As I said in my last lengthy post, apologies as I am not quite sure what’s of interest and what’s not, so will just tell my tale as it happened and let you decide whether to read on or not!
Day of the op: So, the big day dawned and at 6.50am I had found my way to the Same Day Admissions unit in readiness for my Aortic Valve Replacement. Everyone very helpful; calm, reassuring and clearly geared up to receive nervous patients and their companions. We didn’t have long to wait and I was fairly quickly ushered in to be shaved and to have two showers before saying my goodbyes to my wife and being wheeled off to theatre at 7.35am to begin being prepped by the anaesthetic team. It was good to meet the anaesthetist again, as like my dashing Italian surgeon, he had given me lots of confidence, providing loads of information in a succinct and understandable way at my Pre-Op appointment. Also he was quite a funny guy and so eased any tensions with his Irish wit and charm. Again, I was struck by how it felt like a team approach with everyone knowing their part and cracking on with things. I found out later that my throat was particularly sore because they had experienced some issues getting the breathing tube etc in place, but none of this impacted at the time, as by now I was fast asleep. At 2.00pm my wife rang the CICU as instructed and was told I was in recovery, so together with my eldest son, she headed in to see me. Between 3.30pm and 7.30pm I was receiving very close attention with lots of sedation and pain killers together with various infusions of platelets and clotting agents to help stem bleeding followed by a couple of units of blood to make sure I was getting my money’s worth. Later in the week, my son told me how amazing it was during that period to see the various members of staff calmly adjust the flow of things and add or stop activity from my 9 lines whilst keeping a watchful eye on the various monitors that were hooked up to me. Eventually, I was stable and so my family headed home. At 9.30pm that evening when my wife rang to see how things were going, thanks to the foresight of someone making sure it was a cordless phone on the ward, I was able to speak with her. That was worth so much for both of us! Score ten BVH!
Day 1 post-op saw me standing and sitting out of bed! Have to admit, never knew how hard it could be just to get out of and back into a bed, but so much support and such lovely staff (thanks Catherine!) made things much easier. The day was a bit of a blur, with lots going on around me, bleeps and bongs followed by people checking various aspects of my recovery. Good to see my wife and sister, also my surgeon. I was full of tubes, lines and wires and hooked up to what seemed to be a real life version of the Starship Enterprise’s sick bay.
I was really tired! But not too tired to eat… I’ve always had a good appetite and found the food at BVH to be pretty good, if a little bland at times, but let’s face it, serving up meals to 900 plus at a time, all to a tight budget is no easy task, and credit to the catering team because there was always a great range of options and has never been anything I couldn’t eat. Anyway, I ate. Not a lot, but enough to feel I was on the path to normality. I was fascinated by how things were done on the CICU and how they worked as a team, supporting one another and looking after each of us.
Day 2 post-op and I was beginning to be much more aware of everything that was going on. Also I now began to sense how uncomfortable the beds were. But that may have been just me! I was given another wash and clean bedclothes, instantly feeling much better. I also became aware of my ‘Elizabethan hose’ thigh length support stockings. Not sure I recalled when they started to feature as an essential part of my wardrobe.
Spoke to my wife and felt much more like myself again. In truth, as long as I wasn’t doing anything, I actually felt pretty good and almost completely normal, which in a sense seemed rather strange, as my pre-op fear had given me visions of barely being able to move and in abject pain. None of which applied. I felt a bit uncomfortable and I was sore and tired, but given the nature of the surgery, it was a lot less than I had expected. Later that morning I had my drains removed. The arrival of a gas & air canister would have been enough to tell any sensible person this was not going to be a painless procedure. Something that completely passed me by. How long are those tubes? I’ve seen shorter garden hoses. Anyway, I’m pretty sure any discomfort I felt was a lot less than someone having a baby, but the gas & air set up was much appreciated.
I saw the physios, started on breathing exercises and had more practice ‘stands’ out of bed. The removal of my drains plumbing meant I could go on a ‘ward walk’ with them. Passing a couple of other patients doing the same circuit, for a moment I was reminded of the scene in Papillon, where Steve McQueen is in solitary and asks his fellow inmate how he looks and is told ‘great’ when he looked anything but. However, in my case, I was feeling good and felt that I was doing well. Also had one set of lines removed so felt better able to move my neck about. These things count!
