A Heart Mended – Open Heart Surgery at 32 (A Story of Recovery) Part - 4

Recovery Day 3 (10 Feb, 2018)

I soon learned that today would be my last day at the hospital! One day for the surgery, and three days for recovery was a hospital record I was informed. I was prepared for three more days, as initially expected, but my recovery was going very well. I was given a slew of medication from the pharmacist and packet of discharge papers with information about my recovery process and upcoming appointments. I packed my bags and shook hands with and thanked the staff and I was wheeled outside before I really even had time to process that I was being discharged. Standing outside in the Hawaiian sun felt wonderful as it slowly began to bring warmth back to my life and make me, once again, feel human!

Home Recovery

I want to continue serving as a Marine. I want to continue serving as a Marine. I want to continue serving as a Marine! That was what I continually repeated to myself throughout my recovery period, it was my “why” behind my goal of recovering and getting to a point that would leave me better than I was prior to the surgery.

I truly believe that the establishment of well thought out goals is instrumental if you want to be successful.

Check out my article titled “Why” Goals Die Off as Wishes – The Power of Finding Your “Why” to see the importance and methodology of establishing effective goals!

The ride home from the hospital was intense. As I sat in the back of the van and held my pillow tightly to my chest, I was keenly aware of every bump in the road and quickly realized that my tax dollars are not being adequately used for road repair in the state of Hawaii!

Despite Nelli’s overly cautious driving, I felt every push of the accelerator, every tap of the break, every brush of that steering wheel, right in my chest. It was now three days after the surgery, all of the sedation and IV pain killers had completely worn off and the bruising began to set in. My chest was black and blue and yellow all over and any movement became borderline unbearable.

Ride home!

I felt awful for Nelli as she drove exactly as I would have were the roles reversed yet I was very quick to let her know how much her driving was “killing me!” In actuality, this was a complete role reversal as just about 18 months earlier, Nelli was 48 hours into labor with our youngest and despite what I believed to be the smoothest drive to the hospital in the history of driving, I was made aware of everything I was doing wrong for the entire trip to the hospital… and I don’t just mean about my driving!

Pulling up to our home was bittersweet. I was obviously thrilled to be back in the comfort of home and to finally see my kids for the first time since the operation however part of me realized that as soon as I walked inside the recovery was now all on me!

A little funny side story, just to let you know what type of person I am, on the way home from the hospital, despite being in considerable discomfort, I had Nelli stop by the alteration shop to pick up two uniforms I had dropped off prior to the surgery. To me that was something pressing that had to be done at that moment! Priorities!

Seeing my kids for the first time was the best thing in world and was exactly what I needed! These little guys gave me a huge hug and curiously asked me to tell them about the adventure I had just been on. Everything is an adventure when you’re a kid! You know what… everything is actually an adventure!

I had wanted so badly to pick them up however I would have an 8-pound lifting restriction for the next 6-8 weeks. What else couldn’t I do you might ask? Lift both arms above my head at the same time, put both arms behind my back at once, push or pull a stroller or cart, just about anything that put any resemblance of stress on the sternum. I never realized just how many movements we make that put stress on that area until now!

After having some much-needed lunch, I was excited to go on my first walk outside! In checking out from the hospital I was given specific exercises that I was required to accomplish each day, my favorite being my three daily walks!

It was on my first walk that I realized that I was more affected by the medication than I had initially realized. We had run into some close friends of ours and after an awkward conversation on my part, I informed them that I just had to go and carried on a walking… They later would tell me that they could tell that I was on some nice meds because the encounter was comical, and I was completely out of it!

My first night at home was terrible. In fact, the first few nights at home were terrible. I was completely unable to find any comfort laying solely on pillows as I was unable to lay down in any position that remotely resembled flat. Nelli and my mom picked up a wedged shaped memory foam pillow from the store and this was the only thing that brought me some resemblance of comfort.

While the night may have been bad, the first three mornings at home were the absolute worst! From the moment I opened my eyes until about noon I experienced a level of nausea that I had never felt before. I was too nauseous to take my medication, too nauseous to eat or drink, too nauseous to literally do anything. This created an awful cycle as my empty stomach only exasperated the situation.

The only saving grace for these first three mornings came from my wife and my mother who, for hours, sat there next to me rubbing my head over and over again. This was the only thing that brought me any relief and luckily, since I was so exhausted from the awful night’s sleep, was able to drift in and out of sleep until the nausea passed.

While it was impressive that I was discharged from the hospital only three days after the surgery, Nelli will be the first to tell you that she wished I had been kept there another three. I was miserable, and I was letting everyone know it.

Now that some time had passed from the procedure, the bruising really began to set in and I was in some pretty significant pain. I was now relying on oral Oxycodone for pain management and while certainly a strong medication, it was a far cry from what I had being given at the hospital.

