ICU
When you come round, you will be disorientated and bewildered! And more. Everyone is affected differently, and recovers differently. The first thing I was aware of was the Endotracheal Tube OR as I call it “the kreepy Krawly”. This is a tube that runs down your throat and down to your lungs. It is basically a respirator that helps you breath, after your op. As soon as you can breath on your own this will be removed. Bluntly put, the Kreepy Krawly is not nice! You cant talk and it is very uncomfortable. Once you are fully conscious and breathing on your own they will remove it. This is also unpleasant, BUT once this was out I felt I was well on my way to recovery.
Other devices attached to you include: the IV lines, the catheter for your urine, catheters in your wrist and neck, nasogastric tube, two chest tubes and two drains from the heart cavity and lungs. Not nice, but necessary. The quicker you recover the quicker they remove these. Many patients are very disorientated for the first few days. Older and sicker patients battle with not knowing who or where they are. This is natural, and after a couple of days the patient should become more focused and at ease. This is often a sad and confusing time for family and spouses. The patient will know the basics, who they are, who you are, where they live. BUT other things get confusing and they may not realise where they are, how long they need to be there, and why they are even in hospital.I was very self absorbed, and although I was fully aware of everything and remember all, I was pretty moody to say the least. I got tired very easily. Although I loved the visits, after a couple of minutes I would become very tired and want my visitor to leave. In fact I would just say , “I think you should leave now”. You are hooked up to these machines, you have a nurse watching you 24hrs a day, you have a patient to your left and right with the same set up as you. The room is constantly lit with a dimish light, although the drugs may make it seem brighter. I had an 80 yr old man to my right and a 4mth old baby to my left. I think seeing the baby with all these tubes, really put my life into perspective. How lucky I actually was! How lucky we all are to have just had the chance on a beautiful planet like this – some are only given days.I was sick. Complications with the heart at first, then the lungs. BUT I set myself goals and went after them at pace. If a nurse told me to work on my breathing because my lungs were weak. I would take it as a challenge. If she said I had to do 8 reps of breathing exercises 3 times a day with my blow bottle, I would do 15 every 2 hrs. If I was told I wouldn’t need the toilet cause I was on too many drugs for my bowls to work. I made a point of getting them too work. They said I wouldn’t be able to even walk to the toilet, I walked to the toilet.
Im not saying go against what your told. I just set myself short term goals, and this enabled me to focus on getting better quicker.
How long will I be in the hospital?
The average length of hospital stay is about 3 to 8 days in ICU and 4 – 6 in the wards.
Leaving ICU is like summiting a huge mountain. I just wanted to get out. I knew that once out I was on the mend, and it was all downhill from there. And basically it is. Again, people react differently. I was young and healthy and with positive thought and constant humour I began to see life through new eyes. That first night in the wards was fantastic, before the patient next to me went a little bonkers. I loved the freedom. I could watch TV. I washed myself, and shaved for the first time in over a week. Good and clean and fresh.I was only in the wards a couple of days. I passed all my tests and was allowed home, to the best nurse in the world, mum. Many patients spend up to a week or more in the wards. This is not all bad. It gives you time to rest, be monitored and get back on your feet again.
Personally I found the wards noisy, and depressing. This was because I was in better shape than my room mates, who needed constant care, monitoring and attention. I found home a much more positive and emotionally happy place.
Exercise and self protection
I felt no pain. The drugs take care of that. This is great, but dangerous as you don’t know what you are doing wrong sometimes. You will be taught how to hold yourself together. Hug a pillow to protect your chest from sideways and up and down movement. Take this seriously. Remember you have been cut , and opened. Your sternum, was split and prized open. This takes at least 5 weeks for the bone to fuse. Only after 3 months is it strong enough to get back to everyday activities. You will learn how to roll in and out of bed, get in and out of the bath etc. These are things that must become second nature. You don’t want to pop wires and end up back in hospital.
I lost my taste and smell. For almost 3 weeks everything was so different. I was almost another person. I experienced crazy heat fluctuations and had awesome highs and terrible moody lows. Depression is a big thing after ops like this. Much has been written and recorded.
You will experience these lows, but must be positive and realise LIFE IS FANTASTIC! Its your second chance now. Don’t waste it. The sooner you see this the better you will be as a person, and the better place the world will be.
Why did I have so much back pain after the surgery?
A lot of patients complain about upper back pain, especially between the shoulder blades. The pain is from rolling the shoulders in to try to minimize the pain felt in the sternum (breast bone). Tipping your shoulders forward reduces the pull or pain in the sternum. Heat, massage anything you would do to help a pulled or strained muscle will help. Ultimately what helps the most is when ever you think about it, try to make sure to stand straight and not allow you shoulders to tip forward.
What is PPS?
PPS (Post Pericardiotomy Syndrome) is also called Post-MI pericarditis and Dressler’s Syndrome. It is caused by inflammation of the pericardium (the sac-like covering of the heart) that causes blood to be present in the pericardial sac. It is an inflammatory response to the blood in the pericardial sac. There can be a variety of symptoms, which can include a low grade fever, fatigue, “achy all over” and chest pain. The usual treatment for many post op heart surgery patients is NSAIDS (Ibuprofen).
One method of diagnosing PPS is to draw a blood test called a sed rate, that indicates an inflammatory response in the body if the test is elevated. It is not necessarily definitive but can indicate the possibility of PPS. [3]
How do I know that healing of the sternum is progressing okay?
Normally nonunion of the sternum is indicated by a popping or clicking sound of the sternal bone when you cough or breath deeply. However, it is possible to have nonunion and be completely painless.
Sometimes the nonunion can be just a small section, often at the bottom of the incision, called the xiphoid area. That is often non-painful, restricted to a limited area, and tolerated well by many people, so often it is not treated.
For nonunion of the whole sternal bone, surgery may be considered. It is called a “rewire” and the incision is opened, sternal wires are cut and the sternum opened, and sternal edges are abraded and rewired. Usually people are in the hospital overnight and are not very painful. Most are up that same evening of surgery walking and eating. The procedure takes about 20 minutes.
In most people the decreasing pain in the sternum is the indicator of healing.
I struggled with depression after the surgery.
Apparently this is fairly common. I’m not a clinical phsychologist, but I would suspect that one of the reasons for depression is due to a bit of an emotional backlash. I would guess that this time of one’s life is a very intense experience for most people, with a great deal of anxiety before the surgery. It’s probably also a time when one is the focus of a great deal of attention from family, friends, co-workers, etc. After the surgery, as you recover, and finally get back to the day to day grind of life, most of that extra attention disappears, and maybe that is a part of the feelings of depression for some people. For a while, a large part of your life involves the surgery in one way or another, and suddenly, all of that is gone about 4-6 weeks after surgery as you really begin to recover and return to work and a normal life.
