In my last post on 6/16/2014, I was a day away from aortic valve replacement surgery. I had had all my pre-op tests and was ready to go. As you can see, above, from the new title ("had"), the surgery was successful, and I no longer have a heart murmur. Today, I will explain the pre-op tests, and then we will go to the hospital for check-in, surgery and, the first night in the ICU. I'm going to wait for the next post to cover my recovery during my four days in the hospital and my rehabilitation/recovery in the first month since then. Today I am four months and a few days post surgery, and I took a 32 mile-bike ride this morning. CAUTION/WARNING: I have said from the beginning that I am relating MY experience. I am not a doctor, so I don't know if my experience is normal or average. I believe, from what I hear, that my recovery has been unusually fast, due primarily to the fact that I was in very strong condition before the surgery. Dr. Berger (cardiologist) and Dr. Somers (surgeon) and their staffs would say, of course, that my fast recovery is due primarily to superior medical treatment!
My surgery was Tuesday, June 17. On the Friday before I had a complete blood work-up (just a simple blood draw), a carotid doppler, a chest CT scan and an angiogram. These were all to detect other possible heart problems that could be addressed during the valve surgery. The carotid doppler was just like the echocardiogram that I have described before, except the "wand" goes back and forth over the carotid arteries in you neck instead of over your heart. No pain and less than 30 minutes. A bonus: The technician used gel that had been warmed up. No blockages found. The chest CT was just like an X-ray except you are laying down and it's a few minutes longer. This was to detect any abnormalities to my aorta which may have been caused by the murmur. All good here. The final test, the angiogram, was more complex, requiring the kind of anesthesia used for a colonoscopy. Here, they insert a tube from your wrist or groin that makes its way up to the arteries serving your heart. Again, checking for blockages. I was lucky and my wrist artery was sufficient. This is basically the same procedure used when they insert a balloon to open up a clogged artery, only I didn't have the balloon part. There is no pain and the anesthesia wears off quickly. I did need to have someone drive me home and took it easy that night. I also had some restrictions on wrist movement for 5 days. Again, all clear. I was ready for surgery.
My surgery was scheduled for 9 a.m. so we were told to arrive by 7. Way too early, but they do this because some people show up late. We went to a pre-op room where I undressed and put on a gown (yes, the one that's open in the back) and removed any jewelry. At about 9:00, I kissed Wendy goodbye and they wheeled me down to the operating room. Dr. Somers was already there, and I had seen him earlier in the prep room. The anesthesiologist introduced himself, and said he was going to start by giving me something "to relax." As part of the prep, they put a drug port in the back of your hand, through which all IV drugs are administered throughout the hospital stay. You really don't even feel it there. The next thing I knew I was waking up in my ICU room at about 5:30. We will get to that in a minute. (For loved ones: Wendy's notes say the surgery was from 9:15-1:30; she saw Dr. Somers at 2:30; went to the ICU waiting room at 4:15 and saw me first at 4:45).
I'm not going to explain the surgery in detail because I was not conscious. I will say that it was "open heart," meaning they sawed through my sternum and spread everything apart, partially by restraining my arms out to the side. I mention this because my arms were sore for two weeks after. Anyway, then they stop your heart and put you on a heart-lung machine; do their magic; and, then, everyone holds their breath (except you, because you don't have any) while they re-start your heart (apologies to Dr. Somers for making it sound so simple). Then they patch your sternum together with wires and plates and sew you up. NOTE: Many have told me that my incision scar is the nicest/cleanest one they have ever seen.
At Highland Park Hospital and with Dr. Somers, they wheel you straight from surgery to your room in the ICU, rather than going first to Recovery, as it involves less moving around. They warned my that I would have a breathing tube down my throat when I awoke and that I wouldn't like it, but as soon as I was awake enough to REALLY not like it, they would take it out. The second time I woke up was after 6:00 and I was aware of the tube. I was hot and sweating and wanted Wendy to wipe my forehead, but, of course I couldn't talk with the stupid tube down my throat. When I awoke at 6:30 they took the tube out. Not terrible, but I did start to cough as it came out, which they encouraged. I was still drugged, so I really didn't feel any pain. All I really need to say about the first night is that I was pretty out of it so it wasn't too bad. Being in ICU they constantly wake you up to check your vitals, change IVs, etc. I did have lucid conversations with Wendy before she went home. Nothing hurt, and I really didn't take inventory of what tubes, devices, etc. were connected to me until the next morning.