When I asked Nelli how I looked, she was quick to tell me that I looked out of sorts and not like my normal self. When I asked her to explain what she meant she told me that the first thing she noticed was that my posture was completely altered. As a Marine, I am accustomed to carrying myself in a particular way, engrained within from the first day of recruit training. Marines stand with confidence. We stand up straight, shoulders rolled slightly back, chest popped out. Even a Marine who is 5’8” stands as if they are 6’3”! Here I was 6’3” and standing as if I were 5’8”, shoulders rolled forward, I was hunched over and my arms and hands were pulled in as if I were protecting my chest.

Perhaps even worse was that my attitude and behavior was different. I was being very short with people, a bit grumpy and generally just detached, all traits that were very uncharacteristic for me. It didn’t take long to realize that these were all effects from the opioid pain meds.

As soon as this realization set it, about 72 hours after coming home, I flushed every last pill down the toilet! From this moment on I would be solely relying on Tylenol for my pain management and it worked surprisingly well!

As I had said, the first few nights were pretty rough and now I had a new set of symptoms to contend with, opioid withdrawal. I was cold, I was hot, I was shivering, I was nauseous, I was irritable, this sucked!

Each night, after finding a position that brought me something that resembled comfort, I would find myself waking up multiple times each hour due to discomfort, having to take medication, or having to go to the bathroom. The worst part was I was unable to do any of this alone.

In the hospital I was able to get out of bed with ease.  A simple push of a button and the bed would raise my back upwards and lower towards the floor to enable me to climb in and out unassisted. At home Nelli had to help me do everything!

Each moan I would make Nelli would sit up and ask me “what’s going on?” All throughout those nights she would bring me my medicine, help me get up to use the restroom, and help me adjust my sleeping position to get comfortable and then wake up to take care of our two boys the next morning!

At some point over the first few days, I felt so bad for continually waking her up at night that one night I woke up in extreme discomfort and I couldn’t bring myself to wake her up for help. I laid there for the better part of an hour, like a bug stuck on his back, until I finally passed out from sheer exhaustion.

That next morning, after having gone through my mini opioid withdrawal, I felt like a whole new person; I felt amazing! I very quickly recognized that I was more coherent, patient, and kinder to those around me. I also, for the first time since the surgery, felt like I was once again attached to reality.

Nelli would later tell me that this day was the first day, post-surgery, that I actually smiled and found humor in things. Sure, I had been happy over the days prior, and had expressed it through forced smirks however those who knew me could easily tell that I was not the same.

As the days passed on things got continually better. With assistance from Nelli I was able to take my first shower, which felt amazing! I could barely touch my own head and couldn’t apply enough pressure to dry myself off, but the hot water felt amazing!

I continued to follow my daily routine: wake up, shave, shower, eat breakfast, take a walk, rest, exercise, eat lunch, walk, rest, eat dinner, walk, rest, and go to bed, and I loved it. Perhaps it is the Marine in me, but I found considerable comfort in following a daily routine. It enabled me to establish daily goals and it gave me a metric for which I could measure my incremental successes.

Most of these mid-day walks I took were with my dad and I enjoyed the time we spent together equally as much as the time I had spent with my mom. They had both flown in from the East Coast to Hawaii for my procedure and I really have no idea how we would have gone through this without them.

My mother was instrumental in watching the kids during the procedure and helping Nelli tackle the day to day agenda. My dad stayed with me the entire four days and three nights at the hospital and it was great having a familiar face close by.

I cannot stress the importance of having a strong relationship with family and friends. While we had our family close by, we had friends, coworkers, and neighbors who all offered their assistance, from meal preparation to rolling the garbage cans to the curb on garbage day; each of these gestures were greatly appreciated and we are immensely grateful for the kindness expressed by others.

Each day I made small, yet exciting accomplishments that to someone not involved may sound trivial yet they were kind of big deals to me. About 10 days in I was able to lay flat for the first time. This was huge! I cannot tell you how good it feels to lay down when you have not been able to do so. My first night I made it until about 1am and then woke up instantly regretting my decision to lay down. I was in so much pain that Nelli had to help sit me up and prop me back up on that 45° wedge pillow.

Each night I found myself able to lay with the normal pillows longer and longer until about two weeks in I was able to retire the wedge pillow! It was also about that time that I was able to make my first attempt at laying on my side! It went surprisingly well!

It was also around this time that I was able to shower on my own and put on my own tee shirt. It’s comical to think about it now but I could not get a tee shirt on those first weeks and that is why all the pictures you see of me early on are in a button down!

As I began to feel better and better I allowed myself to venture out to go do normal people things, i.e. grocery shopping, walking around shopping centers, walking to the beach; each of which brought back a sense of normality to my life.

