Wednesday, February 27, 2008

Heart Surgery is Awesome

I suspect this may be the last in my heartaliciously themed blog entries for awhile, so listen up, and enjoy it while it lasts. And I'm sorry for the delay, but the whole surgery thing made me far lazier/tired/less inclined to do anything productive than I could have imagined. So, here goes.

As my loyal readers know, I had a little procedure on my heart last week. I will preface this by saying that I am an absolute and utter snob about healthcare. My mother is a hospital administrator, so growing up I had care when I wanted it and how I wanted it. I have worked in hospitals as diverse as the Veteran's hospital in West Philly and the UPenn hospital. And now I work in healthcare consulting and spend my waking hours learning about healthcare/hospitals/drugs etc
. So, I am critical, and I will readily admit that. Luckily, this experience as compared to the Ovarian Cyst incident was relatively pleasant (as surgeries go) and so I won't have to get all ranty.

It went a little something like this:

So first of all, the Bronx is FAR, it might as well be another country. In absolute terms, it's 20 miles from where I live. But in my reality, that means a 1.6 hour subway ride, EVEN with Express stops. I can't even imagine how long it would take without express stops. So, needless to say, the 9am arrival time was plenty early for this girl.

Right, so, I got there, did my financial stuff (I really want to complain right now how I had to shell out $250 for my hospital "copay" or whatever, but, I shouldn't. Because that $250 is a fraction of what it actually cost for me to be there, and I of all people should be an advocate of people taking ownership of their healthcare), and then went into this little room for a blood draw and to stay until my procedure. This is the one part of my day that was a little unnerving. The first room your patient's see should not be fill of old rundown equipment and shoddy stuff, especially if that's not indicative of the rest of the hospital (it wasn't). But so it goes. There I was wearing nothing but a little (ok, one size fits ALL) smock, reading my Time magazine to distract myself, no windows, an IV newly placed in my arm, no food/water in my stomach, and feelin dandy. But actually, I felt surprisingly calm. It's like all those prayers people were praying actually... oh I dunno, worked.

My doc came in around 11:00 to talk through the procedure, listen to my heart, tell me about all those risks they have to tell you about when you have surgery (infection, death, the usual light fare), and ya know, chitchat about the weather and politics.
I was in the cath lab from about 11:30am to 1:45pm, in a recovery area until 5pm, and then in a room somewhere in some wing overnight. Some of the more amusing events of my stay were as follows (in chronological order):

1) Being strapped down to the cath lab table psychiatric ward style. Like, wrists and ankles in white rope restraining things. I didn't understand why this was necessary, but apparently some people do things like squirm or get all freaked out during surgery. Weaklings.

2) Drugs. I asked the doctor who was giving me drugs (wonderful guy, that one) what I would feel like when the morphine kicked in. His reply? "Oh, you'll tell me when you know." Post morphine and verset injections, he asked me to say the alphabet backwards. So I started to. Continued to. Until he stopped me to ask why I can even do that. I'm weird, that's why. Being able to do these things amuse me. When he asked me the square root of 169 and I knew it was 13 without thinking, he really thought I was a big nerd. Until I explained I am taking the GMAT soon. Then he thought I was an enormous nerd.

3) Their realization AFTER I was strapped down AND drugged up that they hadn't done a pregnancy test. Oops. I assured them there was no risk. None. Apparently my word is not good enough to fulfill the law requiring a pregnancy test with urinic (I like making up words, leave me alone) and not verbal proof. Whatever. Let me just say it was a unique experience (I almost wrote "very unique" which I was recently informed is incorrect, if something is unique, it's just unique, it can't be "very" unique. It's unique because it's unique. Thank you Dan, via Preethi) to have a bed pan inserted underneath me and give them "just a few drops" while working against the factors of 1) I had peed not 15 minutes ago, 2) I was horizontal- I mean, come on now, gravity is real good at what it does and 3) There were about 15 people in the room doing their respective duties to prep for surgery. Right. It wasn't happening. So my wonderful nurse Lynn started pumping saline into me through the IV. Then it was happening.

