Saturday, June 25, 2011

Pulmonary Heart Valve Replacement : 2011 - 19

Saturday June 25, 2011:

I have been pushing to see where my physical boundaries are with the new valve. Yesterday I found my limitations. Whoa, did I find my limitations!!

Yesterday morning I decided to cut out a set of scrubs for Cassie. A simple top and pants.

The cutting went well so I decided I felt well enough to weed / thin out a flower bed. It is an unruly mixture of day lilies, tansy, bishop's weed, wild sunflowers and Japanese lanterns. Last Fall I added half a dozen chrysanthemums to the front of the bed for end of season color. My goal was to give the chrysanthemums some breathing room.

Out came the tarp and nitral gloves and kitchen knife. I sat on the tarp as I pulled and cut out the plants growing out of place for over an hour. The discards were tossed onto the lawn where this week's mowing will turn them into mulch for the lawn.

The photo above of the weeds and flower bed was taken this morning from the top porch.

I drove to the store to buy a blade for the rotary cutter. Cassie came along because she wanted a piece of fabric to coordinate with a scrub top she is making. She suggested the JoAnn fabric store as we had been to the Hancock fabric store for the scrub top fabric.

This was an opportunity to remind me why I do not normally shop at this company's stores. They are designed as a maze with bottle necks wherever someone decided to give you an opportunity to see one more item the store is hawking. I always feel clostrophobic in their stores.

A trip to the bank ended my excursions for the day.

Dishes were done.

The VNA showed up and I was released from their care. She was amazed as my remarkable progress.

I was looking forward to sitting in the bleachers at the church league softball game at 6:15. (after a short nap)

I woke up from the nap in what can only be described as a 3 year old who needed another nap. Tearful, fatiqued to the point of ending up on the kitchen floor with my legs elevated against the kitchen sink. This is a yoga inversion that takes the stress off the heart. I stayed that way for a quite a while until I was rested enough to sit up, drink some water and eat some soup. Then I made my way on hands and knees to the living room where I rested sitting on the floor and finally onto the sofa.

Larry was a deer in the headlights during this. He came home from a 10 hour work day expecting to play softball. Neither of us made it to the game.

I forget I am still healing. My heart reminded me in no uncertain terms that I need to slow down a bit. Cardiac rehab begins on Monday. I will have to be intentional about slowing down.

This morning I slept in and then went to the Beliot road weight watchers weigh in to keep me up to date. It is the last time because the plan is to return to the site at work after the 4th of July shutdown.

Thursday, June 23, 2011

Pulmonary Heart Valve Replacement : 2011 - 18

Thursday June 23, 2011:
Yesterday was the first follow up appointment with my cardiologist. It included an echo cardiogram to establish a baseline post surgery. He orchestrated the test in person and examined the results from in the room and a distant location.

I like to check out what is happening on the monitor off and on during the testing. One of the views of the echo cardiogram shows color coded blood going through the valve. Past views were red on both sides of the valve. The view of yesterday showed red on one side of the valve.

My heart no longer sounds like me. It was sureal when I listened during the echo cardiogram in process. No whoosh, whoosh, swish. I cannot describe it because it did not sound right.

I was surprised by my nervousness during this. It seems the never ending medical issues of the past year are catching up with me when I least expect it. I was bracing myself for something along the line of, "Where did that come from?" There were no surprises.

My heart and lungs and stomach were listened to the old fashioned way. Ankles were checked for swelling The incision site was pressed to determine any tenderness or swelling. He found one spot.

I described the sensation of the incision as that of shoe laces holding together a shoe.

The job of a PA (Physician's Assistant) needs to be clarified to establish the importance of her participation in my medical care. You may think nurse with Rx writing privileges. The reality is so much more. She makes sure all the details are taken care of so the doctor can focus on his expertise. She understands everything the doctor does and has the ability to relate this to me (the patient). She also has skills to set up the details of a solution to the medical challenge when a direction of treatment has been determined.

Think Ginger Rogers to Fred Astair. He led and she did it backwards in high heels. My strongest advocate going through this medical process was/is the PA.

That said: Guess what the PA gave to me at yesterday's appointment? Something I did not think I would see. I was given photos of the original valve in various forms of deconstruction. This was very exciting. The PA explained what each photo was and I tried to remember as much as possible what she said. I took a digital photo of the photos and posted them below.

The top photo is the valve in it's entirety. I am not sure if it was still attached to my heart at that point.

The next photo is the valve laid out. The tiny dark nubs are the flaps that could not hold back the blood. I was taken by the cleaness of the valve.

The last photo is the valve in pieces. Note the scale is metric. For a conversion consider 2.54 CM is equal to 1". 5.08 CM is equal to 2". 7.62 CM is equal to 3".

So, you got through the visuals.

There were other things determined and changed at this appointment. I have lost 16# since my February appointment. This pleased all. Weight watchers does work.

I asked about reduction of dose of the Rx with the nastiest side effects. That dose will be reduced from twice daily to once a day July 1.

Two OTC meds were added bringing my morning total to 8. It seems like a lot until it is broken down for the purpose of training my heart to function 'normally' over time.

1- controls atrial fibulation: this will be reduced to once a day. My goal is to be free of this by 4 months out from the surgery.
2- establishes a strong heart beat. This is to help the right atrium shrink after decades of working harder than it needed to causing it to expand to the point that lead to the surgery. This should go away in about a year.
3- beta blocker was something I began in 2007 to reduce extra beats. I am not sure why it is still part of the mix, but when I was not taking it in the hospital my heart noticed. I will push to have this go away after the first two are gone.
4- Anti-cancer drug. This will go away in 4 1/2 years.
5- two baby aspirin. SOP for anyone with cardiac problems. It is better than Warfarin.
6- multivitamin. My gynecologist recommended I take a multivitamin prior to surgery 2 1/2 years ago. He said it would help healing.
He was right. I have been told I heal well.
7- New introduction today 'triple strength fish oil'. There are jelly beans smaller than this pill. It is promoted by cardiologists... I think because it is an anti-oxidant.
New introduction today CoEnzyme Q10 400 mg . Think horehound throat loszenge in size. I forgot why this was added to the list. I do know that a buy one / get one free promotion for #7 and #8 was $60 for two months. The insurance nurse suggested usin as a resource for less expensive OTC drugs.

