Now ICU, now I don’t

Intensive Care Unit.

I feared this experience almost more than heart surgery itself. At least in surgery you’re unconscious.

I was a broken body hooked to machines, lines, pipes, monitors, drains and tubes. Thanks to the drugs, I couldn’t think or communicate easily. I was in the worst pain.

This blog post is about the nurses and experiences in ICU.

Wake up! It’s the first day of the rest of your life.

My Coronary Artery Bypass Graft (CABG) took place on a Monday morning in mid-April, 2015. It took 3 hours (which was relatively quick). I think I woke up that evening.

If you’ve had an anaesthetic you’ll know that waking up is really annoying. You’re in this amazing deep sleep then somebody goes and wakes you up.

Well, imagine also

  • waking up with tubes down your throat
  • being unable to breathe or speak
  • feeling like you dropped out of the sky and
  • landed on a road and
  • got run over by a juggernaut

That’s pretty much how I felt on the first day of the rest of my life.

My first memory is panic. I have a hyper-sensitive gag reflex and a fear of choking. The ventilator tube felt as big as a vacuum hose. There were people hovering around watching me wake up. I gesticulated wildly at my throat…

Get this thing out!

I think there was hesitation. I remembered that I had to demonstrate independent breathing before the assisted ventilation could be removed. So, does panicky hyperventilation count?

Eventually, it did. The “vacuum hose” was pulled out. I coughed, spluttered, gagged and made choking noises.

Vacuum hose

This is how the ventilator tube felt in my throat. (Flickr credit: torsteinsaltvedt)

But, yay! First challenge over. The dreaded ventilation tube has gone. One down, how many to go?

In another blog post I told you a nurse gave me a list of what to expect when I woke up in ICU. Well, as horrible as that was, I’m glad she did.

My Fentanyl nightmare

Q: Drugs, drugs on the ward. Who’s the worst one of them all?

A: Fentanyl. No question.

I had access to a PCA pump (Patient Controlled Analgesia) which sounds like a nice idea in theory.  You get to dose yourself up with painkillers when you want to. I was encouraged to use it liberally to control pain during sponge baths, repositioning myself, and getting in and out of bed.

Trouble is, I am petite. This fact was frequently exclaimed by the nurses.

Oh wow, look how tiny you are! You are so young and so little!

I bit my tongue. It’s all relative, I thought. They don’t mean to, but it really hurts to hear that. It reminded me how unfair it felt to be in this situation.

I am confident they calculated the maximum dose of Fentanyl for me but I don’t always tolerate drugs well. I got some of the Fentanyl side effects quite badly.

Eventually, I was spaced out, swirling, dizzy, unable to focus. I was seeing double, the world was warping in and out, whirling around in a blur.

I was in a Fentanyl nightmare.

Make it stop!

OK, sure. We’ll give you more drugs.

It was very hard for me to think straight, let alone communicate that I wanted fewer drugs, not more. At one point I had the doctor’s face right up close to mine. He was concerned about my anxiety.

You are too anxious. You need to calm down.

No kidding, Doc! Just stop giving me drugs. I’d rather have the pain.

That was the worst day in ICU.

How to get out of bed with a broken sternum

I soon discovered the sternum is pivotal in movements we take for granted. There is a special technique for getting in and out of bed when your sternum is cut in half.

Try this method for getting out of bed:

  1. From flat on your back, shimmy your hips rather than your upper body to gently move to the left edge of the bed

As a mad keen dancer, shimmying the hips is my thing!

  1. Keep your spine as straight as you can. Bend your knees up and roll onto your left side

Notice that your sternum is under pressure in this position and your left arm is underneath you

  1. Swing both your legs over the side of the bed
  2. Place your right hand near your left shoulder on the bed

Notice that moving your upper arm involves muscles around your sternum

  1. Press through your right hand so that you rise vertically through a sideways plane

I have fairly strong triceps and core from years of Pilates, yoga and Barre so for me this step wasn’t difficult.

Mini soapbox rant

Stop thinking that exercise is just for losing weight and looking fab.

Exercise gives you much more than outward changes. It benefits you in ways you cannot start to imagine!

If I had been unfit and unhealthy, then my heart event, surgery and recovery would have happened sooner, been more difficult and taken longer.

Drain, Drain go away.

Over the next 60 hours in ICU, I was gradually released from some of my tethers. The IV drips went, so did the urinary catheter. Many remained to be removed later.

For me in ICU, removing the surgical drains was the worst. It’s not a matter of just pulling them out. It has to be done quickly in a certain way to avoid contamination, air going in, and with minimal pain.

I had 3 drains in my abdomen. Yes, right in the soft fleshy part of the belly where there is nothing bony for the nurses to press against for traction. It took two nurses to pull out each drain. It hurts like hell. Unfortunately, the pain lingers after the drain is gone, thanks to the clever stitches they use.

Purse string sutures” are nifty stitches placed around the drain tube so when the tube is pulled out, the stitches come together and close the wound.

