7-29-09 update

BP 116/79 Pulse 92
Weight 214.5 lbs

Saw Dr. Oswalt yesterday. He cleared me for driving (woo hoo!). He kept me on restricted lifting but gave me a schedule for increasing weight. I am trying to take my pain meds only when needed. That has translated into waiting longer between doses. I think I have built a little tolerance for the pain. A 3-4 is annoying. A 5 is tolerable. A 6 makes me start thinking about taking something. Hopefully, I will soon be taking only the occassional ibuprofen for pain.

I am hoping to start easing into work at the office late this week or next. I have been working from home (emails, phone meetings, etc) but because I have not been cleared to drive, I have been unable to be in the office. The doctor didn't specificly clear me for return to work but, as long as I avoid lifting and such, it should be fine.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab when needed for pain

7-28-09 update

BP 112/74 Pulse 88
Weight 215.4 lbs

The incision is healing nicely. I just have a bit of a teardrop at the bottom of the incision that hasn't fully healed yet. The breastbone is still an source of much discomfort. Laughing, sneezing, coughing and hiccuping make me hurt. I slept through a dose today by about 3 hours and woke with a very heavy chest and quite a bit of pain when I got out of bed. It was not earth shattering pain but it hurt. On a scale of 1 to 10, it was probably a 5. Not bad compared to a month ago.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs

Once again, the extreme outside heat kept me indoors yesterday. I did not get out for a walk. Today I see Dr. Oswalt. Hopefully, he will clear me to drive and return at least part of my regular activities.

Have a great day.

7-26-09 update

No update yesterday. I went for a long walk instead.

BP 107/72 Pulse 89
Weight 213.8 lbs

The incision is healing nicely. I just have a bit of a teardrop at the bottom of the incision that hasn't fully healed yet. The breastbone is still an source of much discomfort. Laughing, sneezing, coughing, -- all of them make me hurt pretty severely. I stopped taking ibuprofen. Unfortunately, that means my arthritis in my hands has returned a little but that's okay. It's not like it is a new thing. I've had trouble with my thumbs for a while.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs
Ibuprophen 200mg every 4-6 hrs discontinued

I took a long walk yesterday and did not need to breathe through my mouth at all. That's a big thing for me. I didn't realize I had such a problem because it has been the same my entire life. I think back to the first time I got glasses. I remember that I was amazed by all the detail of the leaves on the trees. I had no idea that you were supposed to be able to see all that. I also had no idea that you are supposed to be able to exert yourself without your lungs burning. I thought everyone got short of breath and the really good athletes were just able to work through it. I never thought to complain about it to a doctor.

My body didn't come with a manual or maybe it was misplaced at the hospital. All I got was a piece of paper that some baby stepped on. They didn't even given me a clean one. What a gip.

7-24-09 morning update

BP 109/67 Pulse 95
Weight 213.0 lbs

The incision seems fine. The bottom 1/2 inch of the incision still has a scab. The rest of the incision is scab free although there will be a doozy of a scar.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain
Ibuprophen 200mg every 4-6 hrs discontinued - last dose 7-23 at 9 am - I am concerned about taking Ibuprophen over such an extended period. I am waiting for clarification from the doctor's office.

Painwise, there is still some, especially when I sleep through a dose or forget a dose. I guess the fact that I can sleep through a dose or lose track of time and take one late is a sign that my pain is getting better. My neck has started bothering me but I think that has more to do with sleeping on my back (haven't done that for years) than the surgery itself.

I see Dr. Oswalt on Tuesday (7-26). I hope he clears me for driving. I've also got to get back to full work sometime.

7-23-09 morning update

BP 113/68 Pulse 78
Weight 214.6 lbs

The incision is doing great. Under the incision is starting to inch a bit. I have read that this is normal. Bad thing about it -- you can't scratch under the skin! Putting pressure on it with my heart pillow helps.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain
Ibuprophen 200mg every 4-6 hrs

I was such a bum yesterday. I did housework stuff but I did not go for a walk. It wasn't incredibly hot yesterday but it did feel more humid. My weight is holding steady at around 214, which is still 5 lbs heavier than before my surgery and about 30 lbs more than I would like to weight. I can not workout with weights but I definitely need to get more walking in. I haven't been eating excessively. I just haven't been very active during my recovery.

7-22-09 morning update

BP 117/69 Pulse 83
Weight 214.4 lbs

The incision is healing fine. I still feel some pain and stiffness under the incision but it continues to improve. One strange thing I have noticed is that, in the morning, my incision almost seems vertically tight. It is as if I need to stretch it in order to be able to stand up straight.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain
Ibuprophen 200mg every 4-6 hrs

Yesterday was a good day. I experience very little break through pain. The pain meds are managing the discomfort just fine. I experimented with trying to skip a pain dose. I am still not ready for that. After about an hour, I can feel it especially if I sneeze or cough.

Walked for about 30-45 minutes yesterday. I am trying to get more active. I've been doing dishes, some laundry (in small batches), feeding the dogs and some light house cleaning. I have to be careful about over doing it. I don't want to undo any recovery I've accomplished so far.

