Posts Tagged ‘Recovery’

Good Nurses

November 10, 2010

NOTE TO READERS: We’re off on a Secret Mission tomorrow, so there may not be a post on Thursday. You’ll hear all about it later, though!

I was looking through my 1967 Johns Hopkins records and especially looking over the nurse reports. The nurse reports make up over half of my total file – neat sheets with handwritten measurements gathered at certain times. This was long before electronic records and most monitoring equipment. Nursing was really a hands on profession, not that it isn’t now. I’ve been cared for by some awesome people over the years, and a lot of them are nurses. You see and interact with the nurse a lot more than you do with the doctor, so when you are assigned a really good nurse it is a Great Thing and a Big Deal.

A big part of the job is observation and reporting, and in the ’60’s you were doing this constantly. There weren’t many automatic alarms that would go off when something was wrong; it was the nurse’s job to almost see problems coming. You were looking, observing, and making notes on every patient, so a good nurse had her head on a swivel. The nurses reports in my file I’ve nicknamed my “pee and poop sheets” because that was a major part of what was recorded: My temperature, amount taken in (input), amount expelled (output), and what I was doing at the time. Remember I was five months old; at any time of day I might be “playing”, “sleeping”, or more than likely, “crying”. Hey, I was a baby, and you people had just cut my chest open and tinkered around in there. You’d cry, too!

The order of the day was “Observe the patient.” You can almost hear the nursing department answer OK… what are we looking for? Trouble is, Cardiac Surgery was only about 25 years old then – they knew they had to prevent Pneumonia but after that, no one was really sure what to expect. So the Surgical Department just told them to observe the patient closely.

I had a fever on my 3rd day post-op. Hopkins called in a doctor who specialized in combating fever. “We see this a lot,” he told my parents. “Many patients spike a fever on the third day after their surgery, we don’t know why. If this is a 3 day fever, it will last about 24 hours and then it will disappear. We don’t know why that happens, either.” And he was correct – it was a 3 day fever, and it was gone 24 hours later. But he also told the nurses to keep a close eye on me, just in case it wasn’t a 3 day fever.

How do I know? The nurses report for that 24 hour period is crammed with notes. The best I can figure, they were checking on me every fifteen minutes for almost 30 hours.

Good nurses are lifesavers – literally!

 

 

 

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Advice to a friend

July 2, 2009

What follows was written by Stephanie to Heather Magee, before Heather underwent a surgical procedure last year. (If you missed it, Heather is recovering nicely. I saw her while in Colorado, she looks good but says she is still a little weak.)

Stephanie, also a Heart Warrior, sent this note to Heather about getting through an operation and what comes next. Heather wanted me to share it with Funky Heart readers:

I can understand the fear and doubt that races through your minds about the actual surgery. The surgery is not the problem. It’s the aftermath. It’s the emotional part of having Heart Disease. Be prepared to NOT be afraid to ask for professional help. Maybe before surgery reach out to others to see how they have gotten through it.

Be patient with your body. Your mind is always going to move faster and be ready for more than your body may be able to handle, which is beyond frustrating. However, you may discover a new hobby this way. Try to find a way to turn your negatives into positives. But please know that you are not alone if you are having suicidal thoughts, are extremely irritable, or have days where you see no point of getting out of bed. Do not be afraid to ask people to leave you alone, just to be nice. This is a time to heal physically, emotionally, and spiritually. Stress is harder on our hearts than we often think.

Be thankful you have had such a strong heart up to this point. After surgery, you will only be stronger. Never give up hope for tomorrow. Always be thankful for yesterday. Overall, please do one thing for me. Have a moment to yourself where you are standing in front of the mirror naked, with the lights on, and really look at your body. Even if you are crying, and your stomach is twisting, force a smile to your beautiful face, look into those survivor’s eyes and say “I am beautiful. I am in fact a Heart Disease Survivor.”

Smile.

These people are gonna kill me!

November 21, 2008

I don’t think I’ve written much about my second operation. It went so well, I really just hadn’t thought about it. “It went well” is relative, of course… at the time, I thought that I had been hit by a large truck! And that I was going to to be beaten to death.

After being informed that Elevator Sprints was a game that I didn’t need to be playing – even if I was one of the Co-creators – I didn’t cause any more trouble for the hospital staff. But trust me, they got me back, in spades!

I left my room one day to walk up and down the halls (one of the few things you can do when stuck in a hospital) and next to the door was a gurney. Someone had written on the plastic cover

Steve C****

Bed 3, Rm 406

Surgery 3/17/77 0800

Oh, boy. I don’t think that it had “clicked” in my head before that that these people meant to cut my chest open! I ran back into my room, jumped into my bed like Pete Rose sliding into second base, and cried my eyes out. Not a manly thing to do, but I was eleven years old, so I’m pretty sure that it was OK.

The day of surgery was kind of strange, too. The operation was scheduled for 8:00 AM, but when I woke up in recovery, I was in for quite a surprise. I was facing a large plate glass window that overlooked the city, and it was night! Exactly how long did that surgery take?

It turns out that it lasted about as long as they expected it to last – but there had been a serious accident on the interstate. I never heard exactly what happened, but a lot of people came into the ER at about the same time, and a good number of them needed surgery. All the “routine” surgical patients got rescheduled while the critical patients went first.  Since I had already been sedated, they just kept me under a very light sedation until my turn came. Thankfully my parents had heard about the delay so they weren’t climbing the walls.

