11/30/2020
A LITTLE TOO MUCH ABOUT ME
• I can drive again! Yes, that’s me inside my beloved Saab. One of them...I own four. Between my kids and I, we have six Saabs. But that’s another story. I was really cleared to drive as of last week, but I gave it a little more time. I took off for the local (decaf) coffee drive through and the whole thing was uneventful. I monitored my heart rate along the way and noticed only a slight uptick – must have been the excitement to be back in a Saab.
• Amazing, I have received personal notes from more than one person who tell me they are “on the fence” about their own possible open-heart surgery because of, well, each one is a personal choice. If you are looking for an endorsement from open-heart patients, they may be difficult to find unless they are many months removed from the trauma. The fact is no one raves about it. There’s a reason for that: It is as much difficult mentally as well as physically – and I will touch on both from a personal perspective. Many comments say how brave I have been through these times, and I have been struggling to reconcile those remarks until I recently caught up with a favorite film by David O. Russell. He wrote and directed THREE KINGS, and in it, George Clooney’s character says “You do the thing you’re scared of — and get the courage after you do it. Not before.” All those years of searching for the right words. Amen to that.
• I’m curious by nature so I asked my surgeon how long my heart was stopped. “24 minutes,” he said. “I sew really fast.”
• If this ever happens to you, your average 5-days in the hospital will be busy. At first you won’t be left alone for more than two-hours 24/7. It is annoying, but necessary. I am diabetic so I was also getting my finger poked every couple of hours. Whatever sleep I was in was gone. You will be cranky and irritable due to lack of sleep, and when the nursing team shows up to take your weight and get you to walk, you might even be a little terse with them. Do what you can to make it happen. The two fastest ways to get discharged from the hospital: Number one is walking, and number two to is “number two.” Those are the holy grails of discharge. The toughest part of walking is standing up and laying back down. Thank god for hospital beds that tilt you up. Then you use a walker. Cake. The other thing? Well, nurses remind you no one leaves until they can perform the grand second act -- and the drugs you were on earlier tend to block the exit something fierce. I won’t give you the TMI details on my experience, but I do have advice that I did not take until the last minute: Prune Juice. They have plenty of it and, along with other aperients, you will get your ticket out on discharge day.
• During my hospital stay I preferred to keep my “curtains closed but the door OPEN.” I preferred the door open because I liked to hear “life” outside. People walking by, talking, patients on their walks. I didn’t want to be cooped up alone and isolated. I heard many conversations during my stay including one man who, after everything nurses were doing for him, proclaimed that “I am paying for this and you can’t tell me what to do. I have freedoms. I have rights!” It was an animated conversation and I had no business listening in – but he was yelling loudly (from just across the hall) at perfectly innocent nurses who were just trying to help him heal. It resulted in a number of nurses and a supervisor having to attend to this person, making we wonder who was not getting the attention they needed while this guy sucked the air out of his (and any other patient’s) room. As I said earlier, it’s easy to get cranky.
• Can’t say this enough: Cough. That was the hardest, most painful part of the process. Use your heart pillow. Use your incentive spirometer. Your lungs will ache, you will cough, you will hurt, but the more you do it the less you will need to do it going forward.
• If you don’t have a “Lift Chair” at home, RENT ONE. They are relatively inexpensive in relation to the cost of what you are going through. They are basically motorized LA-Z-Boy’s that help you stand up. My heart surgeon even told me that many patients prefer to sleep in a La-Z-Boy when they come home. I understand why. They are comfortable, keep you on your back, and angle your body such that you feel like you are floating. I do have a La-Z-Boy and I love it, but it’s not a lift chair *and* (if you own one you know) you must reach down with your arm to the control lever. That’s a no-no. Lift chairs do the work for you, so we rented one from McCann’s. The first day home that’s where I landed for hours and hours. And later it’s a good break from the bed which you will sometimes come to look at as a prison.
• If you have a bed that raises your head (and/or legs) you will likely be thankful for it. I never cared for that feature when shopping for a bed, but I sure wished I had it for my recovery. My personal hack was stacked pillows. It failed because I could never get them (and keep them to stay) just right. Sidebar: Some people buy wedge pillows (triangle shaped) as foundations to support their shoulders, head, and neck. I can’t tell you if they work. Maybe someone will chime in.
• The sternotomy. Yes, it is a big deal. I am six weeks out and it still aches, especially when I speak forcefully (Blazers games start soon!). In my mind I rationalized it as having had an accident – plenty of people need many weeks to recover from traumatic bone injury and so it’s part of the process. But it truly is short-lived. The first week in the hospital you get to cheat as nurses (and your bed) will lift you up. I was worried about how I would handle things when I got home, so I used the lift-chair at first. After two days I realized I could manage getting in and out of my real bed with minimal discomfort. I bought a raised toilet seat figuring I would need it, but never had to install it. I found ways to let my legs do the bulk of the work and used my arms for balance. I ditched the walker after two days. Thanks to the Physical Therapy team at the hospital, using stairs in my house was a breeze (okay, I took it slowly) by the second day home. By the start of week three I considered myself liberated enough that I could get up and down (albeit gingerly) from almost anything keeping in mind I did not want to over-extend my reach lest I “loosen” the repair. Your sternum is considered only 80% “healed” eight weeks post-surgery, so I’ve got a bit more to go. If you are a fast healer, better for you. Occasionally I will twist or turn in such a fashion that I hear a pop, very much like the plucking of a guitar string, across my chest. Maybe it’s muscle that got hung on the wires holding my bones together? Sounds gross, I know. It doesn’t hurt. It’s just…weird.
