Drugs, Cheese, and Puss

So apparently I have yet another infection. Fun times! This time it’s on my scar. Puss = bad. No matter how much you have of it, it pretty much means there is an infection. So if any of you ever get into that situation after surgery, go straight to your GP. They’ve given me antibiotics and I don’t seem to see any more puss but I still won’t be happy until I’ve seen my cardiologist in 2 weeks time. GPs just seem to be...rubbish.

Now, for life with a mechanical valve. For one thing there is a constant ticking every time the heart beats. Before my operation I was pretty worried about this because if I came to hate the sound...I would be pretty much stuck with it. And there’s no way of listening to it before you have the surgery! The sound comes from the two mechanical valve leaflets opening and closing. Having lived with it for a month now I can safely say that no-one has anything to worry about this. A lot of the time I just don’t hear it – whether I’ve blocked it out or not I don’t know. IN fact, I’m pretty sure my family hear it more than I do. Even when I do hear it, it’s so soft that it just doesn’t get annoying. It’s become part of me, like the sensation of my heartbeat.

Of course having a mechanical valve means taking Warfarin (aka Coumadin in America) for the rest of my life. Not to go in to the details again as I’ve covered this at the beginning of my blog when it started, but Warfarin is an anti-coagulant which slows down how quickly blood will clot. This is important because normal blood will clot on the valve and cause a stroke. The other side is that if the blood is too anti-coagulated (i.e. takes too long to clot), it can cause a fatal bleed (e.g. in the brain).

This sounded terrifying to me before the operation but I will say that living on Warfarin really is a breeze. Yes you have to go for regular blood checks, but if you’re confident enough you can do these independently. I recently bought a machine which checks how anti-coagulated my blood is. This means I can test at home in my own time, then email the results to my nurse/GP. They will then calculate how much dose of Warfarin I need. I will say that if you’re not willing to purchase one of these machines then you will have to go to your GP/clinic every week or so, which can be a hassle for working people.

There are a lot of myths regarding Warfarin but if you do some reading around it should help calm your nerves. Yes Warfarin interacts with a huge amount of things – Aspirin, Ibuprofen, Broccoli (no loss there), Cheese (gasp!). The list is endless. And it’s not just limited to food and drugs. Even the amount you exercise can impact on your anti-coagulation level. But for people considering having a mechanical valve, the key thing to remember is you don’t have to change your life greatly. I still eat just how I used to. You don’t alter your diet, but the dosage of Warfarin you take. As for drugs...well I was never one for them and you can still take paracetamol for aches and pains. The fact that you bleed more easily shouldn’t be an issue – the only time it will be a problem is in a trauma situation (e.g. a car crash).

Scar

So considering it’s exactly one month post-op, I thought it would be best to talk about my scar. A lot of people worry about this, but personally I’m not too concerned. A scar is a scar and as long as your heart it ticking away it shouldn’t be an issue. Admittedly, straight after surgery it might not look pretty. Red and black scabs will form over it and you mustn’t get it wet. But fear not if you’re going to have the surgery! The scabs will start to fall away and be replaced by a pinkish line where new skin has grown. If you are concerned about the aesthetics of the scar the most important thing is not to let sunlight get on it for the first year for an extended period of time because it will become more prominent. Eventually it will became faint, but it will always be there. Personally I think it ‘adds character’! It’s pretty unique and I’m beginning to like it already!

It’s also remarkable at how quickly the scar heals. For those curious, here’s a picture of mine one month after surgery:


For those not too familiar with such things it might look a bit repulsive (my brother still can’t look at it!), but apparently it’s quite a good scar. A nurse actually said it was the best scar she had seen. In time I’m expecting the pink and red to disappear and be replaced by a fine line. But it will always be there and I’m happy with that. For those of you who are considering key-hole surgery to avoid having a big scar, I’d just like to add my two cents... It’s really not a big issue and why would you want to limit the accessibility to the heart just so you can have a smaller scar. Quite a few surgeons have spoken against this type of surgery because they feel it limits what they can do in unexpected circumstances.

Now, for anyone wondering if this blog has anything worth reading now that my surgery is over I just have to say YES IT WILL! There’s the whole issue of how to live life on anti-coagulation and a mechanical valve, which I know a lot of future patients want information about!

Wordle, Wordle, Wordle!

Okay so I've got tagged in this by Sonia so thought I'd give it a go. It's from a thing called Wordle which creates 'Word Clouds' from different websites as well as words you put into it. So I thought it'd be interesting to see what this blog looked like as a Wordle...


See if you can find the sentence - "Good Heart Get Bad". Thank you for the positive thinking Wordle! Anyway, I thought this one looked a bit doom and gloom so I tried one with what I'm thinking at the moment:


You can tell someone's been applying to a lot of jobs today!