My first time driving since May 31 was to the craft class at church last night. I stopped at a Target to buy the OTC drugs recommended. Target did not have what I needed so I drove to Walgreens. This was in addition to the stop at the local fabric store on the way back from the doctor's appointment earlier in the day. This was a lot more activity than the day before, yet no fallout from it. I am not more tired due to the extra activity.

Maybe today I will do the farmers' market with a luggage tote to collect my purchases.

How am I to keep track of my 'exercise' when I am not doing a formal program on the days I am active? Did I walk 15 minutes yesterday. Yes, I did in Target and at least 30 minutes in the fabric store. Did I do light calestetics? Yes, when I hand washed and put away dishes, folded laundry, straighten out the sofa and picked bolts of fabric off the floor I knocked off the table at the fabric store.

I do not do organized exercise well. Yoga works because it is social. I do not understand why walking for the sake of walking is such a desired thing to do. Yep, and I live with two distance runners. I love them. I do not understand them.

Tuesday, June 21, 2011

Pulmonary Heart Valve Replacement : 2011 - 17

Tuesday June 21, 2011:
I was up just one time during the night.

The weight has not budged since yesterday.

The surgery was on June 1. It is the 3 week mark.

I walked 2 Xs yesterday for 10 - 12 minutes. This morning I've already walked 15 minutes. It was harder to walk the 10 minutes on Sunday than the 15 minutes this morning. Normal is happening.

The vein rawness in my right arm is slowly going away.

I put the TEDs back on because I saw a slight swelling in my right leg. My best guess is the swelling is a reaction to the walking program in progress. I will try to go without in a few days and see what happens.

Tomorrow is the first follow up appointment with my cardiologist. I look forward to new information and direction. 'When can I start weaning off the nasty heart meds?', is top of my list.

Monday, June 20, 2011

Pulmonary Heart Valve Replacement : 2011 - 16

Monday June 20, 2011:
Yesterday I actually wanted to sing. It was not something to perform. It has been such a long time since I've had the breath control to sing a phrase.

I am making progress on the Spiro--- ometer. It is not as spectacular as the first few days.

I decided to apply the exercise program as recommended. The calisthenics were a breeze.

The 10 - 12 minute walks --- 3-4 times a day were a roadblock. I discovered it took me 11 minutes to walk around the block. Every time during the rest of the day when I thought, " maybe I should take another walk", my body said, "nope".

I did calisthenics, inversion, steps, laundry, dishes, basic straightening of the house and one walk.

Today is a new day. The 8:15 walk was rained out before I had walked past 4 houses. That was a total walk time of 3 minutes. Then I walked up the stairs and claimed computer time. It is an hour later and it is still raining (with thunder).

My weight went up 2 1/2 pounds since yesterday morning. The call came in from VNA a few minutes ago to check in with me. I am not seeing swollen ankles, but I did eat everything in sight yesterday. This should pass.

Sleeping is still a challenge. My 'normal' sleep position is on either side. Sleeping on my back is not comfortable for me. That is changing because sleeping on either side puts pressure on my collar bone and it lets me know.

The sensation in my chest is that of a girdle [and the ever present 'itching']. Unlike prior to surgery, it is not causing me heart difficulty or breathing difficulty. It is just the tugs of what on a girdle would be the lacings. On occasion there is a dull deep pain that anyone would recognize as a bruise. OTC Tylenol@ takes the edge off and all is right with my world.

Sunday, June 19, 2011

Pulmonary Heart Valve Replacement : 2011 - 15

Sunday June 19, 2011:

Slept well yesterday. Slept well last night. VNA vitals look consistent with prior readings.

My right arm is sore in the veins. Nothing changed. It looks like it will take a while for these veins to heal from all the use from the surgery.

It is an overcast day with thunder and the occasional drop of rain. I should go down to the porch and close the windows before the rain comes.

Saturday, June 18, 2011

Pulmonary Heart Valve Replacement : 2011 - 14

Saturday June 18, 2011:

Larry and Cassie left for Michigan this morning. Phil drove me to the Weight Watchers weigh in his morning. There was a weight loss last week, despite my corruption of my meals. Now my play time is over and I need to become intentional about the program. Maybe after I eat some more orange sherbert.

Yesterday I sat through the church league double header. Today I am tired. It was worth it. I am ready for my 2nd nap.

It is also the first warm day since my internal thermostat reset. That may have something to do with my tired.

The incision is still itchy, but it has not been sufficiently annoying to take a Tylenol@.

The new scale did arrive yesterday. It comes with batteries. They were not good batteries, so I replaced them and the scale works as described.

Friday, June 17, 2011

Pulmonary Heart Valve Replacement : 2011 - 13

Friday, June 17, 2011:

Wednesday June 15th was a day to sleep, and sleep, and sleep. I tried an excursion to the department store across the street. Cassie drove. The parking lot was busy and I realized there was no way I was going to be able to complete the trip. She turned around and took me home. I took another nap.

Thursday June 16th was an entirely different day from the one before. Almost no nap time. There were a number of excursions.

The store across the street was less busy and a parking space next to the handicap parking space was found. Purchases were made for father's day.

On to the bank.

Then a side trip to a Wendy's for a #1. Cassie ate the fries and I enjoyed the burger and root beer. This is not something I can afford the Weight Watchers points from. This week is a 'free' week where I am listening to what my body is screaming for, and it wanted a 1/4# burger with lettuce, tomato and condiments along with a full sugar soda. AND: the number on the morning weigh in is still going down. It must be the result of the hospital food and water loss catching up to normal.

