Couple days late (my 3 week anniversary was actually two days ago - surgery was 5/5) 'cause have had some irregular heartbeats that have pre-occupied me - more on that in a sec. So to re-cap... I kept myself busy (small projects around house) before the surgery to keep my mind off things - highly recommend this if possible. Had a surprising "at peace" feeling the last couple days before surgery (someone else just described this). Surprised me as I thought I'd be more nervous. The thing I was most nervous about going in, other than the small chance of not waking up, was the breathing tube and penis catheter - neither of which were fun, but manageable. Also had some anxiety about the breathing tube being taken out - turned out not to be a big deal at all.
I was shocked (pleasantly so) how well things went the first couple days. Was in a chair and on the computer 20 hrs after surgery posting an update here, and giving people at work an update. At 36 hrs after surgery, was taking pics w/ visitors (see below with heart pillow). They had me up and walking around the floor (I think on the 2nd day?). On the first walk I stopped halfway down the hall 'cause I was getting a little short of breath. But on subsequent walks, I'd get more and more stamina, and by the end (day 4 & 5), was making laps around the floor with ease (not to mention riding a bike, walking on a treadmill and walking up some steps they have in cardio rehab).
The things that bothered me the most during the last few days in the hospital were the 1) the damn shots in the stomach every 8 hrs (can't remember the name of the drug - but it was to get my blood thin before the coumadin kicked in). Not sure if everyone has to have those, or if it was just me, but not only do I hate needles, but those shots stung like an SOB when they were shooting the medicine in. There was one nurse who had it figured out, and I hardly felt it when she did it, but the others - OUCH! 2) The hourly finger pokes for the first day or day and half because my blood sugar had shot up. 3) The IV's - they have trouble finding a good vein in me and a couple IV's collapse so had to be re-done. Oh, and don't be shocked when you wake up and find an IV in your neck - that's normal and comes out shortly after the breathing tube I think. 4) my neck and shoulder were sore. Due to the awkward position they have you lying in during surgery. But the actual incision itself wasn't bad at all, except when I'd cough. 5) That breathing tester thing (inspirational spirometer or something like that). It's not scary to use or anything - you just suck in air as hard as you can with your lips against the thing. But it hurts a little to breath hard the first couple days. The first couple days I couldn't get it above 1000 and was getting discouraged. But by day 3 I was getting up to 1500, and shortly after being home had it up to 3500. It actually became a good friend of mine because this (and walking) are probably the most important things to keep up with - they really do make you feel better sooner. 6) My first pee after getting the catheter out took a while - and they were threatening to put the catheter back in unless I peed soon... So I made damn sure I peed as soon as I could - can't remember how long it took - maybe towards end of 2nd day. And closely related was the first bowel movement - that took days for me, even though I was eating like a pig the first few days. Probably because they emptied me out so well the night before surgery (forgot to mention that part, lol). OH! and for the guys at least, the first 3 - 5 pees after the catheter - ouch! Burns like an SOB! Move this up to number 3.5 above!
But overall I was doing amazingly well, so got released on day 5 (could have been released on day 4 but didn't have a ride arranged, so stayed one more day). Felt great. Like someone else described, probably felt a little too good in fact - got cocky... I took it easy the first couple days at home, but by the 3rd day I was getting around almost like I'd never had surgery. Very surprising (pleasantly) to me. Went out for a drink with a buddy towards end of first week home - not recommended, but felt great to get out and do something "normal". During week 2 was going to cardio rehab 3 times a week and feeling great. Took a 40 min. walk one night around a couple parks in the neighborhood (you're supposed to walk on your "off days" when not in cardio). Other walks were shorter - but felt great to do a long walk like that - felt like I was almost back to normal. Then... Went out with friends last Fri, Sat. and Sun. nights... Probably not smart... But again, I was anxious to get back to normal and get out of the house. And I did - felt like a normal guy again.
Well, then, BAM! Sun. night, after walking home from a close-by bar (for my "off-day" walk) it was hot and humid. It was only a 20 min. walk, but I was pretty sweaty by time I got home. By late that night, I was having some "more than normal" irregular beats. And it was doing some pretty freaky stuff (fluttering fast, then slowing way down, then skipping, then repeating). I went to the ER that night at 2:30 am cause I couldn't sleep and was getting pretty anxious about it. Super long story only somewhat long - I ended up going into A-fib while in the hospital, which is apparently pretty common after this surgery (something like 30% - 50% of folks). I'm still having irregular beats, after visiting the ER twice, staying overnight twice and getting released twice. It seems to be triggered when I recline or lay down. Which is making it very difficult to sleep. In my case, they start as irregular beats (skipped beats, extra beats), then turn into what feels like constantly missing every other beat, which I guess is really just a very slowwwww heart rate (down to like 40-50 beats per min instead of my normal 75). Went into my primary physician today, who was on vacation. While I love the guy to death - this substitute I had today was even more spectacular than him (don't tell him I said that - we go way back!). She explained everything so well, and calmed all my fears (which to be fair, he would have done too - I think she's just better looking than him which is why I liked her so much). Put me on a low dose of anxiety meds for the day, and told me to take my valium at night (which I haven't been doing) because she's also (like the others I've seen recently) convinced that while it's very real, and is pretty common side effect from this surgery, it's being escalated by anxiety.
