nml's Journal

Day 6 post-op (husband)

Today started with the usual pre-dawn chest x-ray followed shortly thereafter by our local tornado sirens and a knock on the door from the nurse. The room was still dark-ish but she told us the power had gone out and now we were on the generator.

Just then a presumed tornado was seen on the radar in Dallas, so an official NWS warning was triggered. With sirens wailing all over town, the staff rolled everyone’s bed or recliner out to the hallway to get away from glass. And there we stayed for close to an hour. It was a little surreal.

We returned to the room and of course no one came by on the usual early morning rounds. The power outage lasted about four hours. Then the docs and PAs started popping in, better late than never. They said that Bill could probably go home tomorrow. They all agree that, aside from some extra fluid/swelling that has waxed and waned, he looks pretty good, the heart looks good, and the wound looks good.

They did x-ray his gut to check on some areas that looked like stuff wasn’t moving through as if should (have not heard anything about that yet) and also did a scan of his swollen legs to make sure there were no blood clots (none seen).

So you’re thinking, great, one week total
and goodbye, even with the delay of the subcutaneous emphysema (almost gone now),

The only problem with this scenario: like 600,000 other households in the area, we have no power at home. The doc intimated that Bill won’t be kicked out if we have no power. Based on previous freak severe storm outages this widespread, it will be days—possibly into next week—before everyone is restored. 

On a positive note, the plywood over the broken window withstood today’s storm (although parts of the fence did not).

So here’s hoping for some pleasant surprises tomorrow…

Day 5 post-op (husband)

This morning they did a sonogram of the heart and it was cool to watch it pumping away as it should. Bill couldn’t see the screen because he was lying down, but I took some pics and short videos.

Later in the morning, he was moved upstairs to the progressive care unit. The occupational therapist came by to fill us in further on what his limitations and possibilities will be upon returning home.

He is taking at least four walks and feels like his limit right now is about 10-12 minutes per essay (at a slower than normal pace, obvs).

And the most exciting part of his day was, of course, the shower!

Day 4 post-op (husband)

Bill is doing great. They took the pacemaker wires out of his chest. He also transitioned from their insulin drip (in an IV) back to his own pump. The surgeon put in the order to transfer him to the progressive care unit this afternoon but as of tonight, he has not been moved. (They are either short of beds or short of nurses or both, possibly compounded by the holiday weekend.)

During his walks today he asked if he could climb a flight of stairs and he did that as well!! Total of five flights throughout the day! After seeing his advancing capabilities and watching him get in and out of the bed and chair on his own (which he has been doing all day today), the physical therapist basically graduated him to doing his multiple daily walks on his own.

The swelling from the crazy complication has almost gone away now.

So despite technically still being in an ICU room, he has no further ICU needs. He should be able to go home midweek.

In other news, I went to our house to pick up something and got the terrible surprise that a big limb from our pecan tree came down last night and broke a window during the storms here. Like I need something else to deal with the week Bill goes home! My next door neighbor came over with her electric saw and cut off the end that was through the window and we covered it up as best we could with cardboard on the inside and heavy plastic sheeting and painters tape on the outside. We might need to nail the sheeting down. Tomorrow is a holiday so I probably can’t get a handyman to cover it with plywood right away, and it is supposed to rain Tues/Wed/Thurs. I only want to cover it better and call insurance right now, then clean up any glass that fell inside before we bring Bill home, and then get it replaced in a few weeks when Bill is more into a routine. Fortunately for him it’s behind my side of the sofa and not his. 😂😭🙏

Day 3 post-op (husband)

The swelling from the subcutaneous emphysema has been slowly decreasing but it’s not completely resolved yet. Maybe a few more days…

Chest tubes were removed today. Other than the external pacemaker setup, there are no attachments” left, save for a blood pressure cuff, oxygen monitor, and insulin drip.

Taking only Tylenol for pain.

Lots of peeing with the diuretic. And finally #2 as well. 

Walked three times, and the last time was with no walker. 

Tomorrow the wires should come out and (we think) he will be moved to the progressive care unit in the afternoon.

They’re talking about going home on Tuesday (surgery was last Wednesday), so even with the extra commotion of the freak complication, he should still be busting out on time.