The cardiologist's office called adding an echo-cardiogram to next week's visit. I mentioned not hearing from the surgeon's office for followup. That scheduling phone call came shortly. It is stunning the amount of cardiac surgery being done by one doctor.

I would not mind if there were no surgeon's follow up appointment because based on the other cardiologists; either it worked, or it didn't. However, I believe the surgeon is the guy to release me back to work. That makes his follow up important.

Had my scrubby brows waxed. She is also my yoga instructor. She does not want to see me in class until July, at the soonest. I told her the reason why I was healing so well was all the crocodile and plank poses of her class. They developed my upper chest and shoulders. Those will be off limits until mid-September.

Home in time for the VNA visit. She encouraged me to set up cardiac rehab time. I checked my files and could not come up with a contact number. I will implement the exercises provided in the hospital and bring up the topic at my cardiologist's follow up next week. The package provided while I was in the hospital came with a 10 - 12 week program to follow. Maybe there will be no need for me to do cardiac rehab once they contact me. Independent soul that I am, that would not be a bad thing.

Cassie drove me to the softball game yesterday afternoon. It was a stretch, but not overwhelming. Ta Da !!! Our team got trounced. I got slimed by my friends new dogs. We convinced a young child that the older you got, the more dogs you were allowed. A good time was had by all.

I need to come better prepared for the question, "How are you feeling?" My in-your-face self is responding, "As well as can be expected for someone who just had her heart sliced open and stitched back together." Definately, I need a kinder response.

June 17, 2011: Today Amazon sent me an email anouncing the scale should arrive today. Yippee!!

Tonight is a double header co-ed softball. Cassie has promised to take me home if it is overwhelming.

Today is the 18th day in a row Larry has worked 10 -12 hour days. He is going North for the weekend. He need to decompress now that I am on the mend.

Wednesday, June 15, 2011

Pulmonary Heart Valve Replacement : 2011 - 12

June 15, 2011: The monitor arrived yesterday afternoon and included a scale. Problem solved. It is set up to be user friendly with voice directions that take you through the process of O2, BP, weight and heart rate. Then it is transmitted to the VNA near by via wireless connections.

There is a lot of heart surgery going on this year. Everyone in the field is operating at maximum capacity. That is why it took a week to get the monitor. It would not surprise me if there were someone waiting for the monitor I am using.

Tamoxefen was restarted today. It is two weeks after the surgery. The hot flashes returned two hours after the first dose. Ya' gatt'a love consistency.

The scabs from the original surgery have all come off.

The sharp pain came back and I am able to locate it to the area of scaring from the breast cancer. It is swollen and feels bruised. No surprise. It was probably stretched and tugged and .... during the surgery. This is one more layer of healing to go through.

A vein on my right arm can be felt from the line insertion point ~ 4" above my wrist to ~ 2" above my elbow. It is hard and tender to the touch. This may pass in time.

Most of the bruising is gone. Each day a little more is absorbed by my body.

I slept past two alarms. It is cold and drizzly. Perfect sleeping weather.

This afternoon the plan is to venture out of the house to buy Larry his father's day gift. Cassie is going to drive me across the street and the plan is to make this a 10 minute walk in the store.

Tuesday, June 14, 2011

Pulmonary Heart Valve Replacement : 2011 - 11

Tuesday June 14, 2011: I read yesterday's posting. The sharp pain is gone. It was one of those muscle things felt in healing probably cause by rolling over wrong while healing.

The scale on the sprio-- ometer will not go beyond the limit set last Saturday. That means there is still a portion of my lower left lung unexpanded.

Today I need to go out into the yard and get some more flowers in bloom. There are some phlox under the spruce and the spirea is coming into bloom. Be prepared for tomato and raspberry blooms. I am running out of material.

I made a logistical error. My weight is supposed to be monitored, now. The scale I ordered will not arrive for another 6 days... at the soonest. The local weight watchers site is available on Saturday. I sent an email to my weight watchers contact asking if there are any other sites near home that are available during the middle of the week.

Until then, I am keeping an eye on my ankles for fluid retention.

Monday, June 13, 2011

Pulmonary Heart Valve Replacement : 2011 - 10

Saturday June 11, 2011:

Cassie drove me to a weight watchers meeting to weigh in: 8:00 am. My discharge papers mention variation in weight as something to be concerned about. We do not have a functioning scale in the house. I went to where I knew accuracy would abound. Got weighed. Then, Cassie drove me home.

I met the third VNA nurse in 3 appointments. I would love to keep one through out. It does not seem to be happening.

She listened to my chest and determined all was well with the exception on the lower portion of my left lung. It has yet to fully inflate. This is where that spiro-blah-blah-blah-ometer comes in.

I am to 750 (what ever units) on the spiro---ometer on a consistent basis. 1000 was accomplished during the appointment and that is where the marker was set on the side of the gauge.

Cassie has been going to town in the flower beds. I inspected her work then quickly found seating in the house. Too much. Too soon.

Larry has declared I am not to do anything from now on.

The cardiac rehab papers suggested resting with my legs 24" above my heart 1 or 2Xs a day. However, this is not to be done in a recliner as it would cause a bend at my waist. Is there any way to follow these instructions without standing on my head? I do not think that is what is desired at this point.

I am lying on the floor with my lower legs resting on the sofa and my upper legs perpendicular to the floor. If I were not in the way, I would be lying on the floor with my legs against the wall. That location in the house is on the pathway to the upstairs. I would be tripped over. The pose is a yoga inversion.

There are sensations over the incision. It is similar to super glue dried on the skin. This is centered over the incision ~ 2 - 2 1/2" wide X the length of the incision.

