December 2018

Wednesday: I took Julie to the VA Hospital today for a consultation with an Ear Nose and Throat specialist. This man is by far the best doctor we have seen since I moved here, and therefore by far the best specialist. His enthusiasm came across as exceptional caring and empathy. The end result is that right after we get back from our mini road trip between Christmas and New Year, we will spend almost a whole day there, for several tests and another consult with him. His assistant was equally helpful. When I quietly mentioned to him that we were unhappy with Julie’s Primary Care Provider, he simply directed us to the Patient Advocate, who, he said, would be able to hook us up with a different provider.

We did find the Patient Advocate’s office, but it was closed. I recorded their phone number for future reference..

After that, we grabbed some lunch in the cafeteria, which is on the other side of the complex, so I left Julie sitting on a bench while I went back to retrieve the car. She was messing with her phone and looked up to see Santa and Mrs Santa, and begged them to allow her to take their picture.

Thursday: Surgery is today, with a 10:30 check-in for 12:00. It’s still early and Julie is still asleep. I’ve taken all of my morning meds and I’m just doing stuff to keep my mind from wandering.

Out of surgery, which turned out to be a diagnostic at this stage. The issues they found are:

  • The Aortic valve is bicuspid, which means that it has 2 flaps instead of 3. I was born with it (I already knew that). It has degraded over time and needs to be repaired or replaced.
  • The Ascending Aorta is enlarged. I’ve known this for a long time but it needs to be contained.
  • The Coronary Artery is almost completely blocked, needs to be repaired. This is actually the critical issue, and probably explains my difficulty breathing.

Sitting here in recovery with my right hand elevated and doing nothing except holding the phone steady while I type labouriously slowly with the left. Because the arterial entry point was the right wrist, it is encased in a thing that looks like a clear watch, with a vacuum holding it closed while the nurse gradually reduces the vacuum every 10 minutes. I’ve taken a picture, but will have to wait until we get home before I can upload it.

Home now. Here’s the picture.

Friday: This was taken this morning. That sticky thing is about 2″ across, and it has to stay on for the rest of the day. I can’t shower with it like this either.

Also taken this morning, showing the swelling on that side.

Saturday: Hmm. I recall saying that I was actually looking forward to that surgery, because I figured that when it was over, I could breathe normally again. Now that I’m facing the actual repair job, I’m not so sure about what I’ll have to go through to get there.

Sunday: I’ve just taken a shower. I have a fantastic bruised area on most of my forearm, and some interesting purple dye markers in two places on both of my feet.

Wow. Things move quickly around here. Here’s the timeline:

  • Nov 9 – Appointment with regular doctor. Referred to cardiology at both Providence and Western Washington.
  • Nov 18 – Providence not available until Late Feb.
  • Nov 27 – Appointment with cardiologist at Western Washington.
  • Nov 28 – Echo cardiograph. Showed nothing new.
  • Nov 29 – Surgery scheduled.
  • Dec 6 – Diagnostic surgery. Showed blocked coronary artery.
  • Dec 6 – While still there, visited by Cardio Surgeon.
  • Dec 10 – Can’t return to work.
  • Dec 10 – New appointments set up.
  • Dec 11 – No truck, no access to workshop.
  • Dec 14 – CT Scan with contrast.
  • Dec 19 – Vascular Ultrasound.
  • Dec 20 – Open Heart Surgery.
  • Dec 25 – Merry Christmas.

Dec 12 – From now until the surgery, the exercise plan: Every morning, take a shower and go for a walk. Fortunately, there is enough level ground to the North and South. I can actually walk into downtown Everett on level ground. Today, I walked to the nearest Starbucks store, sat down for a decaf coffee, and brought home one of the sandwiches that I usually eat anyway.

Ah, the bullshit process strikes again. Dec 20 is not surgery, it’s just an appointment to review my scan results and THEN set up a surgery date, which will be be sometime in January.

The good news is that I can claim on the company provided short term disability insurance (25%) and also my subscribed short term disability insurance (two thirds), which together will pay just over 90% of my wages until I get back to work. At least we will still have an income.

The walk to Starbucks is becoming a daily event. Often, it’s the only time I go outside, dressed up in insulated hat and gloves, plus a couple of layers under the waterproof jacket that was a present from the company last month.

Today’s walk was a little different. On the way back from the CT scan at the local hospital, I stopped the car a few blocks from Starbucks, so that I could walk there and at least get a walk in for the day, albeit a shorter one. On the way back to the car, I caught up with these statues.

Sunday 16: Today’s walk was a disaster. I’d been feeling a bit “not quite right” overnight, but decided to at least stick to the routine, but instead of making it 5 blocks each way, I made just 1 block before turning around. Apparently I looked so pale when I walked in that Julie insisted on calling for an ambulance. The guys were great, and had me hooked up and transported to the hospital in about 15 minutes.

