Open Heart Surgery, Part 2 of 4

Post-Op (Hospital Stay)

In my first entry of this series, I shared what I learned about surgery prep. In this entry, I’ll talk about my post-op experience. It’s sobering to see the pictures of myself sedated and intubated, lying next to 20-some drips and machines keeping me alive. But it ultimately produces awe and gratitude, leading me to praise God for His provision through the knowledge of doctors and cardiac research pioneers.

Looking at this picture, it’s hard to believe I was walking a mile a day only 2 weeks later, and that I started running just 8 weeks post-op. God has been incredibly generous to me through all of this. I want to tell you about it:

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3 hours post-op, before they woke me up.

PAIN: Prior to my OHS (open heart surgery), my idea of post-op pain was focused entirely on my sternum. I imagined how terrible it would be to cough or sneeze. To my delight, coughing wasn’t bad at all (which is good, because they encourage coughing, to clear your lungs). Sneezing is a little more difficult because you can’t control the velocity. 😉

Without question, the things that caused me the most pain were the chest tubes (don’t google it). Fortunately, they’re short-lived. One of my nurses explained them to me: they are inserted during surgery to help drain fluid from your chest, and it’s nearly impossible to place them there without having them pinch a nerve, which usually refers pain to some part of your back. My back was in a good deal of pain, so much so that I barely noticed my sternum. The nurses said that scenario (back pain, not chest pain) was the norm.

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Don’t worry: I’m faking the pain here.

A certain amount of fluid has to drain before they could remove my chest tubes. While they were still in, I could only speak in a whisper because I couldn’t manage a deep enough breath to speak clearly. They warned me I might have a sore throat from the intubation, but that didn’t bother me at all.

My nurse promised my pain would diminish after the tubes were out, so I was willing to do whatever it took to expedite the process. He encouraged me to sit upright throughout the day and take a lot of short walks (around the nurses’ station), both of which encourage drainage. I did everything he said, requesting walks more frequently than they scheduled. They removed my chest tubes about 48 hours after my surgery, and it was a day/night difference in my back pain.

I may be an anomaly, but it didn’t hurt when they pulled my chest tubes. However, when they pulled my heart wires on the following day (about 72 hours after surgery), that was somewhat painful. Heart wires are sewn onto the heart in case it needs a “jump start” in the first few days after surgery. They, along with the chest tubes, come out of the chest through separate incisions below the sternum incision. In addition to my 6″ sternotomy scar, I have 3 other scars below it: 2 for the chest tubes and 1 for the heart wires, about 1/2″ each. They’re healing nicely and fading quickly.

AFIB:
Shortly after they pulled my chest tubes, I went into AFib (atrial fibrillation), which is a rapid fluttering heartbeat. It was painless, but fairly uncomfortable and annoying. They told me about 35% of patients experience it. Mine was a very mild version, lasting only about an hour, at which point they gave me medication that stopped it within 30 minutes or so. Because of this, they had to put me on another drip (amiodarone) to prevent it from happening again, then I had to take the pill form of that for a month after discharge. It didn’t happen again after that.

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Necessary: eye mask and ear plugs.

SLEEP: I did not sleep well in the hospital. They needed to wake me almost every hour for the first 2 nights, for medications and temperature checking and finger pricks, etc. I had a few nurses who fought for me to get sleep, doing all they could to push my tests further and further apart as I was healing, but even then it wasn’t until night 5 that I really slept in the hospital. I tried to take as many naps as possible during the day, which meant I needed to limit visitors, both in number and in duration.

ADVOCATE: My brother (a lawyer) gave me the best advice I’ve ever gotten for a hospital stay: always have someone in the room with you, 24-7. If you have one person who can stay the whole time, that’s optimal, because they’ll learn your rhythms and needs. On the other hand, they may end up sleep deprived just like you, so it might be better to have people trade out in shifts / days. Either way, this is a helpful article for caretakers and visitors.

While I almost always had the “call” button near me (I couldn’t reach it twice), there were many needs I experienced that would be taxing on a busy nurse in the ICU. For instance, I needed water and peppermints and shoulder rubs and to have my bed adjusted frequently. My sister Sonya stayed with me all week and was able to do these things for me without us having to call the nurse. When one of my monitors started beeping in the middle of the night, Sonya could determine whether the nurse needed to be called or whether my oxygen tube just needed adjusting.

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Pre-gaming in my hospital room. GO COWBOYS! (They won, by the way.)

One of the other things Sonya did that was extremely helpful: she wrote down everything (see #31 on that link) — every visitor, every gift and card, and most importantly, every medication and dosage amount, including the time I took it and the next time I would be able to take it. This became especially helpful after my pain meds were decreased to an “as needed” basis. Once, I went 14 hours without pain meds and became really irritable. I didn’t realize I could ask for them. After that, Sonya began to ask the nurses, “Do you have a set time to deliver this medication again? If not, how often can she request it?” Sometimes she even recorded the conversations with doctors and nurses (using an app on her phone), so she could rely on the information to be 100% accurate when she reviewed or applied it later.

