Every morning I check the incision and chest tube sites. The chest tube sites look great - dry, tight, scabby and a good color (ie, not red). The incision is 95% healed, except for a 3/4" section at the bottom of the incision that has been a little slower to heal - it's been a little moist and scabby, whereas the rest of the incision is pretty much a residual scar by now. I've been treating this area daily with peroxide and/or iodine (depending on which bottle is closer) and occasionally covering with gauze, more to protect my clothes than the wound.
Seriously, if you're squeamish, stop reading here.
This morning (or overnight), the scab came loose prematurely and was quite wet. Attached to it, as I discovered when attempting to cleanly clip off the loose dead scab tissue, was a floppy protruding section of subcutaneous suture about 1.5 inches long. It's plastic thread, similar in texture to the gimmick that keeps your Thanksgiving turkey trussed until you get it from the store to your kitchen counter. So I clipped that too.
Now I'm left with a little bit of an opening in the skin where there shouldn't be one. Fortunately over the past 3 weeks the skin layers had healed themselves a good deal and the opening wasn't too bad (ie, I don't think it needs stitches). So, plenty of peroxide on the opening, and a new covering. It's not too red and not too painful, so I don't think it's infected, and I intend to keep it that way. I'll check it regularly and call my doc if it gets worse. Of course, it now being the weekend, if I truly need it stitched it means a non-emergency ER trip.
(Post-entry update: it looks great the next morning, reclosed on its own, clearly no need for stitches or anything interesting.)
Take care,
Michael
Friday, January 29, 2010
Wednesday, January 27, 2010
Trying not to be a bump on a log
Every day is an effort to keep moving, because walking is about the best thing for me right now (and I start cardiac rehab as soon as I can get it scheduled). Plus, I'm bored at home. So we've been out and about, which means I haven't been on the computer much at all. And this blog suffers for it, alas.
So to beat cabin fever, we took a spontaneous trip today to Dublin. Shamrocks, Guinness and the Blarney Stone!
Sadly, no. Dublin, Pennsylvania, home of the nearest state driver's license photo center. For the next 4 years I can excuse my driver's license photo by explaining it was taken not 3 weeks after heart surgery.
It being cold and sometimes rainy here in January, we've been doing most of the walking in malls like this one, this one, and this one, as well as grocery stores/BJ's/Target - anything with lots of aisles, things to look at, and carts to lean on like walkers if needed (which I really haven't). Bonus points if the shopping center has a Barnes & Noble or Borders to take a break at (and so Jenn doesn't come home empty-handed).
The good news is, in all my walking, I haven't hit the wall yet - in fact, Jenn said today she was struggling to keep up. I haven't hit the gym for a "workout" yet, so I'm not ready to definitively term the surgery a success, but I'm very optimistic. I'd like the pain to subside a little more. I'm still taking a whole lot of Advil and Tylenol. My internist, Dr. Schwartz, and my HCM specialist at Brigham and Women's, Dr. Ho, both tell me to quit being a hero and take the Percocet. But that makes me loopy (not to mention "irregular"), and I dislike cognitive impairment just a little more than I dislike pain. Besides, I need something to complain about, else Jenn thinks she gets off easy.
Speaking of Dr. Ho, she gets major props from me here. She had just returned from maternity leave, saw my operative report in her inbox that must have been 2 feet high with papers, and called me personally on my cell phone to check on me and see if there was anything she could do. Wonderful, terrifically attentive (and expert) doctor.
Finally, for those of you in the Philadelphia area, here's a plug for my fellowship's annual choir concert. It's this Sunday, Jan. 31, 2:00 p.m. at the fellowship on Street Road in Warrington. I obviously won't be singing this year, but I'll be there and it should be wonderful. I have 2 tickets free to anyone interested, just contact me. And thanks to Dad for generously donating the printing for the programs.
Take care,
Michael
So to beat cabin fever, we took a spontaneous trip today to Dublin. Shamrocks, Guinness and the Blarney Stone!
Sadly, no. Dublin, Pennsylvania, home of the nearest state driver's license photo center. For the next 4 years I can excuse my driver's license photo by explaining it was taken not 3 weeks after heart surgery.