I'm not sure how the tagging thing words but I tag everyone (is that allowed?! I call it lazy tagging; Mass tag) to do one as well.

The Operation - Live

For those of you who want to see what the surgery entails, head on over to: www.channel4.com/explore/surgerylive/surgical1b.html

You can watch the whole show on 4 on Demand if you're in the UK. It's a fascinating programme where they show the surgeon repairing a mitral valve. This came on television when I was in the hospital but there was no way I could watch it. After recovering a bit and when I was at home, only then could I watch it! I will say if you're going to have surgery soon, think carefully if you want to watch this...

Home Time!

So, fluid around the heart after my initial operation. Apparently this is ‘usual’ in patients who have heart surgery. You can also get fluid in the lungs too which can also be drained. For the fluid around the heart I was put under general anaesthetic again because they take a needle and insert it towards your heart to drain the fluid. Not something you want done whilst you are awake! I woke from the operation just as they were moving me off the operating table and boy was I in a lot of pain. But I kept reminding myself it was nothing compared to having your heart cut open. This seemed to clear up my coughing and I felt a bit better.

So finally, could I go home? No. I had an infection – E. coli. I go into hospital to get one thing fixed and I pick up a damn infection! It was at this point I stopped setting myself goal posts on when I would be going home because it just ended up disappointing me when it didn’t happen. My family were great and continued to come every morning and evening to bring me food and keep me company. I do wonder that if I had the operation when I was much older like most patients, would I have coped as well?

The days went on and they gave me antibiotics to tackle the infection and after a grand total of 2 and half weeks, I was finally released! I had planned on being in there for 5/6 days but in the end, what’s another week or so? I left a card for all the nurses and health care assistants – they really do such a great job and get paid so little for the long shifts they do. Don’t ever be rude to them if you’re in hospital yourself! They keep the whole place ticking.

On a different point, the experience has told me not to apply for a health care assistant job in the mental health field. I really could not handle the long shifts and I think the things they have to put up with are very difficult. I totally respect anyone who has gone down that route for psychology though because in a way it is good hands on experience.

The moment you step outside the hospital you feel better. The fresh air, seeing everyone on the buses going to various places. It all helps. Luckily I didn’t have to go on public transport because that would have been difficult – can you imagine just being released after open heart surgery and going on the London Underground at rush hour?!

The Nice Nazi

When I arrived at the third floor I was given a shared room with another patient. Something I wasn’t happy with but given my situation, anything was better than being in ITU. I was hooked up to a lot of machines which were all very temperamental. The IV machine would go berserk if you bent your arm and would not shut up until a nurse heard it and switched it off. The good thing however was that in such a state, you don’t have to get up to use the loo. After the operation you are given the honour of having a catheter stuck right up you. Not to get in the details but it took a few days for me to gain the courage to look down to how the catheter was attached. Let’s just say you do not want to accidently pull the tube or worse still – have someone step on it and pull it with their foot!

Moving on to more prettier things (I know, this post creates such wonderful images doesn’t it?!), you won’t be allowed to have a shower for a good few days. This is because of the wound on your chest and the pacing wires which hang out of your wound. I think they’re there to set the pace of the heart if anything bad happens and you’re not meant to get them wet. Either way, not having a shower for a good few days is NOT nice. The smell is awful and I found myself apologising every time someone came close! So a word of warning for future patients – take deodorant with you!

Now you might remember a few posts back I mentioned testing how music impacted on my pain after surgery (after doing some research on pain and music myself). To put it bluntly, it did not work. The pain was too intense for me to even want to listen to music. Part of me now questions the research I’m doing but I try to remind myself that I was in a different situation and for some people it might be helpful.

A lot of doctors stopped by to visit and the only thing I asked them was when was I leaving. Because I’m young I was aiming to be out of the hospital after 5 days. It became a running joke with the doctors that I wanted to get out at all costs. The problem was, what I wasn’t prepared for was catching an infection. They planned to release my after 6 days but then the bad news came. I was staying for a good while longer until they found out what I had and got it under control. Any rational person would accept this but I was furious. I wanted to get out. Let me have the medicine and I’ll take it at home!

As the days went on my wound healed more and my pacing wires came out – something not very painful but for some reason it made me very tired to the point of not being able to move. The good news was that I could shower and walk around. Eventually I managed the stairs with the physiotherapist and they were happy for me to go home. Too bad the doctors still wanted to keep an eye on my infection!

