James's Journal

It's been 5 weeks. On average, I'm feeling better and better every day. It feels good to be able to drive again. It feels good to get back in the office. As of today, I'm no longer on lasix. So I'm now down to small doses of metoprolol twice a day and a daily baby aspirin. My cough is nearly gone which is a great feeling! And I plan to go to the San Diego fair this weekend to get some good amount of walking in! I cannot wait for another 5 weeks to pass so my sternum is fully healed and I am cleared to be able to lift more than 10 pounds. It's been far too long since I've been able to pick up and hold my 2yo son. How long did others wait for their sternum to heal before they started lifting any substantial amount of weight? Or any other strenuous physical activity? I'm looking forward to the day I get to hit the gym again, get out on the golf course and also get back to playing softball. Of course I'll get cleared by my doctor before doing any of those activities.

Here are some notes I’ve kept since my surgery. This is my experience. Maybe this will help someone in preparation for their surgery. Leading up to surgery: Try to be in as good of shape as possible. Try to practice using abs and leg muscles to get up and sit down from chairs and laying down and sitting up in bed without using hands/arms/chest. You may need a partner to help you with this. Practicing this will help during recovery. Also, practice getting in and out of car without using hands/arms/chest. Get all wishes in place just in case. It's a scary thing to think about, but it's the smart thing to do. Fill out an advanced health care directive. Again, these are scary things to think about, but it's better to have one and not need one, then need one and not have one. Day 1 (Day of surgery, ICU) Pre-Surgery: I received a lot of the same questions from different people. This was intentional. Just make sure you tell them why you are getting surgery, what surgery you are getting, and any specifics (for me, I was adamant about getting a Ross procedure and wanting all human tissue in my body. No mechanical valves. No pig/cow valves. I felt like a broken record before putting on that anesthesia mask, but I’m glad I stressed this to the hospital team.) After waking up, I didn’t feel any pain. I was in a very good mood. This was probably due to the medication. I was also happy to find that I was not intubated when I woke up. Which I was told was a possibility. Ice chips! I ate so many ice chips. I wasn’t allowed to drink water or eat food at this point. It was amazing to me how ice chips just hit the spot with me. Probably because my throat was very dry and traumatized. Shortly after waking up, I was able to have family visit me in the ICU. That was a big deal for me. It really helped my spirits. After a couple of hours of being awake, the pain started to kick in. So my family left, and I was given pain medication. It worked VERY fast and really helped take the pain away. It also allowed me to take a nap. Night 1 (ICU) Experienced some pain in stomach from the chest tubes. Asked for pain relief and this helped. Had very restless sleep. Several people were coming in and out of the room all night. Which is expected in ICU. I was heavily medicated still. So things were somewhat of a blur. Again… more ice chips. Lots and lots of ice chips! Day 2 (ICU, regular room) I woke up in the ICU, but was told I would be transferred to a regular room. Catheter was removed in the morning which was a big relief. Very strange feeling, but surprisingly not painful. I had to pee within, I believe, 12 hours, which I was able to do. If not, they said they would have to put the catheter back in (ouch!). I sat on side of the bed for first time. This caused extreme dizziness, but I did not pass out. After a few minutes, I was able to stand up and sit in a chair (felt a little off balance and dizzy). My nurse helped a lot with this. Physical therapy came in and we marched and also walked about 10 to 20 steps. I was transferred to a regular room shortly after this. Continued to have chest tube pain. I told the nurse and they were very good at giving me pain medication which greatly helped. My wife brought me my cell phone on day 2, which was a big help. I recommend taking lots of pictures. It’s nice to refer back to them in case you have questions and its nice to see how fast your progress is in recovery. Most pain occurred this night. The pain was from the chest tubes. I recommend to not be shy about asking for medication for pain. I tried to be a tough guy on night two, but it didn’t do me any good. A note about the chest tubes, the pain comes when making deep breaths. Only given a liquid diet today. Broths, jello, water, juice etc. Day 3 (regular room) Started to feel more and more like my normal self, mentally. I felt more aware of my surroundings and could better soak in the information that was being given to me. Was finally given a solid meal for the first time. Which was a good treat. As I had not eaten solid food since the night before the surgery. During meals, I ordered food that would promote bowel movements. Since this is a requirement before being released. Prunes were a good choice. This is the day I started to walk a lot. Be cautious not to overdo it. It may cause chest tubes to hurt and abs/neck/back to get achy/sore. 2 of 3 chest tubes were pulled out. I felt a ton of relief, but not full relief. Since I still had 1 more chest tube in me. Deep breathes were easier. I did ask for pain medication in advance of pulling chest tubes. In anticipation of it being real painful. This was a good call. After the 2 tubes were out, walking became much easier. Day 4 (regular room) Had a bowel movement! Hooray! Means one step closer to being released! The last chest tube was pulled. Afterwards, I could take in deep breathes without any pain! The wounds from the chest tubes were tender. At this point I felt like I did an intense ab workout and had as lot of soreness in my core. Day 5 (Release day!) Prepared for release Noticed I would easily get winded after conversations. Make sure to take it easy. Leaving the hospital I would recommend a car or SUV that has a good seat height in the back seat. To make it easier to get in and out of the car. Make sure to hug your pillow during the drive. Bumpy roads were not that fun. First few weeks at home… Showering takes a lot of energy. Take it easy. And don’t use too hot of water. If possible have someone nearby in case you need help. Be careful in and out of bed and chairs. Get plenty of rest and exercise. Drink a lot of water. Keep up with breathing exercises. Take pictures of progress I ended up developing a dry cough about a week after being released from the hospital. It took a little over 2 weeks to mostly subside. But it is still lingering even after 4 weeks post-surgery. I was told this was from being intubated. And that my throat was probably still traumatized. I just kept my pillow handy and hugged it when needed. Halls and Cepacol also helps. I also noticed that the cough was triggered by talking. So I try to keep my talking to a minimum to avoid any coughing. A list of things I had with me at the hospital? Eyeglasses Invisalign retainers Cell phone/charger Change of clothes for ride home Deodorant Toothbrush/toothpaste I did notice some other heart patients that had shorts or pajamas to wear under their gown. I did have shorts, but didn’t end up using them. But that might be something to think about too. Other tips? Don’t be shy about asking the nurses for help. In and out of bed. Help to use the rest room. Help with pain. Help get more water. Help to take a walk. Don’t be shy about it. They will be happy to help you. In fact I was scolded for not getting help one time getting out of bed. Overall my experience was great. My surgeon Dr. Starnes, at USC Keck, was amazing. A total rock star! And the entire hospital staff were top notch. I couldn't have asked for better care during my stay! Hope this is helpful!