It being cold and sometimes rainy here in January, we've been doing most of the walking in malls like this one, this one, and this one, as well as grocery stores/BJ's/Target - anything with lots of aisles, things to look at, and carts to lean on like walkers if needed (which I really haven't). Bonus points if the shopping center has a Barnes & Noble or Borders to take a break at (and so Jenn doesn't come home empty-handed).
The good news is, in all my walking, I haven't hit the wall yet - in fact, Jenn said today she was struggling to keep up. I haven't hit the gym for a "workout" yet, so I'm not ready to definitively term the surgery a success, but I'm very optimistic. I'd like the pain to subside a little more. I'm still taking a whole lot of Advil and Tylenol. My internist, Dr. Schwartz, and my HCM specialist at Brigham and Women's, Dr. Ho, both tell me to quit being a hero and take the Percocet. But that makes me loopy (not to mention "irregular"), and I dislike cognitive impairment just a little more than I dislike pain. Besides, I need something to complain about, else Jenn thinks she gets off easy.
Speaking of Dr. Ho, she gets major props from me here. She had just returned from maternity leave, saw my operative report in her inbox that must have been 2 feet high with papers, and called me personally on my cell phone to check on me and see if there was anything she could do. Wonderful, terrifically attentive (and expert) doctor.
Finally, for those of you in the Philadelphia area, here's a plug for my fellowship's annual choir concert. It's this Sunday, Jan. 31, 2:00 p.m. at the fellowship on Street Road in Warrington. I obviously won't be singing this year, but I'll be there and it should be wonderful. I have 2 tickets free to anyone interested, just contact me. And thanks to Dad for generously donating the printing for the programs.
Take care,
Michael
Wednesday, January 20, 2010
David and his new ICD, walking, and caffeine
My message board buddy David had his myectomy at CC with Dr. Smedira last Thursday. The procedure itself went fine, but his recovery has been considerably more rocky than mine. He's still in the hospital, having had an implantable cardioverter/defibrillator (ICD) placed today after some rhythm disturbances, including atrial fibrillation and possibly ventricular tachycardia (very serious). Please keep him in your thoughts. Fortunately, as we know, he's in the best place in the world if he's going to have post-op cardiac complications that need to be monitored and managed. Plus his positive attitude and sense of humor are fully intact.
As an aside, part of the evaluation of HCM at diagnosis is an assessment of the risk factors for sudden death and subsequent recommendation for/against ICD placement. An ICD is basically a battery installed surgically under the chest skin, with wires running into the heart, that activates a defibrillating shock when it detects a potentially lethal heart rhythm. It can be life-saving, but it's not benign. For example, an ICD can misfire, which is painful; the leads (wires) can break or permanently embed themselves into the blood vessels; and it needs to be "interrogated" regularly for evidence of abnormal rhythms and use. The risk factors for sudden death in HCM are prior cardiac arrest or sustained v-tach; family history of sudden cardiac death; syncope (fainting); extreme thickening of the septum (>30 mm); and a decreased BP response to exercise. Of these, I have only one, decreased BP on exercise. Therefore, although every HCM expert I've ever consulted has initiated an informed discussion of ICDs, it has never been definitively recommended to me, and neither I nor my doctors believe it's warranted. For obvious reasons, this is a highly controversial and delicate subject clinically, and there are no right answers (at least in my case).
I've been doing some walking every day, and it's obvious that I will be able to tolerate exercise much better. We went shopping in King of Prussia this afternoon, and wandered all around at a reasonable clip (read: I'm no longer being passed by 65-year-olds), with no fatigue or shortness of breath whatsoever. I've been looking for a similar coffeemaker to the one Jay recommended in an earlier comment, but it isn't stocked in Kitchen Kapers, Crate and Barrel, Bon-Ton, Williams-Sonoma, or anywhere else we checked. (Told you we'd been walking - thank you, Jay, for sending me on a wild goose chase and getting me off the couch). So I ordered it online. Caffeination is imminent. Meantime, the baristas at Starbucks now recognize our Toyota at the top of the drive-through lane.