Things to think about

  • How have you felt after waking up from surgery? Relieved, confused, annoyed?
  • Did you try the getting out of bed technique? Easy or not?
  • Will you change how you think about exercise now?

We have a WINNER!

In the last blog, I asked you to guess the internal diameter of my Lateral Anterior Descending artery (the “Widow Maker”).

Kelly wins with her guess of 0.01 mm. Thanks for your guess, Kelly!

The unobstructed internal diameter is 1.5 mm.

The 98% blockage means that my LAD has an internal diameter of 0.03 mm for blood to squeeze through. Think for a minute, how narrow that is.

You know you are interested when you peruse the references!

If you only read one reference, read this one! It’s short and explains everything about the ICU experience after cardiac surgery. I highly rate this reference!

http://www.cts.usc.edu/hpg-recoveringintheicu.html

And this too! It covers things I didn’t talk about – like coughing, eating and drinking.

http://www.secondscount.org/treatments/treatments-detail?cid=afd902b3-1db7-4f67-bcc5-985e7c77587e

Techy talk about purse string sutures

http://www.ncbi.nlm.nih.gov/pubmed/17614809

Post-surgery recovery – the advantages of being fit

http://www.telegraph.co.uk/news/health/news/11138311/Fit-patients-five-times-less-likely-to-die-after-surgery.html

http://coach.ninemsn.com.au/2015/02/16/16/51/fit-people-five-times-more-likely-to-survive-surgery

A loyal follower of “The Heart Source” is a fellow WordPress blogger Dr. Jonathan Neal Colter who advocates self-responsibility in health care. This is a philosophy I like too.

https://allabouthealthychoices.wordpress.com

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10 thoughts on “Now ICU, now I don’t

  1. Surgery, and the details associated with it, are not “REAL” to the average person who has never undergone this “evil” yet LIFE SAVING event. For those willing to take the time to read your postings, it can provide a visual and educational experience to help people consider altering their current lifestyle behaviors that contribute (frequently) to the surgeries many people undergo as a result of these behavioral choices. People may not realize how brave you are rehashing the details and painful memories of this emotionally traumatizing event. Hopefully it brings a new sense of reality to people’s lives creating a better understanding and urgency to modify self destructive patterns. Good health is NOT about passive luck; it is about diligent effort and sacrifice to achieve the life each of us is capable of living. Although your story is based on a pre-existing condition, the average person’s cardiac impairment is self induced.

    Thank you for being courageous enough to share your story and emotions. It is an important story all of us can learn from.
    I also want to personally thank you for the honorable mention at the end of the post. I hope the words in my blog site help awaken sleeping minds and motivate people to begin taking ACTION STEPS to reverse the current path many lives are following.
    Wishing you much continued success on your journey with all the happiness possible.

    Liked by 1 person

    • Thank you sincerely for acknowledging my efforts.

      It has been very difficult to write this and sometimes I’ve shed a few tears over my keyboard. You are right, most people have no idea how hard this experience was for me and those who love me.

      Your support is extremely valuable to me because it motivates me to keep going.
      I find blogging seems to go into an empty silent space with only a handful of comments in return for my invested effort 😦

      Liked by 1 person

      • Don’t base the significance of your contribution on the comments received. You would be surprised how many people read stories without even clicking the “Like” button. I will also gladly include a reference and link to your site (with your permission) the next time I write about cardiovascular issues. You have an important message that needs to be heard. If it ultimately helps just a few people (and I believe it will help a great deal more than this) you will have helped prevent or at the very least humanized the reality of cardiac surgery. I’ll bet you would have appreciated someone compassionately explaining your procedure prior to entering the hospital. Never give up. 🙂

        Liked by 1 person

      • Why do your messages always make me teary? Thanks so much. Yes, please share my blog where and when you feel it is appropriate. I shall reciprocate. Thank you from the bottom of my CABG’d heart 🙂

        And yes, I would have appreciated a blog like this in the lead up to my operation. That is one reason I am writing it, in the hope that it might help one human being at the very least.

        Liked by 1 person

  2. Beautiful Fay, there are no words which reflect the strength, determination and passion for life you have. I am so pleased that you were shimmying in the ICU.
    Your insight, and sharing of your experience has such power and inspiration to others; you’re an inspiration to me xx

    Liked by 1 person

  3. Thank you dear Fay for sharing all of this, it was quite heart wrenching to read, some of it I could relate to, but the absolute terror you must of felt at the possibility of you meeting your maker, I can only imagine. It was great to see Paul’s insight as to how he felt too. I have sent Chris away when I was in horrendous pain, as I did not want for him to see me suffer. I do not know if that was the right thing to do, I dont even know how he felt about it.

    Like

    • I’ve learned that we never know how we will respond to a serious challenge until we are actually in it. No two experiences are the same, either for ourselves or between others. Thank you for sharing your experience too. It adds to the rich tapestry of life as a patient. xxx

      Like

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