DRIVETOPLESS/ Tracy UPDATE

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Thursday, January 20, 2011 5:03 PM, EST
AVR Surgery and Hospital- What I Remember:
Note: This post might be a little gruesome for some, so if you squeamish, stop reading now.

It's hard to believe that this time last week I was getting extubated. I'm getting lots of questions about what it was like and what I remember, I thought I would summarize my memories of the surgery and the hospital stay here. Some of it is what I was told happened rather than what I remember.

Surgery (Thursday):
The surgery was scheduled to start around 7am, but it didn't really start until about 9am. Surgery lasted about 4 hours, including time in recovery before moving to CCU. I remember being wheeled into the operating room and checking out the neat "toys "and the huge team of people bustling around. I remember saying "good morning" and scooting over to the operating table. After that I don't remember anything until I woke up in CCU later that afternoon. I recall looking at the clock in my CCU room at 2pm and feeling VERY UNCOMFORTABLE from the breathing tube and the stomach tube. . . . fade to black (thank God for morphine). . .I remember looking at my Brother Chris and asking for my picture to taken by making the motion of clicking a camera, since I couldn't talk. Was denied by the hospital staff because I didnt sign a prior release. Pictures later where no problem. I guess they don't want the gruesome stuff getting out there. . . ..fade to black . . Clock says 4 or 5 pm. Couldn't believe it was that late and I still had that tube down my throat. I thought they took the tube out right after surgery, but I guess they keep it in for a few hours in case they have to wheel you back in to surgery or if you have trouble breathing. I remember them telling me not to fight the tubes, but I was having a really hard time not gagging. I remember being un-characteristically ANGRY that I could not get them to understand that I still felt like I was choking and couldn't get enough air. I remember frowning at the nurses and pointing at my neck and am told by family I was throwing daggers with my eyes. (Tee hee). Shortly after that they told me to cough on 3 and they pulled out the tubes. Sweet heavenly, relief! After that I got a few ice chips. I have NEVER tasted anything so good as ice chips and ice water the rest of that night.

Later that evening, I sat on the edge of the bed a few minutes.
I had 2 tubes in my neck, a chest tube for drainage coming out of my right breast, a folley catheter, and 2 IVs in my left hand. There were two pace wires implanted (1 was a ground wire) that would be used if I needed a pace maker. My left hand was totally numb and would remain that way for 3 more days. My hands and ankles were swollen from fluid retention.

When they do this surgery, they collapse your right lung to give more working room around the heart. They also have you on a heart/lung bypass machine. Part of recovery is rebuilding that lung capacity that is lost as a result. It is also very common to retain a lot of fluid since this is the body's natural response to trauma. Excess fluid also make breathing difficult. I gained about 15 lbs in fluid that's taken more than a week to get rid of.

Sleeping that first night was near impossible because it was difficult to breathe and I was battling nausea. The shortness of breath triggered panicky feelings which created more shortness of breath. You need to be able to "Zen" out to calm yourself during those phases. I struggled with the Zen part.

Day 1 Post Op (Friday) - I was doing well, other than nausea and thirst and being on limited fluids because of fluid retention. I sat in my recliner all morning. Family thought I looked really good--not like a heart patient at all. I felt VERY mentally alert and present-no pump head for me! That afternoon, I got 1 neck tube, the chest tube, 1 iv from the left hand pulled. There was no pain with any of the removals and after the chest tube was out, it was easier to move/breather. I got to see my scar for the first time. I teared up in happiness when I saw how small it was--about 2 3/4". Dr. Wolfe had never promised an incision smaller than 3 or 4 " for the ministernotomy, but he really hooked me up. I had given him examples of scars size and placement I would like if possible. That scar size and placement sort of looks like cleavage enhancement to me! Thank you, Dr. Wolfe.

It was time to move from CCU to my regular room, which was on the same floor as the CCU. I took my first walk which was a LONG one down the hall from CCU to my regular room. I felt warm and like I was floating outside my body--very surreal--was probably all the meds. I took 2 more walks that day and got lots more respiratory treatments which really helped a lot. Slept much better that night. My Mom sat with me overnight and really helped me over the bumps.

Day 2 post op (Saturday) = Removed the insulin drip as my blood sugar was stable. It is common to get temporary diabetes from major surgery--I did not. Got the neck introducer a freakishly long tube that was sutured into in my jugular vein. I was so impressed, I had Marty take a picture of it. (posted later) Still retaining about 15-20 lbs of fluid so Lasix (sp?) was given. Slept even better, so I feel comfortable about being able to breathe at night at home. Marty stays the night in the recliner.