Since the operation I have had follow ups with both my surgeon and my cardiologist; each have informed me that they are immensely impressed with the rate at which I am recovering and how quickly the scar is healing.

With regards to medication, my cardiologist only has me on two: Metoprolol and low dose Aspirin. The Metoprolol is a beta blocker which slows the heart rate and controls blood pressure, both important in allowing the heart to heal properly after the surgery. This will be taken for month and then discontinued.

The Aspirin is taken as a blood thinner to prevent unwanted clotting during the healing. Part of the surgery involved them sewing in patches created from my own pericardium, the membrane surrounding my heart. This process can leave one prone to clotting as the body tries to heal itself which hopefully get filtered out however could cause blockages in the lungs as a Pulmonary Embolism, or in the Brain in the form of a stroke; both unwanted. Luckily the Aspirin will prevent this. This is the only medication I will be required to take for an extended period; six months.

Today is my one-month anniversary of my operation and I feel great! Physically I am able to go on 45 minute plus walks with no issue, I am able to sleep on my back, and can even transition from side to side unassisted, impressive I know!

The scar is healing very well however in the past few days some slight redness has appeared on a one-inch section of the upper scar and a very small amount of fluid and puss drained from it. After a brief checkup, the surgeon said that it appears to be superficial and that he was not concerned however he wanted me to take a one-week course of antibiotics to ensure there is no infection.

My heart rate has been a bit elevated for the past few weeks, 90s to low 100s, which was a concern of mine since my normal resting heart rate was considerably lower however the cardiologist informed me that this is a rather common occurrence after going through an operation like that and that everything should settle back as time passes.

I am very excited to hit my six-week mark as that is the day I can begin strength training and normal exercise routines, albeit slightly dumbed down in the beginning!

The thing I most look forward to is being able to hold my kids again! It’s a silly thing to wish for in the scheme of things but it’s the one thing I am looking forward to the most. Having your 18-month-old waddle over to you with his arms outstretched, waiting to be picked up for a hug, only to pat him on the back and divert him to mom definitely hurts. Each day my three-year-old asks me, multiple times, if my “ouchy” is feeling better and “when will you be able to pick me up?” Two more weeks boys, two more weeks!

This surgery has been quite a process. While there were some very long days and even longer nights, I cannot believe that a month has passed already. It certainly is not something I would ever ask to undergo again however I am immensely thankful that this team of surgeons, Dr. Moreno and Dr. Lamberti, were able to implement a definitive repair to my heart defects, essentially negating the 15-year life span my initial cardiologist had predicted.

With this surgery my life clock gets reset to that of a normal American male and instead of suffering from heart failure in my mid to late 40s, I will now hopefully stick around long enough to tell this story to my grandkids.

The one thing that has stuck in my mind since my first visit with the cardiologist was that she told me that at the time of my birth, just 32 years ago, this type of repair would have either not been possible or at least probable with the same success rate. That means that, within my short life span the technology, the equipment, and the techniques that were ultimately used to save my life were put in place… all within the span of my life. I can only sit down in wonderment and in awe at what abilities we will have when my kids are my age.

There are some that will ask the question, "why share this story?" The answer is simple; to help others and to ensure that I never forget!

There are undoubtedly others out there who will either undergo or know someone who will undergo a procedure similar to mine. Even those who are slated to undergo unrelated surgeries or those just generally seeking information can find this story to be helpful.

At the end of the day it’s really all about helping others isn’t it? If my story is able to help one person prepare for an experience like this or help them overcome the difficulties, they are facing as a result of something like this then taking the time to share this story was worth it!

Nurses/Caregivers Are Superheroes!

Finally, while I certainly credit the surgeons with performing the procedure that would ultimately save my life, I need to take a moment to talk about my nurses, caregivers, physical therapists, and techs that all played a role in my expedited recovery. These are truly some of the most amazing people I have ever had the pleasure of meeting. These are true professionals who take immense pride in what they do. They work tirelessly around the clock, on oddball shifts, sacrificing their precious time with family, all in the name of taking care of and helping complete strangers in need!

Although I do not completely remember everything from the first few hours, my family tells me that the nurses that cared for me in the immediate hours proceeding the surgery were simply amazing. The initial pictures I saw of me in the ICU recovery room made it appear simply as if I were taking a nap. I was clean, looked comfortable, and all the different support systems were connected in a very organized fashion. While I simply assumed this is how I arrived, my family informed me of the amazing work the nurses had to perform to get me in that condition!

Each of these nurses were over the top kind and, beyond helpful, and really made a huge difference in "cheering" me up so to say. There is no doubt that my expedited recover is a direct result of the phenomenal care I received from these amazing people!

These guys and gals are truly my heroes and I certainly have a new found respect for their profession!

Thank you to each and every one of you for what you do!