Weve been passing the evenings watching  our hockey and basketball teams in the playoffs. Lots of excitement and drama but no energetic cheering allowed with sternal precautions!!! 

Not sure how other hospitals are with visiting, but I’ve been in the ICU room with him pretty much 24/7. 

Day 2 post op semi-update (husband)

It’s only 10am but we have had developments.

They have removed more of the tubes and monitors that had been installed in the OR.

After having been treated with a bunch of Benadryl yesterday and last night for the seeming allergic reaction, it turns out that the crazy head/neck swelling is…not an allergic reaction.

They saw on his daily 4am chest X-ray that it is air trapped under his skin. It is a relatively rare but not dangerous complication of the surgery called subcutaneous emphysema.

It’s definitely one of the “better options” if you’re going to have a complication. It should clear up on its own but may take +/- 10 days.

The doc also turned off the external pacemaker and Bill's heart is now pacing itself on its own at a decent rate. They think tomorrow morning he will be moved to the progressive care unit.

I may have more to add later but wanted to update asap on the complication diagnosis, in case it will be of use to anyone else.

Day 1 Post Op (husband)

Well, the day started out well but turned out to be a hard one. They removed some of the various lines and monitors they had inserted in the OR because all his "numbers" look pretty good. 

They also cleared him to start a clear liquid diet and he ate two little (sugar free, obvs) gelatin cups. 

He did get up and walk up and down the halls twice today with great enthusiasm, but as the day wore on he was having a lot of pain and discomfort. 

The icing on the cake was an allergic reaction to an antibiotic, Kefurox, which made his face and head swell up (throat/breathing/swallowing not affected). They put some Benadryl in the IV and the swelling is starting to go down a little bit. (If anyone is familiar with the “Gluttony” section of “Monty Python’s The Meaning of Life” that will give you an idea of what his face and neck looked like.)

He has been pretty miserable today but everyone says that this first day after surgery is the worst. He spent the morning and most of the afternoon in the chair but decided he wanted to get back in the bed at this point (4pm) and call it a day. Like Scarlett O'Hara, we just have to remember that tomorrow is another day.

OK! Update from the ICU.

Husband was taken into the OR at 7:30am.

Received a Mitris bovine valve via sternotomy and was on the bypass pump for a little less than two hours.

Around 1:00pm was situated in his ICU room.

Intubation tube was removed at 3:30pm and he had a breathing treatment soon after.

By 5:30pm he had been moved to the recliner. They had taken him off the oxygen for a little while but he is back on it now.

BP a little low and blood sugar a little high, but other measures are mostly within acceptable range.

No transfusions in the OR but has received plasma and platelets in the ICU.

So far so good, I guess!

How long were you on the bypass machine? Husband in surgery right now and I think has been on it for two hours so far (I know when he went on it and no one has called to say he’s off). Seems like three hours is the max optimal time in terms of complications and pump head.

How common is the visiting nurse scenario? It hasn’t been mentioned to us as a possibility in any written or verbal communication (not yet, anyway—his surgery is 5/22). I wonder if it is more common with certain hospitals or if it is entirely dependent on the patient situation?

Do you typically get sent home with or wearing any kind of monitoring devices that transmit info to medical team? Going for husband’s pre-op this afternoon and that’s a question I had not yet added to my list…

So…about driving. I’m assuming all the 3 to 4 week timelines I have read and heard are for slush boxes. Both of our cars are sticks, so that’s an entirely different level of upper body engagement. Any members out there who drive MTs? How soon could you drive?

Any T1Ds here? What effect did your surgery and recuperation have on your BG? Husband is religious about exercise and BG control and as a result tends toward lows. But when he's sick, it runs higher. It's gonna be hard for him not to be able to do vigorous exercise for so long, but hope he will be able to scale up the walking as soon as possible. Also, he uses Omnipods and a Dexcom CGM, both of which require placement/insertion of devices on his body. Wondering if the sternum situation will make that hard for him to maneuver and if I might have to assist or do this for him at first!?

Husband will have MV surgery via sternotomy on 5/22. So hoping home from hospital around 5/29. Will he likely need someone with him 24/7 for at least the first phase of home recovery? Or can I expect to be able to run an errand here and there as needed? Trying to figure out how much I need to stock up on, etc, in advance.