That afternoon I saw my wife and eldest son, which was great. Amongst the ward staff there was a discussion about moving me to the cardiac ward and as an interim measure I got moved to a different area on the ward where those of us on the mend were being placed as we were no longer considered as high risk. That evening a bed came up on the cardiac ward so very shortly thereafter, I found myself on the Coronary Care ward in a small bay of 4 beds with three elderly but lively chaps whom I later discovered were in for a variety of investigative reasons.
Day 3 post-op was a Saturday and so I was pleasantly surprised to see my surgeon again. He seemed pleased with my progress, gave me some more info about the op, said my old valve had been more calcified than they expected and was functioning with less than 10% effectiveness so they were surprised my pre-op symptoms had not been worse. He told me that I had had a size 25 valve (I think they go up in sizes 19,21,23,25,27). Apparently having a 25 will be handy if I need a TAVI down the line. He also explained that it would take a while for my heart to adjust to not having to work at full tilt to push the blood around my body but reassured me that in time it would. He said that if the other checks go well he hoped to let me go home on Monday evening. I was left not for the first time pondering how miraculous the human body is. That afternoon, together with my wife, my youngest son and his new wife came up to see me having just got back from honeymoon, which was lovely. I also got my phone back so could catch up on what had been going on in the world. Continued my exercises and caught up with my new found bay-fellows. It was a beautiful sunny day.
Day 4 post-op Sleep has proved more difficult over the last couple of nights, which I had put down to the move onto the ward, new noises and the constant need to go for a wee… the impact of being on diuretics and the removal of my catheter, (a much easier procedure than the drain tubes!) meant I was a man frequently on the move, dragging my IV drip stand with my pacing box and being careful not to disturb my remaining necklace of lines and the wiring loom that I had to disconnect and afterwards reconnect to my heart monitor whenever I went walkabout. What perhaps also didn’t help was that my heart hadn’t settled back into a normal rhythm and so they were adjusting my medication to correct things. I had become very aware of it beating and sometimes felt as though it was pounding away so violently my whole bed was shaking. Nonsense, but still frightening in the still small hours of the night even though I was pretty sure it could only be illusory. The day was spent quietly but good to see my son and his new wife again before they headed back down to the midlands. In the late afternoon, I had the final set of lines removed and silly as it may sound, the relief was immense as they were making my neck quite sore. I also said yes to the morphine syrup on offer today as I had been trying to manage without it, which proved not to be the best plan as I was struggling to cope on paracetamol alone. Also had a return visit from one of the doctors who had seen me earlier to say that my heart rate was settling, so there may still be a chance of me going home the next day. After evening visiting, walked my wife and sister to the door and did a couple of ward circuits as I was feeling pretty good.
Day 5 post-op Last night I had been kept awake (until I put my ear plugs in) by a periodic shrill beeping noise, the sort of noise that a smoke alarm makes when it needs a new battery. Apparently, so had nearly everyone else. Embarrassingly, it turned out to be my hospital issue pacing box, which needed its battery changing … eventually after some searching, the night staff worked out it was me and came to replace it. At which point I woke up. A rainy morning was brightened with a videomessage from my 3yr old grandson and another visit from my surgeon. He now thinks I will be home Tuesday for sure. I had my pacing wires extracted and all my heart monitor leads taken off this morning so I could have a shower. So good! At afternoon visiting I had a surprise visit from my eldest son whose meeting plans had changed so found he could squeeze in a quick visit. That was a very pleasant surprise. Other than a welcome visit from my wife and sister that evening, not much else of note today, I am a man on the journey to discharge now.
Day 6 post-op Saw the physio’s again this morning. We did the ‘stair test’ which was pretty easy, so they were happy to sign me off for going home. Shortly afterwards I got dressed and was moved, with my belongings, to a different bay where I met someone else who had had the same op as me. It was interesting to compare notes and I hope that both of us gave the other some encouragement that we were making good progress and that some of the things we had experienced were a common feature for people having this op. It certainly helped to pass the time until my medicines arrived and I had my discharge interview. By early afternoon I was cleared for discharge and homeward bound!
Aortic Valve Replacement - the Cath Lab
Aortic valve and root replacement