Day 3 Post Op (Sunday) - Trouble with Nausea again, but finally started to get better. First thing Sunday morning I get wheeled downstairs for a chest x-ray, an important step in the check out process. I got my first shower post surgery and it felt like heaven. By this day I am using a spirometer every 2 hours and am walking 3 or 4 times a day. I took the longest walk today. The only IV I have left is in my hand and it just there for injections if needed. I still have the pace wires that will come out on Monday, since they must be removed by surgical staff rather than a nurse. Marty stays the night with me again, but I give him the bed as I can't breather when I lay down to sleep anyway.

Day 4 Post OP(Monday) - Nicole, Dr. Wolfes Nurse Practitioner comes to remove the pace wires -- No pain at all. Marty gets me packed up. I get to shower again all by myself. Chris comes over to assist getting me home and settled. By 2pm, we are leaving the hospital! Later that night I proceed to do too much with my arms in the Euphoria of being home. Ouch!

I got a 21mm On-X aortic valve through a 2 3/4" inch mini-sternotomy incision. I can hear it ticking sometimes in my right ear. It does sound like the tick of a wrist watch when you hold it up to your ear. It is very regular and strong and comforting. It is not keeping me up at night. It is common to hear the tick of a mechanical valve. Right now my heart has not yet adjusted to having an unrestricted valve opening, so it is pumping harder than it has to, perhaps making the ticking louder. I'm just glad that valve is doing it's job.
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From Andrea,

Saturday, January 29, 2011 1:09 PM, EST
As Marty posted earlier today Tracy was admitted to Gwinnett Medical last night. She is doing well and sent this picture outlining her current status & treatment...."smiley face" & "bunch of drugs". Not sure if that is an official hospital lingo, but how can you argue with a smiley face and lots of drugs. :) Please keep sending good mojo and prayers Tracy's way. I am on my way to see her now and will keep everyone updated.
~Andrea
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From Marty,

Saturday, January 29, 2011 11:01 AM, ESTA minor set back :(
Tracy started having heart palpipations Friday evening and went to the ER with help from her good friends Denise & George. It was determinded that her heart was in A-fib and consequently admitted to Gwinnette Medical Center in Lawrenceville for observation. This is not uncommon after heart surgery. Drugs will hopefully do the trick. On the bright side, the room and view are very nice
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I'm sorry to hear about this bump in the road, but those "buncha drugs" can be quite useful. I just loathe arrhythmias! Hang in there, Tracy!
 
Sunday, January 30, 2011 10:57 AM, EST
Still in the Hospital

Progress is being made and the drugs are helping but slower than expected. Tracy’s heartrate is down around 100 but irregular. She was able to sleep last night after being awake for 38 hours. Ouch. She describes the irregular heartbeat as “it feels like you’ve had too much Starbucks”. She’ll be in the hospital for a few more days. Thanks for your support & kind wishes. Mom & Dad are in route
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Hang in there Tracy, hope everything is Zenning itself out. I am trying to find my Zen in Prep for my ohs.
Jeff
 
Today's update

Wednesday, February 2, 2011 3:29 PM, EST
Hospital update - Still here L

Tracy is still in the hospital going on her 5th day. Slight signs of improvement in her heart rhythm noted yesterday. Hopefully, things are starting to get better. She still has arrhythmia and other symptoms. Not well enough to go home yet. Mom & Dad are still here keeping the nurses in line. She got to see her new valve today by ultrasound – works great except for the rhythm. Thanks for all the prayers and good wishes – they're working!
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Today's upfate

Today's upfate

Friday, February 4, 2011 7:34 AM, EST​

Counting My Blessings-Hospital Day 7 with A-fib

When Denise and George brought me to the ER last Friday night, I never imagined I would still be in the hospital a week later! I thought I would get some pills and go home. I was only in the hospital 5 days for the surgery, after all. Yesterday was 3 weeks post op. Oh, well. Man plans. God laughs.

What's happening is my heart is in near constant a-fib and/or tachycardia with PVC's as a result of the trauma from the valve replacement. About 1/3 of patients get this post valve replacment. The surgery can set up a lot of inflammation that affects the hearts ability to pump properly/efficiently. Drugs or shock therapy(cardioversion) are typically used to reset the heart's rythym. My doctors are trying drugs.

When I got here Friday night, my heart was racing up up to 218 beats/minute with me just sitting there. Anyway my heart is responding VERY slowly to the various drugs that have been tried. On top of all that I have a low grade fever and a lot of chest congestion and a lot of nausea from the meds. The goal is for my heart to maintain 80-90 bpm at rest before I can go home. I am currently about 100-120 bpm at rest/ If I get up and just move around a little it races up to 150 bpm.