A dear friend who talked me through last year showed up today to visit with home made strawberry shortcake in hand. What made this gift extra special is I know she does not celebrate cooking the way I do. It was something she had never made before, but did for me.

Sunday June 12, 2011:

I went through the exercises on the cardiac rehab sheet. They are all within my flexibility and strength. It surprised me they ended up being aerobic.

I needed to be outside. One of the drugs I am taking has a side effect of turning the skin blue/grey with sun exposure.

Polarized sunglasses, long sleeve windbreaker, nitiral gloves and wide brimmed straw hat were worn. I was ready to take on a small patch of wild morning glories. I sat on a canvas and reached for what needed to be removed. Cassie showed up and added her youth.

I returned to the house after 20 minutes to take a nap. Cassie spent until after dark pulling weeds and thin-ing out the flower beds.

There is still the rawness in my veins from the top of my right hand over my forearm. It is not equal to a few days ago. It is not gone.

There are knots under two line insertion points. The bruises are slowly fading. My right forearm still looks like I've been in an accident with the black and blue.

There are still visible finger picks from the sugar testing.

The incision is healing and there is some sloughing off of the surgery scabs. It should be as noticable as the original scar in no time.

I started warping for a weaving project when I returned home. It is slow going. So far ~ 100 ends of the 240 needed have been measured on the warping board. It is an aerobic project that requires accuracy.

That 1000 level on the spiro--- ometer is my nemisis. It is not easily accomplished.

I began recording my foods and exercise in the WW binder. I am not yet following the 29 points per day plan. I want another post op week under my belt before I am to that point. It provides a quick and easy method to document what I am doing.

I struggled rolling off the sofa and since have noticed an occasional sharp pain over that rib. It goes away with massage, stretchnig or re-aligning.

Two OTC Tylenol@ will get me through the night.

Monday June 13, 2011:

Woke up with Larry and did a few more rows on the warping board. Then, slept in until 5:45 am. My meds are taken on a twelve hour rotation. 5:30.

It is cool enough to want oatmeal in the morning. This is the first time since the hospital. I figured out the difference between my oatmeal and their's. I make sure the oatmeal gets hot enough to cook the oats. They did not. Mine tastes of oats. Their's tastes like paste. Technique is the difference.

I made it to the basement to transfer laundry. Larry has been very intentional about making sure there is clean laundry. I am ready to take this house hold chore back, with the exception of items that are about my weight tolerance, think Winter quilt.

The scale problem has been resolved. Amazon had a well reviewed 'Eastmart Precision Plus Digital Bathroom Scale with Ultra Wide Platform and Step-on Technology, 440-Pounds' for $36.95. It should arrive next week with their free shipping. A delivery this week would be nice, but I am not willing to add $20.00 P&H.

VNA called. The nurse will be here 10:30 - 10:45. I mentioned the sharp pain that comes and goes. She will investigate further.

Sunday, June 12, 2011

Pulmonary Heart Valve Replacement : 2011 - 9

Late Friday June 3, 2011: Room S9126:

This room had a view to the North blocked by the prayer garden one floor below.

The next morning I was able to observer the roof of the prayer garden. It had flora that was under 6" tall in the colors of an autumn hand knit sweater my sister gave to Cassie a few Christmases ago. Mostly dark greens with rusts and cranberries and bronzes blended into this beautiful carpet.

To the right of the roof top was downtown.

To the left was Miller Park.

I could make out a few of the century old buildings at Woods Memorial just West of Miller Park. I know it has been renamed for some politician, but this is the name I know it by.

Why is this relevant? The modern hospital building of this site is is where the real-estate agent from Ralph, Michigan had his heart valve done in March, 2011. Both a civilian and military hospital within view of each other doing the same remarkable work.

More important to me was a 4 story building to the East of Miller Park. I knew that just behind this industrial confectionery plant was Harnischfeger. This is where I knew Larry was spending his day.

I could see all 4 directions from some perch in the halls during my walks.

To the West was Alverno College. The tree line was too high to pick out West Allis Memorial Hospital.

To the South I could see the tower at the airport and on one occasion saw 8 planes take off. There was a tiny verticle line just to the East of the airport. I am convinced that was the smoke stack of where I work.

To the East is a local high school and a few blocks beyond is St. Francis Hospital. It is where both my babies were born. It is where I was treated for breast cancer last Summer.

The nursing care was now 1 nurse / 1 nursing assistant for up to 8 patients.

There is a sequence to remove the tubes inserted during surgery based on the results of lab work and healing and some other miracle.

I remember the two drainage tubes being removed sometime during this part of my stay. Again, no pain was felt. It was a sensation and a sloppy, slurpy sound. When it was over the tubes were flopping around on the towel placed to catch them. The only visual I can use to describe them is think thick sausage casings made of rubber.

Every so often throughout my stay an IV or line or whatever piece of equipment was removed, or normal activities were introduced. Then I was monitored for a bit to verify the results.

From the time of ICU my heart was monitored via some kind of holter device hooked up the the IV tree. This was converted to a battery pack that fit in the pocket of the hospital gown once I could walk on my own.

It was pretty cool when someone came inspecting because a lead had unstuck. Somewhere in Mission Control a scientist was monitoring every beat of my heart.

Saturday June 4, 2011:

This was a busy day.

Sometime this day the line in my left arm with the acordian pump on it completely failed. It was removed and until I left the hospital my blood sugar draws would be done the old fashioned way before and after each meal. It was not fun, but I did not miss that line in my arm.

My appetite was slowly returning. Phil sent his macaroni and cheese with cauliflower while I was still in ICU. He also sent homemade tapioca pudding. I picked at it as my appetite improved. After a couple days I sent it home. My appetite was not equal to the portions.