My first follow-up internist appointment is Friday. I have a laundry list of things to ask him - pain and sleep meds at the top of the list - but all in all, I think everything is progressing incredibly fast and well. Thanks to everyone for all of their support. I've been reading the comments every post-op day since I could log on, and I believe that they are instrumental in helping me recover as fast as I am.
Take care,
Michael
As an aside, part of the evaluation of HCM at diagnosis is an assessment of the risk factors for sudden death and subsequent recommendation for/against ICD placement. An ICD is basically a battery installed surgically under the chest skin, with wires running into the heart, that activates a defibrillating shock when it detects a potentially lethal heart rhythm. It can be life-saving, but it's not benign. For example, an ICD can misfire, which is painful; the leads (wires) can break or permanently embed themselves into the blood vessels; and it needs to be "interrogated" regularly for evidence of abnormal rhythms and use. The risk factors for sudden death in HCM are prior cardiac arrest or sustained v-tach; family history of sudden cardiac death; syncope (fainting); extreme thickening of the septum (>30 mm); and a decreased BP response to exercise. Of these, I have only one, decreased BP on exercise. Therefore, although every HCM expert I've ever consulted has initiated an informed discussion of ICDs, it has never been definitively recommended to me, and neither I nor my doctors believe it's warranted. For obvious reasons, this is a highly controversial and delicate subject clinically, and there are no right answers (at least in my case).
I've been doing some walking every day, and it's obvious that I will be able to tolerate exercise much better. We went shopping in King of Prussia this afternoon, and wandered all around at a reasonable clip (read: I'm no longer being passed by 65-year-olds), with no fatigue or shortness of breath whatsoever. I've been looking for a similar coffeemaker to the one Jay recommended in an earlier comment, but it isn't stocked in Kitchen Kapers, Crate and Barrel, Bon-Ton, Williams-Sonoma, or anywhere else we checked. (Told you we'd been walking - thank you, Jay, for sending me on a wild goose chase and getting me off the couch). So I ordered it online. Caffeination is imminent. Meantime, the baristas at Starbucks now recognize our Toyota at the top of the drive-through lane.
My first follow-up internist appointment is Friday. I have a laundry list of things to ask him - pain and sleep meds at the top of the list - but all in all, I think everything is progressing incredibly fast and well. Thanks to everyone for all of their support. I've been reading the comments every post-op day since I could log on, and I believe that they are instrumental in helping me recover as fast as I am.
Take care,
Michael
Sunday, January 17, 2010
Finding my limits
Yesterday was an active day: lots of errands, and walking (we joined BJ's and walked the entire store learning where everything is). Today, more of the same: brunch with Mom and Dad, then a visit to Fellowship where I just about blew everyone's mind by showing up a mere 10 days after surgery, and then a lunch date with Laurie to share all the gruesome details of the surgery. Laurie, ever observant (having been there, and also because she's a trained PA and paramedic), noticed I was getting more pale as lunch progressed. Fatigue, pure and simple. When I hit the wall, I do it fast. I was asleep in the car within minutes and napped for a good portion of the afternoon.
There's only one way to find your limits. Now I know what mine are (at least this week). Fortunately, there's little on tap for tomorrow except maybe a trip to the grocery store. And lest you think I'm going to be a total slug sprawled out on the couch drooling in the general direction of the TV, I'm keeping mentally sharp by doing crosswords, reading, and hosting online euchre tournaments and supervising and training a staff of tournament directors (I bet many of you didn't know I do that).
Speaking of lunch, the prescribed post-heart-surgery diet for an otherwise healthy person is lots of protein (and low salt). I'm not joking when I tell you that the CC official recommendations include milkshakes, floats and protein smoothies. The call for protein makes sense, as there's a lot of tissue repair going on in the body. So active weight loss is going to wait 6 weeks or so, and our blender is getting more use than it ever has. I have, however, pretty much eliminated empty calories - no baked goods, no refined sugar, very little starch, and my snacks tend to be yogurt or a banana.
The pain is subsiding more every day, giving way to a deep itch that I'm sure Jay is responsible for inducing since he suggested I might be susceptible to it when we spoke on the phone last night. Thanks, pal.