I kept myself occupied by walking around and I met a few people on my journeys. One appeared to be a nice man and he told me about his time in the hospital. It was at this point I noticed the swastika tattoo on his hand. At this stage I need to point out I’m brown and found this very strange. Was he a reformed racist? Did he see me as being different because I was in the hospital with him? I really wanted to ask but his young daughter was there too and thought it would be inappropriate.

As the days progressed I developed a bad cough which would happen every time I spoke. The doctors eventually told me I had fluid around the heart irritating my lungs and they needed to operate again on me to drain it...

ITU

The first day after my ventilator had been removed was extremely bad. Despite being full of drugs, everything hurts. Now what no-one ever told me was that there is a positive and negative side to pain relief medication. The positive...well that’s obvious! Less pain, hurrah! The negative? Nausea. When you take anything stronger than Ibuprofen your head just starts to spin and everything makes you sick. In ITU I was given a nurse whose job it was just to look after me and no-one else. The first thing she tried to do was to get me to sit up. It took such a long time because it feels the weight of the world is pressing down against your shoulders to keep you in bed. Eventually with some help I managed to move into a chair. Bad move because that was where the nausea kicked in.

I started to throw up on the nurse and a physiotherapist who was younger than me (keep in mind I’m 22!). What makes it worse is that when you feel nauseas, everything makes you sick. Even the bowl they gave me to throw up in smelt bad and made me throw up more. This was the point I hit the floor and started to cry. Something I didn’t think I would actually do, but I was naive to think I could go through such a major surgery without getting upset. I told the nurse I wanted to go home and she did her best to comfort me. Luckily my family weren’t around to see that. Eventually I managed to apologise to the nurse and physiotherapist for throwing up on them and they helped me back in bed.

Later that day people came to visit and I think it was good for them to see me able to speak. My recovery seemed to be going well because at the end of the day they moved me to the High Dependency Unit, which is a step down from ITU. Basically there is one nurse per every two patients. Things seemed to float along here and I don’t remember too much about this. I was then moved to the second floor later that night, and told that the higher up the building you go, the more progress you’re making!

The operation will take a lot out of you and you really lose your appetite. I struggled to eat anything. I think I managed one bite of a sandwich before throwing up. The problem is that you’re weak, but you don’t want to eat which will make you even weaker. Eventually in the middle of the night they moved me to floor 3, the ward I initially came to the night before my surgery...

Day 0

So it’s been a long while since I’ve posted but I’m finally out of hospital. There’s a lot to talk about but I think the best way to do this is go one chunk at a time, instead of one huge post that no-one will want to read!

When you go for your operation you’re asked to come in a day before so they can run some general tests on you and get you admitted. It felt very strange because everyone there is recovering from an operation and having problems with pain and nausea whilst I’m walking about easily and wondering what’s on television that night. I got to meet the nurses who were all very nice, and then the anaesthetist who would put me to sleep the next day. He wrote me up a drug to help me sleep that night, which I initially thought I wouldn’t need but I did take it in the end. At this point I still wasn’t nervous, but that all changed the next day. Word of warning by the way: to any future patients, hospital food is very bad so if you’re lucky enough to get regular visitors, have them bring lots of food!

On to the day of the operation. Mine was scheduled for 8am and despite the sleeping pill I found myself waking up at 5:30am. Probably my brain unconsciously getting me ready for the operation. You have to have a shower and clean, and if you’re a man you have to shave your chest! Once that was done you get kitted out in some very trendy hospital gear – a gown and some anti-clotting tights. About half an hour before the operation the nurse will give you another pill to help you sleep. It makes you feel very drowsy and probably a little ‘drunk’. I remember talking a lot of rubbish to my family when they came to my room.

A porter then came to wheel me away on the bed. I said my goodbyes to my family and I think this was when I started to feel nervous. But things start moving so quickly that you’re soon faced with the anaesthetist. I tried my best to remember everything that happened but for the life of me I cannot remember being knocked out. I just remember the thing the place over your mouth.

From what I’ve been told my operation lasted about 3 hours. My family went to get breakfast because it’s not good to be waiting there and worrying. I was taken to ITU (aka ICU) after the operation. I don’t remember when I awoke but my first memory is my family around me. I couldn’t speak because I had a breathing ventilator down my throat which is very uncomfortable. I just wanted that damn thing out! I eventually started to communicate by spelling letters in the air; and then my family got a pen and paper which I could write things on. My memory of this whole period is very blurry because I was so full of drugs.

Eventually the ventilator was removed and I was suddenly aware of just how much effort breathing takes. The worst thing is that your throat is so saw and dry that you cannot talk – it’s more of a dry growl than coherent words. I drank sips of water but it did eventually go away slowly. From what I remember of that I just drifted off to sleep so I think I shall leave the next part for the next blog post.