Joel Bryan - Heart Valve Journal

Joel Bryanposted a journal

5821 days ago

Well, it doesn\'t seem possible that six months ago I was posting my Pre-Operation fears and jitters. My surgery was October 28, 2009, so next Wednesday will ...Read more

Joel Bryanposted a journal

5913 days ago

Well, I haven\\\'t posted for a while so I thought I should catch everyone up on what\\\'s been happening with my recovery. I finished my cardiac rehabilitation ...Read more

Well, I haven\\\'t posted for a while so I thought I should catch everyone up on what\\\'s been happening with my recovery. I finished my cardiac rehabilitation classes and received a nice certificate saying I\\\'ve learned all I need to know to stay healthy now. I posted a picture of it to prove to you all how \\\"worthy\\\" I am of graduating from such a prestigious class. :-) I continue to walk on my treadmill at home every day. On a more serious note, I saw my cardiologist, Dr. Christenson last week. I was concerned because the nurse at my cardiac rehab class had heard a murmur - exactly what my surgery was intended to fix! Dr. Christenson ordered an echo and a bubble test. The echo was to get clear pictures of my heart valves and to measure their function. The bubble test was to determine whether there was any leakage between the chambers of my heart. In both cases,my heart was working perfectly! The murmur that the nurse heard was a result of having my aortic valve tightened by the surgical repair. There is no regurgitation, and the repaired hole between chambers has healed completely. My heart was functioning at about 40% before surgery, it\\\'s now at 55% and improving. My sternum continues to mend and my lifting limit has been increased. I\\\'m now allowed to lift up to 50 pounds, provided that I do so \\\"carefully\\\". I\\\'ve been working on some upper body strengthening exercises. I\\\'ve been released to return to work with full activity beginning on February 1, 2010. I guess by the end of that first day of work I\\\'ll know if I\\\'m really recovered! It\\\'s hard to believe that it has been 4 months sine my life was \\\"normal.\\\" I\\\'m looking forward to getting back to it! Until next time, Joel PS. Ok, I guess you can\'t read the picture so here\'s the translation: CERTIFICATE OF COMPLETION As a matter of record, this document attests to the undersigned\'s diligence in pursuing a standard of excellence and the fulfillment of all exercise sessions and education classes associated with the completion of PHASE II CARDIAC REHABILITATION This individual, by undergoing intensive exercise training and education classes, has indisputably proven to be worthy of all rights and privileges in correlation with the conclusion of the aforementioned course.

Joel Bryanposted a journal

5991 days ago

Dr. Hockmuth’s surgical nurse Deb had told us on Sunday that Joel could go home on Monday, so when this day dawned we knew it was the last in the hospital. ...Read more