Somewhere between the surgery and Friday, meals were introduced. The hospital Larry's mom stayed as she declined had a macaroni and cheese in the cafeteria to cry over. St Francis hospital does a stunning oatmeal. This hospital food service had limited foods to enjoy. Their vegetarian bean soup was nice. Their fruit plate was fine. I do not know what they did with the cottage cheese that came with it. Their fresh vegetable plate tasted like something left on the buffet table too long. Then the food starting getting bad.

The nursing staff began paying attention to bowel sounds when I transfered to the 9th floor. I began to declined Hydrocondone for pain I did not have. They plyed me with various methods to get things moving. I did what I could by walking as much as possible. Sometime on Saturday success was met and I requested a package of Tucks.

X-rays had been taken where ever I was, so far. There was a request for a traditional x-ray. I was chaired and wheeled to the basement for standing front and side shots. Then, quickly returned to my room. The heart monitor I was set up with was good only for the 9th floor.

Lasix was kept a part of my reginma to reduce H2O and swelling. The catheter was kept in to allow me to rest instead of having to use the bathroom. There was one unintended consequense that blindsided me, by leaving the catheter in 4 plus days. I would later discover it was a spastic bladder. It presented itself to me gradually as vaginal orgasm.

Go ahead, smirk. Get it out of your system. Everyone does. It was no longer fun after the 3rd go 'round.

I was aware of the sensation while walking the halls with Larry. I sent him home by 9:00 on a Saturday night ---- anyone who has raised young children knows how this works with problems and access to medical care ---

I was able to time the spazms to five minute intervals. I thought this would pass.

The nurse came in somewhere after this and I explained what was going on and asked if there was something topical to use to numb the area. I later discovered there is a pill for just this problem.

She told me I could take a Vicoden. That was the only thing she had to offer me.

Problem solver that I am, I called my gyn's service requesting he return the call. It is now quarter to 10 and the telelphones are shut down to the rooms at 10:00 pm.

Just after 10: 00 I took the #%#$ Vicoden. Three hours later I took the second %@#! Vicoden. What a @%#$ sleeping pill.

Don't send nasty thoughts to the nurse. It was late on a Saturday night. I learned [commonly] the PAs stop work at ~ 4:30 pm then the on-call for problems goes directly to the surgeon covering the weekend. My gut tells me, if it's not heart related don't call.

Her body language was the same I saw on the CEO during an annual company wide report. The only choices available were not good choices. He had to retire people before they had planned, and laid off the balance to keep the company solvent. She was working with the only option she had, and her body language told me she hated it.

So, you're thinking, "What's so bad about a few more Vocodin?" They are a codein based drug. Codein wil bind up the bowels everyone worked so hard to get moving. It also impedes my thought process. I do not like that fuzzy feeling. Both would delay my release from the hospital.

Sunday June 5, 2011:

Every time the nurses shifted I repeated my night before. At this time I still did not know what the medical description was. I knew it would end with the removal of the cathetor.

The reason the cathetor was still in place was because I was getting lasix from time to time. They did not want me to have to get up to go to the bathroom. By this time I was capable of self directed movement.

One of the heart rhythm doctors showed up during the morning. I explained to him that I wanted the catheter removed and why. He made it happen. Things quickly returned to normal.

There was a visit from the pastor and his wife along with a prayer shawl she had made. Then a couple from church showed up to visit for a while. He had been on the same floor a few days before I arrived for a stent insertion. I discovered another church member was at Froedert and was next on their route.

I did a lot of crying on Sunday. Sleep deprived. Codein detoxing. Too active for my angry heart. I cried when no one was around.

In the early afternoon was another lasix treatment. It did what it should and I was thrilled to use the bathroom.

Just as the sun began to go down a sister showed up with a potted plant I was instructed to put it in my garden once I returned home. (Cassie planted it yesterday)

Supper had been put on the table in front of me. It was something I did not remember ordering. I looked like meatloaf and mashed potatoes with gravy and baby carrots. It did not have any flavor. Like... hello... have you not heard of Penzys?

I went into meltdown. My sister asked what was wrong. I told her the food was icky. She laughed.

Then I explained about the night before. While she was wiping the tears of laughter from her eye Larry showed up with a Burger King burger. Their burgers give me the runs. Considering what I was going though, I ate all but one bite of it. Then I began telling Larry what I went through the night before. With my glasses off I saw his smirk. And, my sister began rolling all over my bed again.

My notes also list a 'central line' was removed' on Sunday.

Monday June 6, 2011:

This was a whole new day.

I left a message with the company nurse to touch base with my reality.

The wires left in should I need to be hooked up with a pacemaker were removed.

I called the insurance company to verify coverage for VNA and cardiac rehab after I met the cardiac rehab guy.

A new 'line' was put in my arm should it be needed. It wasn't. And the heart monitor system remained. All the other tubes and wires and devices attacted to by body with stickup were gone.

I was well rested and let everyone know if the day continued on as it was I would be ready to leave on Tuesday.

My body was functioning on a near normal level, with the exception of my heart. This was where all the attention is now needed to allow for healing.

I made a phone call to my Gyn's office requesting clarification of my Saturday night experience. Gail told me it sounded like a 'spastic bladder' and there is a pill to make it stop.

WOW!! The difference making it past the weekend has on problems.

[My inquries led me to discover that only the admitting physician or his/her substitute can determine medical treatment while in the hospital. So... had the surgeon been contacted on Saturday night and followed through with my gyn (Wheaton Fransician) or an Aurora gyn this could have been taken care of Saturday. My gyn cannot treat me for gynecological problems without being invited by the surgeon.

This makes sense to keep all care central.]

I talked with my surgeons PA about my Saturday night. She came up with 'spastic bladder'.

She sent in the head nurse on the floor to talk with. Her assesment was, 'spastic bladder'.

Before I was released I spoke with my cardiologist's PA. Her assesment.... drum roll please........ 'spastic bladder'.

