The Road to Recovery…baby steps

“Wake up Sandy! Wake up!”

Why are these people trying to wake me up, can’t they see I’m trying to sleep?!

“Take a deep breath and cough”

Boom, the endotracheal tube is out, phew, that wasn’t bad at all…in fact, I don’t even remember feeling it in!

Being intubated is every ICU nurse’s worst nightmare, but, luckily, I don’t really remember it and it certainly wasn’t painful. Thank goodness they extubated me while I was still drowsy! These were my first thoughts when I was extubated about 4 hours after surgery. I first remember thinking, wow, I’m not in too much pain…boy, that would change in a few hours! I wasn’t quite sure what time of day it was, but I did remember that I had had open heart surgery today. Mmm…it must be in the evening because I recognize my nurse and she works nights. Ok, now I can take a real nap…

That first night was pretty much a haze of vomiting, taking deep breaths, and sleeping. It may have lasted 12 hours, but in my mind it’s only a few minutes. This is probably due to the anesthetic, pain meds, and a coping mechanism.

Post-op Day 1: Friday, March 26, 2010

Fast forward to early morning, bed bath time…I’m too sick to care that my co-workers are washing me down and I admit it does feel good to get cleaned up a bit and get a new gown on. When x-ray arrives that’s not so fun, they lay me flat, pull me up and put the hard plate under. Oh my God that hurts my sternum! Holy cow! I remember one of my surgeons coming to check on me at 0500 on his way to the airport (he had been scheduled to go out of town). Wow, I had the wherewithall to understand how nice this was!

Once my morning labs are drawn, my bath is done, my nurse brings “The Chair” in. What? She wants me to get up in a chair now? Hell no! Yet, the nurse side of me knows this is exactly what I’m supposed to do. I’m so nauseated there is no way I can even move without vomiting, much less get up to the chair. Yet, I know I need to make an effort so I agree to dangle on the side of the bed. Wow, that was really tough and I could barely sit up. I certainly have a new respect for what we ask our patients to do! I used to joke with one nurse that her patients had boot camp because she always had them up within an hour of extubation. Here I am 12 hours later and can barely dangle on the bed.

It’s change of shift now and I recognize my day nurse and am viewing the early morning bustle from a different perspective. I’m in room 9 in the MSICU, facing the nurses’s station, where I’m usually seated. This is odd, and, why is everyone walking around trying not to look at me? Do I look that bad? Apparently I did!

During change of shift, the cardiothoracic team rounds and checks on me. I look and feel absolutely miserable. I’m in pain and extremely nauseated. But, I’m alive, and that’s what matters. I’m doing well taking deep breaths and I know how crucial that is to prevent pneumonia. A short time later our ICU Attending comes by to discontinue my pulmonary artery catheter. I didn’t even realize it was in, along with the large IV in my neck. Mmm…those always looked so uncomfortable, but it isn’t that bad.

That first day after surgery was again a haze of pain, vomiting, and sleeping. My husband arrived in the morning to visit and stayed with me much of the day. Every now and then my coworkers would peek in on me, but I was pretty out of it.

Evening rolls around and I have a different nurse from last night. It is nice when you personally know all the nurses and trust everyone. This is a dynamic that our patients don’t usually have so I am very lucky. I’m still in room 9 and can see what’s going on but I’m too sick to care. I pretty much just lay in a haze, trying to deal with the nausea, and the excruciating pain that comes every time I have the dry heaves. It’s now late at night and I hear activity next door, a new admission. And, a loud one…he sounds confused and yells all night long. Poor guy. There is no escaping the noise and constant sounds, I try to shut my eyes to ignore it, but it’s still there.

Postop Day 2: Saturday, March 27, 2010

I’m a little more with the program this morning…I got through my bath and x-ray without too much discomfort and, oops, there it is again, “The Chair”. My night nurse brings in the chair and tells me it’s time to get up. I’ve been in bed for 48 hours now and I can’t really argue. I struggle to a dangling position with the help of 2 nurses and my heart pillow and hobble over. My chest tubes and foley are dangling but aren’t uncomfortable…yet. I sit up but feel absolutely horrible. I’m super nauseated and just lay there holding my tub in case I throw up. This is pure misery. My other surgeon stops by while I’m sitting up to check my labs, etc. I can tell he feels bad that I feel so awful. None of the antiemetics are working and the pain is horrible every time I vomit. When will this end? It is at that moment I decide to forgo any more pain medicine (narcotics) because I think that is what is causing the nausea. They have started me on Toradol, an IV anti-inflammatory, to help with the pain. That is going to have to do because I’ve come to the conclusion that I’d rather be in some pain than be nauseated and in excruciating pain.

