June 6 was the date scheduled for my aortic root reconstruction.
I was scheduled for Dr. Gaudiani's second slot of the day, reporting
in at 6:30 for the Betadiene shower and the whole-body shave.
The cheerful orderly who shaved me told us a couple of reeeeelly bad
jokes as well as singing *all* of Rod Stewart's "Maggie May."
At 8:30 I was rolled into the operating room, where even without my
glasses I could see the Rube Goldberg complexity of the heart-lung
machine, a wall of stainless and plastic plumbing. The anesthetist
set an IV and we were having a pleasant chat when
...I was in a much darker room, with a tube down my throat, looking up
at a clock that said 4:30, feeling a strong need to pee and wondering
whether or not I was plumbed for urine. (Of course I was, but if there
is any tension on the catheter line it makes you feel as if you need
to go even tho you don't.)
This of course was the ICU, where nurse Nancy stayed with me the rest
of her shift, removing the breathing tube and cranking me to a more
upright posture, as well as doing lots of things out of sight. My state
until the next morning was "punctuated alertness" in which I would be
awake, interested, & talking for a few minutes, and then would drowse
off for a few minutes. Nurse Dennie who came on at 7:30 told me that
this kind of broken cat-napping was typical for the first night. It was
Dennie who brought me the wonderful gift of a cup of ice chips and a spoon
about 10pm.
What happens next is so weird I'd think it was a drug-induced dream,
but I have physical evidence. Sometime about 2:30 am, a nurse named
either Beverly or Bernadine (something with a B...) came around and
taught me how to use a breath-therapy tool that I've dubbed the
windsucker -- you inhale on a tube to raise a piston to a certain level.
Ten reps, one set per hour, to help your lungs reinflate and avoid
pneumonia. Very useful -- but 2:30 am? Oh well, I was awake and bored,
why not?
An interesting point is that I could suck the piston to a higher level
on the scale that night and the next morning, than I have yet attained
since! My chest hadn't figured out how badly it had been hurt at that
point, I guess. Only today (+6) am I getting back to the
same point on the scale!
Early next morning I got up from bed, to be weighed. Up 2KG from
pre-op weight, due to extra fluids introduced during the op. Later in
the morning the official breathing therapist came around and was
surprised to find me already set up with a windsucker, and gave me a
second tool, looking something like a plastic kazoo, for blowing into.
Ten reps and cough, 3 times per hour.
All this day and the next (+2) everyone was telling me how great I looked,
how I didn't look as if I'd just had an operation, etc.
On this day the lead and 2nd surgeons (Drs. Gaudiani and Castro) came by.
Vince Gaudiani was tickled; mine was the fastest root replacement he'd
ever done, 41 minutes bypass time. He commented that I had "a classic
Marfan's [syndrome] root" and the root tissue was "crummy - very soft."
Later, the #3 surgeon (whose name I didn't get) also said that my
root tissue had been "very floppy - you were fortunate." Fortunate,
presumably, to get rid of it before it dissected.
Late on this +1 day rooms opened up in the Cardiac Surveillance Unit
(1 nurse: 4 patients, as opposed to the ICU's 1:2) and I was offered a
choice of a double or a single. Gee, tough choice...
That afternoon Marian sent an email to a list of family and neighbors,
including the hospital #, and I got a couple of phone calls as a result.
Saturday (+2) a friend came by and talked for an hour; Sunday (+3) I
had practically a house party of 6 or 7 visitors in the afternoon, which
in fact was fairly tiring and that night I felt somewhat fevered and crummy.
Monday (+4) I woke up to realize that the night nurse had not come in
to take my vital signs at midnight and at 4am, as had been the custom.
Obviously I must be better... And the day nurse said that my discharge
had been written, but not signed, pending bloods and a chest xray.
It took hours to get the xray scheduled, and more time before the
on-duty surgeon got time to take a look at it, but indeed about 1pm
came around and allowed that there didn't seem to be any clinical reason
to keep me around. So an orderly pushed me downstairs while Marian got
the car, and home we came, on the 4th day post-op!
That evening we walked around the block. Day +5 we went on on couple
of two-block walks. Today, Day +6, we walked about 7 blocks to a local
center where we hit the ATM, bought a few things, and sat for half an
hour over juice and buns before coming home.
The surgical scar remains modestly painful, ranging from 0.5 to 2 on
a scale of 10, depending on how long it's been since I took some painkiller,
but I have pretty well stopped using the Vicodin and gone to just
Ibuprofen. The bruises surrounding the scar only became visible in
many shades of yellow on day +4, and are starting to fade again now.
I would seem to have had an especially easy and rapid procedure, and
the biggest problem in the coming weeks will be keeping a steady level
of effort and not getting impatient.
Dave Cortesi