4) My intense need to ask questions. I just wanted to know everything. Why give into the morphine and verset when I can stay awake and WATCH IT ALL?? I know, I increasingly show how utterly weird I am, but come on people, this is like the height of cool shizzle for me and my world. I asked so many questions that at one point my surgeon kindly asked me to STOP asking questions so that he could focus for just a ticktock. Oh right, you have a job to do, sorry.

5) Contrast solution. This is the same stuff they give you when you have a CAT scan that makes you feel warm inside in a completely unusual way. I have experienced this before when being scanned for the cysty awesomeness, but heart surgery takes it to new levels. They were squirting that stuff in me left and right JUST TO SEE inside my heart. If you've never experienced this, it's kind of akin to that feeling when you swallow food that is too hot and you can FEEL it going all the way down your food tube and into your stomach. That's kind of how it felt, but not exactly- much warmer, and yet much less painful, and altogether all over my mid section from sternum to pelvis. Wacky.

6) Numbers. 60cc of lidocaine (to numb me) in my groin. 3 camera things by me- one on each side of my chest and one above my chest. 6 large high definition screens with projections of all that was going on in there. 2 holes in my groin where the catheters were inserted. ~3mm as the width of the PDA at its smallest point.

7) Pressure. Like the kind that involves my nurse Karen place her full upper body weight on my groin after the catheters were removed until those platelet dudes did their thing and clotted away so I wouldn't, say, bleed out. Then, as if that weren't pleasant enough, another nurse brought over a 10 pound sandbag to replace Karen. This nurse said, "Just think of it like your 10 pound baby boy. He'll be sitting right there on your bladder anyhow." Thanks for the visual (Oh, and in case you were wondering, the pregnancy test came back positive. Just kidding.). This 10 pound Little Johnny stayed on my bladder/groin for a solid 3 hours just to remind me not to move. Just in case I was thinking of going out for a smoke or something.

8) Lying flat on my back for 6 hours. Now, I tend to be a rather, shall we say, movement-oriented person. Lying anywhere for that long for me invariably involves sleeping, or perhaps it would involve being knocked out or passing out if that ever happened (which it hasn't), and even when I sleep it usually involves movement, given my tendency to not only talk in my sleep but sometimes get up and do things in my sleep. Some would call this sleepwalking. So, I thought maybe it was up for negotiation when my doc said I had to "lie flat for 6 hours." Negative.

9) Prior to getting a room of my own (and that I did- a solo room!), lying in the "recovery" area by the nurse's station. And by "by" the nurse's station, I mean, literally smack on top of it. We're talking nothing but a sheet separating me and the dudes on either side of me. We could have each reached out our hands and did a little ET finger touch. And I pretty much know all the gossip and updates on all the nurses in that unit. Except for the information that was conveyed in Espanol. Which was about 50%. Sorry, those 6 years of Spanish were clearly useless, I'm a slacker, I know.

10) The plant. My wonderful darling friend Cassie came to visit me while I was still in flat-back mode, still in the speedy gonzalez zone, and she brought with her a lovely little plant with purple flowers. Potted. With plant food. In a ziplock bag. This is one of the many reasons why I love her.

11) The blood pressure cuff. Ok, so I understand that I had heart surgery, and for most people that would mean that their heart needs to be monitored regularly. But is blood pressure taking every 15 minutes REALLY necessary, when I'm also hooked up to more wires than I can count on one hand? Between the poking and prodding and full medical histories I was giving every hour on the hour

12) Allergies? If I had a dollar for every time I was asked whether I am allergic to anything, I would probably have made back my copay. Yes, I understand this is an important, even vital piece of information to possess when caring for patients in the 21st Legal Palooza century. But didn't it say somewhere in the 3 medical histories I gave to you people in BOLDFACE HIGHLIGHTED font that I have NO ALLERGIES? And since it probably did, why didn't you look at that before making answer (again) a question you can answer yourself? I would get fired from MY job if, say, I asked our librarian if there were any articles in JAMA this week about allergies. You know why? Because she emails the entire company the Table of Contents of JAMA every week. So I could just LOOK MYSELF (Really, I'm just kidding though, I have to make fun of something right, and this is just too easy. I mean, it's not like they did any of the 4632 incorrect and awful things that were done/not done to me at The-Hospital-That-Shall-Not-Be-Named. They just wanted to make sure I didn't break out in hives. Or die.).

