Late This Week and Late Last Week

Been away from blogging for a few days. Sometimes someone else has the computer at the end of the day; sometimes I just get a little tired. First, I'll catch up on the last few days and then I'll talk about the procedure on November 12 to drain the fluid around my heart.

This Week

I've been building up my walking each day. On Thursday I did walks of 17, 26 and 28 minutes. I visited my cardiologist in Sacramento, Dr. M. He did an echo which verified that no fluid had returned to my heart. Good news. He thought my recovery was going well. We discussed easing off of the pain medication. As of Thursday, I no longer take Oxycontin (which I had been taking every 12 hours). Instead I take Vicodin at night, and sometimes during the day if my pain is significant.

On Friday I did walks of 26, 37, and 26 minutes. Today, I was little tired and did just two walks of 37 minutes each. For now, my goal is going to be 3 walks a day, each one at least a half hour, with one longer walk of about 45 minutes. Until six weeks I can't really do any other kind of exercise because the bones in my sternum are still healing. After 6 weeks, I plan to add the stationary bike to the exercise mix.

Thursday November 12

Thursday was the key day. First off, this was the only day where I woke up feeling worse than the day before. Generally, each day had been better than the last. Today was different. Everything was a little harder from getting out of bed, to walking, to bathing. I had an echocardiogram later in the morning. It confirmed that I still had fluid around my heart. Around lunchtime Dr. DCM came by and explained that the fluid was still there despite the diuretic drugs I had been taking. He said that best option was to drain the fluid. It was slowing down my recovery which otherwise was going well. The procedure to drain the fluid would be done in the cath. lab. by a cardiologist. In the meantime, I would be NPO (nothing to eat or drink) before the procedure. I visited with the kids in the afternoon and then waited to be taken for the procedure. Later Dr. SS, a cardiologist, came by to further explain the procedure and get my consent. She explained that a catheter would be inserted just below my existing incision and then guided a short distance to my heart to drain the fluid. The only real risk was another chance for infection. Later, the nurses explained that I would be moving to a different floor after the procedure because my body would retain a catheter to potentially drain more fluid. Patients with drains were handled on the first floor, not the 3rd floor where I had been for almost a week. They came to get me around 5:00.

As I've said before, the staff in the cath. lab are upbeat and give off a happy vibe. Once they had me at the right level, I was able to slide myself onto the table from my mobile bed. Some medicine to relax me was provided through the IV. Some antiseptic stuff was applied to my chest to make the field sterile. The attending, Dr. T, called in the fellow, Dr. SS and she started the procedure. First I was given a local anesthetic. I barely felt it at all. Then they made some sort of puncture and inserted the catheter. Again, I could barely feel this at all. Within 2 minutes the catheter was in the right spot draining the fluid. They drained a total of 530 ML of of fluid. That's over a pint which was in an area no more than a 1/2 inch thick surrounding my heart. No wonder I was having trouble taking deep breaths. As promised, they left the drain in to see if more fluid would emerge over the next day. This is the standard protocol.

By 6:00 I was in regular room on the first floor. This time a private room. Meg found me soon as did my Aunt Marlene. This next hour represented the one mix up which occurred during my time at Stanford. Essentially, no new orders had been written. The standing order of NPO (nothing by mouth), which was correct before the procedure, now made no sense since the procedure had been successful. It appears that the surgical team, which had been in charge of my care on the third floor, assumed that the cardiology team would write new orders depending on the outcome of the procedure. Meanwhile, the cardiology team assumed I was still under the orders of the surgical team. My aunt worked on this issue for about an hour. Also, one of my nurses from the earlier in the week passed by and recognized me. She was working the first floor tonight. She knew which doctors to contact from the surgical team. It got sorted out. Eventually they brought me some dinner. Once Marlene was sure that things were on track, she said good night. I thanked her for all her help. Meg visited with me into the early evening.

Generally, I felt better by evening time. Because I still had the drain attached, I had to ask for assistance to move around and use the urinal. This was a significant change from the 3rd floor where I had come to feel more independent, able get out of bed myself. Tomorrow, I'll write about my last day in the hospital.