I’m now on the surgery recovery floor, presumably because it’s only a matter in timing and availability before I go to surgery, probably tomorrow. But here’s the kicker: because of my Restless Legs, I take a TON of sleep meds just to get to sleep, but because I just gathered up a week’s supply of everything, they put me through a whole drama of figuring out what dosages they were. On top of that, I haven’t eaten much today, and because I might have surgery early tomorrow, I’m now fasting! Talk about being tired, hungry and cranky!

On a brighter note, the view from up here is impressive, and I have the window side of the 2 bed room.

I came across this on of my forays up the passage.

Monday 17: Now that I’ve had a few hours sleep, and I’ve eaten, I feel a whole lot better. This is the daylight view from my bed.

And looking a bit further north. The strip of land in the foreground is Jetty Island. Further out, Hat Island on the left, Whidbey Island in the background, the bottom end of Camano Island to the right of centre, and Priest Point on the right.

I’ve had the Ultrasound test, firstly on the carotid artery to make sure it can take the strain, and then on arms and legs, looking for the best veins as candidates for “harvesting”, to be used as a bypass around the blockage in the coronary artery.

We just had a visit from the surgeon and I am now confirmed for surgery on Wednesday. He drew a diagram on the bathroom door.

He will:

  • Replace the Aortic Valve with a synthetic one.
  • Remove a section from the enlarged Ascending Aorta, and replace it with a mesh graft.
  • Harvest a section of my left radial artery (the best candidate) and plumb it into that mesh at one end, and into the coronary artery below the blockage, at the other end.

The sun came out!

Tuesday 18: Today being our 15th wedding anniversary, I ordered some flowers online. Because it was me ordering them and me as the recipient, I had to answer their query and explain the situation. Fortunately, they arrived mid afternoon, before Julie left to go home.

Wednesday 19: Operation Day. I had a “late” start at 5am and I’m trying not to be scared. I trust the surgeon and I know that he knows exactly what has to be done. I’m just not looking forward to all the pain. We got right through to the point of finishing in pre-op, to receive the news that the surgeon had to work on an emergency case, and that we had been canceled, to try again tomorrow.

Later in the day, a surprise delivery from my colleagues at Solie Funeral Home. Thanks, guys. BTW, the answer is, “Because he was Koala-fied”.

Thursday 20: Surgery was a success. That’s all I remember..

Saturday 22 (maybe): The story gets a bit mixed up here, due to the seriously crazy drugs for pain management. For a few days, I was seeing double, but not just double. Sometimes, it was the same view, offset a bit, other times, it was a different view completely flashing in front of whatever I was looking at. A bit hard to see the keyboard, let alone type on it, when that’s happening!

This the scar with drainage tubes still in place.

This the scar itself.

Apparently, I perked up a bit when Mike and Julie called in. I had “some colour”.

Way too much “stuff” here.

Tuesday 25: I sent this report to April this morning – sums it up pretty well.
Now that I’m sitting up this morning, I just wanted to update you on my condition. It feels SO good to be able to see what I am typing!

The drainage tubes up into my chest came out yesterday, along with the catheter. That improved my mobility hugely, although I’m still SLOW and I hurt – chest pain level is a constant 5, spiking to 8 when I cough! I have to walk at least 4 times a day and cough up muck whenever I can. I also have to use the spirometer as often as possible. It measures how much vacuum I can generate with my lungs. I still have wires and tubes for oxygen, phone, call button, blood pressure and wires for the heart function monitor, plus 2 IV tubes in the right arm.

I have an 8″ scar up my left arm for where they harvested a vein for the coronary artery graft, plus an 8″ huge scar on my chest.

I expect to be discharged today at about 2pm, via cabulance to a recovery facility, since Mum would not be able to care for me in the apartment. BTW, dear, you have been a real trooper in the face of adversity. I know it’s been tough not being able to get here very often, but until now, I would have been crappy company anyway.

Surgical notes:

On the left: Coronary Artery Bypass Graft (CABG, commonly referred to as a cabbage), using the radial artery from my left arm.

To the right of that: Ascending Aortic Aneurysm graft (commonly referred to as a AAA), replaced with a HEMASHIELD PLATINUM Woven Double Velour Graft. At both ends,where it says “anastemosis”, it simply means the 2 ends were sutured together at top and bottom.

At the bottom, the aortic valve was replaced with a Carpentier-Edwards 21mm perimount aortic bioprosthesis.

Finally got a clear view of the ranges, from the window at the other end of the floor during one of my mandatory walks, with enough energy to go back and get the phone to take pictures.

I’ve just had a shower for the first time in a week. I can’t believe how much weight (mostly fluid) I’m carrying in my belly and legs.

Wednesday, 25: I’ve now been transferred to the Bethany facility in the Providence Pacific building, and I have another view out over the water. Not as spectacular as before, but still a water view.

I have finally nailed down what it is that my eyes are doing. It’s like a freeze frame. I’m looking at something, then there’s a super fast transition, during which (if I’m really lucky), I’m looking at the same thing in the same position, and then I ‘m back to looking at the original scene. Wow! Normally, I’d say, “I’ll have what he’s having”, but really, I don’t want it!