Sleeping kicks serious butt. Waking up rested is such a new thing for me. I can't believe it. No grogginess, no grumpiness (well no more than my normal baseline grump) and no need to hit the coffee right away to wake up.

Have a great day.

7-20-09 morning update

BP 120/66 Pulse 83
Weight 214.5 lbs

The incision is healing fine. I still feel some pain and stiffness under the incision but it continues to improve. I can now get out of bed in the morning with a minimum of hassle. It's not easy yet but at least I don't wake Veronica with all of my groaning when I get out of bed.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain
Ibuprophen 200mg every 4-6 hrs

I went for a longish walk yesterday (45 mins) before the temperature got over 90. I probably overdid it but it felt good to walk for an extended period without my chest burning. Dr. Mingea said the burning was due to blood being forced back to the lungs through my mitral valve. Funny, I've experienced burning lungs upon exertion my entire life but I never thought anything of it. I even played tennis and swam competitively in my younger years. I thought that was just what happened when you breathed hard. It would usually start to subside after 15-20 minutes of activity (or maybe I just got used to it).
I walked for about 30 minutes today. I felt good. I really want to try running but I do not want to over-do it while I am healing. It's not like heart surgery fixed by knees and ankles anyway.

I see Dr. Oswalt on the 26th. Hopefully, he will lighten up on my restrictions so I can do more. I especially want to get clearance to drive.

Have a great day.

7-19-09 morning update

BP 114/71 Pulse 87
Weight 214.5 lbs

The incision and tube holes are healing nicely. The big scabs fell off and smaller ones have formed on all three spots. There do not appear to be any issues with healing.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain
Ibuprophen 200mg every 4-6 hrs

During my recovery, breakthrough pain has been a fairly normal occurrence. I just have to stop what I'm doing and wait for it to pass. Yesterday was a good day as far as discomfort goes. Only minimal pain yesterday that broke through the pain med. Hopefully, today sees further improvement.

Yesterday was not the break from extreme heat I had hoped for (was promised?). It was still stinkin' "I think the dog just ignited but don't spray him with the water hose, it is filled with lava" hot. Today is supposed to "just" hit the upper 90s. It seems strange to think that will be a relief but it will.

I got about 7 hours of solid sleep before some nameless little dog woke me to go outside this morning. "Sleep good. Little dog bad."

Hope your day goes as planned.

7-18-09 morning update

BP 112/70 Pulse 89
Weight 214.3 lbs

Incision is doing nicely. There is still soreness and pain in the area where my breast bone was cut. That's going to take some time to heal. The pain medication does a good job of keeping me comfortable. Still hurts when I cough, laugh or hiccough -- pretty much any sudden movement ending in "ught" is no fun. When I sleep through a dose, I wake to a reminder of just how much the pain med is doing for me. Still, I know I sound like a broken record, sleep is cool.

I suppose my resting pulse rate is not going to come down much until I am able to exercise more. Right now, walking and light housework (dishes, straightening, putting laundry in) is about all I am supposed to be doing. I also get tired pretty quickly although I have noticed an improvement in that area. I am beginning to understand why so many sources I found put the recovery for heart surgery at 6-8 weeks. I am pretty sure I'll be able to return to full-time work quite soon but I will need to watch my lifting and such for a while longer. It sounds weird but I miss work a bit. I'm sure my family is misses me going to work as well. :p Can't wait until I'm cleared to run a marathon. Not that I would ever run without an assailant chasing me but it would be cool to be told I could if I wanted to. Actually, just being able to drive again would be great.

Have a great weekend.

7-17-09 morning update

BP 120/69 Pulse 85
Weight 214.0 lbs

The incision continues to heal nicely. The breastbone under the incision feels fine unless I have to cough, hiccup or laugh. Last night we watched Most Extreme Elimination Challenge (XMC) and I thought I was going to die! I wanted to watch the show because it is frequent hilarious but I just couldn't stand it. Even squeezing my heart pillow tightly against my chest couldn't keep it from hurting.

Taking medications for pain:

Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain
Ibuprophen 200mg every 4-6 hrs

Last night I stayed up later than I should have but Gunga Din was on and it is one of my favorite movies. Isn't it strange how a movie you have on DVD comes on TV and you have to watch it. Anyway, I got to bed very late, actually so late it was early. I was sleeping very well when I had a weird dream of someone throwing little wet-naps at my face. I woke up to our chihuahua, Guero, licking my face. He wanted out and I guess I was the most likely target. Maybe he tried Veronica and failed to wake her. Anyway after about 4 hours of sleep, I was up to let the little dude go check on his girlfriend, the neighbor's dog. Because I had just been slathered with slobber, I figured it was necessary to wash the doggie drool off my face. Once I wash my face, there is little chance for going back to sleep for me.
Maybe I'll get to sleep early tonight.

I am looking forward to a few days of sub-100 degree heat. That will be a treat. Maybe I'll be able to go outside during the day without fear of a flash fire breaking out on my clothing. I hope the weather predictions are right this time. I despise the uber-heat. If I hear another person say, "But, it's a dry heat," I'm going to politely ask them to stand in the dry heat until their brain desiccates.

