Recovering with a Bypass Patient |For what it's worth

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Wednesday

Recovering with a Bypass Patient

 He started to rise from the dining room table after a nice meal with the kids and their families.  His balance was off and he almost fell as our son and grandson grabbed for his arms in alarm.  Our paramedic son asked how often that happened and when he said whenever he gets up too fast or from squatting in the garden he elicited a promise to talk to the doctor.  Two weeks later amid the covid19 pandemic we sat in our car outside a cardiologist office 90 miles from our home.

heart beat graph

I still sat in the car talking on my phone and waiting while he went inside for a stress test when a knock on the window startled me but not as much as his next words.  My husband of nearly fifty years said he was to be admitted through the ER across the street.  I was confused and startled as he tried to explain there were three abnormalities to his stress test and there would be another test performed there.  


As I read aloud the paper work we were carrying over to the hospital we came to understand the next test was a "Cath" procedure that required a Covid test and overnight stay.  


Trying to rest the night before your spouse goes in for a medical procedure of any kind is not very achievable.  I wasn't able to stay with him so I drove the 90 miles home and back again early the next morning.  Then I waited, alone in the hospital heart unit while he was wheeled into surgery.  It's a weird experience even without the Covid restrictions.  One person per patient is allowed to be inside after answering a series of illness related questions and taking my temperature.  I sported a color coded bracelet for each day I visited.  In hindsight I wish I'd kept them as some kind of trophy like those vacation t-shirts that say "My parents went to Hawaii and all I got was this t-shirt".  Maybe I'll come up with my own t'shirt slogan. "My husband got a heart upgrade and all I got was some paper bracelets."


The Cath procedure only took about an hour but the look and hushed tone from the Doctor gave me immediate warning.  Multiple blockages and swellings made putting in stints a no go.  The Doctor explained simply and directly that I'd be taking my husband home today but he should not get too hot (the Texas heat was already soaring in the triple digits) or anxious about anything until a heart surgeon called to confirm yet another appointment for a heart bypass.  So, in silence we checked out of the hospital and drove home digesting the information given to us.  


A few days later found us back in the Heart clinic meeting the surgeon that would perform a triple bypass on my husband.  The seriousness of the procedure stunned me and thus began my first feelings of a panic attack coming on.  I held it together because I couldn't imagine what my husband must be feeling.  We were told that this is an elective surgery so the planned date for his operation could be postponed due to the availability of respirators and intensive care rooms for Corona patients.  As predicted, we'd barely pulled out of the parking lot when a call came that his procedure would be delayed because the hospital had a spike in Corona virus cases and all elective procedures were cancelled until further notice.  


Meanwhile we made another trip the following day to the hospital for a Carotid Doppler in preparation for the Coronary Artery Bypass grafting X 3. It was later I understood the purpose of this sonogram was to be certain the arteries in his neck were clear enough for a pic line during the surgery.  Five days later a call came re scheduling surgery in 16 days. 


The next 16 days I made preparations by scrubbing everything in our home hospital clean and distracting ourselves as best we could visiting with the children and grandchildren while staying socially distant from every one else so as not to be exposed to Covid.  


Seven days preceding surgery we drove again the 90 miles so my husband could pre-admit, give a lot of blood samples and get another Covid test.  The next seven days were full of stress for both of us.  At one point I wondered if I might be having my own heart attack but knew it was likely another anxiety/panic attack.  

Heart

On the Thursday morning of the surgery we left our home at 4:00 A.M. for 5:30 A.M. check in at the surgery center.  Our sweet daughter met us there and visited with her dad until he was allowed to go inside the building to start the procedure.  Once inside we were escorted to a pre op room where his vitals were recorded and we met everyone involved in the surgery and prayed.  We learned more about the ventilator that would be inserted to breath for him along with the pic line, catheter and wires that would re-start his heart when the grafts were completed.  Yes, that's right, they stopped his heart for surgery.   I waited in a calm peaceful area to stare at a surgery progress monitor.  Thankfully I received status updates via text messages from an attending nurse that kept me sane.  I shared the updates via text to our children, their spouses and adult grandchildren. Five hours later I was very grateful that when I saw the surgeon he was happy with everything.  The heart restarted just as it was supposed to and they'd try to take him off the ventilator when he awoke and could breath on his own.  Another hour later I moved to the Intensive Care room where we waited for my husband to wake up.  


Waking took several hours and when he did wake he was very confused.  In Intensive Care a nurse sat at a monitor in his room keeping a very close eye on him.  I felt confident enough to leave him in their care while I ate some food and slept in a nearby hotel with our daughter.  That night I slept very hard.  I guess I was exhausted from the weeks of waiting.  


