Saturday, March 31, 2012

DAY 26 - Recovery

With depression hitting hard at the beginning of the day, I slept away most of the morning. Later I set some bricks for the greenhouse floor and walked the incline from the cabin to the barn multiple times.  This evening I logged a mile at the outdoor track.  With my lungs working better, walking was so much easier to do and I did it in less time.  Even though my progress is slow, I can see that I am progressing.

Meds:   Coumadin, Furosemide, Bupropion, Multaq, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps, 2 bananas (potassium) 


Friday, March 30, 2012

DAYS 24 & 25 - Recovery

I actually feel like I'm getting back a bit of energy and stamina, albeit just a bit. We were out and about today and yesterday and I don't feel totally wiped out.  No longer having the pain in my right lung yesterday I was able to work on some upper body strength by setting bricks that weigh 6 lbs each (I'm not supposed to lift anything heavier than 10 lbs) in sand on the greenhouse floor.  Okay, so I can't do very many at a time, but a few every day or so and eventually I'll have wrapped up a project.  Last night we enjoyed some burgers and one-dollar pint PBR's at one of my favorite Irish pubs.  I'll be so glad when my taste for food returns in full.  I was so nauseated most of the first week after surgery that I couldn't keep much down except for some fruit and Ensure milkshakes and since then food doesn't have the same taste that I remember and expect.  It's getting better, but I still have a long way to go especially with wine, which I have absolutely no taste for, and chocolate.  What a bad case of timing I had last night.  I was walking down a hallway when returning from the ladies' room at the pub and there was a girl standing to the side talking to someone. Not knowing I was coming up behind her, she swung her arm back and hit me square in the chest.  I'm so frail, it almost knocked the wind out of me and the impact pressed the metal zipper of my hoodie right into my incision.  Ouch!  

Today after a medical appointment at the lab to get an INR reading for Coumadin, the blood thinner I'm taking, we ran some errands and did a bit of shopping.  I'm still taking Namenda, a drug used for treatment of Alzheimer's disease as a prevention for Post Operative Cognitive Decline.  After today I'm doubting its effectiveness.  This was the first time since the surgery, and it's been almost six weeks, that I had some obvious mental confusion and believe me, it was scary.  I was directing Darryl to a farm supply store that I clearly know the location of and yet I gave him the wrong exit number and didn't realize I was on the wrong road until we had driven several miles out of our way.  Then at the store I became confused about the items I had special ordered.  Last night was the first time I'd had alcohol since the surgery.  Could one beer have interacted with some of the meds I'm taking and caused a mental problem the next day?  I'm also concerned about the lack of mental energy I have for reading and writing.  I also have a feeling of what I can only describe as disassociation or a lack of feeling connected to some things.  I hope all this is temporary and I can soon get back to being and feeling like myself again. 

Meds:   Coumadin, Azithromycin, Furosemide, Bupropion, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps, 2 bananas (potassium) 

Wednesday, March 28, 2012

DAY 23 - Recovery

I slept away a big chunk of the morning because I didn't want to participate in life.  All my thoughts were sad ones.  I just wanted to curl up in a ball and wither away.  With the cloud of depression pulling me down, I got myself outside with my animals.  Their antics and their wanting to interact with me usually does a good job of lifting me up and it worked well today.  By afternoon I was ready and willing to tackle some work in the plant yard and pulling weeds in the ground cover area.  Instead of shrouding my face and hair with a big brim hat and scarf like I always do, I lifted my bare face to the sun and let it spill its warm beams over my forehead and cheeks and down my arms.  I let the wind tangle my long hair. The warmth of the sun felt healing especially to my chest that was painful with the congestion of bronchitis.  Later when I came in to rest, I found an email from a friend suggesting that I do just what I had done with the sun.  That made me smile.  

Meds:   Coumadin, Azithromycin, Furosemide, Bupropion, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps, 2 bananas (potassium) 

Tuesday, March 27, 2012

DAY 22 - Recovery

Most of today was spent sleeping.  That seems to be what I do best these days.  Hopefully my body is healing during that time.  As much as I love to read, I thought I would be devouring books during this time of recovery, but I find I don't have the mental energy that it takes to read.  I look forward to the time when I can enjoy life again.  

