Hi all,
I'm going to test the forum post length limits here...
I had mitral valve repair surgery via port access (minimally invasive incision) on Friday August 7, 2015, at Kaiser Hospital in Santa Clara, CA, by surgeon Dr. Robert Gordon. I am a 53-year-old woman who was previously very fit: I worked out in the gym 3-4 times a week doing weight training and cardio, and I play clarinet and tuba.
Getting out of the waiting room: There is a long version of the story, but the short version is that I started feeling symptoms in early June, mostly a rapid heartbeat. Then I developed a gurgling in the chest which I thought was a touch of bronchitis, but the accompanying shortness of breath occurred only at night and I didn't have a cough. The gurgling turned out to be pulmonary edema and I was on the fast track to surgery. The good thing about that situation is that I didn't have to second-guess timing, surgeon, hospital, or anything.
As for the whole process, I want to say that nothing was as bad as I had feared. That's my big message to all of you who are still waiting. I used to be a needle phobe and got over that through becoming a blood donor, but I'm still a big chicken about medical procedures and pain. Yet nothing was awful at all.
Surgery
----------
First I had an angiogram. They were able to use my wrist instead of my groin, even though I'm average-sized with small bones. The pre-procedure sedation (Versed and fentanyl) worked very well and I only remember the beginning of the procedure. I was out before I could feel anything or see any pretty pictures.
The angiogram showed clear arteries, so I was able to have what they called a "port access" procedure, which is a minimally invasive incision on the right side. I have a 4.5-inch (11 cm) scar under my right breast and that's all, aside from the chest tube/drain holes and the groin incision for the bypass.
My surgery started at 4:00 p.m. the next day (Friday) and finished at 8:00 p.m. I may have woken for a moment then, but really woke at 9:00 p.m. Again, the pre-procedure sedation worked beautifully and I was asleep shortly after being wheeled into the operating room. The next thing I knew was waking up in the cardiac ICU.
When I woke up, I think I was pretty well oriented. I could feel the breathing tube but not the other tubes and lines. Thanks to the forum, I knew not to fight the breathing tube. I was able to identify, mostly by the sound of the ventilator, when a breath was coming in, and I could then help by timing a breath of my own to go with it. One thing that helped me tremendously was hearing a nurse say that I was doing a good job of keeping myself calm. That made me realize that I had some control over the situation.
I was able to scribble notes to my boyfriend and sister, though the notes were pretty hard to read. (I blame the difficulty of writing on a pad held in midair with no backing.) There was a TV playing a baseball game in the background, and I apparently asked "who team?", wanting to know what teams were playing. (It turned out to be the SF Giants against the Chicago Cubs.)
The breathing tube was taken out at 11:00 p.m., two hours after I woke up, and the removal was pretty easy. The nurse or whoever was doing it knew just how to talk me through it. "Cough cough cough" and it was done. My throat wasn't even sore afterwards.
Post-surgery
-----------------
On Saturday afternoon I was moved to a regular hospital room where I stayed until I was discharged the following Tuesday. I walked laps around the unit from the first day and got stronger every day. The catheter came out on Sunday and the chest tube and drain on Monday. There was definitely pain but nothing agonizing, and they were very good about giving me pain medications.
I was surprised to find that the catheter didn't hurt at all, and it was very handy not to have to get up to use the bathroom, especially while on IV Lasix! The chest tube didn't hurt at first but started bothering me after a couple of days, so I was glad to get it out. All the removals (catheter, central line, and chest tube) were as easy as the breathing tube removal. The chest tube looked giant but felt relatively small and short coming out, and I can't even say it hurt. For the central line, the nurse told me to inhale, exhale, and then hum, and while I was humming the line just came out easily.
I'm grateful to the forum for, among other things, letting me know about the blood sugar tests and insulin shots that were in store for me. I had never heard about this before I joined the forum, and what would have been a somewhat unpleasant surprise became a matter of course.
What did surprise me was the heparin injections, which were twice daily in my stomach. I hadn't expected the heparin and it hurt somewhat more than the IV sticks and definitely more than the insulin, which I almost couldn't feel. It was still very manageable, though. Other surprises were the facts that I have to be on Coumadin for three months and that I have to follow a low-sodium diet. I don't know whether that part is temporary or not, but I'm hoping for the best.
It was hard for me to eat when I was in the hospital because I had no appetite. Dry foods and foods that required a lot of chewing were no fun at all. It helped when I figured out that I should order foods like yogurt and Cream of Wheat instead of French toast and turkey sausage.
What I took to the hospital that was most useful:
- lip balm!