Crappy Mistmus.

To top off the day, this is dinner.

An indication of the fluid that I’m carrying

Over the last few days, my heart rate spiked and went into an arrhythmia. With all the additional drugs they pumped into me, I’m now being treated for Gastroesophageal Reflux Disease, Diabetes and Tuberculosis. Apparently, this is quite normal. Really?

Thursday 26: I’m finally feeling better. Won’t be doing any sprints any time soon, but it’s a definite improvement.

The hallucinations eventually subsided today, and I actually ate some lunch, and enjoyed it. One of the staff here said that hallucinations like that are quite common. My legs and belly are still badly bloated, but at least I’m back to being myself.

The plan is that Nancy will come over on Friday and help Julie to de-clutter the apartment. I expect to leave here on Monday and we have a big day at the VA on Tuesday. I expect to be off my day job for 3-4 months.

Julie was here for quite a long time today. We received visits from a variety of counselors. One of them, Robyn, connected with me in a way that I haven’t seen for 15 years now, not just that she had been where I am now, having survived a head-on car crash, but also that she understood what it is to be a healer. Doris was trying really hard to interrupt, so it must have been important, and I actually told her to shut up for a while. I recalled that she has been assigned to me for the rest of my current lifetime.

Much later, sitting on the bed waiting for my evening meds, I realised it. I’ve done a lot of learning my lessons, but I still have my life’s work to do, and Julie is an integral part of that work, as I found out back in August of 2004. The simplicity of that revelation just blew me away.

  • We’ve been through a lot of stuff together.
  • I’ve just experienced a life changing event.
  • Julie is right here with me.
  • We do it together

Thursday 27: When I have a rough night, it degenerates into something really ugly. I woke up in the very small hours to find my shirt wet and what looked like a blood nose. Turns out that my wound was pushing out a lot of thin red liquid, which looked at first like blood, but we concluded that it was more likely to be extra liquid built up in the area. Once something like that happens, it throws me. I can’t seem to find a comfortable place in the bed, then I get cold, then it all goes to crap after that.

On further thought, I figured out that I had slipped off my pillow and had been sleeping off to one one side, which could easily have twisted the wound just enough to cause the leakage. Fortunately, the day progressed a little better, as I started therapy to:

  • Teach me the techniques I need to know to protect my sternum.
  • Start me on a program of walking, specifically to improve my fitness.

Friday 28: Amazing what a decent night’s sleep can do. I have woken up with a clear head and a positive attitude.

By the time the physical therapist walked in, just before breakfast, I have already done a 5 minute walk, and her words to me, “Don’t do too much, I need you for this afternoon”. It’s a rehab facility and I need to accept that “go with the flow” is the new normal, for now at least. Today’s session revolved around the kitchen. Given that we don’t do much cooking anyway, and Julie will have to learn to load her own wine casks into the fridge (which she does most of the time now anyway), I don’t anticipate much change, other than grabbing the fridge door handle with both hands.

Oh wow. I’ve been coughing, and yes, it hurts. I asked for some cough syrup, and yep, you guessed it, it must be ordered in, presumably to the pharmacy, who will then deliver it up to here. I just smiled at the nurse and shook my head. No point in aggravating her any further.

The view from the Northern end of this building, which is part of my walking trail.

I came across this and agreed.

Heh heh. This is what happens when you combine an engineer with a simple jigsaw puzzle.

Here’s today’s puzzle. You’re looking at the top of my sternum down to the sutures at the top of my belly. The incision has developed a leak of fluid, which needs to be contained. After several attempts to “dam it up over” the last 2 days, this is the current attempt. Anyone got a better suggestion?

Saturday 29: We now have in place, another Care Conference on Monday 31, with a view to release on Tuesday 2. Mike, Duncan and Julie will be there to learn what it is that I now know about looking after myself and protecting my sternum from damage. Meanwhile, I’ve just done 3 laps of this place, out past the end rooms, then to the other end, around the elevators and back to my room, 3 laps in just under 9 minutes, at full stride but not yet full speed. I figure that will be my benchmark for the next couple of days.

The incision on my chest has now dried up, so now I can leave alone to dry out properly.

Just got off the phone with Julie.  Big thanks to Nancy (yesterday) and Trish, Destiny and Heather (today), some of my work friends at ActivSpace, for the clean up. I’m told I won’t recognise the place when I get home on Tuesday.

Finished the jigsaw puzzle.

Sunday 31: The sun came out again!

Navy vessels at the local base.

Love those mountains.

Julie, Mike and Duncan are coming here today to receive instructions on what to look for when I get out, in relation to protecting my sternum. Mike and Duncan made it, Julie fell off her computer chair last night when the arm rest dislodged and threw her off balance. I do know she was in a LOT of pain last night.

She’s just called 911 and they are taking her to Swedish Hospital in Edmonds. Wow, it just doesn’t seem to stop. She made contact a few hours later to say that she has 2 broken ribs and was home again.