Meds:   Coumadin, Azithromycin, Furosemide, Bupropion, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps, 2 bananas (potassium) 

Monday, March 26, 2012

DAY 21 - Recovey

Today was consumed by medical appointments, lots of driving and lots of waiting.  We headed 25 miles north this morning to have a blood test for the blood thinner, Coumadin.  Stopped at the mini-mall but with lungs not cooperating I walked less than a half-mile.  Drove 40 miles south to SC this afternoon for a chest x-ray at the Diagnostic Center and then to the heart surgeon's office.  The good news is that I didn't get waylaid to the hospital.  I was sent home with a prescription for an antibiotic for bronchitis and a diuretic to disperse any accumulating fluid.  I've felt miserable all day.  I look forward to tomorrow in hopes of a better day.

Meds:   Azithromycin, Furosemide, Bupropion, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps, 2 bananas (potassium)  

Sunday, March 25, 2012

DAYS 19 & 20 - Recovery

I just had to go out last night to do a little celebrating for my big 70th bday.  Darryl and I enjoyed dinner at a loud and boisterous chain restaurant.  Perfect venue for someone who is prone to having coughing attacks. This isn't exactly the way I pictured celebrating such a landmark birthday, but given the circumstances with my health, I was grateful to at least do this much.  I awoke feeling much stronger today.  It no longer seems like such an effort to hold my body upright.  I gained 3 lbs overnight which isn't good as it feels that fluid is building up around my right lung again.  I'm dreading tomorrow because I suspect I'll be put back in the hospital.  I am so not looking forward to that.

Meds: Coumadin, Multaq, Bupropion, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps

Friday, March 23, 2012

DAYS 14 thru 18 - Recovery Interrupted

Pie-Shaped Room Revisited

On Monday, March 19, when I went to SC  for my follow-up visit with the cardiothoracic surgeon, little did I know I wouldn't be coming home.  He sent me immediately and directly to Spartanburg Regional Hospital where I had been just two weeks before.  The first two days were spent in the Intensive Care Unit where they inserted a port in my lower back and drained a quart of fluid and blood that had built up around my right lung and was restricting its expansion.  No wonder I was so short of breath.  I spend two additional days in the heart care unit of the hospital where I had been before.  The relief was almost immediate and I'm feeling much better overall.  Now I feel I'll have a better shot at a successful recovery.  My rebuilt heart is working beautifully, I just have to bring my pathetic 113 lb skeletal body up to speed.  

Meds: Coumadin, Multaq, Bupropion, aspirin 81mg, Namenda, Metroprolol, Zantac, multivitamin, vitamin D, I-Caps

Sunday, March 18, 2012

DAY 13 - Recovery

After a McDonald's breakfast, we walled .8 miles at the mini-mall.  This is one of those days when I wonder if I'll ever feel good again.  Darryl spoke with his brother who is a cardiologist in Nashville regarding the blood clots in my lungs.  Prior to getting his MD he was a respiratory therapist.  It sounds like this whole lung thing is a much bigger deal than I thought and it can be quite debilitating which I'm realizing. Just getting up from a chair and walking half-way across a room today leaves me gasping for breath.  The recovery is going to be long, probably a full six months and slow.  This is so discouraging. While pushing myself to walk long distances is good for my heart, for the lungs, I'm better off doing more moderate movement/exercise between periods of rest.   I wish there was a way to fast-forward my life to the middle of September.

Meds: Coumadin,  Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps

Saturday, March 17, 2012

DAY 12 - Recovery

Walked a full mile on the outdoor track this morning.  My lungs fought me every step of the way.  I was pretty much wiped out for the remainder of the day.  No green beer,  no Irish pubs, no St Pattie's Day debauchery for me this year. 

Meds:  Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps

Friday, March 16, 2012

DAYS 10 & 11 - Recovery

It's days like yesterday that make me wonder if I'll ever feel good again.  I was so totally miserable - extremely weak, short of breath, very painful lungs, and nauseated. I carried a barf pan everywhere. That's not a fashion  accessory that will ever catch on.  It took all my strength and energy just to walk across a room, yet we had to be on the go all day. 

The Coumadin check was our first stop.  I've taken none of this blood thinner since Monday, yet my blood remains dangerously thin.  I was told not to take any until Sunday and then only a half dose and return Monday for a recheck.  If they can't get my blood thickness to say within the desired parameters with this drug, I'll have to take twice daily injections.  

