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Wednesday, August 29, 2018

SAVR px post-op discharge week

I'm home. Discharged at 2 pm yesterday. Thanks to everyone for your kind words of concern and support.


Well, that was indeed interesting. Lots to think about and recount as I gather my thoughts. Stay tuned.

For now, Major Props to my surgical team and all of the Muir Concord Cardiovascular center staff.
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OH, YEAH, 
DON'T FORGET TO SAVE THE DATES: SEPT 16TH - 18TH, 2018

THE Health IT event of the year.
I don't guess I'll be attending this year (I've covered the past six). I applied for the press pass, but never got a response, but, as a practical matter I doubt I'd be physically up to it. Hate to miss it.

ERRATUM

RIP Senator John McCain.




Whatever you thought of his politics (and I was mostly not a fan), he served courageously, and suffered mightily for our country.

WEEKEND UPDATE


My offending aortic valve. Quite frankly, I'm lucky to be alive. There was probably heart valve failure or a stroke in my not-to-distant future.

I'm having a lot to continue to adjust to at home this week (a lot of it related to fastidious antiseptic hygiene measures). I'm out walking every day. Reading a lot. Tire easily. Vitals are stable.

My medical economist and writer pal JD Kleinke has warned me about the risk of "pump brain." Yeah, bro', I saw that in my Dad after his heart surgery in 1996.

Among my frustrations is that I will not be able to play my guitar for another 6-8 weeks (sternum pressure). Grrrr...
On a terribly sad note, I got a call from my close Seattle friend "Joey T's" cell yesterday. It was his wife Kathy, calling to say he'd died the other day from brain mets stemming from his bladder cancer. He'd been doing better of late, but things took a rapid turn south. Joey and I had talked at length about his cancer repeatedly. I knew he'd been struggling. Nonetheless he showed up unannounced at Danielle's Memorial. That is a friend.
Very sad.
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UPDATE
SAVR the experience. 


Up at 3:45 a.m., after a difficult, anxious, short night's sleep. No foods of liquids allowed. Ugh. Off to Concord, arriving at the Cardiovascular Institute at 5:23. Preregistered, straight up to “Short Stay” on the 2nd floor to begin pre-op prep. First (after vitals and a bunch of Consent signatures), neck-to-ankles full-frontal body shave (“OMG! I’m a Foster Farms Thighs & Breasts Valu-Pack!), then blood draws and chest x-rays. IV insertions next (both arms), and EKG telemetry hookups follow forthwith.

Quick discussions ensue informing my wife and sister as to where to go to wait and what to expect in the way of surgery progress notifications. The anesthesiologist comes by to introduce herself and chat reassuringly. My cardiac surgeon stops by to warmly greet and further encourage me. Cardiac staffers would subsequently remark, on multiple occasions, “boy, did you ever get the A-Team!”

All good to hear. My anxiety is pretty minimal, all things considered, but it would not be true to claim there wasn’t any. I guess I’ll wake up. Or not.

More prep — lost of stuff going on all around me in tandem — and then it’s off to the OR.

They sidle my gurney up aside the operating table, which has a large stainless steel hump on it. I’m instructed to slide over on to it, with my upper-mid back positioned over the hump. It’s uncomfortable…

That’s the last thing I remember until waking up several hours later in Cardiac ICU (it seemed like mere minutes). Eventually the intubation is removed, I and have episodic bouts of harsh coughing. Right away they push me to begin using the spirometer. Pre-op I’d been pinning it at 2,500, no sweat. Now I can barely get it to move.

In short order I start intractable bouts of rather harsh, persistent hiccups from my irritated windpipe, some of which last 2-3 hours at a time through Saturday. Nothing works to abate it. They finally resort to two sequential IM doses of thorazine, which knock me out.

I will never EVER do thorazine again. You can just forget it. The most vivid adverse side effect was my mouth feeling like the surface of planet Mercury. Bone dry. By Saturday evening I was totally exhausted.

But, that aside, rehab progress began right away. Sitting up, doing minor PT extremities’ exercises, then standing, then a walk down the hall using a walker.

By Saturday I’m moved from ICU down to the PCU (Progressive Care Unit). I quickly regain my “sea legs” and start stably lapping the PCU floor around the nurses’ stations, doing 4-6 laps at a time rather than the expected one or so.

Struggle to eat. Hospital food, man, particularly for us cardiac pts. Like eating cardboard. Ugh. I struggle to down some chow that I know I need.

By Monday, the tentative talk is that I might be able to go home Tuesday (thought my surgeon equivocates a bit). Those damned hiccups have cost me at least one additional post-op inpt day.

On Tuesday, though, the consensus on Rounds (my surgeon, my cardiologist, and his on-call practice colleague) is that yeah, I’m good to go.

More reams of paperwork, and then a protracted hurry-up-and-wait interval.

Finally, at 1:50 pm, an aide with the requisite wheelchair comes for me. Loaded into the car curbside, I have to sit in a back seat (airbag risk).

Homeward bound. Pretty happy camper at this point.

I can’t say enough good about my entire care team.

Some thoughts about my workflow observations shortly (yeah, I can't help it, I'm always watching and counting). Stay tuned.
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More to come...

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