Dr. Hockmuth’s surgical nurse Deb had told us on Sunday that Joel could go home on Monday, so when this day dawned we knew it was the last in the hospital. I still was apprehensive about caring for Joel at home, but I also felt like we were ready to go. Joel walked quite a bit in the morning with the Cardiac Rehab staffer, even walking on a treadmill for a while. Lindsey, another of Dr. Hockmuth’s nurses, came in about 11 a.m. and went over Joel’s medications and instructions for home. She said she would fax Joel’s prescriptions to our pharmacy in Ames and gave us a written one for the pain medicine because narcotic prescriptions have to be handwritten. Joel told her about the “popping” sound and she ordered a CT scan. That left us hanging, wondering if Joel would indeed be going home or if he’d be going back in for more surgery. Lunch came and went and there was no word. Naps came and went and there was no word. It was after 2 when Dr. Hockmuth came in and visited about the results of the CT scan. He said the bottom tip of the sternum is partially overlapped, but that he believes it will heal completely anyway. He ordered a “Heart Hugger” for Joel to use to help him get in and out of bed. It is an elastic band with suspenders that clasps in the front and has handles in the front so the patient can hold on to the handles to keep the chest stable while getting up and down. We’ll post more about this with a picture later. So at that point Joel was completely released from the hospital; just the paperwork had to be done. So we waited. A long while later one of our favorite Cardiac Rehab staffers stopped by and was surprised to see us still there. He went and checked on the status of our release and came back and said it would be at least a couple of hours and we should order supper. And so it was that just as we were finishing up our supper, the nurse walked in with the final release papers. She took off Joel’s heart monitor and gave us final instructions. Joel got dressed (of sorts – he went home from the hospital in his pajamas just as Adam did, but with a coat overtop since we live in Iowa) and then we waited for his “ride”. When his wheelchair arrived he sat down and we were off to the races. I barely kept up. It was down the elevator and then they had to wait at the front door while I went to get the car. He was no more out of the wheelchair than it was gone in a flash and I was left to help Joel get into the car. The wheelchair drivers clearly get paid by the speed at which they do things. Halfway home I realized that we were so late getting out of the hospital that we were going to be getting to our pharmacy very close to closing time (which I thought was 6 p.m.). I called the pharmacy to make sure they would stay open a couple of minutes for us only to find out that they were closed at 5:30 p.m. that day. Panic! What to do – they hadn’t sent any meds home with Joel. We finally realized that all of his meds were morning meds except for the pain pills and we had the prescription in hand for them. So we went to Walgreen’s and filled that prescription and will pick up the other prescriptions early in the morning. It was 7 p.m. by the time we finally walked in our own back door. We were tired, but we were very happy to be home. Bedtime came early. The wedge pillow that Joel read about in someone’s journal worked very well and Joel slept comfortably. And that was Day 6.

Joel Bryanposted a journal

5992 days ago

Joel continues to gain back his strength. Today he walked up and down the halls without a walker and his pace got quicker and steadier each time. He continues ...Read more

Joel continues to gain back his strength. Today he walked up and down the halls without a walker and his pace got quicker and steadier each time. He continues to use the spirometer regularly, also, and that has made a great difference to his oxygen levels and breathing in general. His oxygen level was 96 this morning and, after walking the halls without oxygen, it remained at 96. That was the magic point for leaving him off the oxygen machine. That left only the arterial IV port in his right hand and the nurse took that out in the afternoon. Finally Joel was almost just himself, no attachments. The only things remaining are the electrodes and monitor that send Joel’s heart telemetry to the nursing station for analysis and monitoring. That won’t come off until he is released. And the electrodes aren’t invasive, they’re just stuck on and the battery lives in his gown pocket. More a nuisance than anything, but a lifeline if anything was to go wrong. Joel was alert most of the day today. He took some phone calls, had some visitors and watched some television. His appetite is back and he is eating better. He said the food is tasting better all the time and the metallic taste in his mouth is diminishing. He has lost 3.5 pounds since he came to the hospital. That is good – it means he isn’t retaining fluid or leaking inside. One thing Joel has noticed as he is taking fewer pain medications is that he feels a “popping” in his chest sometimes when he moves just right. He has mentioned it to several different nurses and a doctor and they seem to agree that it is probably the sternum grinding against itself at the point of incision. They say as the bones knit it will go away. We will ask Dr. Hockmuth about it when he comes in next. Joel is very emotional right now, probably as a result of the anesthesia and pain killers and the overall stress of the surgery. He doesn’t seem to be depressed, in fact, he seems very upbeat and positive. However, depression is a common side effect of this surgery so we’ll try to keep watch for that and avoid it if possible. I wrote about the rubber leg wraps that kept Joel so hot and miserable the second night and there were some questions about what I was talking about. The leg wraps, which aren’t really rubber but felt hot like rubber that night, are fabric air pressure cuffs that go from your ankles to your knees and gently massage your legs by building air pressure and then releasing it. They have tubes attached to them that hook to an air pressure pump/regulator that is attached to the bottom of the bed. The technical term for this is DVT (Deep Vein Thrombosis) Prophylaxis System. The use of this system greatly reduces the possibility of developing Deep Vein Thrombosis or blood clots. Joel found them to be minimally problematic except that one night when he was so hot and they made him hotter. Otherwise, he said they were actually comfortable and they certainly serve a good purpose. This was a relatively quiet day followed by a quiet evening and a good night’s sleep. And that was Day 5.