I was assured by the head nurse that this was a training issue and would not repeat. More than enough said on this topic.

Tuesday June 7, 2011:

Cassie arrived ~ 8:00 with over easy eggs on whole wheat toast and 4 cups of cut up fresh fruit. I cried. The eggs were still warm. The fruit had flavor.

She came back ~ 3:30 to take me home. Then, she filled my prescriptions.. except the Vicoden.

This is the end of my hospital experience.

Friday, June 10, 2011

Pulmonary Heart Valve Replacement : 2011 - 8

Wednesday, June 1, 2011, 5:30pm: ICU, 1 to two patients per nursing team.

I was woken up with 'Nannette, your husband and daughter are here.'

'Hi Mom.'

'We're going home now.'

It was audible and cherished.

Cassie told me when she saw me I was doing a one sided spaz with my arm and leg. That is not part of my memory.

Next I realized an ache in my shoulders and the inability to move them to a more comfortable location.

The next sensation was the breathing tube in place. The anesthesiologist told me I would wake up with it in place. It was terrifying and I panicked.

Again, the original voice, 'Nannette you have to calm down and breath'. I tried. Then I came to for round two.

'Nannette, don't panic. Breath. We cannot remove the tube until you can breath on your own.' Something to focus on. I am a problem solver. I can do this. Every brain cell and muscle I could muster was directed to intentional breathing to get that tube pulled.

I floated in an out of the anesthesia and heard, '60%'. Then someone said my assisted O2 was cut back. I kept doing whatever I could to breath on my own.

Every time I found reality I focused on breathing in and out. It was my mission. It was my singular goal in life.

Someone asked me if I was in pain. When I tried to respond I was told they could not understand me. Yep.... go figure. Must be some sort of test for brain activity. If I were dumb enough to answer, I was not smart enough to breath.

There was no pain except the deep ache in my shoulders from lying too long in one place. I was not hot or cold or tingles or... Just that ache and the tube down my throat.

Then, somewhere in the night between June first and June second the tube was pulled. My arms were unbound. My shoulders could rotate out the kinks.

I was asked to talk and no sound came out. Next try was a vibration. Each attempt was closer to a single word. Finally, I was able to ask for ice chips.

Their procedure is to grant small sips of H2O to swallow, but not inhale. Ice chips followed once this was accomplished.

I was so achy from lying in one position for so long.

My time in ICU was spent having almost constant lab work.

There was a portal in my left arm with an accordion box that would form a vacuum to bring a blood sugar sample to the line for collection. All open heart patients are treated for diabetes right after surgery. It is a very common post operative side affect that passes.

There was that original line in my right arm hooked up to multiple drips.

There were two wire leads directly to my heart should there be a need to shock it to correct a rhythm in my chest.

There were two drainage tubes for whatever they are needed.

Later I realized there was a line into my neck being used for other drips.

There was a catheter attached to a Foley bag.

There were no lines in my groin area, even though I saw a marking for a location.

I slept in short frames of time. When I was able to make out the time it seemed to be in less than one hour spurts.

Thursday, June 2nd included a visit from the surgeon, his PA, the anesthesiologist, my Pastor, Tina from Weight Watchers, Larry and Cassie, and I think my cardiologist was on site with his PA. Or was it the 3rd for him? Most of it images. I doubt that any was coherent.

I was retaining H2O so Lasix was put in my IV drip. The Foley bag immediately had a fountain. That stuff is very effective.

This Spiro-blah-blah-blah-ometer was introduced to me some time after the surgery. I was still in the breath in, breath out mode and some fool thought this would be fun to do.

Then I met Jamie in the middle of the night. Straight and to the point, no nonsense, these are the consequences that I needed to hear.

The Spiro-blah-blah-blah-ometer is used to force open the aereola (sp) within my lungs that were allowed to do whatever they wanted to do while I was on the heart lung machine. Should I not utilize this instrument it was entirely possible I would develope pneumonia and be put back on the breathing tube. Nuff said. I was converted.

There is a lot of mental over lap in a short time frame, so please excuse me if something is out of sequence.

Friday, June 3, 2011: The arrhythmia cardiologist introduced himself. He is the guy responsible for making the most of what the surgeon did.

My heart was NOT happy about the surgery and was in some kind of atrial fibulation. His goal was to guide it back to some sort of 'functional' as the heart healed. This is done via short term drug intervention. The goal is to be off the drugs in some factor of 4. I don't remember if it is 4 weeks or 4 months. I do know the side affects to my liver are not nice if used long term.

The back up to my surgeon for the weekend showed up. The rooms are designed with a corner window for the doctors - nurses to use for observation and the never ending documentation. I saw him looking my way and talking so, I stuck out my tounge and said. 'If your'e going to talk about me you should talk to me.' I have no idea how it came out. But he did introduce himself.

My pastor from my Summer church visited. He is looking forward to my healing sufficiently to attend his services. He also repeated that my husband's soft ball team should go easy on his church's team.

The most surprising visitor was my general practicioner. I knew she was being fed information as I went through the pre-op testing. It surprised me she was aware of my situation among the 10 (?) patients she sees per day. My visits to her are at most every other year for things like wart removal.

No complaint. I never made a connection between her inquiring mind and my heart.

There were x-rays taken while in bed. Things have changed since 1960 when all x-rays were flesh against a cold glass plate.

One thing not yet mentioned was crying. I just needed to clear something from within and did it with tears into the softness of the cotton blankets. It was a lot to take in physically and emotionally and socially in a short time frame. I would pull my knees up and cry for a few minutes. It calmed me to go on to the next challenge. I would do this alone.. most of the time. larry was gone. I was on my own with my thoughts and God. It purged emotions that needed purging.

Late on Friday I was moved to the 9th floor. I was up enough to be walking with the IV tree. The
arrhythmia was being treated. Room 7128 was reserved for someone who needed more attention than I did.