Take care,
Michael
There's only one way to find your limits. Now I know what mine are (at least this week). Fortunately, there's little on tap for tomorrow except maybe a trip to the grocery store. And lest you think I'm going to be a total slug sprawled out on the couch drooling in the general direction of the TV, I'm keeping mentally sharp by doing crosswords, reading, and hosting online euchre tournaments and supervising and training a staff of tournament directors (I bet many of you didn't know I do that).
Speaking of lunch, the prescribed post-heart-surgery diet for an otherwise healthy person is lots of protein (and low salt). I'm not joking when I tell you that the CC official recommendations include milkshakes, floats and protein smoothies. The call for protein makes sense, as there's a lot of tissue repair going on in the body. So active weight loss is going to wait 6 weeks or so, and our blender is getting more use than it ever has. I have, however, pretty much eliminated empty calories - no baked goods, no refined sugar, very little starch, and my snacks tend to be yogurt or a banana.
The pain is subsiding more every day, giving way to a deep itch that I'm sure Jay is responsible for inducing since he suggested I might be susceptible to it when we spoke on the phone last night. Thanks, pal.
Take care,
Michael
Saturday, January 16, 2010
Home sweet home
We flew home yesterday, and man, are my arms tired.
In a comment a while back, Laurie referred to a "bed wedge" as a solution to comfortable sleep. It keeps you propped up on a slight angle, which helps breathing and takes some pressure off the chest. I had one waiting for me at home. It definitely helps, I got about 7 hours of only mildly interrupted sleep last night.
There are a lot of brands and models of wedge pillows out there. If any HCMers are reading this, I definitely recommend this wedge pillow in the 25" x 24" x 12" size. It's super-firm and sufficiently big (for comparison's sake, the sole model at Bed Bath and Beyond when we visited looked as thin as a slice of pizza).
I sneezed yesterday on the plane, the first one I hadn't been able to suppress. Holy throbbing chest wall, Batman. I'll be getting back on the Claritin ASAP as this is one experience I do not wish to repeat for a few months.
The incision looks mostly good except at the bottom, which is a little oozy at the base and the left chest tube site. It's also swollen and a little painful at the top, but they tell me that's normal (it's not hot or "angry"). We're treating the bottom area with iodine and keeping it covered. I'm pretty sure it's not infected, but I'll have the doctor look at it next week for sure.
Today is errand day: pharmacy, optician, and a sexy new coffeemaker (which I promised myself as a gift for making it through). And some walking at some point, the new daily requirement.
Take care,
Michael
In a comment a while back, Laurie referred to a "bed wedge" as a solution to comfortable sleep. It keeps you propped up on a slight angle, which helps breathing and takes some pressure off the chest. I had one waiting for me at home. It definitely helps, I got about 7 hours of only mildly interrupted sleep last night.
There are a lot of brands and models of wedge pillows out there. If any HCMers are reading this, I definitely recommend this wedge pillow in the 25" x 24" x 12" size. It's super-firm and sufficiently big (for comparison's sake, the sole model at Bed Bath and Beyond when we visited looked as thin as a slice of pizza).
I sneezed yesterday on the plane, the first one I hadn't been able to suppress. Holy throbbing chest wall, Batman. I'll be getting back on the Claritin ASAP as this is one experience I do not wish to repeat for a few months.
The incision looks mostly good except at the bottom, which is a little oozy at the base and the left chest tube site. It's also swollen and a little painful at the top, but they tell me that's normal (it's not hot or "angry"). We're treating the bottom area with iodine and keeping it covered. I'm pretty sure it's not infected, but I'll have the doctor look at it next week for sure.
Today is errand day: pharmacy, optician, and a sexy new coffeemaker (which I promised myself as a gift for making it through). And some walking at some point, the new daily requirement.
Take care,
Michael
Wednesday, January 13, 2010
Onward and upward
Welcome to the boring but important parts of recovery.
I'm almost off the Percocet and managing pain with Advil and Tylenol. I feel like I lost a bar fight, but that this type of soreness will eventually dissipate. Sleep is still sporadic.
A couple of milestones yesterday.