I can’t emphasize this enough: Of the entire list of things from my first entry, Sonya was the single most important thing I brought with me into the hospital. Without her, I wouldn’t have been as happy and at peace in the hospital, and I wouldn’t have healed as quickly as I did.

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Kayla’s tattoo says “to bind up the brokenhearted.” Appropriate.

VISITORS: My hospital had no visitor restrictions, so we had to self-impose based on the suggestions of nurses. It was tiring to have people visit for long amounts of time, so if your friends ask how long they should stay, tell them what you need. For me, 30 minutes seemed to be my sweet spot. It’s also important to make sure your visitors are not sick at all and that they don’t bring potted plants (for some reason).

WATER + FOOD: One thing I wish I had done differently: I would’ve monitored my fluid intake and output. I likely would’ve been discharged 2 days earlier (5 days instead of 7) if I’d paid more attention to this. After surgery, I was very thirsty. All I wanted to do was drink water. Anesthesia robbed me of my appetite, so I didn’t want to eat, but I wanted to drink everything. Because of that, I gained 26 pounds during my first 4 days in the hospital (the average amount is 10-20 pounds). That’s when the doctors restricted my water intake, because the extra fluid was throwing off my potassium levels and putting me at greater risk for complications / heart failure. I started to use peppermints instead of water, because they kept my mouth from drying out when I couldn’t drink.

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Smoking the peace pipe (therapy)

THERAPY: The hospital staff set up various types of therapy each day during my stay. My first walk seemed so soon it felt cruel. At 5:00 a.m., about 16 hours after I got out of surgery, they woke me and made me stand up. Getting out of bed felt impossible. But with a nurse on each side holding me up and my IV tree dragging behind me, I took about 100 steps down the hallway and back to my room. After I returned from my walk, they sat me in a recliner, and I slept there most of the day. The only thing more exhausting than walking was showering.

Different therapists came in to work with me on walking, breathing, and movement. I set goals for myself and pushed past them to new goals, celebrating every milestone like it was a big deal (because it was). They aren’t fun exercises, but they’re worth it. This was probably one of the best things I did, and I believe it really sped my recovery. I did the breathing exercises as frequently as possible, because I was terrified of getting pneumonia (that’s what they serve to prevent), and it worked!

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FUN: I think fun should go wherever I go, even if it’s a hospital room. So I brought Dallas Cowboys face tattoos and a jersey for Sunday’s game, and I successfully convinced a few of my visitors and nurses to apply the tattoos too. I brought “beauty” masks and eye pads for us to wear one night. We tried to watch funny things on TV, etc. Sonya painted my nails. A nurse borrowed a wheel chair and took me on a “field trip” outside. A massage therapist friend came to give us massages. We added non-hospital type things to our agenda, and it made the time pass more quickly. By the last night, it felt like I was hanging out in a dorm room in college again, knowing all the nurses by name, having them pop in to say hello, etc. I really believe a person’s attitude can affect the speed of their healing, so I aimed to stay upbeat about the process and encouraging to my nurses and caregivers.

As strange as it may sound, and despite the discomfort, my most prominent memories of my time in the hospital are fond ones. I had great doctors and nurses, kind visitors, and a fun, attentive advocate staying with me. I couldn’t design a better experience, thanks to the great people in my life and at The Heart Hospital Baylor Plano. I pray this is the case for you too!

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7 days and 26 pounds (gained) later… ready for discharge!
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Open Heart Surgery, Part 1 of 4

Pre-Op

A note about this series: I’ve written the first 3 blog entries for those who might undergo open heart surgery and those caring for them. I suppose you can also read it if you’re just curious, but it might not be interesting. 😉 Parts 1-3 offer practical information from my perspective, and Part 4 covers my surgery story, as well as its impact on me both physically and emotionally.

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Most people don’t have the luxury of scheduling their open heart surgery (OHS) in advance. However, mine was scheduled a couple of months in advance and I still felt somewhat clueless. These are a few things I wish I had known.

Some doctors and hospitals will give you prep info, but many just hand you a list upon discharge, telling you all the things you need to buy. In my case, I didn’t really feel like taking a shopping excursion 7 days after my OHS (when I was discharged). Thus, sections “B” and “C” below are mostly a shopping list.

If you’re a friend or family member of the OHS patient, people may ask you, “What can I do to help?” It can get pretty expensive to purchase all these things, so if you have people who want to help, this is a very practical way they can extend a helping hand. I suggest setting up an Amazon Wish List including the things I’ve listed below, so people can purchase the items and either bring / ship them to you directly.