- a tablet for email and entertainment
- underpants (for after the catheter was out -- made me feel more human in my hospital gown)
Going home
----------------
When I got home, I felt quite good and overdid by a lot. I walked too much and got up and down to get things too much. After a couple of days I realized what my real strength and endurance were, which weren't much. I had to overcome the gym paradigm of always trying to work harder every day, and remind myself that my body is healing from the inside as well as the outside and that the healing takes enormous amounts of energy. I lost weight for the first few days at home though I thought I was eating well. The home health nurse said to increase my protein and eat more snacks, which I'm doing.
I've been able to sleep lying flat, either on my left side or on my back, since before I left the hospital. I haven't needed a recliner, though I'm enjoying sitting in a big armchair with my feet up on an ottoman.
My chest tube and drain holes were draining quite a bit the first day or so that I was home, but that got better quickly. For the first couple of nights I used old sheets and an old nightshirt in case of leakage. Since then the gauze has been sufficient.
There has been some postsurgical pain but it's very manageable. I've been alternating between oxycodone and Tylenol. Interestingly, I only feel pain around the incision, not anywhere near my heart.
I got a shower stool and that is proving to be very helpful. Showering standing up would still take more energy than I have right now.
Female stuff: I bought a loose front-close bra to wear home but find even that to be painful due to the location of my incision and of the chest tube/drain holes. And I thought I would be spared getting my period, but it arrived early while I was in the hospital, on day 16 of my cycle. I feared it was the Coumadin or heparin, but all the doctors including my gynecologist said no, it was just stress hormones causing this. Fortunately the cardiac telemetry unit nurses have seen it all and were positively blase about handing me a stack of maxipads. As my mother used to say, "When illness comes in the door, modesty goes out the window." Fortunately dignity remains.
I saw the thread about optical migraines. I have gotten those every few months for over twenty years, and I had one on the day after surgery and have had a couple more since then. They don't concern me since I have so much experience with them.
Wrapup
----------
The care I received was outstanding. I had been happy with Kaiser for routine stuff but had never put them to the test before. Without exception, the nurses, aides, techs, doctors, and everyone else I came in contact with were positive, competent, and kind.
If you're still with me after this epic post, thanks for reading, thanks for your support, and feel free to ask me more questions if there could possibly be anything I didn't mention already
.
Thanks,
Claudia Z.
I'm going to test the forum post length limits here...
I had mitral valve repair surgery via port access (minimally invasive incision) on Friday August 7, 2015, at Kaiser Hospital in Santa Clara, CA, by surgeon Dr. Robert Gordon. I am a 53-year-old woman who was previously very fit: I worked out in the gym 3-4 times a week doing weight training and cardio, and I play clarinet and tuba.
Getting out of the waiting room: There is a long version of the story, but the short version is that I started feeling symptoms in early June, mostly a rapid heartbeat. Then I developed a gurgling in the chest which I thought was a touch of bronchitis, but the accompanying shortness of breath occurred only at night and I didn't have a cough. The gurgling turned out to be pulmonary edema and I was on the fast track to surgery. The good thing about that situation is that I didn't have to second-guess timing, surgeon, hospital, or anything.
As for the whole process, I want to say that nothing was as bad as I had feared. That's my big message to all of you who are still waiting. I used to be a needle phobe and got over that through becoming a blood donor, but I'm still a big chicken about medical procedures and pain. Yet nothing was awful at all.
Surgery
----------
First I had an angiogram. They were able to use my wrist instead of my groin, even though I'm average-sized with small bones. The pre-procedure sedation (Versed and fentanyl) worked very well and I only remember the beginning of the procedure. I was out before I could feel anything or see any pretty pictures.
The angiogram showed clear arteries, so I was able to have what they called a "port access" procedure, which is a minimally invasive incision on the right side. I have a 4.5-inch (11 cm) scar under my right breast and that's all, aside from the chest tube/drain holes and the groin incision for the bypass.
My surgery started at 4:00 p.m. the next day (Friday) and finished at 8:00 p.m. I may have woken for a moment then, but really woke at 9:00 p.m. Again, the pre-procedure sedation worked beautifully and I was asleep shortly after being wheeled into the operating room. The next thing I knew was waking up in the cardiac ICU.
When I woke up, I think I was pretty well oriented. I could feel the breathing tube but not the other tubes and lines. Thanks to the forum, I knew not to fight the breathing tube. I was able to identify, mostly by the sound of the ventilator, when a breath was coming in, and I could then help by timing a breath of my own to go with it. One thing that helped me tremendously was hearing a nurse say that I was doing a good job of keeping myself calm. That made me realize that I had some control over the situation.