This part's for Ross and others that have been concerned about my recommended lower-than-normal and tighter than normal INR range of 1.8-2.2 (although I'm sure Ross stopped reading this long-ass post a few paragraphs ago, lol). Went in for my INR check today, and it's up to 2.7 (as expected, higher than the 2.1-2.5 I'd been at due to the Amiodarone which I'm now on to help with the irregular beats and prevent afib again). So, they're reducing my Coumadin dose again today (down to 3 mg from 4) because they don't want it to go much higher than 2.7. Going back in again tomorrow to see where it's at, because it's getting higher than they like. Here was the reasoning of the doc I talked to today - which seemed to know her stuff very well. They like to start you off on a tight INR range to reduce likelihood of bleeding issues as you heal, while of course keeping you anit-coag'd enough to prevent clots. Which tells me they may increase my range later on (who knows, but maybe 1.8-2.8). Will get more info on this from my surgeon on 6/6 - as I remember, the lower than normal low-end of the range has to do with the particular valve I got (newer model that tolerates lower INRs).
Alright, that's enough for today - sorry for the loooooonggggg post, but am documenting this not only to potentially help others with what to expect, but also for myself (so I can remember the details later of what I went through - and can tell my grandkids about it someday, lol). See below for pics 36 hrs after surgery (with the pillow), the scar 1 week after surgery (with bandaid on chest tube hole) and the scar today (3 weeks and 2 days after surgery). Very pleasantly surprised with how it's healing - I don't know if you can tell but the "scab" which I think is more glue than scab is gone now except for the top 3 inches or so. I'm hoping that extra belly button I've got (from the chest tube) will flatten out a little - not be so much of a divot. Maybe when I lose some weight... Which reminds me - stop laughing at my love handles and man boobs - haven't been able to work out since a couple months before surgery. Ok, fine, neither were much better when I was working out, but hey, we work with what we've got - and you learn to be a lot less self concious about your body when going through this. I included all the gory details (including love handles and man boobs) so you can see the size and placement of the scar and chest tube hole (I found it comforting before surgery to see others scars and find out that they're not that bad).
- Andy
PS - crap it won't let me attach more than one pic so you'll have to see previous posts for the 36 hour post op pic w/ the heart pillow and the 1 week scar pic. So below is only the 3-week scar pic...
I was shocked (pleasantly so) how well things went the first couple days. Was in a chair and on the computer 20 hrs after surgery posting an update here, and giving people at work an update. At 36 hrs after surgery, was taking pics w/ visitors (see below with heart pillow). They had me up and walking around the floor (I think on the 2nd day?). On the first walk I stopped halfway down the hall 'cause I was getting a little short of breath. But on subsequent walks, I'd get more and more stamina, and by the end (day 4 & 5), was making laps around the floor with ease (not to mention riding a bike, walking on a treadmill and walking up some steps they have in cardio rehab).
The things that bothered me the most during the last few days in the hospital were the 1) the damn shots in the stomach every 8 hrs (can't remember the name of the drug - but it was to get my blood thin before the coumadin kicked in). Not sure if everyone has to have those, or if it was just me, but not only do I hate needles, but those shots stung like an SOB when they were shooting the medicine in. There was one nurse who had it figured out, and I hardly felt it when she did it, but the others - OUCH! 2) The hourly finger pokes for the first day or day and half because my blood sugar had shot up. 3) The IV's - they have trouble finding a good vein in me and a couple IV's collapse so had to be re-done. Oh, and don't be shocked when you wake up and find an IV in your neck - that's normal and comes out shortly after the breathing tube I think. 4) my neck and shoulder were sore. Due to the awkward position they have you lying in during surgery. But the actual incision itself wasn't bad at all, except when I'd cough. 5) That breathing tester thing (inspirational spirometer or something like that). It's not scary to use or anything - you just suck in air as hard as you can with your lips against the thing. But it hurts a little to breath hard the first couple days. The first couple days I couldn't get it above 1000 and was getting discouraged. But by day 3 I was getting up to 1500, and shortly after being home had it up to 3500. It actually became a good friend of mine because this (and walking) are probably the most important things to keep up with - they really do make you feel better sooner. 6) My first pee after getting the catheter out took a while - and they were threatening to put the catheter back in unless I peed soon... So I made damn sure I peed as soon as I could - can't remember how long it took - maybe towards end of 2nd day. And closely related was the first bowel movement - that took days for me, even though I was eating like a pig the first few days. Probably because they emptied me out so well the night before surgery (forgot to mention that part, lol). OH! and for the guys at least, the first 3 - 5 pees after the catheter - ouch! Burns like an SOB! Move this up to number 3.5 above!