I think this was when the hospital chaplain showed up and introduced himself. A Baptist from Brazil. How cool is that. Yes, I can be that high maintenance.

Pulmonary Heart Valve Replacement : 2011 -7

I realized I am quickly forgetting what happened during my hospital stay and do not want to be in the same memory situation for the time I've been home. To get up to date today I will publish this post in two parts. The first will be what has happened since release from the hospital and the other will be a continuation of the hospital stay. This is possible because my forearm did a lot of healing since yesterday and no longer aches to the bone. Today's blog should be interesting, because I am in an irreverent mood.

June 7, 2011 ~3:30 pm: released from the hospital. I was ready to leave, physically and emotionally. I do not believe I have focused as much on blood sugar, poop, pee and K in my entire life as I did in the prior 7 days.

I was sooooo ready to leave. HOME!!!!! I blew past the release papers.

Then I took a nap after that 20 minute ride. It was in the 90s outside and I was cold. I had been since the surgery.

Cassie took the Rx.s to Target and had all but the pain Rx filled.

I got up and took a shower. 1st one in a week. None could be taken while I wore the monitor. There are the ghost outlines left behind from surgical tape used throughout the last week. I am slowly rubbing them off.

No more finger sticks before and after meals. No more being woken up from sleep for needed vitals. No more good food destroyed through institutional preparation. [Jamie Oliver should give up on the USA school lunch programs and focus on institutional foods.] I was entrusted with my own care. The surgery has been successful and I was now obnoxious enough for everyone to agree to send me elsewhere!!!!

Aside: I am continually met with surprise at the speed of my recovery. I would like to say it is exclusive to my wonderful self. Sure... I don't believe it either. Credit is to be shared by my health insurance and my employer.

My employer offered 'free' on site yoga in 2009, with the encouragement of the health insurance. At that time I was not able to step up onto a kitchen chair to retrieve a basket from above the cupboard without feeling off balance. The yoga class helped me establish core muscles where I did not know there were muscles.

When that class ended I joined a class of ladies who meet on Thursday nights. When the instructor became aware of my upcoming surgery, she spent an entire class focusing on strengthening our hearts. My last full yoga class until mid September was May 27.

I joined the weight watchers program offered 'free' on site by my employer about a year ago. I learned how to make better choices than the already good choices I was making. In my case, removed soda, fewer grains and dairy. Alcohol was never an issue, nor was smoking.

It did not hurt that I have an 'Everyday Foods' subscription. Martha can make mud taste good.

I was also intentional about not pulling back from my normal activities prior to the surgery. The week before the surgery I finished my first weaving class using a floor loom. It is a great workout for the glutteous maximus. The last day of work I continued to use the 'tunnel' to get from a distant parking lot to my work area.

June 8, 2011: Phone call from Cindy of my health insurance company. She was making sure all was going well and provided direction for my next steps. We went over my release papers. This time I paid better attention, and followed up with a phone call to VNA. They are to fill in the time from hospital to cardiac rehab.

I called VNA and set up an appointment a little later. VNA showed up and I discovered they were expecting someone sicker than me. She tried to teach me how to take my pulse. It is a skill from my 20 somethings that has not returned. I cannot pick out the pulse. One of my meds has a side effect of loss of skin sensation. Or, maybe it is from the finger sticks. Or ... I have no idea why.

Maybe I should enlist Cassie for pulse taking. They want one prior and one after 'workout' pulse.

Here is my list of overall health goals:
- My heart needs to heal, and I keep forgetting this. It keeps reminding me with tears.
- My lungs need to be deliberately expanded with the Spiro-blah-blah-blah-ometer. This is a torture device designed to force the lungs open after being on the heart lung machine. To operate wrap your mouth around the mouthpiece and inhale. If you are my age... think water bong. I have no pratice with this device. Yet, it is progressively effective. I can now lay on my back and breath.

I may have that device bronzed.

- My throat needs to heal from the breathing tube. This is happening on it's own schedule.
- My collar bone needs to heal. There is not much I can do about this, either. The healing will take time.
- The incision needs to be kept clean and from time to time stretched so I do not get used to sitting shoulched over.

THERE IS NO PAIN that OTC Tylenol cannot handle.

The rest of me is functioning at 'normal'. The goal is to avoid infection and be aware of any negative changes.

June 9, 2011: Cassie took me to the bank and Walgreens across the street. I made it to the second story 3Xs. Took a nap on the lower porch. Checked out the upper porch.

VNA sent 'Lizbeth' to take my vitals. She was expecting someone sicker than I am.

Phil brought my warping board down from the 2nd floor. I explained to 'Lizbeth' as long as I could wrap a warp, those exercises could be bypassed. [Think teaching Mozart to read music at 15. Well, maybe not quite so obvious...]

At bedtime I went into meltdown. Too much. Too soon. Larry brought some Tylenol for the aches and pronounced I was to do nothing the next day.

June 10, 2011: I woke up with Larry at 3:30 and saw him off to work. Then I wrapped 10 ends on the warping board. Took my vitals. Then I took a nap. I wrapped another 10 ends on the warping board. Wrapping the warping board is definately an aerobic exercise.

Cindy called from the insurance company to see if all was still going well. It is.

I called my cardiologist and my arhythmia cardiologist for follow up appointments. They are now set. I anticipate a call from the surgeon's office in the next couple of work days to set up that after surgery appointment.

Hospital Stay: ICU (AKA 7th floor): to be continued in 2011-8 posting. I need another nap.

Thursday, June 9, 2011

Pulmonary Heart Valve Replacement : 2011 -6

My right forearm is raw from the veins out. They were flushed with saline on a regular basis during my hospital stay. I will type this posting as long as my brain or fore arms do not freeze up.

June 1, 2011, 5:15 am: Phil pulled up to the main entrance of the hospital. I got out and walked in. He took my car home to this week's body work.

