Naomi's Journal

It's been a little over 6 months post-op. I'm scheduled for a dental cleaning appointment in two days. My cardiologist told me that I would need to take special antibiotics (4 capsules of Amoxicillin 500 MG) 1 hour prior to any dental procedures including cleaning for the rest of my life to prevent bacteria from interfering my new aortic valve (bovine). I thought the requirement for the antibiotics for the dental procedure was only for the first six months after the OHS. It's only a few times a year, and it's not a big deal, but I was a little bit surprised to hear that.

It's been 4 months since my open heart surgeries in May to replace my bicuspid aortic valve (congenital heart disease) that was causing severe aortic stenosis. As a ski patroller (White Pass Ski Resort), I'm required to renew my CPR certificate between late summer and fall. It includes, written and practical tests. My main concern was my ability to perform chest compression. Especially prior to the surgery, I had no idea when I would undergo the surgery and if I'd be physically ready for the CPR class. I managed to schedule the surgery as early as possible right after the end of ski season. With some complications, such as another OHS to fix the blood leak from the attachment of new valve and minor pulmonary effusion following the OHS, my recovery seems to be very slower than the others. I was so uncertain whether I'd be strong enough to do the CPR class up until last month. But it actually went pretty smoothly last Sunday. I was actually feeling better practicing chest compression all afternoon. My chest and shoulders were not bothering me much while pushing down my hands on the dummy's chest. While counting out loud enough, I was not running out of breath as much as I did in the past. I think my chest will be sore at least for few days, but I'll be fine. I'm very proud of completing it and moving forward. This was a major mile stone for my journey. There'll be a refresher for Outdoor Emergency Refresher at our ski patrol in two weeks. I've been working out my legs and seeing my physical therapy for recovering my upper body, including moving rib cage better. I'm ready for the new ski season.

At the end of July, I had my first echo, followed by an appointment with my cardiologist, at Swedish Medical Center in Seattle, WA. This was to get my baseline. The test result shows that my hear valves are doing well, including my new Bovine aortic valve. The wall of left ventricle is getting back to normal thickness, whereas it was getting very thick due to overworking from pumping blood through very narrow aortic valve before the replacement surgery. I told my doctor that I still have some pains around my chest wall, and I take Tylenol occasionally. He said that my sternal precaution period is over after 12 weeks. He also told me that they know everything about my heart and lung, and I shouldn't worry about it. He encouraged me to keep seeing my physical therapy while doing walking exercise on my own as my cardio rehab. He told me to keep taking just a baby aspirin every day. I'm supposed to come back for a followup in the beginning of March. After going through so many negative experiences at doctor's visits recently while feeling so miserable due to a severe aortic stenosis, this visit was like icing on the cake on top of already feeling normal and happy after the heart surgery.

3 weeks post-op. I'm still dealing with cough and new chest pains. This morning, I visited a PA at my primary care physician's office. Then we came up with some answers. After going through some lab results including the ones from my ER visit 2 weeks ago about the coughing, and consulting several other medical professionals, the nurse at the surgeon's office told me that my pains are in the sternum and chest wall, and caused by the coughing. My chest wall has gone through so much stress (two open heart surgeries in one day), and the coughing is making it more tender and sore. She also mentioned that some images indicate that I had some small pulmonary effusions (buildup of fluid between chest wall and lungs) since I was in the hospital. Turns out that I'm also very sensitive to some of these oral meds, and my body is rejecting them. The suggested solution: keep taking Furosemide (Lasix, diuretic) to remove that extra fluid. I'm also taking Tramadol (for pain) and Ondansetron (Zofran), and just stay indoors so that I don't suffer from dizziness and possible falling. I'm just going to take short walks around home or indoors like a supermarket, and not worry about a long walk this weekend. I'm also going to take Miralax and fiber supplement to deal with constipation caused by those meds.