I’m starting to come around a bit more, awareness-wise, and am forming more memories. At around 3:30 pm Saturday they move me to a different room, with a door! Yahoo! I also ask them to take my foley out so I don’t get a UTI. I’m still so weak I need to use the bedpan all evening and all night because I can’t really get up very easily. By the end of night shift I am a professional with the bedpan! I never thought I’d show up for work one day and be a patient in my own unit who cannot even go to the bathroom on my own, but there I was. And, to be honest, I didn’t care I felt so crummy.

Post-op Day 3: Sunday, March 28, 2010

I’m starting to feel like my old self this morning. I actually get up and walk through the unit a bit, telling the staff to “Look Alive”. I think it helped everyone when I came out of my cave. I was able to sit in the chair and nibble on a little food for breakfast. I still had my chest tubes and Cordis (large IV in my neck) in but those would come out today. Now they were starting to bug me. I must be feeling better! I spent the day visiting with family and co-workers. Everyone was careful not to wear me out and the staff even went and picked up Fro-Yo! Finally something that I could hold down!

That afternoon, the cardiothoracic fellow came in to discontinue my chest tubes. My nurse pre-medicated me with a little Fentanyl but it didn’t help. They don’t actually hurt coming out but the pain occurs when they pull the sutures tight. I don’t think any pain medicine would help the feeling of your skin being pinched together really tight. But, it only lasts a few seconds and I’m free of the big tubes hanging out of my chest.

The next project is to get my Cordis out and an IV in. I asked to have it out and my nurse looks at me like I’m crazy (she knows I’m a really difficult IV stick). The next 2 hours are spent trying to find a vein with several nurses coming to look but no one with the nerve to poke me except for my nurse who tried a couple of times but was unable to get an IV. Finally they call anesthesia and he was able to put in a 22 gauge (tiny) IV in my hand using the ultrasound. I have to guard this like it’s gold!

Late in the afternoon I started to notice the symptoms of a UTI…uggh. I kept having to get up to go to the bathroom but only a few drops would come out. I notified the ICU doctors and a UA was sent. A few hours later the results showed I had a big UTI and I was started on antibiotics. Uggh.

Another night in the ICU…sleep was elusive (as I would find for several weeks)…I’d sleep an hour or so and then wake up. There were constant alarms from my frequent PVCs and my blood pressure cuff would wake me up. By now I was stable enough to only have it checked every few hours at night. I was able to participate more in my AM care and was up in the chair by 6 am.

Post-op Day 4: Monday, March 29, 2010

Wow, I’m finally starting to feel human again. I can now get up to the bathroom without much assistance and spend a good portion of the day in the chair. I’m able to eat more, but I’ll admit, the VA food isn’t the tastiest. Luckily I have staff who are bringing me yogurt and fruit. I ambulate around the unit more and my hubby visits later in the day as he had stuff to do with our son and get him to school. I miss them both dearly but I know he has everything covered on the home front. His mom flew in Sunday to help and they visited that afternoon while Riley stayed with my mom. The plan for today is to keep increasing my activity level. The nausea is finally gone and I’m feeling better. My surgeons have checked in every day and are happy to see the progress I’m making.

Post-op Day 5, Tuesday, March 30, 2010

Wow, I feel a lot better this morning. I’m up super early again, which, is a relief because hospital beds just aren’t that comfortable. It’s dificult to find a position of comfort in bed and I’m ready to get the day started. I ambulate around the unit several times today, and my husband, our ICU Attending, and I even walk outside the unit and surprise my surgeon in his office. This longer walk kicks my butt a bit, but it also feels good to get out of my room more. My husband talks our son into visiting (he was scared) and it was so fantastic to see them! I finally feel like everything will be ok and seeing my son made it all worthwhile!

The day is spent visiting with many staff members, so many, that both myself and them got “in trouble” from my boss. Everyone is super protective of me and doesn’t want me to overdo it. They shut my curtains and door in the afternoon so I could take a much-needed nap. That day was also spent with a PT and OT consult to get me ready to go home. The goal is to go home Wednesday if the surgeon gives his blessing. It’s hit or miss depending on my labs, etc. but I’m hopeful.


About scvb13

Mom, wife, ICU nurse, athlete
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