(1) Caffeine. I caved and ordered a latte from Starbucks, as a purely scientific trial, mind you (remember, I work in pharmaceutical R&D). And it felt frickin' GREAT. Remember I'd been abstaining from caffeine for more than a year. Yes, I, the guy who owns a $35 Thermos that keeps his coffee hot 'n' fresh all the working day and includes a shoulder strap, coffee made from beans roasted to order and shipped overnight from a boutique in NYC, gave up the joe - it made me feel that bad. Well, success! I got a rush to the frontal lobe (good) but not to the left ventricle (would have been bad). Jenn says she doesn't remember the last time she saw me smile so wide.
(2) Restaurant food. We went to a very nice restaurant, Table 45, for a multi-course meal last night, the type that would have sent my gradient through the roof pre-op. A lot of food (all of it heart-healthy), and no trouble with dizziness or shortness of breath at the dinner table or afterward. A very pleasant change indeed.
I'm looking forward to coming home. The concierge at the Clinic is unbelievable. We provided them our travel itinerary an hour ago. By tomorrow afternoon they will have taken care of - at no charge to us - printing boarding passes, ground transportation to Hopkins Airport (they had also chauffeured us to the Clinic on arrival), and wheelchair service/cart service/luggage assistance at both Hopkins and Newark. They do this for every single out-of-state surgical patient, gratis. Amazing.
Finally, in the spirit of "Pay It Forward," I met with a fellow HCM patient today who is scheduled for a myectomy tomorrow (Thursday) with Dr. Smedira. We got to know each other a little bit online through the HCMA message board. His name is David, he's a great guy, and if you could keep him in your thoughts, I'd appreciate it. I believe his status will be updated here.
Take care,
Michael
I'm almost off the Percocet and managing pain with Advil and Tylenol. I feel like I lost a bar fight, but that this type of soreness will eventually dissipate. Sleep is still sporadic.
A couple of milestones yesterday.
(1) Caffeine. I caved and ordered a latte from Starbucks, as a purely scientific trial, mind you (remember, I work in pharmaceutical R&D). And it felt frickin' GREAT. Remember I'd been abstaining from caffeine for more than a year. Yes, I, the guy who owns a $35 Thermos that keeps his coffee hot 'n' fresh all the working day and includes a shoulder strap, coffee made from beans roasted to order and shipped overnight from a boutique in NYC, gave up the joe - it made me feel that bad. Well, success! I got a rush to the frontal lobe (good) but not to the left ventricle (would have been bad). Jenn says she doesn't remember the last time she saw me smile so wide.
(2) Restaurant food. We went to a very nice restaurant, Table 45, for a multi-course meal last night, the type that would have sent my gradient through the roof pre-op. A lot of food (all of it heart-healthy), and no trouble with dizziness or shortness of breath at the dinner table or afterward. A very pleasant change indeed.
I'm looking forward to coming home. The concierge at the Clinic is unbelievable. We provided them our travel itinerary an hour ago. By tomorrow afternoon they will have taken care of - at no charge to us - printing boarding passes, ground transportation to Hopkins Airport (they had also chauffeured us to the Clinic on arrival), and wheelchair service/cart service/luggage assistance at both Hopkins and Newark. They do this for every single out-of-state surgical patient, gratis. Amazing.
Finally, in the spirit of "Pay It Forward," I met with a fellow HCM patient today who is scheduled for a myectomy tomorrow (Thursday) with Dr. Smedira. We got to know each other a little bit online through the HCMA message board. His name is David, he's a great guy, and if you could keep him in your thoughts, I'd appreciate it. I believe his status will be updated here.
Take care,
Michael
Tuesday, January 12, 2010
Day one without the safety net
It's a little scary when they say you can leave the hospital, knowing that no one will be at the other end of that red call button at the bedside to administer painkillers or manage a fluky heart rhythm at 2:15 a.m.
By the time we completed the discharge, all the outpatient pharmacies at CC were closed for the night (surprising - I would think at least one would have been open 24 hours). We don't have a car here, and I was not about to walk or try and get a cab to the nearest Rite-Aid in the East Cleveland night (and wasn't going to let Jenn leave me). So I asked the nurses for a final lidocaine patch to the chest and vowed to make it through the night on Advil and Tylenol before resorting to the prescribed Percocet in the morning.
