Category Archives: Recovery

The Kaiser Medical Team

Some of the that helped me. Photos from Kaiser Permanente.

Some of the that helped me. Photos from Kaiser Permanente.

This post has been sitting on the server for at least a month. Yep, haven’t updated this blog… so I am now in catch-up mode. So here we got a short list of Kaiser doctors that helped me get through the heart attack and surgery. Was not easy but without them, I’d be pushing daisies today.

Dr. George Wilkinson, MD – Cardiac surgery – Was Dr. Wilkinson on loan from another location? Do I even have the right person. His connection to Kaiser is not listed online. I definitely met him before surgery. He is the doctor who did my open heart surgery.

Dr. Jeffrey Wu, MD – Cardiac surgery; “There is a Steely Dan song with your name on it”. Dr. Wu was also on my surgical team. As I understand it, he was second to Dr. Wilkinson.

Dr. Steven K. Kramer – My primary health care physician. Conveniently located at Kaiser Honolulu Clinic on King and Pensacola Streets. Mild mannered and listens.

Dr. Ali Z. Merchant – Cardiologist; consulted with him on heart follow-up.

Dr. John Lee – PAC – Encouraged me to cough early on; cardiology dept. Mac guy. 🙂

Dr. Timothy Skovrinski – Emergency room, 1-10-2016

Dr. Sue Lim, I liked her. “It’s okay to swallow the mucus you cough up”.  Her specialty is “hospital medicine”. She wrote some of my prescriptions.

 

Home is Where It Was Not

Pagoda Hotel

The Pagoda Hotel on Rycroft or Kanunu streets in Honolulu.

One of the unexpected events that happened because of my surgery and hospitalization was the fact that I could not go home. What you ask? Yes, my sister Sandra and friend Daniel before her were the only 2 people who went to my apartment and found that was a total mess. I was told by both of them that I could not go back until the mess, which consisted mostly of electronic equipment, cameras, CDs, tapes, records, DVDs and paper was cleaned up.

So on January 5 I started my long stay at the “affordable” Aqua Pagoda Hotel on Rycroft Street. On discharge day (January 5) Sandra flew in from Hilo on the Big Island of Hawaii to begin her stay with me. Her mission was to help me in my recovery after the operation. She knew about my heart attack early on, but we decided there was no reason for her to come during the time I was in the hospital. She saved her trip to help me with my recovery.

For the next several weeks Sandra and I were almost permanent residents of the Pagoda Hotel. That was not cheap.

The hotel is nice. Not a “five-star property” but genuinely hospitable, convenient (very near my place of residence), and “affordable”.

So there I was learning how to recover some of my most basic skills. Doing stuff like walking, cooking, bending, eating and even sleeping had its challenges. I was also still in pain.

After you have a bypass surgery one of the major annoyances is the constant, painful coughing. The doctors all encouraged me to cough so that liquid junk does not build up in the lungs. Every cough was greeted with stinging pain and at the beginning the words I used to describe each cough were not the type you use in pleasant company.

Surely at the outset I took pain medication along with all of the other pills that were and still are required of me to this day. By the way, medications are also not cheap.

Eating was a hassle because I had to make a major change to my eating habits, which from that time going forward consists mostly of fruits, vegetables, fish, some grains (like cereal) and water. Occasionally I do eat other foods like chicken or turkey. Beef and pork have been off limits and so are foods that you get at places like Burger King, McDonald’s and Pizza Hut.

The other fact regarding food is that I had to learn and am still learning how to cook my limiting types of meals (mostly lately, steaming, microwaving or “saute” (what does tht mean; seems like frying to me)….. More on food again, in a later post.

After discharge from the hospital I could not walk very far without running out of breath. For every few feet that I walked, I would have to stop, rest and catch my breath. At first I only hung around the hotel and occasionally walked down the hall or to the downstairs lobby. Later Sandra took me shopping to WalMart, where walking to and from the car was a chore. I ended up usually sitting at the front bench at the entrance while I waited for her to shop.

Other things that I had to get used to with was taking a shower on my own (I needed assistance at first), using the toilet, brushing my teeth, putting on my clothes, getting to bed and trying to lie down in a specific way. Because of my pain and my weakened condition, all of these tasks that we all take for granted are not easy after you get out of surgery. I also did not feel like updating my blogs, websites or even visiting Facebook.

In time though, I did get better and slowly improved, though another major bump was looming.

 

Stress, Fribillation, Pain, and Release

Heart Pillow

Heart shaped pillow given to Kaiser heart surgery patients during the holidays.

At only 3 entries in, I found that this one is one of the hardest to write. The main reason is that shortly after my surgery was done, I was extremely stressed and worried about a lot of things, some not even with my health condition. Not being overly detailed in describing this part, I have to say that I was so stressed that I did get angry at some people for doing things that was out of my control (intense questions “I wish you were dead” and pre-mature release of my health status to a group of people that I best did not want to let know regarding anything in my life). These just made my recovery much more stressful at the time. As a result, I think these stresses only a couple days after surgery contributed to my “heart fibrillation” that I suffered through the next 5 days in the hospital.

Now that I have made my condition known through this blog on my own time, I am OK about people knowing. I just did not want it to happen so early.

Anyways, I’d like to say “sorry” to everyone that I have offended.

That all said, briefly going into the next few days of my January 2016 hospitalization before I hopefully zoom into the present day….

