4 times a day, one day I did 5. I also had arm / stretching exercises to do. The goal for these was 3 times a day, and I usually did 2 to 3. “The Wave” is Missy’s favorite, btw, but I’ll let her explain it.

The bed, when packed with pillows around me, was reasonably comfortable. The first couple days, though, I was so beat from the surgery that I could have slept on a bed of broken glass. The only downside was that the controls for the bed were on the side railing, and I was too sore and stiff that made twisting my chest painful, so I generally had to rely on someone else.

“Boardrow, 6/10/68”

I came into my room on Wednesday, and on Saturday I had progressed fast enough and far enough that they were ready to discharge me. I wasn’t quite ready, though. I expressed a desire to stay another day, just to be sure. Missy was not happy, but supported my desire. So we stayed another day and I was discharged on Sunday. The extra day gave me a peace of mind that everything really was ok, and that was important to me. What was estimated prior to be a 4 to 6 day stay was 6 days total, but could have been 5 days.

So we get packed up, they put me in the wooden wheelchair for the trip to be dumped off at the curb, and away we go. I’m on my way home.

Oh, and btw… “Boardrow, 6/10/68”

*- Birthday made up for example purposes.