It’s the little things… and some TMI

Checking in before the big Christmas holiday and thought I’d share some random stuff, just some random observations and experiences.  So, let’s get started…

Water Weight

No, I’m not talking about weight gain from water retention due to increased sodium.  Technically.  This time, anyway.  Though that is part of it.  I’m talking literally how much water weighs, and how this relates to your body weight.

As part of my water retention regimen my doctor has me weighing myself once a day every day and recording the results.  I had always been told that when on a weight loss program that you should weigh yourself no more than once a week, or else you become too obsessed with the numbers and start making bad choices and veer off-track.

But I’m not trying to lose weight, per se, I’m monitoring water retention in my body, which is most easily measured by body weight, and since water retention from sodium can fluctuate drastically from day to day, then a daily weight measurement is justified.  Plus, to keep an accurate comparison you should weigh yourself at the same time and same circumstances every day.  My choice is to weigh myself before I get into the shower.  Naked, of course.

In my quest for ‘encouraging’ numbers, I became curious the difference between before and after peeing.  Turns out there’s quite a notable difference… 1.0 to 1.8 lbs difference, in fact.  I’m almost embarrassed to admit that I got kind of excited.  I could shave one to two lbs off my weight in an instant.  The numbers looked now ever so slightly better.  Obviously nothing had really changed, I was merely gaming the numbers, but at the same time I’m not cheating, either.  I’m still weighing myself under the same circumstances every day.

Sometimes it’s the little things, the little “victories”, that serve as unexpected encouragement.  LOL!

Reasonable Eating… Holiday and Otherwise

As a heart bypass surgery patient I have doctor instructions to consume less sodium, as little as possible, knowing that one’s body needs some sodium to survive and that some level of sodium is in virtually everything.  This has been placed as an even higher priority than watching my carbohydrates (carbs) for my diabetes.

The key, of course, is to strike a sensible balance.  Too many people freak out and try to do zero sodium, and that’s simply not realistic.  On the flip side, many people completely ignore the advice and warnings and go back to what they’ve always done… go back to what got them where they are to begin with.

I’m trying to strike a reasonable balance, a happy medium, if you will.  I want to be healthy, but I also want taste, and given that a person literally needs some sodium I think that’s a reasonable quest.  Here’s my current plan of attack, as preliminary as it is…

  • Virtually eliminating adding salt when cooking.
  • Eliminating added table salt on most dishes where it really doesn’t make a difference and I was adding it for added flavor.
  • On a small handful of dishes where it does make a difference, I keep adding table salt, just not as much.
  • Seeking and trying various low-sodium recipes… which is a very hit-and-miss prospect.

This whole process doesn’t necessarily have to be rocket science.  That’s why I’m thinking my approach above is reasonable… and realistic.

And be wary of various pre-packaged low/no-sodium and low/no-fat and low/no sugar.  Read the labels.  Read the ingredients.  If they cut the fat, they might have increased the sodium.  If they cut the sodium, they might have increased the sugar.  You can’t win for losing.  “Diet products”, I call them, generically.  I prefer to eat the real thing and watch my portion control.

Here’s a recipe that I found that is quite tasty AND low in sodium, 150 mg per serving, Green Beans Amandine with Almonds and Garlic.  The only modification I made was using regular fresh green beans instead of haricot verts.  It was a nice edition to my Thanksgiving dinner.

For every yin there’s a yang.  Another new recipe I tried was a low-sodium turkey gravy.  Long story short, I’ll never do that one again.  I’m going to guess that it is for people who have to aim for almost nothing in sodium because they’re in an even more dire health situation than I am.  It literally had no taste, even after I added pan drippings to enhance the turkey flavor.  My dressing and mashed potatoes actually tasted better without the gravy than with.

There’s going to be a lot of testing, triumphs and failures, as you work out your new diet.  The primary point that I’m trying to convey here is to be reasonable and realistic.  You will never find the ideal food or recipe, the one that combines perfect sodium, carbs, vitamins, and taste.  Work out something you can live with… literally.

Note:  This is just what I am doing.  I am not a doctor, and this is not medical advice.  Please consult with your physician before making any changes.

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.  🙂

Privacy? Yeah, sure.

When in the hospital you will have so many different people walking through your door wanting to poke and prod and just look at your various crevices and orifices.  For the most part, this is legit, though sometimes you have to wonder.  For example, if one person took my blood pressure 2 minutes ago, and they’re still in the room, why can’t you just use their numbers and leave the patient alone?  I’m sure they’re told to do it anyway, so they can check off their checklist that they did indeed check the patient’s blood pressure, but there has to be a better way.

That’s not extreme, but you can forget about privacy… or modesty.  Maybe that’s the real loss here, your modesty.  I mean, you try to maintain some sense of dignity, but there comes a point where you feel like you want to throw your clothes off and yell, “Ok, here!  Look at me!”  Not that you seriously consider that, of course, but the thought does enter your mind.

Example:  On my last full day the nurse’s aid comes in and asks if I’d like a “bath”.  A “wipe bath” with sanitary baby wipes, it’s easier with less clean-up than sponges.  Anyway, She seems surprised that I had had none since the morning before my surgery at home.  I was never asked.  <shrug>

I’m sensing maybe I should, and I was feeling a bit ripe, so we go for it.  Missy and Vicki were visiting at the time.  They left at my request, I still had that much say in who sees what.  The nurse’s aid is a 22 year old who normally doesn’t work this floor, normally she’s in a rehab wing.  This was the second day (not in a row) that she was my aid, and we had built up something of a casual rapport.

So, Missy and Vicki leave.  The aid pulls the curtain closed in case someone else walks in.  It’s just us.  She starts on the legs with the sanitary wipes and works up to the neck, then back down the other side.  Then, *sigh*, the “fun” part.  She needs to do the more intimate regions.  We both are a bit hesitant, I am actually her first “sanitary wipe bath”.  I’m here to help.

We both figuratively heave a sigh of resignation, and the sheet and gown are whipped off leaving me in all my glory.  I’m embarrassed, but not as bad as I normally would have been were I not gradually eased into a lack of modesty the preceding week.  She does the outer regions, and the only part left is… you know.  She hesitates, I sense she is really uncomfortable, but breathes another sigh of resignation and dives in.  I am now clean all over.

We finish up, I cover myself, and all is good.  We’re both relieved it’s over.  She might be scarred for life, not sure.  Our banter was not quite the same for most of the rest of the day, it had an awkwardness that we were both dealing with, though we both lightened up later on.

To top it off, when Missy and Vicki come back, the aid is still there having just finished, and Vicki says somewhat loudly, “Did she get your ‘junk’?”

Oh, the aid blushed.  If she wasn’t scarred by the procedure, she had to have been now.  I, on the other hand, was speechless.  I didn’t know whether to say something serious or sarcastically funny.  I said nothing, just sat there.  There are very few people that can make me speechless, but my sister is good at it, and succeeds more than most.

Many women,especially women who have given birth multiple times, tell me that you just give up trying to stay modest at some point.  I can kind of understand that now.  You develop an attitude of, “Here, just get it done.”

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.

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.