When the thermometer is rockin' 105, you should have the decency to admit it is hot. There is no sunny side to temperatures over 100. You don't hear ER staff saying, "Well at least it was just a .38 through your belly". No you don't. That staff is professional enough to panic when you come in with a bullet wound in your belly, just like the should. It's easy to get obsessed with the heat in the south when you hide from the weather indoors all day like people in Canada do during January. Except I can not put on more clothes to beat the hot weather. It also gets to a points where, if I take any more off, I'll be spending summer in an un-air conditioned cell in the Texas state penal system.

Let's face it, air conditioning has got to be man's greatest accomplishment. The automobile was awesome but a car without AC is a lousy place to be. The light bulb is terrific but, in a world without AC, why would you want to turn the light on and highlight the sweat stains on everyone's clothes? Modern surgical techniques are amazing but if a doctor got so sweaty that the scalpel slipped out and landed point down in a patient's heart, the doctor would have some serious 'splaining to do. The old "it was there when I got there" excuse doesn't really work for foreign objects inside someone's chest cavity. Television is great but I would rather sit in an empty air-conditioned room listening to Carol Channing singing Achey Breaky Heart A Capella repeatedly than watch the Oakland Raiders win the superbowl on a 92 inch HD flat screen TV if the AC was out. When I think back to my youth when I grew up on the Texas-Mexico border without air conditioning, I can only wonder why my mother was not prosecuted for child neglect. It probably stunted my development. I could have become the scientist who developed a cure for cancer, the astronaut who verified the existence of alien life, or better yet, the inventor of a solar-powered personal air conditioner that could keep you cool inside your clothes.

7-16-09 morning update

BP 117/72 Pulse 86

Weight 213.0 lbs

The incision is healing well. The real discomfort is in my ribs and under the incision. That's going to take some time to heal. Morning muscle stiffness in the chest and back makes getting out of bed a challenge but it seems to be slowly improving, or I am getting better at "pouring" myself out of bed.

Taking medications for pain:

Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs except when experiencing increased pain (rare)

Ibuprophen 200mg every 4-6 hrs

Looks like this weekend we will see some sub-100 temperatures. I am ready for it. I want to get out to get some exercise but it is too doggone hot outside to do it. I am not cleared to drive so I can't take myself somewhere to walk indoors. I've been waiting until night to go for walks but I'd rather do things during the day. I'd also like to be allowed to lift more but I know that is a doctor's order to assure a better recovery. I don't have to like it. I just have to follow it.

Have a great day.

7-14-09 morning progress

BP 120/74 Pulse 88
Weight 213.2 lbs

The incision is looking great. No infection. There will be a scar but not a really bad one. Oh well, there goes my modeling career.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs - lowered dosage with minimal increase in discomfort
Ibuprophen 200mg every 4-6 hrs

Still waking with pain and stiffness. Took a shower after getting up this morning. That seemed to help with the stiffness quite a bit. Showers are becoming less of an ordeal than before. Yesterday was pretty busy by recent standards. We went to Walgreen's, Micheal's and Target. By the end of it all, I was really spent. My energy is coming back but it is not where it was before. Also slowly coming back is my appetite. Appetite is a harsh mistress. I need food for energy and nutrients during the healing process but I am also less active than I would like to be at this time. I need to be careful about eating too much or I could start gaining weight. If I gain too much weight, I put myself in danger for other health issues. I guess all the buffets in town can take my picture of their "Do Not Serve" boards. I won't be killing any profit margins again. Well, maybe once in a great while.

7-13-09 morning progress

BP 117/69 Pulse 88
Weight 211.8 lbs

The incision continues to heal nicely. The muscle around the incision continues to be sore but the incision itself doesn't seem to hurt (says the man on pain meds). No swelling, redness, heat or any of the tell-tale infection signs.

I am still in increased pain when I get up in the morning because I am sleeping through doses. That's cool. I figure the sleep is just as important to my recovery as pain management. I've never slept well in my life so the whole comatose, no multiple wakings, go to the bathroom and go back to sleep thing is an entirely new experience for me. I like it. My mother always told me that I never slept through the night and it wasn't until I was almost three that I learned to keep myself entertained at night (that probably speaks volumes of my personality and why my mom looked so tired). It's about an hour until some relief once I take my pain meds but compared to 8 hours of sleep, it is a fair trade-off. I can not remember when/if I ever had 8 hours of uninterrupted sleep. Hopefully, it will continue after my recovery is complete.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs - lowered dosage with minimal increase in discomfort except upon waking
Ibuprophen 200mg every 4-6 hrs

I skipped updates yesterday because I was feeling down. I needed a change of scenery but, because I can't drive and Veronica was out running errands, I was stuck at home. To make matters worse, I tried to get out of my big dog's way outside then tripped and fell. Luckily, I did not hit my chest but I did a good job of scratching up my right shin. After that, yesterday was spent looking for warning signs of damage to my breast bone. None appeared. It made my imprisonment all that much more torturous. Listening to my heart with the stethoscope really helped me keep perspective and stave off the depression. I feel much better in that respect today.

Have a great day.

7-11-09 evening update

BP 122/69 Pulse 92
Weight 212.4 lbs

Healing at the surgical site is excellent. It's not itching today at all. The new red dot highlighted to the right of the incision is a stinkin' ingrown chest hair from the shaving they gave me before surgery.
Chest muscles are still a bit sore but I can't remember having a spasm at all today.
My back is also a little sore but nothing like previous days.

Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs - lowered dosage with minimal increase in discomfort except upon waking
Ibuprophen 200mg every 4-6 hrs

After the morning initial vocabulary inspiring brush with great discomfort, the day has been pretty mild. Not much happening today. Both Veronica and Rock slept in a bit today. They deserve it. They both stay up late to get work done at night when the temperature is 15 - 25 degrees cooler. Pretty smart idea.

The little dog has been a thorn in my side all day.
He wants out.
It's too hot.
He wants in.
He wants out.
It's too hot.
He wants in.
When I try to break his little psychotic pattern, he starts whinning.
He's in love with the neighbor's dog (who probably out-weights by a factor of at least 3) and he has to see her. Veronica says he wants to make sure she's not talking to other dogs. I think he wants to make sure I don't get comfortable but, hey, what do I know. I'm the idiot getting up every few minutes to let him out and in. Who's the "pet" in this relationship?

7-11-09 morning update

BP 126/73 Pulse 96
Weight 212.4 lbs (still losing weight a little at a time)

The incision is looking good. No new redness, no heat.

The tube holes at the bottom are also healing nicely.

Taking medications for pain:Hydrocodone/APAP 5mg/325mg 1 tab every 4 hrs - lowered dosage with minimal increase in discomfort except upon waking
Ibuprophen 200mg every 4-6 hrs

Waking this morning was a good news bad news affair. The goods news is I slept for over 8 hours straight for the first since well before my surgery. The bad news is I slept through two medication doses. I woke up feeling okay until I tried to get out of bed. Then it hit me, a Super-Sized Owie of the first order. If I had to describe it in one word, I'd have to create a 63-letter polysyllabic word that would requite umlats, tildes and that weird little character that looks like an A invading an E's personal space.

As some people know, one of my favorite words is schadenfreude (sha-din-froi-da) , a German word which refers to enjoyment obtained from the pain and troubles of others (literally Schaden damage + Freude joy). I just think it is so amazing that there would be a word for such a thing. If there were a person in the room this morning who experiences schadenfreude, I could have charged admission. I am sure it was quite a sight to see me slowly slide off the bed because I could not manage to get myself into a sitting position before getting to the floor. I guess the only thing more demeaning would be blogging about it.

Yesterday was a pretty good day. You may have noticed I missed both entries yesterday. I woke up early and found Veronica on the internet looking up estate sales. She loves estate sales. I usually would rather go to an 8 hour performance of Songs from Disney played entirely by the Nails on Blackboards Orchestra at a venue where they lock the doors after you get there and confiscate all ear plugs, fire arms and cyanide capsules upon arrival. Roni asked me if I would like to go and I said yes. Must have been the medication talking.

Anyway, we went to three estate sales, it was nice to get out of the house and get moving. I can't take myself anywhere because I can not drive. I walked through what can only be described as the "Final Garage Sale". I usually can only handle one pass then I have to go to the car. Veronica can lovingly view each and every room and each and every item in it. Bama jelly glasses with cartoon figures on them. The characters arms long since amputated from repeated washings with steel wool. A velvet painting of a matador that the artist actually took the time to sign. What artist looks at a velvet painting and says, "Oh Yeah, I gotta sign this baby"? Veronica loves estate sales to the point where her personal slice of heaven (TM - religious right all rights reserved) will have endless estate sales, thrift stores and garage sales. Technically, I guess they would have to be mock estate sales, I mean people don't die in heaven do they? I mean except from boredom. It is fun to watch her enjoy herself. It is a bonus that she often finds outrageous deals. For me, it is a reminder that, at some point, strangers will be rummaging through my possessions and remarking on my complete lack of style and taste. I hope someone cool buys my Kiss memorabilia not just some money grubbing collector who does not understand the true artistic genius of a group of guys in Kabuki make-up signing songs like Love Gun, Come On And Love, Rocket Ride and Dr. Love. Songs like that come straight from the, well, a bit lower than the heart.

Last night I rode Veronica's adult trike for a while. It was fun. I don't have the nerve to ride my "big boy" bike. The entire balancing, stopping, falling over and chest bursting open thing worries me. I mean, how does one get gravel out of their chest cavity after something like that? Is that a 911 call or an "excuse me, could you please drive me to the ER" moment? If I died on the spot, would my bowels release? That would be SO embarrassing. I don't think I would ever be able to look another person in face after that.

Wow, I just realized that I have been typing so long that the pain meds are now working. Woo Hoo! I now can go and ... Oh yeah, I can't go anywhere. I can't drive. I wonder what's on TV at 8:30 on a Saturday morning. I bet it's choice!

Have a great day.

7-10-09 morning update skipped

Not to worry, all is fine.

This morning, Veronica was going to a couple estate sales and I decided to tag along.
I didn't get to the update.

I slept well, about 6 hours straight, but woke up in pain. Nothing Earth-shattering but enough to give me a good reminder that I had heart surgery two weeks ago (today!).

