Sorry there hasn't been a post for awhile but actually Anthony's healing process has thankfully been uneventful.
He is walking about 3/4 of a mile daily and doing his movement exercises. His pain has been managable and we are looking forward to his check up due 1/28 in hopes that some of his other meds may be reduced (blood pressure, cholesterol, lasix, pepcid, asprin, coumadin).
Anthonys coumadin was adjusted and we believe that may have made for a difficult day yesterday but back on track today. We are having to go in to get his blood drawn about every 3 to 4 days for the coumadin levels to be checked.
Over all each day is better than the day before. All incisions are looking good but the numbness does exist in his right pec. And constant pinching if the shirt in the outward position is definately a continual reflex.
The day moved very slowly knowing that we would be going home sometime today. First thing the morning was busy with the regular testing. Then finally the second chest tube was removed making Anthony much more comfortable. The only remaining equipment was the heart monitor and the external pacemaker which would be addressed closer to our exit time.
Around 11:30 we instructed on the meds that Anthony would be taking and other necessary information. Finally the time arrived that the monitor was removed and the wires of the pace maker were cut. (Yes, the internal wires remained!)
We were discharged and on our way home at 12:30. Anthony has been responding well with the Tylenol 650mg dosage so we stopped on the way to maintain his dosaging.
We stopped in town to fill Anthony's prescriptions and then home around 4:30pm.
Around 7:30 Anthony complained that his stitches were catching on his shirt so I figured I would just tape them over for now. Unfortunately, when he lifed his shirt we found that one of the "wires" were protruding from his chest about 1 inch. I called USC and we were instructed to go to the emergency room immediately.
The doctor at the emergency room had not seen anything like this before and she called one of our attending physicians at USC. The wire must be cut not pulled since Anthony was on coumadin.
That was complete and once again we were on our way home. So ready for just another regular day.
When the doctor came in this morning he was not giving us a clear indication that we would be leaving anytime soon. They were watching an air bubble that was in Anthony's chest cavity and because of that they were delaying removing the second tube.
It was a busy day, the same as the rest (respiratory therapy, occupational therapist, physical therapist, meds, bath) These activities went on through 2:00pm. It was after that time that the doctor came in and removed the 2nd chest tube (yea!!) That seemed to be the biggest source of pain that Anthony could identify up to that point.
Anthony was having some vision issues (squigglies) and dreams that made him happy to wake up so, after reading the fact sheet on all the meds we chose to lessen the dosage of his narcotics to see how he responded (since the chest tube was removed).
It's been 2 hours and he is feeling good on one pill over two.
The very best news of the day we got from Dr Starnes during his rounds this evening....WE''RE GOING HOME TOMORROW!! WHOO HOO!!!!
At 9:45am one of the attending surgeons removed Anthony's anterior chest drain tube just leaving the posterior chest drain tube. The second one will be removed tomorrow morning. I considered posting a picture but not sure all would want to see it.
At 11:30am was the physical therapy appt. He gave Anthony a second gown that he put on backwards over his existing gown so as not to be the hallway flasher. After doing a series of muscle testing on his arms and legs and walking the preliminary path he gave Anthony the assignment of walking 3 additional times before calling it a day.
At 1:45 was another xray then at 2:30 another respiratory therapy session. At 4:15 the pace maker recording box was detached however the wires are still attached internally.
For those coming up on your surgery make sure that you personally make note of the pain meds timing. Beyond ICU they are on an "as needed" basis so they won't automatically bring them to you. This is when you can easily get behind the pain. Anthony was feeling ok and his pain med interval could be between 4-6 hours....don't let it go to 6 hours, it takes way too long to catch up - at least for Anthony this recent to surgery.
At 8:30 was another respiratory therapy.
The evening charge nurse has made a point to Anthony that a BM is due here pretty soon.....
It was about 10:30am when Anthony was moved to the step down unit. I have to say that trying to put down all that those to follow us would want to know is harder than it seems. With all the tests and meds administered throughout the 24 hour periods of our days it makes your mind swim.
So, through the night the room was just as busy with glucose checks, antibiotic drips, pain meds and his vitals check. It seemed non stop. This morning was another EKG and chest xray and respiratory therapy. The doctor is very satisfied with the progress and mentioned that Anthony's general good health has played a key role.
As of last night Anthony started his coumadin and is taking Norco for pain which is administered every 6 hours. As well he is on, what is called, an "On Q" pump which contains an anti-inflammatory.
Apparently we will be moving rooms one more time this morning since the volume coming out of the ICU has increased.