When my turn finally did come, the operation went smoothly. I was supposed to have a Blalock-Taussig Shunt, but they were worried about finding a vein that was large enough to act as the conduit. (No MRI scans in 1977!) Thankfully, it was big enough to do the job!

I didn’t get a Cough Bear after my surgery. I didn’t even get a pillow – remember this occured in 1977, and no one had thought about using a soft object to brace against when you cleared your lungs yet. In fact, the accepted practice for cleaning your lungs out will make most modern cardiac patients cringe.

Two nurses would come into your room and help you sit up. Then they would get you to lean forward as much as you could, and when you couldn’t go any further, one of the nurses would take you by the shoulders and lean you over another few inches. Then the other nurse would cup her hands and pound on your back – HARD!

After you were beaten like a tough steak you were told to cough into a cup. The purpose of this form of torture was to prevent mucus from building up in your lungs and causing pneumonia. I was hoping that there would be a river of mucus – enough to get these nurses (literally) off my back!

You could always hear echos of their slaps as they worked their way down the hall. To hear them getting closer and closer caused more fear than any movie Wes Craven ever made. But once, they reversed their usual pattern and started at my end of the hall. I was number one on the list. These ladies were warmed up and ra’ring to go when they hit my door.

After a particularly ferocious lung clearing series of smacks, I coughed up my liver and gasped, “I don’t know what I did to make you ladies angry, but I sincerely apologize!”

I was here as a Child…

August 17, 2008

Back when Adult CHD’ers were Cardiac Kids, doctors would often tell our parents that our operations had fixed our heart. Sure, we might have some limitations due to Cyanosis, but kids can learn to live with that. The important thing was that we were A-OK!

Time passed, and one fact become glaringly obvious: We weren’t A-OK.

No one had been lied to. Congenital Cardiac Surgery was a young field, and there were practically no older survivors to draw data from. Our doctors were sincere when they believed that our heart problems were in the past. Perhaps part of it was a feeling of relief that the immediate crisis had been dealt with. The patient was stable and should survive. Ergo, we were “fixed”.

But as someone with a Congenital Heart Defect ages, they can begin to to have some of the problems that heart-healthy people do. Granted, we probably won’t have the same problems, but age gets to all of us. And a good percentage of us may hear those dreaded words, “I think we’re going to have to operate…”

Often our first surgery was done as soon as it became apparent that we were sick. Lots of Adult CHD’ers have “We need to operate NOW!” stories from their early years. But if we are getting proper medical care, a good cardiologist can detect the subtle changes in our adult heart that are the first signs of trouble, and with luck we have a “heads up” and can prepare for surgery. When an Adult CHDer is facing a possible heart surgery, he or she needs to ask several specific questions.

“What kind of tests do we need to do before the operation?” A surgeon isn’t going to open you up just to look around and see if he can find the problem. You’ll certainly have to have some X-rays taken, and quite possibly a CAT scan or an MRI. Your Cardiologist may even order a Catherization to get a good look at the heart structure.

“What exactly do you plan to do to me?” The answer is going to be based on what the results of the various tests are, plus the Cardiologist’s report on what is going on inside of your heart. A good surgeon has the operation planned out in advance, and he has a back-up plan in case there is a problem.

“How much experience do you have doing this type of operation?” A poster on the Adult Congenital Heart Association message board once stated that he needed to have a valve replaced. His aunt had recommended the surgeon who had performed her husband’s bypass surgery, and he was going to meet with him.

He’s getting off on the wrong foot already. What he needs is a Congenital surgeon, someone who has experience cutting into the heart. A Bypass surgeon doesn’t normally do that, so he is not the right person for this operation. And even though she means well, the aunt needs to be told just to leave well enough alone. When it is her health, she can make the decisions. Until then, no dice.

And don’t be alarmed if you find that the best Congenital surgeon for you is a Pediatric surgeon with adult experience. Most of the Congenital Heart Surgeries being done today are performed when the patients are children, so the children’s surgeon could be just the person for you… even if you are in your 30’s.

“Which hospital are you planning to use? How much experience do they have with this type of operation?” You’ll probably have to contact the hospital or the state health department to learn how much experience the hospital has with your planned surgery. Having the best surgeon in the world won’t do you any good if the Recovery Room staff can’t start an IV correctly. Make sure that they know how to care for someone who has had your type of operation. And once again, Congenital surgery and Bypass surgery are not the same thing, and competence in one field doesn’t always translate into competence in the other.

“What can I do to assist in my recovery?” Moaning in your hospital bed isn’t helping, and it is probably driving your roommate batty. Do something that will help you heal faster.

“When can I go back to work?” That’s your ultimate goal: to get this behind you and get your life back on track. You’ll be released from the hospital first, with lots of limitations. You’ll also have some informal exercises or perhaps a formal Cardiac Rehab program. Follow the doctor’s instructions! You’ll be able to do more, do it quicker, and won’t hurt yourself. And soon the answer to the “go back to work” question will be “Next week should be fine, if you take it easy.”

You won’t mind the boredom of your job; you’ve had quite enough excitement for a while!