A Heart Mended – Open Heart Surgery at 32 (A Story of Recovery) Part - 1
Cardiac ICU
Day 0, Surgery Day (7 Feb, 2018)
“Okay he’s waking up!” (Eyes still closed, not fully conscious) “Mr. Forras we are just waiting for the respiration team to come and remove your breathing tube for you!” “Mr. Forras, I need you to calm down for me ok, it won’t be much longer” “Don’t touch that, that’s your breathing tube!” “Alright, where are they?” “Mike, please don’t touch that buddy!” “Okay, restrain his hands please!” “Mr. Forras I need you to calm down please!” “Okay, give him some more of the sedation.” “I already did!” “Okay, give him some more!” (My inner voice) “Wait, a se..c…..o..n…………d………..”
Approximately one hour later… Eyes still closed, not sure if awake or dreaming, “Mike can you hear me?” Replied yes with thumbs up! “Okay Mike, we are going to remove this breathing tube for you okay?” Replied with thumbs up. “Okay, this is going to be a bit uncomfortable but I need you to cough for me while we are removing this okay?” Motioned the “hurry things up” gesture with my hands. “Okay here … we … go!” (Cough, gag, discomfort, and unconscious once more).
This was the first thing I remember as I began to wake up from my open-heart surgery to repair my Arterial Septal Defect (ASD) and my Partial Anomalous Pulmonary Venous Return (PAPVR).
Laying in the Cardiac Intensive Care Unit I had abruptly begun to wake up from my post-surgery sedation. The nurses, whose typical patients are anywhere from their 60s – 80s, were not exactly prepared for how a 32-year-old Marine would come to. From what I was told, I have no personal recollection, I quickly began to try and move around, and my hands immediately went to my mouth in an attempt to remove my breathing tube.
In an effort to prevent me from ripping out my own breathing tube, or other IV catheters, the nurses restrained my hands and ultimately had to re-sedate me until the respiration team arrived to remove my breathing tube.
The initial dose of sedation they pushed into me, the dose they are familiar with giving to their average patient, had little to no effect on me, the next dose they pushed into me, five times their normal amount, would have me out cold for the next hour.
As I began to come to, once more, my eyes remained closed, but I could feel my wife’s hand on mine, and the voices of nurses and family reassuring me that everything had gone well and that all would be ok.
Nelli holding my hand as I slipped in and out of consciousness
Although my memories are a bit foggy, I distinctly recall feeling significant discomfort and the desire to gag due to the breathing tube still being inserted. While the feeling to gag or cough was there, there was no ability to do either.
I can recall my communications with Nelli and somehow, I got her to understand that I want the breathing tube removed. As I continued to pass in and out of consciousness I could recall being told that the tube was going to be removed. I remember being told to cough, feeling discomfort, and then once again, “lights out.”
For what seemed like forever, I can recall passing in and out of consciousness, with my eyes remaining closed. I remember being extremely thirsty and asking Nelli to have the nurses bring me water. One of the nurses slowly fed me some crushed ice and I can remember it feeling amazing.
I continued slipping out of consciousness and coming back and each time I can recall wanting more water. At some point I recall the nurse saying that she couldn’t give me any more, but she then swabbed my lips and inside my mouth with a wet, minty sponge, and that felt amazing!
At some point later, I awoke in the Cardiac ICU, a brightly lit, yet windowless wing of the hospital where the top nurses stand at the ready for any uncertainty one might experience after a massive surgery. It was here that, for the first time since the surgery, I was able to actually see my wife and my father.
Initially I felt as if I was 100% present however after attempting to talk I was very aware that I was still experiencing the effects of the many medications they had me on. I recall trying to tell my family about my experience in the operating room. I remember telling them how the anesthesiologist was preparing me for the surgery and as I was explaining to my family that the doc had to sedate me before giving me the full anesthesia in order to put in an arterial IV in my arm, I somehow ended up telling my family that I "really wanted a new Harley!" I immediately realized that what I had said was out of place and motioned to my wife to stop filming me!
Sure wouldn’t mind that Harley though!
Looking back at my detachment from reality, I was still feeling the influence of the anesthesia fairly strongly. Not to mention that the doctors had me on a steady drip of Fentanyl, directly into my neck via a central IV line. What is Fentanyl you ask? Well it’s sort of like morphine, except about 100 times stronger, and with the dose they were giving me it really was impressive that I was awake, yet alone carrying on semi-lucid conversations!
I had now been in the ICU for a couple of hours and for the first time I actually began to come back to reality. It was at this time that I was able to sit up in my bed and realize just how badly I wanted some water! After asking my family for the 100th time what was going on, and how everything had gone, I finally had enough computing power to remember all that I was told!
The remainder of that day was fairly uneventful. I remained in bed, and although I was not able to eat solid food, my awesome nurse Nic was able to sneak me in some water and some Jello towards the end of the day, which was very much appreciated!
My wife went back to the house to relieve my mother from kid watching duties, as she had been watching them throughout the day so that Nelli could stay with me at the hospital during the procedure. I cannot stress enough the importance of having family with you during a recovery like this.
After a few more tests, some water, and some more Jello, it was time to turn in for the night. I found relative comfort rather quickly however the first night was a bit restless. Around midnight, right about when I hit the depth of my sleep, the radiology tech wheeled in a mobile X-ray cart, a rather cool device that transforms from a push cart to a full on X-ray machine, and popped a quick chest X-ray to check for proper lung inflation, signs of pneumonia, and proper setting of the sternum; everything looked great!
The remainder of the night was a bit rough. Every hour, on the hour, my blood pressure cuff would take a reading, the nurses would come in, draw blood from the central line in my neck, give me medication, ask me how I was doing, and then tell me to get some rest! It felt as if each time I would fall asleep, the cycle would continue.
Interesting note, the continual blood samples the nurses would pull were to monitor my blood sugar levels. Apparently after major surgery it is common for the body to experience temporary “diabetes like” symptoms due to the shock of the procedure on the body. While I never experienced abnormal blood sugar readings, they informed me they would have insulin prepared should my blood sugar levels fluctuate abnormally.
I had a pretty solid period of sleep from about 2am onward and I can recall waking up feeling sore but decently rested.