• Before all this, my friends (and some listeners) gave me lists and lists of TV shows to binge. A good friend even put together a thumb drive of shows to watch which I deeply appreciated. Full disclosure: I am not a TV binge watcher by nature but I figured I’d have plenty of time to catch up on shows I’ve missed. Didn’t pan out. My irregular heartbeat had me feeling so miserable that I didn’t care. I couldn’t pay attention to a plot line for more than a few minutes. So don’t use me as an example. I imagine patients on a good recovery arc could devote the time to those shows and it would be a good diversion. I *did* manage to make time for one series early during my down-time before all the irregularities set in. The plot and film-making was just good enough to keep me coming back to it again and again without regret. It was NETFLIX’S “The Queen’s Gambit.”
• Books on tape. Even more friends recommended books on tape. Again, being miserable lying in bed listening to a book didn’t move the needle for me. There are short books, long books, inspirational books; and maybe you are a books on tape person – I commend you. It’s not reading…but it is. For the average patient not going through post-operative challenges as I was, I bet it’s a good diversion – might even help put you to sleep (yes, there are books on tape designed to do just that!) When I get back to feeling like myself I may try them. In the meantime, I own but ONE book on tape: THE MARTIAN by Andy Weir. I got it five years ago when my leg challenged my very existence. So a book about a man, alone, forced to adapt to life-threatening situations and overcoming them - with a modicum of humor – well, that connected with me. It still does. The movie did the novel justice and, if it’s on TV, I never miss it.
• Do you have a caregiver? Luckily, I married Louise. Just as lucky, she’s a nurse. Okay, she's a pediatric nurse but I behave like a kid, so it works. Back in 1986 when we were married at the top of Heavenly Valley, Lake Tahoe, our Right Reverend Blaine Bender rolled out the old “in sickness and in health” line. They were words on a page until 30+ years later. She’s done the “for worse” for me far too long. I can’t thank her enough. My post-op complications really tested her. Every day to the hospital to see me and stay with me when my heart had a plan of its own, many trips to the pharmacy to get updated meds, doctors’ appointments, COVID testing site, the false start to my ablation. The hardest part of my recovery went on far longer than it needed to. I didn’t help her with my poor post-op planning, either. If I had to do it all over again, I’d lay in a larger supply of bedsheets because I soaked mine every night. And both of us are also horrible meal planners; we are very last minute and impulsive. Layer on the fact that I couldn’t decide what sounded good to me until early evenings and Louise would race around town trying to find something for me to eat (I lost 25 lbs during this time). Maybe this was her “Louise Time” as she got out of the house – I hope so. I realize that is a first-world problem and we are more fortunate than most. But meal planning, if you are in any way good at it, will help. I have also taken to more protein drinks and drinkable yogurt (I hate both) but that it is out of necessity. Oh, and it’s been easy to avoid In-N-Out Burger because it’s 30 miles away. But I thought about it.
• When it comes to the game of life, I am an overly optimistic person. So much that I think it sometimes drives Louise crazy. Consequently, when I read my pre-op literature that warned of post-op depression, I figured it would not affect me. There are a few things you are told about post-op health that don’t get enough emphasis. There’s the physical aspect: Your body temperature may fluctuate wildly as your post-op health looks for equilibrium; you may have night sweats like you’ve never had before; your vision may temporarily change and get blurry (mine did)(it popped back to normal the day after my ablation); or your heart rate may take a while to find its rhythm. And then there is the MENTAL aspect. Post-heart-op depression and anxiety are real, and do not beat yourself up if you experience it. It is completely normal. For me, an optimistic person, I never expressed any of that anxiety during my waking hours – I was too focused on overcoming the challenge at hand so I suppressed it. But at night when I surrendered myself to sleep, I had some of the most terrifying dreams I have had in years. Thankfully, I remember only two. The first dealt with me walking down a street when my legs slowly started to lock up. Each step got harder and harder. When I got to the point where my legs felt like 1,000 pounds each, I woke up out of breath in a pool of sweat. In the other, I dreamed that our family owned a beautiful second home in Montana. It was so large we barely used a few rooms in the front of the house – but the further into the house you went the darker and more sinister the house became; murky rooms whose ceilings were dripping with thick dark ooze, slanted floors with decrepit carpet, walls cracked and wallpaper peeling, beams splitting, unhinged closet doors, windows so dirty you could not see outside. The kids would not go near that part of the house, and, after seeing it once, neither would I. It was so vivid I could describe to you the street it was on, the fences in the yards, the cars that drove by, the shape of the house, the wall of windows in front, and the landscaping and trees that surrounded it. Just to be sure, the next morning, I asked Louise if we owned a house in Montana. We don’t. You can interpret these for me, I don’t want to dwell on them. As I tell you this my heart rate is going up, so I will simply say that no one is immune. Be aware things like this can happen and do not be afraid to speak with anyone about it.
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There are good days and bad days when recovering from major surgery – today was a better day than yesterday, so it has to be a good day. My son came over to help put up Christmas lights (he did all the work). And I walked .85-miles using my poor man’s self-guided cardio rehab (the real deal delayed thanks to Covid freeze) with help of Borg Perceived Exertion Scale I found online. Improvise. Adapt. Overcome. And, for the first time since I came home, the 49ers won.