7-9-09 evening progress

BP 136/71 Pulse 93
Weight 213.2 lbs
Taking medications for pain:Hydrocodone/APAP 5mg/325mg 1 tabs every 4 hrs - lowered dosage with minimal increase in discomfort
Ibuprophen 200mg every 4-6 hrs

The back pain and stiffness is biggest challenge today. The incision is beginning to itch a bit but nothing that will drive me crazy. Except for a bit at the top and bottom of the incision, the scabs have pretty much come off on their own.

I am being slapped with the realization how limited I am. I had to leave the garbage and recycle cans on the curb all day because they are over my weight limit. Rocket was in Dallas today so I had to wait for him to get them in. I am unable to use any of my guitars because they are all over my weight restriction. Maybe I can get a Martin Backpackerto use while on restricted weight. Being unable to drive is another biggie. I wanted to run a quick errand today, to see if Guitar Center hadthe Backpacker, but ended up just forgetting about it. I didn't want to bother Roni with it so I just blew it off. It wasn't very important anyway.

Oh well, my heart still sounds good. :)

7-9-09 morning progress

BP 110/72 Pulse 90
Weight 212.4 lbs

Taking medications for pain:Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs - I am going to attempt to reduce the dosage today to 1 per 4hrs

Ibuprophen 200mg every 4-6 hrs

Today started off very well. I slept through a med dose by three hours. When I woke, I was not in that much pain, maybe a 3 or 3.5. That's not bad at all.

So far today, no muscle spasms. That's a great relief!

The incision is almost to the point where is doesn't need mentioning. It is almost completely healed and even the surgical bruising is fading. There are almost no scabs left -- just skin.

7-8-09 evening progress

BP 111/75 Pulse 89
Weight 214.4 lbs

Taking medications for pain:Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs
Ibuprophen 200mg every 4-6 hrs

Today has been a much better day as far as pain is concerned. The spasms in the upper torso are not that bad. The spasms are fewer and the pain level is pushed to, maybe, a weak 6 rather than a solid 8. Getting in and out of a sleeping position is still very uncomfortable but it is getting better. The incision is healing nicely (on left).
My "bullet holes" where the chest tubes were (close-up, bottom right) look scary but are also healing quite well.

I actually took a nap today! Woo Hoo! All those years in daycare of messing around during nap time and now it's a treat. Holy cow! Does that mean I've gotten old? Maybe it means I am returning to childhood.
My energy level is improving but my appetite has not quite returned to its former glory. The latter is probably a good thing.

7-8-09 late morning progress

BP 123/70 Pulse 90
Weight 213.4 lbs

The spasms in th upper torso are not as bad this morning. The pain is more of a constant lower level pain rather than a series of spikes. Constant is much better in my opinion. I know what to expect.

I bought a stethoscope today so I can listen to my heart. What a beautiful sound! I think it will really help me deal with the challenges of recovery. It sounds so "normal". I don't recognize it. The previous "washing machine without clothes in it" sound was much more unique. This is one time in my life when I'll take mundane over unique, thank you very much.

7-7-09 evening progress

The incision continues to heal nicely. Extreme soreness has set into my upper torso. The pain is a constant 3 with pain meds. I occassional experience twinges that border on 7-8. Feels like the worse muscle strain I can imagine times 3. My back is also quite sore. I talked to Gail at Dr. Oswalt's office and she said this pain is usually related to using posture to protect the incision. I need to work on standing up straighter (the story of my life). When I am able keep good posture for an extended period, the spasms improve. The incision is looking good.

BP 129/75 Pulse 85
Weight 216.0 lbs

7-7-09 morning progress

The incision continues to heal nicely. Extreme soreness has set into my upper torso. The pain is a constant 3 with pain meds. I occassional experience twinges that border on 6-7. Feels like the worse muscle strain I can imagine times 3. My back is also quite sore. I didn't sleep well at all last night but things could be much worse. I feel fortunate the surgery was successful and I did not require a valve replacement (no Coumadin!).

I'm going to ask Gail, Dr. Oswalt's nurse, If I am allowed to use my inversion table. Hopefully, that will help with my back pain.

I want to get a stethoscope today or tomorrow. Listening to my heart sound like a heart instead of a washing machine will help motivate me to keep up my rehab, especially the exercise part.

BP 127/75 Pulse 93 (my pulse rate seems to be staying high but I don't feel it)
Weight 214.8 lbs

Taking medications for pain:Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs (1.5 tab / 4hrs was ineffective) Ibuprophen 200mg every 4-6 hrs

7-6-09 afternoon progress

I do not notice pain at the actual incision site. The incision, itself, seems to be healing fine -- no drainage or heat from the area. Thebruising around the incision is fading.

I am experiencing muscle tightness through my chest, shoulders and back. This pain is more distressing than the surgical pain of a couple days ago. It is much more persistent and annoying. It is not addressed very well by my pain meds. It feels like a really bad muscle strain in my chest, probably very understandable but no fun at all. Massaging the tight areas seems to help for a while. I left a message with Dr. Oswalt's nurse about what can be done. I haven't heard back yet. This may be what I've heard is "worse than the surgery" -- the healing ribs.

On the plus side - no heart palpitations, no shortness of breath, no feeling like I will blackout if I bend over.