Well when Anthony was settled into ICU we left to get some dinner (feeling Anthony was in good hands). At 7:00pm I got a call from Anthony (!). He sounded a bit distressed and asked me to return to the hospital. This is where patient advocate means everything. When someone with presence and clarity is not on site the attention to needs may not be as prominent. His pain level had escalated and he felt like he wasn't being attended to.
I was able to stay the night with Anthony in the ICU but not much sleep occurred for either of us with the attendants and beeps.
At 3:00am an EKG was performed and was showing that there may be a potential blood clot in the lower area of his
heart. We would have to see what the next one would show for clarity.
At 4:00am a chest xray was done and then around 5:00 another EKG showing all was clear.
At 6:00am (16 hours after surgery) Anthony has a spit bath and was moved to a chair in preparation of the doctor's rounds.
So far Anthony has been changed to oral pain meds which have proven to last much longer.
Well my honey didn't look near as scary as I thought he would. Most of the IVs were on his right arm and one in his neck and one as well in his left arm. The incision site between the ribs was closed up but two drain tubes protruded from the lower chest cavity as well as an external pace maker was still attached to his heart. He has the bladder catheder in tact as well. The staff so far is awesome in making sure of what he was feeling (nausea,pain) and addressing it. Although I know he will have no memory of any of the conversation that we had post surgery he was able to answer any questions we asked clearly.
Anthony's biggest complaint was that he was so very thirsty but was able to eat, what seemed like, as many ice chips as he wanted. His second complaint was the ache in his chest. Although not so much as to require additional meds. He just felt like someone beat the crap out of him.
He will remain in ICU for the evening and with each proper progression the excessive tubes will be removed until he is ready for the step-down room tomorrow.
Not much sleep last night as the hotel seemed to be hosting a kareoke night just below our room. Up at 4:30 to be at the hospital at the 5:30. Accident on the 710 freeway caused a bit of stress since we aren't familiar with the area - thank goodness for the garmin !
Got checked in and taken to the pre-op area for the gown and bootie fitting :-) and shaving (could have done a better job myself). IV installed and then again we wait. Anthony was not taken to the operating room until 7:45 and then the waiting continued.
We got word that the 1st hour is prep (anesthesia, wash etc) and that the actual surgery started at 9:20. At 12:20 we were notified that "everything was OK but it would be a couple more hours (:-0 WHAT!!!!?). Only bad news is going through my mind.
Thankfully it was only about 45 minutes later and the surgeon appeared to say it all went fine and the repair was done and we will be able to see him once he has been moved to the icu. Can't tell you the relief that I feel.
Well here we are the day before already. Came up to Los Angeles early this morning to have blood work, chest x-ray, carotid artery ultrasound and ekg done. All checked out great and we are to be back at the hospital at 5:30 am for showtime.
Yesterday we made our final trek to USC for the last update/info exchange before our return to complete the MVR surgery on January 8. Following both Scott N and Brian W gave us so many great questions to follow up with our surgeon, thank you so much for that! Sometimes you feel you just aren't asking enough.
All checked out great for Anthony's angiogram. Talking with the head nurse she mentioned that 99% of surgeons don't do the angio test and it is unfortunate as other valve /heart problems could be caught ahead of the anticipated surgery to repair all that may be going on rather than maybe having to go through it again.
Anthony is having his angiogram done this morning. We checked in at 6:00am and he has been prept and wheeled back to begin the contrast test by his cardiologist. This isn't even the surgery and I am overwhelmed with emotion. The procedure is about 1 1/2 hours but he has to be here for 6 hours as he can't stand or lift for at least that long.
We now have a date set for January 8th, 2013. Now it feels like a count down. We are still on target for the Angiogram on the 13th of this month (Dec) and then some last minute confirmation x-rays, bloodwork on January 7th. Wishing the day was sooner than later but it will be here soon enough.
We had been informed after my latest echo test (June 2012) that although I still wasn't showing any outward symptoms identified with Mitral Valve Regurgitation, my heart had enlarged. We had been interviewing potential surgeons over the last few months and decided on Dr Starnes (Adam's Doctor). The surgery is tenatively set for the second week of January 2013. After our first meeting with Dr. Starnes (Oct 31, 2012), we were hoping to put the surgery off til March 2013 however, that was not advised due to potential damage so January was set. We have one additonal test to be completed (angiogram) to make sure all the capillaries of the heart are clear. This will confirm if the minimally invasive surgery will be a viable option.