January 1, 2016 started with an early rise (for medications, etc. How can anyone actually sleep in the hospital when nurses are coming in and out at hourly intervals to give you medication and check your status?) to catch the first sunrise of 2016.

I told the nurses that one of the things I always did in past years was to take a photograph of the first sunrise for the new year. In recent years that usually occurred at Diamond Head Lookout or somewhere at Ala Moana Beach Park or Kaka’ako. This year, given the state that I was in that Friday morning, all I simply wanted to do was take my tiny camera and get an image of the sunrise from the Kaiser Moanalua hospital balcony just outside the 3rd floor.

The nurses in charge of my care obliged with my request to be taken out to the balcony and see the sunrise and get my shot. I was not strong enough to walk very far, so I was wheeled out by an assistant nurse. I lingered on the balcony for more than 45 minutes and was just so thankful to be there and live to see the first sunrise of the new year. I got my shot, not the best in the series, but it was a shot. I was happy.

I think it was later that afternoon after I met two visitors, that things started to go south. By the end of the day I had the heart fibrillations. I think I was put quickly put on new medications and my heart was probably monitored more intensely.

January 2 to January 5: Subsequent days in the hospital I was highly encouraged by the medical staff to “exercise” and start walking around. I was weak, but I did take short, painful, feeble walks around the 3rd floor facility. I had to push or pull the IV rack around with me as I was on a constant flow of medications….. even while I walked around. Plus I had the heart sensor device (about the size of a large iPod) with wires hooked up to my chest 24-7 monitoring my heart rate and all that stuff.

I remember walking past the heart monitoring station where a bank of computer screens kept track of each patient in cardio care. My heart rate while walking around was high at around 120 beats per minute. I am sure this was due in some part to my fribillations and that I was still feeling stressed.

Over the next several days the tubes that were initially stuck into me during surgery were removed one by one. The two that I remember the most was the long suction tube or whatever it was that they had inserted just below my chest. I think I had to hold my breath while they pulled that foot long tube out of me. It was a weird sensation and that thing had a wet iodine color coated on the outside when removed.

Later the catheter was removed from the private place where the flow should be one way out only. It was briefly painful when the nurse pulled that sucker out. Ouch! I hate those things.

Let me tell you about pain. You would think that after going through such an intense surgery that I would recover quickly, be free of pain, and just walk out of there in a couple of days. Nope… not happening!

Pain was my constant companion and to this day still is. However pain a day and a few more after surgery was intense. The most intense pain happens during the process of coughing. It seems like coughing is part of the process in recovering from heart bypass surgery.

From what I understand, since my breastplate bones were cut and then put together again with a fragile wire mesh (which allows new bones to grow in place), whenever I coughed, the motion (I think) forces my heart and other organs back there to hit up against the breast, causing intense pain per cough! Ouch.. Ouch… OUCH!!!!!

The reason for coughing I had been told was to get the liquid build up out of my lungs. Apparently after surgery your body produces a lot of liquid that ends up in the lungs and a couple of other places like your legs. The lung ones are a problem because you don’t want a large build-up of liquid mucus in there. Best way to get rid of it is to cough it out.

Let me tell you about the hospital’s pain scale that they use. The one that Kaiser Permanente uses is the Nurmeric Rating Scale (NRS 11) which “is an 11–point scale for patient self-reporting of pain. It is for adults and children 10 years old or older.” The breakdown of each pain threshold is as follows:

Rating Pain Level
0 No Pain
1–3 Mild Pain (nagging, annoying, interfering little with ADLs)
4–6 Moderate Pain (interferes significantly with ADLs)
7–10 Severe Pain (disabling; unable to perform ADLs)

The pain that I experienced while coughing was in the neighborhood of 7, 8 and 9. Extremely painful per cough. Imagine 10 being equal to the pain of having a shark bite a limb off you… well 9 is just short of that hugely intense pain factor.

Fortunately they give you two tools to help ease the pain.

The first tool I got was a “heart pillow” that the people at intensive care gave me. You can see a photo of it at the top of this blog post. Fact is I got two of them from IC. The red and green one was a holiday design since I had my surgery shortly after Christmas. Nice.

What you do with the heart pillow is hold it tightly against your chest whenever you cough. While it doesn’t totally alleviate the pain, it lessens the blow. Use of the pillow is to also lessen the impact of support the chest while coughing, assuring the wire seems holding the cavity together do not come apart. I still use pillows.

The second remedy I got were strong pain killers (pills, drugs, what have you). This medication is given to help patients reduce the amount of pain they are experiencing. Unfortunately the medications do not totally alleviate the pain in totality when I cough.

For comparison’s sake let me tell you that the pain I felt during my December 26 heart attack was about a level 4 or 5. Not as intense as one would think.

The result was I learned very quickly to hold back on the coughing. That would prove to be the wrong move in a few days.

Eating: Before I had my surgery, I was eating OK. After surgery I lost my appetite and only ate a little every day. While we had a choice of “healthy” food from the hospital menu on a daily basis, most of it I found either bland or tasteless. Bland would be in the future of my eating habits…. more on eating in another post.

Discharge: January 5, 2016 came around fairly quickly. The doctors seemed to want to get me out of the hospital as soon as possible, even suggesting an earlier date. However I had several issues (like not being able to go home and no one to care for me) before I could leave. Lucky for me, my sister Sandra showed up from the Big Island of Hawaii on January 5. She came in the morning and I was discharged later that afternoon.

The first major changes to my life had happened with more to come.