From there we drove to SC to meet with the hematologist. I've seen more than my share of medical offices , yet I've never seen one as well run as this one.  They have an on sight lab with several technicians and the whole thing was run like clockwork.  There was no waiting.  The hematologist found that I have a rare blood clotting disorder which puts me at high risk for blood clots leading to strokes.  Women with this disorder usually have multiple miscarriages.  I've had five.  This hyper clotting was the cause of the blood clots in my lungs after the surgery.  Even though they had me on a boatload of blood thinners, it wasn't adequate to cover the hyper coagulation.  This isn't the news I wanted to hear because this means I'll need to be on blood thinners the rest of my life.  This genetic disorder may be the reason so many of my relatives die of strokes.  The hematologist wrote me a prescription for some anti-nausea medicine so I got some relief late in the day. This drug makes me so drowsy I can't stay awake, but if I can hold down my food maybe I can start gaining back some of my much needed weight.

Our last stop was at a diagnostic center to have chest x-rays in preparation for my follow up visits with the heart surgeon and lung doc next week. 

Today was a great improvement over yesterday. Although the pain in my lungs was resistant to the pain meds and I was short of breath with much coughing, I was able to do some household chores.  I walked here, plus I did 3/4 mile on the outdoor track. The last quarter mile was a killer, but I have to keep pushing myself if I'm going to see continuous improvement.  The track has a resident eastern bluebird.  We saw him last time and he was there again today sporting his rosy breast and intensely blue feathers.  He perches on the back of one of the benches and watches the walkers go by.  

3/10 Meds:  Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps, Tramadol/Apap, Promethazine
3/11 Meds:  Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps, Promethazine, Mucinex

Wednesday, March 14, 2012

DAY 9 - Recovery

Not the best of mornings - wasn't able to keep food and my medicines down.  I enjoyed the afternoon though. Darryl brought a wheelbarrow full of compost to the plant yard.  While my little duck, Click, waddled around my chair, I potted some bare root starter plants.  It was satisfying and fun to play in the dirt, but oh, so exhausting.  Everything that used to be easy is now so difficult.  I found some big juicy worms in the compost for Turtley, my little soft shell turtle.  I felt so happy to be able to spend time outdoors in the sunshine on this beautiful 76 degree windless day.  

Meds:  Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps

Tuesday, March 13, 2012

DAY 8 - Recovery

This was by far my most challenging day.  After a marathon night of coughing and, at most, two hours of sleep, I attended the cardio rehab orientation. There was no way I could do any walking today.  It took every ounce of my strength and will power just to hold my body upright in a seated position during the one-hour session.  This medically supervised program, which offers  custom tailored rehabilitation exercises meets for one hour three days per week for three months.  Most of the work is done on treadmills, stationary bikes and various other fitness machines.  Statistically women are poor participants.  Most of those that do begin, become dropouts. There are some doctors that don't even refer women to the program.  In my group of six today, I was the only woman.  One other was supposed to be there but no-showed.  Two weeks in a hospital bed and many days of not being able to eat has taken a devastating toll on my body.  Surprisingly my hair and nails have had a growth spurt. Being rail thin, I'm lost in my clothes and what little muscle is left has a disgusting soft and squishy feel.  I'm really looking forward to this rehab program and hope to begin in a couple of weeks once my doctors give me the go ahead.  I just hope it's possible at my age to rebuild muscle and restore fitness to my aging body.  I don't want to be one of those frail little 70-year olds who lift nothing heavier than a tea cup.  I have too many more horses to ride, mountain trails to hike, fences to build, and land to till.

From the rehab orientation we met with my local cardiologist.  An EKG showed my heart working beautifully.  My lungs sounded clear except for congestion in the bronchial area.  The pain in my lungs continues and has become worse this evening. 

We stopped by the lab at the cardiologist's office to have my Coumadin level checked.  Coumadin is the blood thinner med I'm taking because of the blood clots. The reading was dangerously high, which means my blood is dangerously thin.  No running with scissors for me and no playing with any other sharp objects.  I have to go back on Thursday for a recheck.

Meds:  Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps, Tramadol/Apap, Temazepam, Mucinex

Monday, March 12, 2012

DAY 7 - Recovery

For my half-hour of walking today, we went to another neighboring town and walked the mini-mall.  It's been 3 weeks since my surgery.  I really don't think I should still feel this badly, this weak, winded and exhausted. The pain in my lungs has returned. I'm wondering if I traded my heart problem for a lung problem. 

Meds:  Coumadin, Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin D, I-Caps, Temazepam

Sunday, March 11, 2012

DAY 6 - Recovery

Another night of coughing.  Another day of exhaustion. Darryl took me to the equestrian center in a neighboring town where we walked three laps on the quarter-mile outdoor track. 

