I’m writing this blog to share my experiences of the last couple of months. During this time, my life has drastically changed as I’ve undergone emergency open heart surgery in the unit where I work. Never in a million years did I think this could happen to me, yet it did. Here’s a look back on that day and how I started my full circle journey. I am the assistant nurse manager in a very busy ICU at a large VA Hospital.
The date was Wednesday, March 24, 2010…it started out as any other workday early in the morning. I remember waking up, showering, but feeling completely wiped out, absolutely exhausted. I’d just turned 40 12 days prior and was chalking the exhaustion up to a busy schedule. What else could it be? Aren’t all moms who work full-time exhausted? More on that later. I had even posted on my Facebook page that I felt like a zombie. As fate would have it, it’s a good thing I went into work.
It was another busy day in the ICU when I arrived at work at 0720, we had a full house and were expecting one open heart surgery patient at around noon. Odd in that we don’t usually have heart’s scheduled on Wednesdays so that means this case was fairly urgent. After report, I started on my usual charge nurse paperwork and the unit was running smoothly. As the assistant nurse manager, it’s usually my role to be in charge and I also have admin time each week to complete other responsibilities such as scheduling, meetings, audits, etc. It makes for a busy job but at least I don’t get bored!
Each morning we have a bed meeting at 0900 with all the charge nurses and the bed control nurse to ensure the patients flow through the hospital smoothly. This is our time to let everyone know how many patients can transfer out of our unit and how many beds we have available. On this particular morning we started off with only a code bed but had several patients ready for transfer. This is pretty typical for us. After the meeting I started having chest pain, or “heartburn” as I thought it was. I told my manager I was having heartburn and had my morning snack, figuring it would help if I had some food in my stomach. It didn’t.
I went back to the unit and continued to work for the next hour and a half, progressively feeling worse. I don’t know how to describe it except I was wiped out and had chest pain. I finally told one of my coworkers and she checked my pulse and immediately told me to go lay down in our empty room, the code bed. She’s a very experienced nurse so I figured I better listen to her. She told me my HR was irregular and the next thing I know is I’m being hooked up to an EKG and our ICU Attending is in the room with me, along with a couple of nurses. I was feeling progressively worse, sweating, nauseated, and the pain was getting worse so they gave me a nitro tablet for under my tongue. Woo wee what a feeling that was, I got very lightheaded and had a bad headache…but…it helped the chest pain so I knew this was real. At first we were talking about me driving to Kaiser (where my insurance is), but I knew at that point it wasn’t safe to be in a car. Our doctor started an IV on me and got our cardiologist in to see me. She took one look at the EKG and told me this was real and I was not going to Kaiser but that I needed to get a cardiac cath ASAP.
Holy Shit! A cardiac cath? A zillion thoughts were going through my mind…I’m 40 years old with a 4 year old at home, this can’t be happening! I was terrified and started to cry. By now there were three of our doctors in with me all working on stabilizing me, along with my own nurses. “Ok” I said, let’s do it. I then figured I better go pee because I was going to have to be flat on my back for several hours and God forbid I use a bedpan! As it turns out, that was the least of my worries, but more on that later!
I got up to pee and at this point I didn’t even care who saw me or that there was a camera watching my every move. On the way back to bed I started feeling even worse and started vomiting. My staff were preparing me for transport to the cath lab while I was puking my brains out. Once I got to the cath lab I was given Compazine for the vomiting, Fentanyl, and Versed to calm down. I’d also had several nitro tabs by now. I was happy to see two of my friends as my cath lab nurses and I know the doctor is one of the best. I think I slept through most of my cath and woke up to find my husband and the cardiologist showing me the video and explaining how I had an extremely rare coronary artery anomaly. My right coronary artery was just a branch of my left anterior descending artery and was kinked and stenosed. At first the cardiologist thought it was something that could be treated with medications, but the next thing I knew is our cardiac surgeon was in the room telling me I needed coronary artery bypass surgery and quickly! What???? Holy Shit! I told him, “you are bullshitting me”. But, he clearly wasn’t. He looked very stressed and had me sign the consent right on the cath table. He explained that it wasn’t safe for me to go by ambulance and asked if I minded if he did the surgery. Minded? Of course not! I know he is one of the best and I couldn’t think of a better place to be with familiar faces everywhere.
After that they decided to do a 3D CT scan of my heart to verify that the coronary artery was, indeed, running under the aorta and pulmonary artery (essentially causing mechanical obstruction). I had received a lot of medications by this time and I don’t know how long we had to wait for the CT scanner but it was a while. They also gave me several doses of beta blockers to try and slow my HR down as it was too fast to get a good scan.
Finally, the CT scan was completed and I was wheeled up to the Intermediate ICU where my husband works (he’s a nurse also). I remember seeing my son in the elevator and daddy holding him and he looked very frightened. They checked me into my room and the cath lab nurse who had stayed by my side all day took out my sheath. She had to apply pressure on my groin for quite some time but I’m not sure how long.
That night in the IICU was pretty much a fog…I didn’t sleep much but I also don’t remember much until my husband came back at 0600 to visit. He hadn’t slept much either in anticipation of my surgery. I do remember borrowing a laptop computer and posting on Facebook that I was taking my last sip of Gatorade before being NPO after midnight.
My surgery was scheduled for around 10:30-11 am, they had to do a case before me and then the OR would be ready. Our wonderful anesthesiologist came in to see me and told me he was assigned to the case and would I mind? Of course not, he is awesome and very experienced. Another anesthesiologist friend was also going to stay in the room and help. Wow, who gets two Attending anesthesiologists? I knew I was in good hands with people I trusted and that are like family.
The cardiac fellow also came to see me and asked how I was doing. “Nervous” I replied while trying to keep a brave face. He laughed and said he was probably more nervous because there were 50+ nurses upstairs that would kill him if anything happened to me! Ha! Two more of my best friends and coworkers stopped by right before their shift started and they were clearly upset but were trying to be brave. By this point I was mentally prepared for what needed to be done.
A few more hours went by and the OR staff showed up to wheel me to the OR…haven’t I seen this with patients a hundred times? Now it was me! I kissed my husband good bye and into the OR holding area I went. More familiar faces, my friend, a CRNA was starting an IV across the room and the OR nurse checking me in is an old friend as well. My anesthesiologist came to see me and that’s all I really remember until later that night!
I was in surgery for about four hours and had a one vessel bypass. Of course I don’t remember anything but I do remember waking up to people cheering for me and encouraging me to “open my eyes”. All I remember thinking is…”leave me alone, can’t you see I’m sleeping?”. When I finally did open my eyes I saw a large group of our nursing staff standing around me and they were about to extubate me. The RT told me to take a deep breath and the next thing I know the tube is out. No pain, no discomfort, not what I had imagined at all after seeing it hundreds of times! Phew! I also remember thinking, “gee, my chest doesn’t hurt too bad”…well, that thought was short lived once the anesthetic and pain meds wore off!
More on my journey to follow…