All in all, I think I got the better of this deal. The soreness will subside sooner or later. Then I'll probably feel the best I have in my entire life.

BP 133/68 Pulse 88
Weight 216.2 lbs

Taking medications for pain:Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs (1.5 tab / 4hrs was ineffective) Ibuprophen 200mg every 4-6 hrs

7-6-09 morning progress

I do not notice pain at the actual incision site now. I am experiencing muscle tightness through my chest, shoulders and back. Massaging the tight areas seems to help. The incision, itself, seems to be healing fine -- no drainage or heat from the area. Even the bruising around the incision is beginning to fade.

BP 120/73 Pulse 90
Weight 215.4 lbs


Taking medications for pain:
Hydrocodone/APAP 5mg/325mg 1.5 tabs every 4 hrs (1 tab / 4hrs was ineffective)
Ibuprophen 200mg every 4-6 hrs

Slept pretty well last night. Luckily, I woke to go to the bathroom at precisely the time I needed to take a pain med dose. I was able to go right back to sleep. Bea-u-tee-ful!

I'm going to get out for a walk before it starts to heat up outside.

7-6-09 1:30 am update

7-6-09 1:30 am
BP is 118/74
Pulse is 84

Sitting up waiting for the most recent dose of pain meds to kick in so I can sleep.
Muscle soreness is really bothering me. Back, ribs and chest muscles are sore. The soreness is pretty much equal on both sides. The pain does not radiate. It feels like someone beat the crap out of my upper torso meticulously making sure they got all areas equally abused. A sore back was why I first stopped sleeping on my back years ago. Now I am forced to sleep on my back for a least a month, most likely longer.
Fun, fun, fun!

On a side note:
I made 5000ml on the Voldyne 5000 Volumetric Exerciser twice today!
I am prepared to do testimonials if the company is interested.
I may need some time to catch my breath though.

7-5-09 afternoon progress

There's only a little soreness at the incision and a dull pain in what seems my chest bone (top and bottom), my back soreness is less noticeable. The sides of my chest seem much more sore than before but it may be that I didn't notice it until the incision site pain subsided a bit. My chest muscles feel like I lifted weights yesterday. The incision, itself, seems to be healing fine -- no drainage or heat from the area.

BP 128/71 Pulse 94
Weight 215.2 lbs

Taking pain medications:
Hydrocodone/APAP 5mg/325mg 1.5 tabs every 4 hrs (1 tab / 4hrs was ineffective)
Ibuprophen 200mg every 4-6 hrs

I worked my arms today with a 2.5 lb medicine ball. Just lifting curl, french curl, and arm out to the side. Felt good to do something with my arms. I don't want to do too much or I may damage the healing of my breast bone.

I was in danger of running out of pain meds today, completely my own fault, but a PA from Dr. Oswalt's office called in a prescription for me (on a Sunday). I know I would not have been able to sleep tonight without it. The pain would have kept me awake all night.

7-5-09 morning progress

There's some soreness at the incision and a dull pain in what seems my chest bone (top and bottom), my back soreness is less noticeable this morning. The incision, itself, seems to be healing fine -- no drainage or heat from the area.

BP 115/74 Pulse 92
Weight 215.2 lbs


Taking pain medications:
Hydrocodone/APAP 5mg/325mg 1.5 tabs every 4 hrs (1 tab / 4hrs was ineffective)
Ibuprophen 200mg every 4-6 hrs

No photo this morning -- camera battery is charging.

7-4-09 afternoon progress

There's some soreness at the incision and a dull pain in what seems my chest bone (top and bottom), my back is sore under my right shoulder blade near the spine. The incision, itself, seems to be healing fine -- no drainage or heat from the area.

BP 120/66 Pulse 94
Weight 216.4 lbs

Taking pain medications:
Hydrocodone/APAP 5mg/325mg 1 tabs every 4 hrs (reduced from previous days)
Ibuprophen 200mg every 4-6 hrs

I reduced my pain medicine dose to see if I can ween off of it. I can certainly tell it. The pain is more annoying than yesterday but I am taking 1/2 the dosage. It may be too soon to try to reduce the Hydrocodone. I'll probably need more to sleep tonight. I tried to lay down to rest earlier today and it was a complete non-starter. I couldn't even get comfortable. Update: I had to increase to 1.5 tabs every 4 hours in the evening as I was pretty much in 5-6 level pain all day.

7-4-09 morning progress

There's some soreness at the incision and a dull pain in what seems my chest bone (nothing really new here), my back is very sore under my right shoulder blade near the spine. The incision, itself, seems to be healing fine -- no drainage or heat from the area.


BP 131/77 Pulse 84
Weight 216.0 lbs

Taking pain medications:
Hydrocodone/APAP 5mg/325mg 1 tabs every 4 hrs (reduced, beginning this morning, from previous days)
Ibuprophen 200mg every 4-6 hrs

I slept fairly well last night considering the contrived way I have to situate myself to stay on my back. Woke up at 3:45 am, took meds and went back to sleep at about 5 am and slept until 8 am.
Veronica stayed up straightening the house. It looks amazing. I feel guilty that I can't help much right now. I don't know what I did to deserve her, but I'm glad I did it.