Expectedly, finding a comfortable sleeping position was a challenge. Tried the bed, even with a "fort" of 6-7 pillows - no go, gave up at 1:30 a.m. after redosing the Advil and Tylenol. Tried upright on the couch, but the cushions were too firm (reminiscent of airplane seats) and hurt my butt. Finally laid out on the couch with many pillows and sacked out until 5:30, when I woke in pain crisis. Redosed again and made Jenn promise to set an alarm and be at the CC pharmacy upon opening at 8 a.m. She has really been an angel through this so far. (And it's hard to be a caregiver. I remember all too well her battles with radiation therapy in 2004. She's blogging her experience as well, and I'm sure she'd love your support.)
Then I had my first really good, thorough sleep: 4 more hours completely unconscious, with vivid dreams. Jenn's entering the room woke me and precipitated another pain crisis, but finally we had the tools to deal with it. Ate some crackers, Gatorade and a banana for breakfast, relaxed and read, and then cleaned up around 11:30.
We're off to the hospital to thank the nurses on J5-1 and check out the rooftop pavilion that everyone raves about but that we didn't get to catch. Also going to see if I can squirrel up a chair massage.
Take care,
Micahel
By the time we completed the discharge, all the outpatient pharmacies at CC were closed for the night (surprising - I would think at least one would have been open 24 hours). We don't have a car here, and I was not about to walk or try and get a cab to the nearest Rite-Aid in the East Cleveland night (and wasn't going to let Jenn leave me). So I asked the nurses for a final lidocaine patch to the chest and vowed to make it through the night on Advil and Tylenol before resorting to the prescribed Percocet in the morning.
Expectedly, finding a comfortable sleeping position was a challenge. Tried the bed, even with a "fort" of 6-7 pillows - no go, gave up at 1:30 a.m. after redosing the Advil and Tylenol. Tried upright on the couch, but the cushions were too firm (reminiscent of airplane seats) and hurt my butt. Finally laid out on the couch with many pillows and sacked out until 5:30, when I woke in pain crisis. Redosed again and made Jenn promise to set an alarm and be at the CC pharmacy upon opening at 8 a.m. She has really been an angel through this so far. (And it's hard to be a caregiver. I remember all too well her battles with radiation therapy in 2004. She's blogging her experience as well, and I'm sure she'd love your support.)
Then I had my first really good, thorough sleep: 4 more hours completely unconscious, with vivid dreams. Jenn's entering the room woke me and precipitated another pain crisis, but finally we had the tools to deal with it. Ate some crackers, Gatorade and a banana for breakfast, relaxed and read, and then cleaned up around 11:30.
We're off to the hospital to thank the nurses on J5-1 and check out the rooftop pavilion that everyone raves about but that we didn't get to catch. Also going to see if I can squirrel up a chair massage.
Take care,
Micahel
Monday, January 11, 2010
Things move fast
I'm doing so well that they're discharging me tonight. Yeah!!!!!!
Jenn is semi-frantically packing for me ahead of schedule, as I have no shoes or outdoor pants here in the hospital. I'm sure there will be a pharmacy visit in store for us tonight as well as extensive discharge instructions. Plus we'll need dinner. I'll post more tomorrow.
Take care,
Michael
Jenn is semi-frantically packing for me ahead of schedule, as I have no shoes or outdoor pants here in the hospital. I'm sure there will be a pharmacy visit in store for us tonight as well as extensive discharge instructions. Plus we'll need dinner. I'll post more tomorrow.
Take care,
Michael
Caption contest
In line at the one food prep kitchen at Cleveland Clinic that gets your order correct the first time:
Yes, there is really a McDonald's within the Cleveland Clinic (that's the entrance to the "official" hospital cafeteria behind me). The story I heard was that the Clinic's breach of contract penalty for kicking out McD's would have been $4 million, so the hospital decided to swallow it. (Ha!)
No, I didn't actually order anything, silly. No PhotoShop, either.
