Saturday, 13 October 2012

IIDD, Moondance: Saturday, October 13th

Choose the life that is most useful, and habit will make it the most agreeable. -Francis Bacon, essayist, philosopher, and statesman (1561-1626)

Pat,
    I probably won't be in attendance tomorrow but Sylvia intends to meet up with Kerry and George to walk to the church.
    Hope it's a very good send-off for your mother. Ray

Sat. Oct. 13, 1:30 pm.
So today I have at least a bit of my wits together and will report as I promised.
Background:  As most of you know, this was Mike's 2nd open heart operation.  In Sept 2009, he had surgery to correct five problems.  The operation included repairing the leaking mitral valve, correcting his atrial fibrillation w. a laser procedure (maze), replacing a portion of his aorta where there was an aneurism about to explode, replacing his aortic valve w. a St. Jude mechanical valve, and a bypass procedure to correct a partially blocked brachial artery. That was a long surgery.  "Super sized" as the doctor said.  And it was a long recovery.
Things were going along quite well when all of a sudden, 2 years ago, Mike started running out of breath and felt fatigued all the time.  Turns out he'd become extremely anemic.  He even required 4 blood transfusions in 2011.  So he underwent every test under the sun, in and out of all the body orifaces.  Moderate and extreme procedures checked his digestive system and urinary tract from every possible direction.  No one could find leaking blood or the cause of the extreme anemia.  He was making red blood cells at an abnormally high rate, but they were disappearing faster than he could make them.  Eventually, (and it took almost two years to figure it out), a hematologist determined that his anemia was due to a faulty heart valve that was damaging the red blood cells, which the body then removed from his system prematurely.  A second echo-cardiogram performed through the esophagus (from behind the heart instead of through the rib cage from the front of the body) showed an abnormal jet stream of blood through the mitral valve.   
The condition is called hemolytic anemia, and although not life-threatening, it was certainly life-altering, and Mike decided to have this second surgery to correct the problem.
Yesterday's surgery began very early in the morning.  It took more than two hours before Mike was attached to the bypass machine (heart / lung).  Because there was so much scar tissue surrounding his heart, the bypass machine was hooked up through the aorta in his leg.  The surgery went very slowly, and to quote the doctor "Mike's body fought me every step of the way."  By that he meant that the scar tissue (which he described as extremely angry and nasty) did not cooperate in being removed.  Mike came off the bypass machine at 12:50 and they closed him up, finishing around 2:30.  So well more than 6 hours in all.  A long wait. 
The surgeon quipped that he would have to charge Mike double the price since it took so long.
Early this morning, or possibly during the night, they removed the ventilator (breathing tube).  He could speak this morning, altho' his voice is very raspy.  He is not comfortable and keeps forgetting to press his "self medication button" before the pain becomes acute.  He complains most about the drainage tube in his side which is pumping bloody fluid from around his lungs.  He thinks it is raining because of the sound the machine makes.  He's still quite goofy to talk to.
This morning, I spoke with the cardiologist.  He says Mike's doing fine, but this will be a more difficult recovery because of the effect that all the scar tissue has on the heart muscle.  They are monitoring his pulse and adjusting it with a pace-making device.  Periodically they turn the electrical impulse down to see if Mike's pulse has returned to normal.  So far, it is too slow, so until his system finishes waking up from all the drugs, that will be one of their primary focuses. 
When the amount of fluid draining from his lungs reaches an acceptably low level, they will remove those drains (hopefully tomorrow) and he should be more comfortable.  They have had him up in a chair, but until the drain comes out, he will not be able to start walking around.  Movement is very important to control fluid levels and prevent pneumonia.  He is, however, doing his coughing and breathing exercises (when reminded). 
Once all these tubes are out and they determine he is ready, he will move upstairs from the CRU to a regular room in the cardiac wing.  Then he can have visitors.  I'll let you local folks know when that happens.
That about sums it up.  I appreciate your emails and have saved them all for Mike to read when he comes home.  I'll let everyone know when that happens.
Thanks again for being such good friends and neighbors. Marilyn

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