But overall I was doing amazingly well, so got released on day 5 (could have been released on day 4 but didn't have a ride arranged, so stayed one more day). Felt great. Like someone else described, probably felt a little too good in fact - got cocky... I took it easy the first couple days at home, but by the 3rd day I was getting around almost like I'd never had surgery. Very surprising (pleasantly) to me. Went out for a drink with a buddy towards end of first week home - not recommended, but felt great to get out and do something "normal". During week 2 was going to cardio rehab 3 times a week and feeling great. Took a 40 min. walk one night around a couple parks in the neighborhood (you're supposed to walk on your "off days" when not in cardio). Other walks were shorter - but felt great to do a long walk like that - felt like I was almost back to normal. Then... Went out with friends last Fri, Sat. and Sun. nights... Probably not smart... But again, I was anxious to get back to normal and get out of the house. And I did - felt like a normal guy again.
Well, then, BAM! Sun. night, after walking home from a close-by bar (for my "off-day" walk) it was hot and humid. It was only a 20 min. walk, but I was pretty sweaty by time I got home. By late that night, I was having some "more than normal" irregular beats. And it was doing some pretty freaky stuff (fluttering fast, then slowing way down, then skipping, then repeating). I went to the ER that night at 2:30 am cause I couldn't sleep and was getting pretty anxious about it. Super long story only somewhat long - I ended up going into A-fib while in the hospital, which is apparently pretty common after this surgery (something like 30% - 50% of folks). I'm still having irregular beats, after visiting the ER twice, staying overnight twice and getting released twice. It seems to be triggered when I recline or lay down. Which is making it very difficult to sleep. In my case, they start as irregular beats (skipped beats, extra beats), then turn into what feels like constantly missing every other beat, which I guess is really just a very slowwwww heart rate (down to like 40-50 beats per min instead of my normal 75). Went into my primary physician today, who was on vacation. While I love the guy to death - this substitute I had today was even more spectacular than him (don't tell him I said that - we go way back!). She explained everything so well, and calmed all my fears (which to be fair, he would have done too - I think she's just better looking than him which is why I liked her so much). Put me on a low dose of anxiety meds for the day, and told me to take my valium at night (which I haven't been doing) because she's also (like the others I've seen recently) convinced that while it's very real, and is pretty common side effect from this surgery, it's being escalated by anxiety.
This part's for Ross and others that have been concerned about my recommended lower-than-normal and tighter than normal INR range of 1.8-2.2 (although I'm sure Ross stopped reading this long-ass post a few paragraphs ago, lol). Went in for my INR check today, and it's up to 2.7 (as expected, higher than the 2.1-2.5 I'd been at due to the Amiodarone which I'm now on to help with the irregular beats and prevent afib again). So, they're reducing my Coumadin dose again today (down to 3 mg from 4) because they don't want it to go much higher than 2.7. Going back in again tomorrow to see where it's at, because it's getting higher than they like. Here was the reasoning of the doc I talked to today - which seemed to know her stuff very well. They like to start you off on a tight INR range to reduce likelihood of bleeding issues as you heal, while of course keeping you anit-coag'd enough to prevent clots. Which tells me they may increase my range later on (who knows, but maybe 1.8-2.8). Will get more info on this from my surgeon on 6/6 - as I remember, the lower than normal low-end of the range has to do with the particular valve I got (newer model that tolerates lower INRs).
Alright, that's enough for today - sorry for the loooooonggggg post, but am documenting this not only to potentially help others with what to expect, but also for myself (so I can remember the details later of what I went through - and can tell my grandkids about it someday, lol). See below for pics 36 hrs after surgery (with the pillow), the scar 1 week after surgery (with bandaid on chest tube hole) and the scar today (3 weeks and 2 days after surgery). Very pleasantly surprised with how it's healing - I don't know if you can tell but the "scab" which I think is more glue than scab is gone now except for the top 3 inches or so. I'm hoping that extra belly button I've got (from the chest tube) will flatten out a little - not be so much of a divot. Maybe when I lose some weight... Which reminds me - stop laughing at my love handles and man boobs - haven't been able to work out since a couple months before surgery. Ok, fine, neither were much better when I was working out, but hey, we work with what we've got - and you learn to be a lot less self concious about your body when going through this. I included all the gory details (including love handles and man boobs) so you can see the size and placement of the scar and chest tube hole (I found it comforting before surgery to see others scars and find out that they're not that bad).
- Andy
PS - crap it won't let me attach more than one pic so you'll have to see previous posts for the 36 hour post op pic w/ the heart pillow and the 1 week scar pic. So below is only the 3-week scar pic...
. 