A. BEFORE YOUR SURGERY:
– Arrange for someone to check your mail or have the post office pause delivery.
– Pre-pay all your bills for the next 6 weeks.
– Arrange for transportation to / from the hospital.
– Arrange for transportation until (and to) your follow-up visit. You won’t be allowed to drive until then (usually 4 weeks).
– Move all frequently used items in your house to waist-level. You don’t want to bend or reach up.
– Clean your house thoroughly. You’ll be more susceptible to illness and infection upon your return home.
– Arrange for one friend / family member to stay with you as an “advocate” during your entire time (24/7) in the hospital (more on this in post #2)
– Determine where you’ll recover. (Tips: You shouldn’t be alone for the first few weeks, and you won’t want to climb stairs.)
– Ask your doctor if they can give you copies of the discharge paperwork and pamphlets in advance. If they can’t (they may not have access to it), go directly to the hospital to ask for the advanced copies. This will help you prepare.
– Some of my friends set up something like “Take Them A Meal” to provide food for my family while they were staying at the hospital with me. This was incredibly helpful. You could extend it throughout your recovery time as well, but be aware that you’ll likely have a severe decrease in appetite, and most things won’t taste good. You might also be on a “healthy heart” diet, which would restrict the options for what types of food people would need to bring (usually low sodium, high protein, mild flavors).

B. DURING YOUR STAY AT THE HOSPITAL:
Peppermints – to prevent nausea and dry mouth; these were a mainstay for me.
Cough drops – to help with sore throat
Plastic water bottle / cup with lid + bendable straw – I couldn’t hold a cup up to my mouth, but I could get close enough with a spill-proof, straw-equipped, lightweight water bottle.
Essential oils + diffuser – I used Young Living’s frankincense and lavender.
Eye mask – it’s hard to sleep in the hospital, but this helped.
Ear plugs – the machines beeped all night, so my advocate (more info in post #2) and I both used these.
Lip balm – my lips were so dry after surgery, so I applied this constantly.
Moisturizer – the hospital might have some, but it probably won’t be awesome.
Muscle rub – my back and shoulders hurt far worse than my incision (they say that’s normal).
Clay heat / cold pack – as I mentioned, my back hurt a lot, and this clay pack lasts 4x longer than gel (ask your doctor / nurse to make sure you can use this, as it may affect your blood pressure).
Grabber – it hurt to extend my arms, so this helped in the first few weeks especially.
Loofah on a stick – showering is hard.
Dry shampoo – this helped me avoid washing my hair, which is the hardest part.
Shower cap – I needed a big, durable cap since I have a lot of hair. This one is the best!
Pajama shorts / pants (loose-fitting, drawstring) – I liked having something to put on under my hospital gown during my mandatory walks around the hallway. They need to be very loose so they don’t cut off your circulation, and you’ll likely gain weight from the fluids. I needed 1-2 sizes up from my normal size.
An advocate in the room with you at all times (#38 on this link) – I’ll cover this more in my 2nd post.

C. DURING RECOVERY (BUY IN ADVANCE!)
Button-up pajama shirts (as well as regular button-up shirts) – it’s easier than putting shirts on over your head.
Stretchy bras without underwires (for women) + bra extenders – because you may gain weight.
Slip-on shoes – it was hard to bend over to tie my shoes, but I needed comfortable walking shoes for the daily walks they encouraged (up to 20 min). These were perfect!
Paper plates / bowls / cups + plastic utensils – I did not feel like washing dishes.
Protein food options – they suggest protein for recovery, but I didn’t want much food, so this helped. I also ate Fage 0% plain Greek yogurt, cottage cheese, eggs, and oatmeal.
Blood pressure cuff – this is the most accurate one I’ve found. They asked me to track it 2x daily for the first 4 weeks post-op, plus I need one for checking it regularly.
Oxometer – for testing my oxygen while walking, lying down, etc. They advised me to keep it above 90.
Scale – they had me weigh myself daily, and this travel sized one was great for recovery.
Cottonelle wipes – they may give you these in the hospital, but if not, you’ll have backups.
Shower stool – I’ll be honest with you: I never used this, but I can see why it’s helpful. Showering was the single most tiring thing I had to do. It felt like I’d run a marathon.
Cetaphil Gentle Skin Cleanser (Face & Body) – they suggested an unscented cleanser for face and body, and this was the brand my dermatologist recommended.
Unscented body wipes – for those days when I was too tired to shower.
Giraffe razor holder (for women) – this brilliant invention extended my razor-reach.
Lightweight folding bed tray – this kept my water, meds, peppermints, books, muscle rub, lip balm, eye mask, ear plugs, and cell phone all within my reach. It hurt to extend my arm to my bedside table.
Wedge pillow – I use this in both the horizontal and vertical positions, depending on my need at the time.
Chest pillow – they gave me a “heart pillow” at the hospital, but it wound up everywhere (the sink, the floor, etc.). I didn’t want to bring all those hospital germs home with me, so I replaced mine immediately. They’ll explain why this pillow is so important (it is).
Ibuprofen – I was able to get off my prescription pain meds pretty quickly, at which point I transitioned to ibuprofen 2-4 times a day for a few weeks.

I hope this helps! Can you think of anything I’m missing? If so, add it in the comments!

Disclaimer: These are just my preferences. You’ll want to consult with your doctor and health care professionals to see if your situation will be different than mine.