Joel Bryanposted a journal

5993 days ago

A good night’s sleep can make a remarkable difference in how one feels. Joel is moving much easier today. He can move himself in bed and actually lean forward ...Read more

A good night’s sleep can make a remarkable difference in how one feels. Joel is moving much easier today. He can move himself in bed and actually lean forward without a lot of pain. Some of this, of course, is due to the better pain meds he’s getting, but he’s also getting stronger. Will’s comment when he arrived at 8 a.m. that I looked worse than Joel this morning was perhaps the most telling comment about how good Joel is looking. (I refuse to take it any other way! LOL). During the afternoon one of Dr. Hockmuth’s surgical nurses checked on Joel and removed the drainage tubes in his chest that had been in since surgery. The tubes had collection bulbs at the end and the nurses measured the liquid that came out each day. Once the amount coming out had diminished to a certain level, the tubes could be removed and the body will absorb whatever fluid still remains/is created. Getting the tubes out made Joel a lot more comfortable, plus it was good to know that another threshold of recovery had been reached. That leaves oxygen as the only support system he is still on. He continues to take walks with the Cardiac Rehab staff and also with family members and uses the spirometer religiously. Those are two of the most important things he can do to recover his strength and prevent secondary infections like pneumonia. He has maintained a really positive attitude throughout and hasn’t complained even when the pain made him most uncomfortable. Joel’s appetite is returning a little. There are still some foods that don’t taste good to him. It has been interesting to note which foods tasted good from the beginning and those that have started tasting good at different stages. Grapes and milk have always been good. Apple juice tasted sour at first but a couple of days later tasted fine. Same with applesauce. Vegetables have tasted “awful” all along, even though they look appetizing. The only food he has really been excited about was the beef and noodles he had for supper tonight. I assume that taste buds start working in stages after surgery, just like the rest of the body. By evening Joel was stable enough that I felt comfortable leaving so I went home to sleep and left Will and Jenny with Joel overnight. They had a party and stayed up late watching the World Series! Joel said it was a good game and he stayed awake through the whole thing. That’s another sign of recovery – staying awake. That probably reflects lessened pain and therefore lessened pain meds and adequate sleep. And that was Day 4.

Joel Bryanposted a journal

5994 days ago

The first night started out as a painless morphine haze for Joel, but with the shift change at 11 p.m. came a change in pain medication. The second half of ...Read more

The first night started out as a painless morphine haze for Joel, but with the shift change at 11 p.m. came a change in pain medication. The second half of the night was much more uncomfortable than the first part, largely due to a long staff delay in giving him pain medication. On a happy note, though, he was up by 3:30 a.m. sitting in a recliner, dozing off and on, nestled in a bed of tubes and monitors. By morning, he had taken one very slow stroll up and down the floor. In spite of the pain, he was looking much more like himself and was feeling better. His condition was improving the way children grow: almost visibly. Dr. Hockmuth came on morning rounds and said Joel was doing so well he could be released from ICU and sent to a private room. This started a barrage of testing, taking samples, making X-rays, etc., and then finally detaching tubes and machines that took several hours. In the end, Joel was moved to a private room and started taking walks up and down the floor. We learned that a move out of ICU is not a quick thing. Joel’s moving van turned out to be a wheelchair. I expected them to move him bed and all, but instead they put him in a wheelchair with all his attachments and drove him helter-skelter through waiting rooms and hallways to the main elevators and then up to 7th floor. Once installed in Room #739 Joel’s life started revolving around numbers: oxygen levels, spirometer uses, temperature, heart rate, etc. His oxygen levels are measured before and after Cardiac Rehab staff take him on walks. Joel uses the spirometer 10 times every hour he is awake. The real measure of how well he is using the spirometer of course, is how his x-rays look. They’ve come in each morning to take an x-ray in his room using their mobile x-ray machine and so far his lungs look clear. Night the second day was a miserable affair. Joel was very hot and uncomfortable because of the rubber leg wraps they use to prevent blood clots. Also, his back was hurting a lot and the pain medication he was on just wasn’t helping enough. I don’t think he slept at all that night. To make things worse, they re-catheterized him around midnight because the first catheter had been taken out too soon. Altogether not a fun time. And that was the end of Day 2.