I had done the 'night before shower' and the 'morning shower' using an anti-bacterial body wash. My allergy to chlor hex eliminated the hospital preferred method. I smelled of fresh mountain spring, when I normally go fragrance free. I was well fasted. Anything I could do to improve the outcome of the surgery was pursued.

I carried a canvas bag similar to those reusable totes used for groceries. It contained a toiletries bag, a Shutterfly book of our travels since June 2010, the information folder of what I would need to know when I could not think straight [such as the business cards of doctors I've seen], a copy of The Shack, and the prayer shawl, [well used during my brush up with cancer last Summer].

The elevator just inside the entrance took me to the third level 'same day surgery' area. I ended up in a hall behind a sign requesting I wait for the next available person. One of the people doing the admitting looked up and informed me she would be with me in a few minutes.

I felt like Daniel must have going into the lion's den. Things were closing in around me, and there was NO WAY I could stand in one spot for a few seconds, much less a few minutes. I backed up to one of the hallway walls and slid my butt down to the floor for the wait. I learned something new about hospitals. They do not like it when your butt touches the floor. And,(from the nurses I spoke with later in the week), there is a bunch of paperwork that is needed to be done when this happens. A chair was produced from somewhere. I stayed where I was because it was too much effort to get up to sit in a chair that did not look as comfortable as I was at that time.

Admissions was quick with a verification of who I was and the standard, "What is your birthdate?"

I was led to a patient waiting/transition room and given the clothes I would need to change into for surgery.

There was paperwork to fill out. There is one form that grants the hospital permission to dispose of tissue. I hand wrote in a request to see the original valve. It has tethered me for my entire life. I wanted to see what was so important about it. I cannot remember a time there not a shadow in the back of my mind weighing the pros and cons of an action relevant to how this valve would respond. I wanted to see the culprit!! I wanted to see how big it was... the reports gave it 3.8 cm diameter. Was that an inner or outer diameter? How long was it? What was the texture like? What color was it? I wanted to see it before it joined the scrap bin. I had no desire to take it home in a Mason jar.

My pastor showed up during the wait and provided comfort and company for a while. I sent him on his way. I needed time to finish rectifying my life to this point and what it would mean should I go to God leaving my remains to the cemetary in Northern Michigan where my husband's parents lie.

There is a man from my church who died this last Spring. He left our world for God's in a joyous dance, ever mindful of where others' were in their God quest.

My thoughts were: Where could I have grown more? I could not find one area. I chalked it up to my mind going a mile a minute with anticipation.

I began pacing the hall of the prep area. There was one other patient and no one seemed to care that I stay put. One wall of this area was glass. Bright sunlght streamed in and warmed my skin.

The next step was to go to a room for sugery prep. Here a line for IV was put in and I repeated my request to see the valve. A new nurse showed up and I repeated the request to see the valve. She told me it was not procedure. Maybe a picture would be possible.

I met the anethstesiologist for the first time. I understand why my surgeon chose him to be part of the operating team. He told me I would be taken to another prep room prior to surgery and he pointed to areas of my body where tubes - lines - portals - etc. would be put in. I understood he was describing where they were going to hook up the heart lung machine to my body, without him saying so outright.

The request for my heart valve viewing was requested and there was a quick conversation of my making the addition to the paperwork.

I was woken up ~ 5:30 pm. There is nothing in between.

Wednesday, June 8, 2011

Pulmonary Heart Valve Replacement : 2011 -5

I'M HOME!!!!!

Wednesday, June 1, 2011 I underwent pulmonary heart valve replacement.

Tuesday, June 7, 2011 ~ 3:30 I was released from the hospital to go home and recover. There are many things I experienced and will gradually blog as I am physically able. It is amazing how tiring that 20 minute ride was.

The picture above is June 2, 2010 documentation of warping up my loom for the first time in two decades. (There are more flowers in the camera from my morning walk in front of the house and a 'replace batteries' message.) The warping of the loom seems appropriate because I feel all tangled up inside, yet I know as long as I follow the plan everything will fall in line.

Today I will say my thank yous. I do not know if it was mentioned in the prior blog, but my valve is a homo-graft. Homo-grafts function longer than the other biological valves. So, beating within my heart is a remnant of a young person who gave me a much better future. This done by a family out of the depths of horrendous loss. Humbled is not a strong enough description of my gratitude.

Thank you to the surgical team. There are modifications needed to work on the pulmonary valve. I lost consciousness around 9:00 am. I was in the ICU by 5:30 pm. How many of us are at our best for 7 1/2 hours straight?

Thank you to the cardiologists who guided me through the pre-op testing and decision making.

Thank you to the arrhythmia cardiologists who beamed happiness when their drug therapy brought the results needed.

Thank you to the physcian assistants who knew what to expect. They gave me a clear headed view when I was having trouble forming a noun verb noun sentence.

Thank you to my personal Primary Care Physician, who showed up with the intern-of-the-month to pay a visit. Every time I had a test or visit I was asked who my Primary Care Physician was. She was getting updates and came to check out what the results were.

Thank you to my gynecologist's office who fielded questions on Monday morning, via telephone on non heart related issuses

Thank you to the Chaplaincy from inside the hospital and my beloved local churches. They brought God to me when I was too muddle headed to feel Him.

Thank you to the nursing staff. I began compiling a list of their names Sunday. Initially I was looking for a repeat of names. Instead it turned into a baby name directory: Veronica, Linda, Adala, Tacy, Heather, Judy, Andrea, Melissa, Jessie, Eric, Michell, Shella and Melissa Part II. This is a very incomplete blended list of RN and nursing assistants assigned to me. They work nasty hours and are pleasant and encouraging to those they care for. Try asking your spouse for a glass of ice water at 3:30 am. It always came with a smile.

Thank you to those who know me and still called, sent cards and visited.