He spent two days in ICU.  He had to be off the ventilator breathing on his own successfully before moving to a room on the heart patient floor of the hospital.  Even when that was accomplished he was still tethered to wires monitoring his oxygen, blood sugar, heart rate, pulse, and other stuff.  The pic line still dangled from his neck which bothered him tremendously.  A patient sitter/monitor was assigned to be with him 24 hrs a day until his confusion and agitation subsided and he ceased trying to remove the lines attached to his body.  That allowed me three more nights to get some much needed rest in the hotel.  


Sunday, the fourth day after surgery, the surgeon removed the wires from his chest.  That was terrifying for both my husband and me.  Luckily my husband couldn't see it and because of the medication wouldn't remember it. It would be too graphic to describe here, just know I realized again just how serious this whole thing is. A nurse removed that annoying pic line next and I started to see improvement in his awareness of where we were and why.

angel holding heart

Monday, only five days following surgery, he was dismissed from the hospital and we made the long drive home.  I had stressed a lot with anticipation of that drive but my husband managed it amazingly well.  He and I walked up the sidewalk, up the three steps into the house and made it to our bedroom where he slept for several hours.  I sat in a chair by the bed and waited for him to rouse, which he did for a short while before drifting back to sleep.  I dozed on and off too.


The next few days he continued to experience moments of confusion and some agitation.  He had trouble swallowing and did not want to eat.  That continued for another week.  As the medication cleared from his body he became more alert.  His lack of appetite concerned me as he could only swallow a few bites a day. The weakness after so many days of very little nutrition was obvious to both of us.  He began to make concerted effort to eat something each time it was offered.  Ice cream, protein shakes, and broth were about the best he could manage. A telephone contact nurse assured me as long as he was getting some food down and his blood sugar remained in range he'd improve.  He did, slowly.


I wasn't sure if I was having more panic attacks or depression but my emotions were becoming overwhelming. I had been warned bypass patients often experience depression and to watch for it, but I had not expected to feel it myself.  I considered contacting my doctor but put it off until the weekend was over.  


Monday, 12 days post surgery, my husband woke and was fairly pleasant. His glucose tests started running a bit high so I added Glipizide back to his daily meds as I'd been instructed at the hospital. His swallowing was a bit better and he ate a low carb waffle with blueberries and sugar free syrup.  He kept mentioning fluctuating temperature changes.  Even though the room was consistently the same he alternately complained he was too hot or too cold. Often within minutes.  Our son and his 5 year old daughter came by for a very short visit.  Both my husband and I benefited from the visit emotionally.


The following day we had a phone visit with a transition therapy P.A.  He confirmed the  medication change and also confirmed that the body temperature fluctuations would level out in a few days.


On day 14 he woke hungry and wanted to walk to the den to sit up a while.  He was a little shaky so he used a walker we borrowed from friends. He ate a good breakfast then went back to bed for a long nap.  He woke again to eat another good meal for lunch, a 2:00 snack and 7:30 dinner napping between each.


Day 15 he ate a nice breakfast and showered, then I drove him to meet with a Rehab therapist for evaluation.  An hour later he was back home exhausted from the trip and slept several hours only rousing to drink liquids and fall back asleep.


He slept a lot the following day too.  Two of our other grandchildren stopped in for brief visits which greatly pleased him.  I realized I was feeling fewer stress attacks on this day and attribute that to the visits, calls, prayers and improved mood of my husband.  Because of this realization I am determined to call and visit friends going through similar events.  Also because I recognized that contact with other humans was proving so beneficial I started making at least one contact a day with a family member or friend.  My stress/panic attacks have almost receded to nothing.  Even the nightmares I was experiencing ceased.  


On day 18 Hubs started going to physical therapy for an hour twice a week.  Each session left him exhausted so he slept a lot the first week.  


The surgeon visited with us via a telephone video conference on day 20.  He was pleased with the healing progress of the incisions and reinforced the need to wear the heart hugging vest for six weeks.  Hubs really hates that vest because he feels uncomfortable in it.  


The following week, as instructed by the surgeon, we sat through another telephone video conference with hubs primary doctor to update him on progress and medication changes. 


After four weeks I see significant improvement.  Finally.  The incisions are healing, the bruising is almost gone. His appetite has returned. The hot/cold fluctuations are subsiding. Hubs is beginning to stay awake longer periods, walks to his chair in the den for some TV viewing and has even taken a couple of short walks outside with no walking aides.  I credit the physical therapist for giving him the confidence.  He's looking forward to the end of six weeks so he can go out to breakfast with his morning guy friends.  We've had no new cases of the Corona19 virus in our county for weeks, so I see that breakfast as a real possibility.


couple holding heart

After six weeks and six days we met with the surgeon again via telephone video conference.  He released Hubs from his care and he can resume regular activities with caution and can drive himself again.  It was a trying six weeks but his future prognosis looks very bright.  I knew it would be hard, but the emotional ups and downs were more than I could anticipate.  I'm positive that our vows given fifty years ago "for better or worse" and our Lord brought us through this.