7-3-09 afternoon progress

Some soreness at the site, my back is a bit sore , no incision drainage, no warmth from incision

BP 125/77 Pulse 84
Weight 217.4 lbs

Taking pain medications:
Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs (going to try alternating 1 every other 4 hrs)
Ibuprophen 200mg every 4-6 hrs

Roni and I went to Randall's today for some light shopping. I needed to get out to walk and an air conditioned store seemed like a great location. We were there about an hour. I got a pretty good walk in. I didn't really help with the shopping that much because my lift limit is so low that I can't gauge it (Sorry, Roni). I can grab cans, bottles, etc that are clearly labeled for weight.
One thing really struck -- when the energy goes, it goes all at once. I was close to exhausted when we left the store. I am going to have to pay close attention to that on future walks. Paying attention to my body's signals hasn't been a strength for me in the past.

7-3-09 morning progress

Still some soreness at the site, my back is a bit less sore today , no drainage, no warmth from site

Just noticed I can not remember the last time I was short of breath

BP 119/72 Pulse 94
Weight 217.0 lbs

Taking pain medications:
Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs (going to try 1 every 4 hrs)
Ibuprophen 200mg every 4-6 hrs
3:30 pm Update: With 1 Hydrocodone, I can definitely feel more pain but it is not unbearable.

Going to increase the amount of walking I do today. My digestive system seems to be returning to its normal function.

Sleeping exclusively on my back is a challenge. I have to pillow myself into a position so I will not turn during the night as I usually do. I do not want to crack the breast bone as it is healing.

7-2-09 afternoon progress

Still some soreness, my back soreness has set in (information from Dr. Oswalt's office says that is expected), no drainage, no warmth from site

BP 136/82 Pulse 88
Weight 221.0 lbs

Taking pain medications for pain:
Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs
Ibuprophen 200mg every 4-6 hrs

One piece of torture equipment - Voldyne 5000

One of the most serious complications from any procedure that requires general anesthesia is lost lung capacity which can lead to pneumonia or permanently lowered lung capacity. Well, this little beauty, the Voldyne 5000 Volumetric Exerciser, is used to help the patient clear out and regain their lung capacity.

The goal for me is to inhale through the Voldyne 5000 and get to 3500ml consistently. Sounds easy, right. A child could do it. A one-lunged no armed monkey with emphysema and a hole in his cheek could do it (although he may have difficulty holding the tube). No problem. Well neither of those examples has a freshly separated and closed breast bone, an 8-inch suture or a chest tube laying across their lung. The first time I tried it, shortly after having my surgical breathing tube removed, or at least what I remember to be shortly after breathing tube removal. Everything is a bit hazy those first few hours after surgery. Anyway, I digress. My first attempt at this produced a result between 2500ml and 3000ml. Piece of cake! It makes little difference that I was receiving morphine at the time and the swelling had not set in from the surgery. Right? No biggie.

I tried it again about an hour or so later (once again, the timeline is a bit hazy here). This time the results were not as good -- about 1500ml. I should probably also include that that lackluster result was accompanied with what was the most excruciating pain I have ever experienced in my life. I was literally terrified I had split my incision, ruptured a lung or somehow permanently damaged myself. Luckily, in ICU, morphine was administered in my IV and my suffering was abated quickly. What happened? The general anestethic had completely worn off and expected surgical swelling had set in. Now my chest tube resting on my lung was much more restrictive. My early success with the Voldyne 5000 (hoping to get an endorsement deal with them) would haunt me for the next few days. Not that I have an obsessive personality or anything like that.

On the afternoon of the second day, several of my more exotic bio-connections were removed (another posting for those details). My chest tube came out. Wow, what a strange sensation. I felt the tube coming out the entire length of the pull. I felt it run across my lung and through the holes below my breast bone. I also felt a huge load come off my chest. Shortly afterwards, I was taken from ICU to a private room. After getting situated, I tried my breathing exercises using my now familiar Voldyne 5000 (I can be reached through email for ad campaigns). I did quite a bit better but also noticed increased soreness afterwards. Keep in my, they were doing a great job of keeping my pain managed at this point. If I was feeling a little soreness, it was probably giving me one whopper of a smack had I been in the unfilter world of genuine "holy cow that hurts, make it stop, stop it, stop it, stop it, Mommy!" pain.

I noticed deep breaths were not pleasant to perform. What I needed was something that allowed you to work on expanding your lungs, showed a clear goal and could be made into some sick masochistic game that could become so addictive that any bored individual with a borderline obsessive compulsive disorder could really focus on it an unhealthy way. Then it came to me like something produced by someone with Photoshop and too much time on their hands.


The Voldyne 5000 could be my savior. I could suck my way back to respiratory health! And suck I did. Last night, almost a week after first meeting "Voldy", I was able to reach 4000ml 10 times in a row. That would be terrific and a monumental accomplishment if it were not for one thing -- the scale goes up to 5000ml. That extra 25% taunts me like a like a guest eating peanuts at the monkey cage. Should I ignore the taunts, throw feces or face my nemesis head on in some respiratory suck-a-thon where there can be only one victor?

Oh precious Voldyne, have you truly become my Voldemort?

