Pravin's Journal

Hi All I Went through an emergency mini incision AVR (sternum cut) while on a biz trip to Bangalore India at Sakra World Hospital. Surgery performed by Dr. Adil Sadiq Dr. Sunil Kumar(Cardiac Anasthesia) Dr. Rajni(Cardiac Anesthesia) and team I was initially scheduled to get it done in US end of Feb but had an emergency(severe palpitations and breathless while lying down) and was advised to get it done in few days. My condition was severe AVR with LVD of 6.4 cm, chose tissue valve age 39. Incision was just 2 inches long of course had the other under the skin stuff for right leg venous cannulation, drainage tubes and pacing wires from the stomach, IV lines in neck and arm , arterial line in the leg , breathing tube, urinary catheter, Ryle's tube for hydration if I remember all of them correctly. Day 0- Preop testing blood echo x-ray etc everything looks normal green signal for surgery. Day 1 - Went into surgery bit nervous but the surgeons and anesthesiologists calmed me down before I was put off. Woke up some six hours later staff shouting at me to wake up, although I could hear them and understand them but could not fathom the energy to even open my eyelids. Few hours later they tried again this time my eyelids obliged faster but could not move my hands or feet, took another half hour to get those going. Soon after the feeding tube and respirator came off , remember a choking feeling and very rough throat. Was given little bit of oxygen and then completely breathed on my own. I was forced to get out of bed same night and sit in chair got tired and went back to bed. Blood extractions for testing overall heath. Wife and parents visited in ICU for 5-10 mts each. Day2-Early morning feeling of incredible thirst,kept requesting ICU nurses for ice chips which they provided whenever asked. Later given a sponge bath urinary catheter extracted , I was wondering why I was urinating so much and not wetting the bed, didn't realize I had a Urinary Catheter ON :). Moved from bed to chair , urinary catheter removed , sat for about an hour than the first walks began, maybe two short walks. The stomach tube hurt a lot while walking. As blood discharge was still seen from the chest cavity was asked to stay in ICU for one more day. The diet was mostly liquid food , staff didn't allow to sleep much as they want all the Cardiac patients to be as active as possible so most of the time trying to sit in the chair or raised bed but not much shut eye. Blood extractions for testing overall heath.Wife and parents can visit 5-10 mts 2 times a day. Day 3-Another early morning sponge bath with some coffee, some walks later in the morning, slightly painful extraction of the stomach drain tube cleared to go to step down ward after some semi solid food. Wife gets to be with me all the time, some more semi solid food in evening a few more longer walks , mask nebulizations for cough prevention. Feel relieved to get better quality of sleep away from bright lights of ICU but still had a sleepless night. Always connected to a pulse heart and BP monitor have to request nurse assistance for going to bathroom. Getting up and moving around in the bed is still an ordeal due to sternum pain. Woken up a few times at night to get blood samples from neck IV line as well as administration of potassium injections, as I was passing urine a lot (>2 ltrs) potassium deficiency shows up in my blood report. Pain medication mostly limited to paracetamol. Day4- Similar to Day 3 but got pacing wires removed dressing for the sternum cut removed jugular catheter removed took my first bath by myself. The sternum wound doesn't look as bad. Walked a lot more this day climbed stairs, took it slow no need for fast paced activity first one month as advised. Started solid food with chicken menu. Urination still high due to diuretics bit of a concern for me as having 6 lb loss compared previous to surgery. Got echo and X-RAY no surprises here echo shows not even trace leakage and LV dilation has gone down by 0.3 cm what a miracle , doc doesn't believe this though :) Day5- Move out day report back in a week for another echo. Medicines administrated during stay 2-3x day Paracetamol, Blood thinner, dueretics(40mg), multivitamin, amoxycillin, potassium injections Overall Experience : Beyond belief that the experience was smooth and everyone from the surgeon anaesthetists, radiologists, PAs, nursing staff gave their 200 pct to have me up and running so soon, even though I consider myself moderately fit person even I wasn't expecting such a smooth experience. The first few days are painful considering that your heart has just been stopped cut open, restitched and restarted and you have a plethora of tubes sticking out from you. Positive attitude will see you through. Don't know what the road ahead holds but I certainly hope that I can get better quality of life with a better functioning heart, of course there will be ups and downs but so far my experience has been ever better than text book perfect. will keep posting.