Submit your caption in the comments section. Winner as determined by Jenn and me gets a genuine Cleveland Clinic respiratory device, official Cleveland Clinic latex gloves as used on unit J5-1, and 2 packages (single serving) of Nabisco Original Graham Crackers.
Yes, there is really a McDonald's within the Cleveland Clinic (that's the entrance to the "official" hospital cafeteria behind me). The story I heard was that the Clinic's breach of contract penalty for kicking out McD's would have been $4 million, so the hospital decided to swallow it. (Ha!)
No, I didn't actually order anything, silly. No PhotoShop, either.
Submit your caption in the comments section. Winner as determined by Jenn and me gets a genuine Cleveland Clinic respiratory device, official Cleveland Clinic latex gloves as used on unit J5-1, and 2 packages (single serving) of Nabisco Original Graham Crackers.
Update: getting close to discharge
Generally, things are going going great, especially for just 4 days post-op. I'm doing a ton of walking (including off the assigned floor and to different, interesting bits of the hospital, with doctors' OK). Here's the bullet point update.
One man deserves props for visiting Jenn and me twice, offering his support in any way imaginable. His name is Michael Manos, and he leads the Pediatric Behavioral Health department at the Cleveland Clinic Children's Hospital (he's a child psychologist). I've known him for years through work. He is a genuinely wonderful man (as well as a fellow Northwestern Wildcat with a history of pranks), and he deserves a plug here.
Finally, I got pneumococcal and H1N1 vaccines. Step right up to the head of the line, young man!
Take care,
Michael
- Pain: Frequent and bothersome, but not agonizing. It's mostly controlled with a prescription anti-inflammatory (Toradol; I'm off the narcotics and Percocet, and should be for good). The last 2 hours before the dosing window reopens are predictably bad. Unlike Laurie, the spot that gets me is the top of the incision, whereas my chest tube sites and extraction were a piece of cake, pain-wise. They had me hooked up to a "Q-ball", a continous infusion of lidocaine wired into the chest tube sites, to ease pain, and it really did wonders.
- Rhythms: Much better today with improved monitoring of electrolytes and potassium and magnesium supplementation, and an appropriate dosage of beta-blocker. The beta-blocker will be weaned when the time comes - but now isn't it. I haven't had PVCs since before 9:00 last evening. They were really bothering me because they were so frequent.
- Fatigue: Comes and goes. I'm not sleeping well at all, thanks to gas pains, unfamiliar environment, and frequent visits from nurses who would like nothing more than 2 tubes of A-positive and a BP measurement at 4:00 a.m. This is not unexpected and should resolve when we get home and I can figure out a way to sleep in peace.
- Heart function: An echocardiogram this morning estimated a resting gradient of 21-22, going up to 28-29 with administration of amyl nitrate. This is a terrific improvement over pre-op.
- Food: Still hit-or-miss on the orders. If medication management were handled this way, no one would survive. Naturally this morning's omission was the banana (think potassium!) to go with my oatmeal. Jenn gave up and squirreled away 2 from the hospital cafeteria for me. And yes, the food is bland - I'm OK with that, I'd expected absolutely no salt whatsoever - but I get graham crackers with just about everything. And graham crackers make everything better.
- Pump-head: going away fast, thank goodness. Wooziness and unable to concentrate has generally correlated with electrolyte or rhythm problems, and go away with supplements. Walking helps too. I still haven't received all the surgical details (such as total pump time), but it may be moot. I'm going to keep trying, if only because I'm curious.
- Discharge: almost certainly will be tomorrow (Tuesday). We're staying here through the week, and will take advantage of an offered repeat consultation at the CC outpatient clinic on Thursday. We won't be at Brigham again until March, so this will get us going with recovery plans.
One man deserves props for visiting Jenn and me twice, offering his support in any way imaginable. His name is Michael Manos, and he leads the Pediatric Behavioral Health department at the Cleveland Clinic Children's Hospital (he's a child psychologist). I've known him for years through work. He is a genuinely wonderful man (as well as a fellow Northwestern Wildcat with a history of pranks), and he deserves a plug here.
Finally, I got pneumococcal and H1N1 vaccines. Step right up to the head of the line, young man!
Take care,
Michael
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