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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