Anyway, I admit after so many days in the hospital with no doctors suggesting I could go home any time soon and feeling pretty crummy with no relief in sight, I've had moments of fear and feeling pretty pitiful. I'm happy to report right now I'm feeling much more optimistic after a good night's sleep. I feel good right now in this moment (or until they give me the next megacocktail of meds), so I want to count some blesssings, on the suggestion of Ross.

Here's a few of my many blessings:
1. I'm still here.
2. My parents are still willing and able to take care of me just like when I was a little girl. They were so selfless and patient and nuturing this week. Going through this has allowed me to see how blessed I am. Without this bump in the road I might have missed it.
3. Marty, who is only a phone call away and will be here soon.
4. Breathing Treatments- They really work
5. Visits and calls from friends -how often do you take the time to be together with NOTHING to do but talk.
6. When I'm feeling a sorry for myself, God sends an angel. Yesterday it was AnnMarie, my nurse. This morning it was beautiful technician Leton from Liberia, mother of 3 who lost her husband to a drunk driver last year. My problems are nothing.
7. Bekka-when folks ask me about children, I have a beautiful daugher to talk about.
8. Family- My brother and his wonderful family are just 50ish miles away if I need them.
9. Local friends who have given selflessly of their time so I am not alone. I might run with scissors, you know.
10. Learning that having to wait is not the worst thing that could happen.
11. The scar is looking pretty good! The pic is the 3 week cleavage shot.

Love you guys!
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Boy, I know how you feel. I thought I was NEVER going home after my first surgery. 1 week in prior, 3 days home, 2+ weeks afterwards. PRISON!

Hang in there, girl.
 
Sunday, February 6, 2011 5:40 PM, EST

Day 10 in Hospital-Superbowl Sunday- Signs of Normal Sinus Rythym-FINALLY

To the left are 3 of my EKGs: BELOW

Middle: Jan 30 HR 97 PVC's 4
Top: Jan 31. HR 124 PVC's 17, Tachy
Bottom: Feb 6 HR 82 PVC's 0--Note the even spacing and the appearance of a good "p wave" compared to the other 2

My meds have been changed every day since I got here in an effort to find the magic combo that will put my a-fibbing heart back into normal sinus rythym.

Today's meds involved a mixtures of 200 mgs of Lopressor (beta-blocker), 800 mgs of Multag (anti-afib), and Cardizem (slow release tab 125mg calcium channel blocker/anti-afib).

Shortly after taking the new Cardizem tablet this afternoon, my heart had a few seconds of NORMAL sinus rhythym as shown here! I feel like I just got an "A+" on a test. That is a very positive sign after so many days of trying to get this elusive type of heart beat to appear in my little pea-picking chest. My heart appears to be on the verge of "converting" to normal sinus rhythym. Keep your fingers crossed. I am SOOOOOOO ready to go home.

I've had some time to learn about reading EKG's. The folks in the monitoring room have given me lessons, too. Here's a cool website I found that does a really good job of explaining EKG's and how they measure/indicate heart function. Scroll backwards to see the first 2 pages.

http://www.amperordirect.com/pc/help-ecg-monitor/z-interpreting-ecg-3.html


On another positive note, other than feeling like inmate number 561 with an ekg monitor as my tracking device, I feel good and want to go home.

Somebody have some pizza and beer for me tonight while you watch the game. I'll be having ice chips and bananas.

Did I mention I'm ready to go home?
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Ever the sense of humour, Tracy attached the cartoon to her update
Monday, February 7th, 2011 10:11 AM


Day 11- Leaving the Hospital and Headed Home

I am FINALLY going home. My heart is in normal sinus rhythym about 80% of the time now! I did a lap around the 5th floor and was able to keep my heart under 100 bpm as well.

I will get a Holter monitor to wear at home so the cardiologist can monitor my heart remotely as I return to more normal activity levels. Hopefully, the meds will continue to help my heart return to normal. There is a possibility I will need an ablation done later to permanently correct the electrical issues with my heart beat.

http://www.webmd.com/heart-disease/treating-arrhythmias-ablation

Now you are updated!
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Wishing you the best Tracy. I was also one of the lucky ones who landed back in the hospital in A-Fib! I was converted the next day and shipped out home the very next day. I wonder why they didn't just convert you? It's been almost 18 months and so far no more A-Fib! Hope it also goes that well for you! Hang in there!

Mileena
 
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