13) My A-team. Better known as Amy and Alexandria. Because they came all the way up to the Bronx to visit me after their respectively long days at work/school, I love them more then I already did. And because they brought candy. And because they didn't make me carry the conversation, but just talked about their days and their lives, enabling me to listen but not exert that uncomfortable amount of energy that is often required to tend to guests even though they completely want to be there to put you at ease. And because they saw my awesome groinal bruise that was at that point a bloody mess and didn't vomit.

14) Food. Better known as plastic substitutes. Now, hospital food is notorious for being less-than-stellar, and this food was about par for the course. Nothing to write home about, but it got the job done. I have to knock on this though, because my mother's hospital has the most wonderful food of any hospital. And choices. Like a full menu from which each patient can order a veritable cornucopia of tasty treats. So, of course I'm going to be all snobby and pull a "don't we live in New York City??" It's fine, I wasn't really hungry anyhow; not like I was burning off too many calories what with all the fast paced channel changing I was doing.

15) Standing up Take 1. Around 10pm I decided it was time. Peeing in a bedpan once that afternoon was enough to make me not ever want to experience that again (not even Rob My Friend With Cancer had to do that in all his time in the hospital- he just puked in a lot of buckets. Lame), so when I had to go again, I decided I would give the upright peeing thing a try. With the help of a nurse I was unhooked from the monitors. I sat upright. Feeling alright, I slowly stood up. Feeling alright, I walked the 3 feet to the bathroom. I sat. I did my business. I stood back up and walked the 10 feet to my bag to remove my toothbrush and soap to get everything done all at once. Feeling nauseous, I cautiously walked myself to the sink. Uh oh. I thought maybe I would be ok. But I thought wrong. Feeling real nauseous, I set the toothbrush down and then immediately set myself down as well. Back on the bed. Dirty teeth and all. Back to square one.

16) Chest X-Rays. Nothing like waking up at 1am (after convincing the nurses I wouldn't die on them if the set the blood pressure cuff to once-every-2-hours) to a strange (albeit good looking) man walking into your room with a large piece of capital equipment who is apparently (clearly) there to take a Chest X-Ray. What, because the slots were all booked from 9am to 9pm? Who even knew that dudes like that worked at 1am??

17) Big Brother Barry. My fabulous coworker Barry, who serves as a big brother figure to me and teaches me such valuable information as which colors correspond to which pool ball numbers, where to buy the hottest tabasco sauce a human can tolerate, and what his fantasy team is up to this week, came to pick me up from the hospital. He not only came to pick me up, but he came inside, sat with me until they discharged me (read: until he started kickin' ass and takin' names because I slipped through the cracks and even though my doc had cleared me to leave, the bureaucracy of the 6th floor wouldn't allow me to leave until my paper was signed by Random Doctor X who was rotating somewhere else and would maybe sometime eventually come by, sorry for the inconvenience), and, most nobly put on my sock and shoe on the leg where the cath had been. Because my ability to reach that far was zilcho. He even actively avoided potholes on the terrible NY highways so that I wouldn't be in unnecessary pain. Oh, and if all that wasn't enough, he brought me flowers. Just like the older brother I never had did when I imagined him in my head. Thanks BK.

18) Home. My bed. My couch. My Netflix. My food. Glory glory Hallelujah! Which is not to say that my stay at Montefiore was anything but smooth and the people there were anything but kind. It's just nice to be home. And I walked in to a distinct smell of soup. Because my wonderful roommate had made soup in the crockpot. Because she's awesome.

That about sums it up folks. Not really so much a SUMmary as the makings of a chapter in my autobiography. But still, I hope you were amused. I certainly was.
A week later, I am walking normally, and the bruise is getting smaller rather than bigger. I still tire pretty easily, but in general I'm pretty much alright. Me and my new heart thank Dr. Pass, the nurses, and all the staff who helped facilitate my care, all my friends who visited in the days after my surgery and cooked up a storm in our wonderful kitchen, my parents for visiting over the weekend, my roommate for putting up with me, and most of all God, for lookin after me and hearing all the prayers everyone offered up for a safe and smooth surgery and a speedy recovery.

From my heart to yours, until we meet again.

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