Joel Bryanposted a journal

5995 days ago

This chronicle of the days of Joel’s surgery and recovery will hopefully give an outline of events to others approaching this type of surgery. The scariest ...Read more

This chronicle of the days of Joel’s surgery and recovery will hopefully give an outline of events to others approaching this type of surgery. The scariest parts of this journey have been the vast amount of unknowns. I hope by describing our experience to dispel some of the fear of the unknown that is part of this process. Day 1: Surgery We arrived at Mercy Hospital in Des Moines at 5:15 a.m. Wednesday, October 28 in a group. There is definitely comfort and solace in facing something like this with your friends and loved ones by your side. When we walked into the front lobby Joel grabbed the first friendly passerby to snap a picture of his 5 A.M. Support Group: our children, Dave, Chuck, Will, Sara, and Jenny; our niece Chris; Joel's sister Leah, and me. That was the last light-hearted moment of the day as we settled in to the serious business of checking into the hospital. The reality of the impending surgery was inescapable at that point. Finally all the paperwork was signed and at 5:49 a.m. Joel was taken to Pre-Op. We were allowed two persons in Pre-Op with him, so Dave and I accompanied him. The rest of the group gathered in the Operating Waiting Room. During the day more people joined our group: Pastor Lynn, Pastor Mitch, and friends Betty and Don. In Pre-Op Joel changed from street clothes into hospital gown. A changing cast of nurses and technicians and other medical personnel began prepping him for surgery. His vitals were taken, blood samples were drawn, pills were given, and the dreaded full-body shave was administered. An IV and a catheter were inserted and drugs were started. Joel was hooked up to oxygen. About 7 a.m. Dave and I said our goodbyes to him as he was wheeled out of Pre-Op toward surgery. We lose the story here because Joel doesn’t remember being taken to surgery and we, of course, were not present. Dave and I joined the rest of the group in the waiting room. The Operating Waiting Room attendants were wonderful. They kept us updated every hour and made sure they knew where we were at any time in case we were needed. That is how we know that at 8:17 a.m. they made the first incision and at 8:45 a.m. they placed Joel on the bypass machine. And it was at 10:15 that we were given the report that “they were closing him up and were very happy with how it went.” We were ecstatic because this meant that Dr. Hockmuth repaired the valve and didn’t have to perform the Ross Procedure which would have taken up to 5 or more hours longer. This was the best possible outcome and one we had been praying for from the beginning. Around 11:30 a.m. the entire entourage of Joel’s Support Group was taken to see him in his ICU room. Joel was still under anesthesia and was connected to a huge array of machines. The ICU nurse explained what all of the machines were doing/measuring/displaying and the expected course of Joel’s stay in ICU. After that first instructive visit, we were restricted to two visitors in Joel’s room at a time. Joel slowly became more and more awake over the course of the afternoon. He spent much of the time sleeping and was given morphine for the pain. He began using a spirometer (an instrument for measuring the volume of air entering and leaving the lungs) to reduce the fluid in his lungs. Using the spirometer causes a great deal of chest pain, but is essential to prevent complications like pneumonia. During the night his pain medication was changed from morphine to Vicodin, which wasn’t nearly as effective. There was a delay in being given one dose, also, and that resulted in a pretty miserable night. And that is the way Day 1 ended. Mary

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