Meds:  Coumadin, Multaq, Bupropion, aspirin 81mg, Furosemide, Memantine, Metroprolol, Zantac, potassium, multivitamin,  vitamin C, vitamin D

Saturday, March 10, 2012

POST OP - Days 1 and 2

The first couple of days after surgery were spent in the intensive care unit of the hospital.  I thought the ICU would be a room with interior glass windows or glass walls so everything could be easily seen and observed.  In reality it was located in a round shaped building with a doctors/nurses station as the hub and pie-shaped rooms around the circumference.  My recollection from those two days is hazy at best.  I recall big bright lights, many people, they seemed very tall, hovering around my bed.  Darryl was allowed to visit but only for a few minutes at a time.  I don't know if the limited visitation was for his benefit or mine.  Really, just how long can you stand there staring at your loved one who is pretty much in a comatose state, devoid of color, with swollen eyes, a puffy face and is hooked up to machines which makes communication impossible? 

I remember a loud alarming siren sound with people saying it was a fire alert false alarm.  From time to time the intercom would blast CODE BLUE, CODE BLUE.  At other times it would play a sweet version of Twinkle Twinkle Little Star or the alphabet song on chimes.  I later learned that this was piped through the whole hospital and every time a baby was born the parents activated the switch to play the joyous little melody as an expression of the cycle of life, apparently to offset  the grimness of the Code Blue announcements. 

At one point Darryl was standing at the foot of my bed along with several others.  I understood them to be discussing my breathing tube.  Before going to the hospital I expressed to Darryl about how much I hated having to endure the breathing tube down my trachea and the scope down my esophagus.  Other times when this was done I was left with a killer sore throat for at least two weeks.  My thinking was that the sooner they removed it the better.  Lying there I became paranoid that with Darryl advocating for early removal of the tube, it would be taken out too soon and I would die.  I was thinking about that whole living will thing. I desperately wanted to tell Darryl that I changed my mind and the breathing tube was no longer an issue, but with all that stuff down my throat I couldn't communicate.   I was also remembering how the psychiatrist told me to handle my anxiety about it.  He said if I could remain cool and calm then everything could be handled in a more timely manner.  Cool and calm quickly fell by the wayside as I tried to think of ways to communicate with Darryl.  Making hand motions and flailing my arms wasn't working.  Everyone was looking more  confused.  After I made writing motions with my hand someone brought me a pen and paper.  That didn't work either because I was unable to get the words from my mind to come out through the pen.  The  paper showed only scratch marks.   I felt my only alternative was to put a death grip on the tube so they would know I didn't want it removed.  Someone pried my hands loose and that’s all I remember.  The next time I came to, I was breathing on my own.  

I really wanted to talk to someone about those pie-shaped rooms, but no one seemed interested, that's until the cleaning lady came in.  When I mentioned it, she stopped pushing her Swiffer WetJet in mid-stride, looked around the room and told me she'd been cleaning those rooms for seven years and she had never noticed that.  She then gave me the biggest smile I had seen in days.  It made me feel good to know I may have given her a whole new perspective on those rooms that just might get her through another seven years. 

My chest had a big bandage down the middle.  There were loose wires protruding through my skin that were attached to a temporary pacemaker that would be pulled out when the time was ready.  Two tubes protruded from my lower chest that were draining blood and fluid into a large container.  Probes were attached to a half-dozen places on my chest that connected to a heavy little heart monitor box that was tucked into the breast pocket of my hospital gown.  I was hooked up to a catheter and I had IV's dripping stuff into my arms.  Then they told me I had to get up and walk.  Walk?  Surely they were kidding.  They might as well have asked me to climb Mount Kilimanjaro.  They weren't kidding.  They said no one gets out of ICU until they can walk.  I was thinking I could be there for a very long time.  Darryl said he didn't mind how long I stayed because they had some really good-looking nurses.  After much prodding I got myself to a somewhat vertical stance and with a cart carrying all the stuff attached to my body I took my first steps.  With all that stuff pulling inward on my chest there was no way I could stand up straight.  Believe me, this was a very pathetic looking walk.  After making my way around the nurses station and back to my pie-shaped room, I felt deserving of at least a fake plastic Olympic medal.  Yeah me!   I was relieved to know I had to do that only one time.  My next trek would be out of the ICU to the elevator.  So what do they have against using wheel chairs?  They kept reminding me that no one leaves ICU until they can walk out.  I wanted to know just how far away this elevator was and what happened after I reached it.  They said a gurney would be waiting that would take me to the heart care center on another floor of the hospital.  By the end of my second day in ICU wearing my butt exposing bile green hospital gown I make my exodus.    

DAY 5 - Recovery

Getting a decent night's sleep, I awoke two hours earlier this AM than I have been and I haven't needed to sleep so much during the day.  This is a giant step toward getting my life back.