I was able to scribble notes to my boyfriend and sister, though the notes were pretty hard to read. (I blame the difficulty of writing on a pad held in midair with no backing.) There was a TV playing a baseball game in the background, and I apparently asked "who team?", wanting to know what teams were playing. (It turned out to be the SF Giants against the Chicago Cubs.)
The breathing tube was taken out at 11:00 p.m., two hours after I woke up, and the removal was pretty easy. The nurse or whoever was doing it knew just how to talk me through it. "Cough cough cough" and it was done. My throat wasn't even sore afterwards.
Post-surgery
-----------------
On Saturday afternoon I was moved to a regular hospital room where I stayed until I was discharged the following Tuesday. I walked laps around the unit from the first day and got stronger every day. The catheter came out on Sunday and the chest tube and drain on Monday. There was definitely pain but nothing agonizing, and they were very good about giving me pain medications.
I was surprised to find that the catheter didn't hurt at all, and it was very handy not to have to get up to use the bathroom, especially while on IV Lasix! The chest tube didn't hurt at first but started bothering me after a couple of days, so I was glad to get it out. All the removals (catheter, central line, and chest tube) were as easy as the breathing tube removal. The chest tube looked giant but felt relatively small and short coming out, and I can't even say it hurt. For the central line, the nurse told me to inhale, exhale, and then hum, and while I was humming the line just came out easily.
I'm grateful to the forum for, among other things, letting me know about the blood sugar tests and insulin shots that were in store for me. I had never heard about this before I joined the forum, and what would have been a somewhat unpleasant surprise became a matter of course.
What did surprise me was the heparin injections, which were twice daily in my stomach. I hadn't expected the heparin and it hurt somewhat more than the IV sticks and definitely more than the insulin, which I almost couldn't feel. It was still very manageable, though. Other surprises were the facts that I have to be on Coumadin for three months and that I have to follow a low-sodium diet. I don't know whether that part is temporary or not, but I'm hoping for the best.
It was hard for me to eat when I was in the hospital because I had no appetite. Dry foods and foods that required a lot of chewing were no fun at all. It helped when I figured out that I should order foods like yogurt and Cream of Wheat instead of French toast and turkey sausage.
What I took to the hospital that was most useful:
- lip balm!
- a tablet for email and entertainment
- underpants (for after the catheter was out -- made me feel more human in my hospital gown)
Going home
----------------
When I got home, I felt quite good and overdid by a lot. I walked too much and got up and down to get things too much. After a couple of days I realized what my real strength and endurance were, which weren't much. I had to overcome the gym paradigm of always trying to work harder every day, and remind myself that my body is healing from the inside as well as the outside and that the healing takes enormous amounts of energy. I lost weight for the first few days at home though I thought I was eating well. The home health nurse said to increase my protein and eat more snacks, which I'm doing.
I've been able to sleep lying flat, either on my left side or on my back, since before I left the hospital. I haven't needed a recliner, though I'm enjoying sitting in a big armchair with my feet up on an ottoman.
My chest tube and drain holes were draining quite a bit the first day or so that I was home, but that got better quickly. For the first couple of nights I used old sheets and an old nightshirt in case of leakage. Since then the gauze has been sufficient.
There has been some postsurgical pain but it's very manageable. I've been alternating between oxycodone and Tylenol. Interestingly, I only feel pain around the incision, not anywhere near my heart.
I got a shower stool and that is proving to be very helpful. Showering standing up would still take more energy than I have right now.
Female stuff: I bought a loose front-close bra to wear home but find even that to be painful due to the location of my incision and of the chest tube/drain holes. And I thought I would be spared getting my period, but it arrived early while I was in the hospital, on day 16 of my cycle. I feared it was the Coumadin or heparin, but all the doctors including my gynecologist said no, it was just stress hormones causing this. Fortunately the cardiac telemetry unit nurses have seen it all and were positively blase about handing me a stack of maxipads. As my mother used to say, "When illness comes in the door, modesty goes out the window." Fortunately dignity remains.
I saw the thread about optical migraines. I have gotten those every few months for over twenty years, and I had one on the day after surgery and have had a couple more since then. They don't concern me since I have so much experience with them.
Wrapup
----------
The care I received was outstanding. I had been happy with Kaiser for routine stuff but had never put them to the test before. Without exception, the nurses, aides, techs, doctors, and everyone else I came in contact with were positive, competent, and kind.
If you're still with me after this epic post, thanks for reading, thanks for your support, and feel free to ask me more questions if there could possibly be anything I didn't mention already
.Thanks,
Claudia Z.