Important things I learned during my hospital stay

I learned a few important lessons in the hospital:
1- Hospital beds kick butt. You can adjust them to that perfect position very easily. I want one for my living room. It would be perfect for movies. (Now you know what to get me for my birthday in December :D )
2- A room with a thermostat that goes down to 55 (probably really 60) is AWESOME! It was over 105 outside a couple days I was in the hospital but I had no idea because I was chillin'. The pain meds make me feel hot so it was kind of a necessity.
3- They hire young, cute, perky women to be cardiac rehab therapists so you are less likely to kill them for being sadists. The two I met were professionals but I could see how someone might want to do them in.
4- ST. David's Hospital has really good hospital food. You actually get to order from a menu.
5- Insulin shots are not that bad (very thin needle although I do have bruising afterwards) but monitoring blood sugar stinks big time. They keep your sugar levels below 130 after cardiac surgery to speed healing. "Normal" is usually considered 70-150. No one hipped me to that before I ordered the orange gelatin and put sugar in my tea. I spent the entire time getting tiny insulin shots for blood sugars in the 130-135 range. Almost not worth poking the skin. Lancets suck! I feel for anyone who has to do it on a frequent basis.
6- A room with a thermostat set to 55 is not that great when you have to get out of bed to use the bathroom at night. No fun at all especially in a backless hospital gown. Equally unfun when you get out of the shower and shivering causes your chest to feel like it is on fire.
7- It is difficult to find patients under 50 in the cardiac wing at ST. David's Hospital.
8- If your channel line-up is lame enough, it IS possible to go 4 straight days without being able to watch a single episode of MASH or any good cartoons (5 movie channels and not a thing worth watching).
9- The iPod Touch is a great movie machine and decent internet browser (ST. David's has free wireless internet).
10- The nursing staff at ST. David's is awesome. I hope I never have to see any of them again but I am eternally grateful. They were solid gold. St. David's should be proud of their staff.
11- Even with extremely competent staff around all the time, you'd still rather have your wife and kid in the room when you're in the hospital.
12- One needs to delete the brutal death metal off their iPod if they are going to shuffle songs while in the hospital. I just about made myself soil the bed. I was dozing listening to the ipod and it went from Mediaeval Baebes (mellow vocal-based Madrigal stuff) to something off a compilation album from a band called Amputated Genitals. Not a smooth segue at all.
13- After chest surgery, your "heart pillow" is your best friend. It is the most important thing to have with you at all times. Even more important than pants! I'll probably devote an entry to my new best friend very soon.
14- A hiccup can be the most terrifying experience of your life after heart surgery. It feels like the alien burrowing through Kane's (John Hurt) chest. Hiccups are worse than a cough because, you know a cough is going to subside sooner or later. In my life, I've had hiccups that have lasted days. Luckily, I've only had them for a few minutes since surgery.
15- If you are on a pain-med regime stay on the dosing schedule.
Do not think, "The pain is not that bad, I don't need to take my dose now." Take that dose. Keep in mind that oral pain meds take 45 mins to 1.5 hrs to give you relief. If you are already feeling it, you may be in for a long unpleasant wait before you get relief. I slept through a dose Tuesday night (6-30) and woke up at 3:45 am in a ton of pain. In the ICU, they can hit you with something in your IV like morphine and, boom, 5-15 minutes and you experience relief. Oral meds are not as quick but they are longer lasting. On a side note, I fail to see how anyone could seek out pain medication. I do not find the side-effects pleasant at all.

I'll update my "What I Learned" list as I go. Seeing how this one was just under a mile long, I am sure few people made it this far. If you did, congratulations! You officially need to find something better to do with your time. :D

7-2-09 morning progress

Some soreness, no drainage, no warmth from site
BP 125/72 Pulse 94

Meds and Supplements

Meds:
Metoprolol 25mg twice daily (9am, 9pm)
Hydrocodone/APAP 5mg/325mg 2 tabs every 4 hrs
Ibuprophen 200mg every 4-6 hrs

Nutritional Supplements:
Multivitamin (One-a-Day Men's Health) twice daily
Aspirin 81mg per day
Niacin (nicotinic acid) 1.5g twice daily
B-Complex (B100) twice daily
Chromium Picolinate 200 mcg twice daily
Flaxseed Oil 5g twice daily
Vitamin D3 2000 IU twice daily
5-HTP (L-5-Hydroxytryptophan) 100mg twice daily
GABA (Gamma-Aminobutyric Acid) 750mg twice daily
CO Q-10 50 mg twice daily

Marc's Heart Blog

On June 26, 2009, I had open heart surgery to resolve a congenital heart defect called Hypertrophhic obstructive cardiomyopathy (HOCM - "HOKEM" - for short). This condition caused me to be frequently out of breath, suffer from heart palpitations, have generally poor sleep quality and a host of other symptoms. In late January of 2009, I had a heart scare that sent me to the emergency room. I was refered to an excellent cardiologist, Dr. Robert Mingea, and the tests started coming.

First, I had a heart murmur. This I already knew. My heart sounded more like a washing machine than a heart. This was news to me.

Long story shortened, I am at home recoverying from open heart surgery at the age of 42.

This blog will document my recovery as well as cover lessons learned along the way and, hopefully, convey some interesting episodes that occurred along the way.