Meds:  Coumadin, Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin C, vitamin D

Friday, March 9, 2012

DAY 4 - Recovery

The recliner is my daytime place.  The bed is my nighttime place.  I was in bed last night for eleven hours, most of that time was spent coughing.  I have no idea how Darryl was able to get any sleep.  The coughing must have been productive because I no longer have the continuous pain in my lungs that has been there since the blood clots were discovered ten days ago.  Feeling totally and completely exhausted, there was no way I could celebrate this good news.

A hematologist and a pulmonary specialist were added to my medical team once the clots in my lungs became an issue.  I have follow-up appointments with both during the next two weeks.  I just completed 12 pages of insurance and medical history forms for the hematologist.  Does he really need that much information?  I've never heard of anyone going to a hematologist.  I thought they were more scientists that studied blood rather than practitioners who interacted with patients.  Makes me wonder if there might be some vampire types lurking around his waiting room.

I feel such a great need for sleep but it eludes me. I've washed dishes and paid bills.  It feels good to do some ordinary things.  I need to eat to both gain energy and gain weight, but the least little bit of food fills me up.  I've lost a pound a day since I've been home, hopefully bottoming out today at 114 lbs. 

Darryl's patient, attentive and loving care giving has been extraordinary.  I'm so fortunate to have such a good man as my husband.  I know there are many people who have to go through situations like this alone.  I don't know how they do it.  Once my appetite and taste for food returns, I know I'll gain my weight back quickly with Darryl's yummy meals.  Today he baked a ham with a wonderful glaze along with baked sweet potatoes and a chopped cabbage and broccoli salad.  I wish I could have eaten more.

This isn't the first time that Darryl's had to exercise his care giving chops.  We were living in New Orleans two dozen years ago when, at age 46, I was pregnant with Douglas and had to be put on complete bed rest for 2 1/2 months.  Things were even more challenging then since we had a big place, Darryl was working full time running his business and our super hyper-active Jonathan was 3 years old.  Darryl's family and our wonderful network of friends came to our rescue with his care so that Darryl could focus on my needs.  We made it through that and now we'll make it through this.  

Meds:  Coumadin, Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin C, vitamin D 

Thursday, March 8, 2012

DAY 3 - Recovery

I'm feeling so much better today than yesterday - no nausea, able to eat and drink.  Most of today, like everyday, is spent coughing.  Coughing is good and encouraged because it helps to clear the congestion from my lungs.  Coughing is also very exhausting, so when I'm not coughing, I'm usually sleeping.   Half of my half-hour walking time today was done in the cabin where I go from the front door, looping around some of the furniture, stepping into the U-shaped kitchen area before making my way into and out of the bedroom and then to the mudroom.  This route takes 121 steps and I do it over and over again.  Since I'm not supposed to walk inclines and living on the side of a mountain where everything is at an incline, my outdoor walking is confined to the 30x40 foot area we leveled for the greenhouse and garden storage building.  It lifted my spirit to be outdoors with my animals on this warm winter day.  My goats and both GG, our house cat, and McKenzie, our barn cat, walked along with Darryl and me as we repeatedly walked around the greenhouse and storage building. A huge carpenter bee buzzed right at my face, a sure sign of spring!  I spent a little while folding clothes from the dryer, going through a backlog of mail, and entering expenditures into the household accounting program.  I'm more optimistic today and can once again picture myself leading an active normal life.  I couldn't see that yesterday.

Meds:  Coumadin, Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin C, vitamin D 

Wednesday, March 7, 2012

DAY 2 - Recovery

After a full two-week hospital stay, I finally arrived home late Monday night.  Nothing about the ordeal was like I expected.  Yesterday, my first full day at home wasn't bad. I suppose the euphoria of not having to face any more hospital food and being in my own home on a beautiful warm winter day with a pear tree in full bloom outside the window and  bright yellow daffodils poking through the rough mountain soil heralding spring carried me through from morning to night.  I was able to eat, walked a little more than my required half-hour and looked forward to Day 2 (that's today) to continue my progress.

This has not been a good day - feeling sick all day, can't keep anything down, too weak to walk.  I thought all the "sickness" was behind me and now I could focus on working hard everyday to build my strength and stamina.  That doesn't seem to be the case.  

Meds:  Coumadin, Multaq, Bupropion, aspirin 81mg, Furosemide, Namenda, Metroprolol, Zantac, potassium, multivitamin, vitamin C, vitamin D, Tramadol/Apap