Wednesday, May 8, I was scheduled for an open-heart surgery to replace my bicuspid aortic valve that was causing severe aortic stenosis. After spending a night with our friends close to Swedish Medical Center in Seattle, WA, I checked in at Patient Registration at 9 am. While I was lying on the bed in the preparation room, I saw a bunch of staff coming and going, including anesthesiologist. My husband Peter was waiting in the waiting room, receiving updates from the anesthesiologist about the progress of my surgery. Dr. Ryan, cardiac surgeon, successfully replaced my bicuspid valve with a Bovine valve. The new valve is made from a piece of pericardial membrane from a cow. Around 4 pm, I was moved to the cardiac ICU. Apparently, my heart function and BP came back a lot quicker and stronger than average, and with no arrhythmia. Partly because of that, during the night they found that there was an unusual amount of blood coming from the tube that drained fluid from around my heart. They figured out that this was a leak in the aorta, which happens to about 5% of patients. So they took me back to the OR for another open-heart surgery, where they added a suture near the new valve. I was returned to ICU after 2 am. I was asleep for the whole time, and I didn’t know about it until afterward. Thursday, May 9, I woke up in the morning at the ICU finding myself with the breathing tube and all kinds of tubes and wires attached to my body. They removed the breathing tube shortly after I woke up. It was nice to see my husband Peter. Later in the afternoon, I walked to the chair with the help from nurses, I ordered room service dinner and split it with Peter. We had pasta, salmon, and fruits. Thursday night was one of my most miserable, due to the strong meds, and many other reasons. I was in an emotional mess all night. I ended up getting little sleep. Friday, May 10, early in the morning, they moved me out of the bed, and made me stand on the scale; I gained 21 pounds in two days. In the late afternoon, I was moved from the ICU to the Telemetry Unit, as soon as a bedroom became available. Before getting discharged from the ICU, a Foley catheter in my bladder to drain urine was removed, as well as an IV tube from my neck. The nurse from the ICU took me to the Telemetry Unit in a wheel chair. As soon as I arrived at my new room, I went to my private restroom, I had a little bit of both Number 1 and 2. After Peter left for home. I ordered Asian Stir-fry with Tofu for dinner. Shortly after eating, I became nauseated, and vomited twice. They gave me an anti-nausea med, but it didn’t work. It was very miserable and painful. Saturday, May 11, I woke up feeling nauseated. The nurse encouraged me to order something for breakfast. While waiting on the chair for the breakfast to arrive, I vomited, just clear fluid. I had a bite of scrambled egg, and yogurt. I was also having diarrhea all day. The PA removed more drain tubes and wires from me. She also removed the tape from the incision over my sternum. I took my first post-op shower with help from a nurse. I kept a banana and a fresh fruit cup on the overbed table. I managed to eat a few grapes and a banana by the end of the day. I also took a short walk in the hallway with the nurse. Sunday, May 12, with an encouragement by a nurse, I ordered a scrambled egg, yogurt, and banana again. I managed to eat a few bites of each. I still felt nausea even with anti-nausea meds. They stopped giving me narcotics, to avoid nausea. Monday, May13, I became independent enough to go to the bathroom, and take a shower, with standby assistance. My surgeon suggested ordering anything that I felt like eating, delivered from the cafeteria to my room. I finished a small bag of baked potato chips, and Boost protein drink with chocolate flavor for lunch, and a few bites of grilled cheese and tomato soup for dinner. They kept giving me tramadol, Tylenol, and Zofran. I haven’t been able to sleep well at night. I got up from the bed at midnight and walked around the entire Telemetry Unit by myself. I still couldn’t sleep even with melatonin sleep aid. Tuesday. May 14, I woke up very early with a little sleep. The nurse weighed me. It turns out that I gained 21 lb. on the first day, and I lost 24 lb. in the four days after leaving the ICU. My goal of the day was to convince the nurses and doctors that I no longer have nausea, and I’m fine to go home soon. I ate a half of a grilled cheese sandwich, and a chocolate protein shake for lunch, and I didn’t throw up. When Dr. Ryan came to see me. I convinced him that I’m ready to go home. While Peter was driving down for 2 hours, the nurse removed the last IV tubes from my neck, and they went over the discharge process. On the way back, we stopped by a nearby Vietnamese restaurant that the nurse recommended. I had Pho, and it was so good. After all that bland hospital food, I craved something with flavor and salt. We drove home to Ellensburg in the rain, and got there a little before midnight. It was so nice to sleep on our own bed at home.

Since the night before the surgery, I haven't been able to sleep well. I've been crying a half of the time. Maybe from pain, maybe from anxiety. Last night and this morning, I had emotional breakdown because I couldn't sleep at all in the ICU room. It was a little bit better today, and I liked removing some tubes and moving out from the ICU to a new room. I even went to the bathroom with 2 nurses assisting me. My O2 level was 90%, and they put me back on the O2 supplement. I was able to eat dinner last night, and ate meals today, but I ended up vomiting twice after managing to eat a part of dinner tonight, and it was tauramatic, causing maJordan chest pain. The nurse gave me more pain med and anti-nausea from the IV tube on my neck. And that allowed me to finish writing this post. It's been a rough ride. But I know tomorrow will be a better day.

They're taking some of the tubes and wires out, and soon I'll be moving to a "telemetry" room on another floor. I didn't sleep well last night, so I hope it will be quieter there. I've been out of bed two times today, and tomorrow I will practice walking and showering.

Everything went well during the surgery, but later when they were getting me ready for extubation, they found more blood in the chest drain. So they took me back to the OR. Another surgeon opened my chest, and he found a small leak in the aorta by the valve. They put in one suture, and stopped the leak. This might delay my discharge by a day.

Has anybody used Heart Hugger Sternum Support Harness after the heart surgery? I've been looking at it online, thinking about buying one. It's not cheap. Should I get it? What do you think?