Monthly Archives: February 2016

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.


Heart Bypass Surgery

Heart Bypass

Single, double, triple and quadruple heart bypasses. Art by Bruce Blaus.

DECEMBER 26, 2015: After suffering a moderate heart attack, I was admitted to Kaiser Permanente’s Moanalua Hospital for further tests and corrective action to my condition. The first few days that I was there, I was given a variety of medications in either pill or intravenous (IV) form to control the heart and whatever else was in distress.

Once I got admitted, I did tell some of my friends and relatives that I was legs up in a hospital bed after suffering a heart attack. Some of my friends like Daniel, Laura, Spencer and Jay visited over the next few days. Daniel was the person who picked up my car and drove it home from the Magic Island parking lot.

It was nice to have visitors.

DECEMBER 27, 2015: I was subjected to a few more tests including chest X-Rays, and Electrocardiograms over the next couple of days. I was also kept on a number of medications too.

The big event of this day was a procedure called a Coronary Angiography. It is a procedure  where doctors “look at the large blood vessels of your heart (coronary arteries).” A doctor inserts “a thin, flexible tube (catheter) through the blood vessel into your groin or arm.” The test is used to see if an artery is blocked.

The doctor and the medical team moves the catheter through the blood vessels into your heart. A dye is injected to see where the blockage is, if any. (Kaiser publication 1047 6161)

Frankly I don’t remember the procedure. Information on the topic say that the patient gets a medicine to help him or her “relax and not feel pain”. Well that certainly happened and I don’t remember the procedure at all. The entire thing took about a half hour or less. I certainly remember waking up and asking the doctor whether or not the procedure was over.

It was. I would have loved to see the image of the dye running into my arteries and veins. I’ll ask Kaiser if they have one and if I can get a copy of it. Everything in imaging at the hospital is digital today (which is one reason why Kodak filed for bankruptcy) and hopefully an image can be passed on to me.

They told me that they had wanted to put a stent in arteries that had a blockage. Instead they found a major blockage of about 50% in one of the big ones. It was decided that a Coronary Artery Bypass Surgery was needed.

DECEMBER 30, 2015. The day of my surgery arrived early. I was awoken by two or three female nurses in the telemetry ward where I was holed up since December 26. They got me up, took off my clothes and shaved almost my entire body except for the hair on my head. The nurses are good at nursing but I would not recommend them as barbers or hair stylists. For the most part most of my bodily hair was gone or at best, reduced to a short stubble.

Then they gave me some special kind of soap and made me take a shower… which was nice. Scrub a dub dub! No one but me in the tub… well stall that is.

One of the funny things before this all happened was my bed was labeled as a “NPO Zone”. I had no idea what NPO stood for until I looked it up, but the subtitle under the label read “Do Not Eat or Drink Anything” (see photo).


NPO Zone traffic cone. Funny!der that label read “Do Not Eat of Drink Anything.” The funniest thing is that the warning looks just like a traffic cone. See photo.

I guess they don’t allow patients to eat because (I am just guessing) they don’t want them to do #1 or #2 while on the surgery table. Maybe #1 is OK as I found out later they had a catheter inserted into that sensitive area where traffic is supposed to be only one way… down and not up!

Anyway after the hair removal and shower, I dried off and was given a new gown. Someone brought in a gurney and I was shortly thereafter wheeled out of my room (with my things in tow – cell phone, wallet, clothes, slippers, books, papers, Chromebook laptop and bag) and to the 4th floor surgical level of the hospital.

I was wheeled into a staging area for everyone undergoing a surgery that morning. Needless the say, the staging area room was busy with doctors, specialists, technicians and nurses scurrying about and talking to each other as well as patients in hushed tones. I was wheeled into a small area segregated by thin curtains from other patients.

I met my anesthesiologist, whose name escapes me for now. As I was lying in bed, we chatted and I think he put a breather thing over my nose. I think I was also hooked up to an IV. During the course of the chat, which I don’t remember now, I somehow and miraculously just faded away.

This is what I remember of my surgery:

Black Square

Surgery was several hours of unaccounted for time in my life.


This is a good thing. For the next 5 to 8 hours I was out like a light. Don’t remember a darn thing.

In a brief nutshell, heart bypass surgery involves cutting the sternum area of my rib cage open, gaining access to the heart, removing veins from my leg and moving them to the heart in which a bypass is created and then putting me all back together. Sounds simple but I bet it is 110% complicated.

The process also involves stopping my heart and having a machine take over pumping my blood and helping me to breathe. The heart is stopped for a period of time to which the surgical team can put in the bypass.

The possibility of death exists if something goes wrong. That I know as I had to declare my sister as my “Power of Attorney” just in case something did go wrong,

Nothing went wrong. I had an excellent surgical team, led by Dr. Wilkinson and Dr. Wu. They explained the process to me beforehand which I had already known, since my Dad had the same procedure done in 1988. I will write something about my doctors and Kaiser support staff in an upcoming post.

In the end, I had a triple bypass done on me.

If you want all of the gory details related to the procedure of Coronary Artery Bypass Graft (CAGB) you can read all about it in this article on Wikipedia.

Intensive Care Tech

Intensive care tech at my bedside. Photo by Mel.

DECEMBER 30, 2015 – Later That Day: I vaguely recall waking up hours after my surgery. The first things I remember seeing was a new room, a pretty blonde nurse (her name was Chelsea) and I think some glass nearby. I also heard the faint sounds of electronic machines monitoring just about all of my body functions.

The first thing I noticed was that I could not talk. I asked the nurse for a piece of paper to write stuff with. One of the reasons why I could not talk was that I had a breathing tube going down my throat. My body was also hooked up to a number of tubes and IV feeds going to the different machines that were managing some body functions, and administering medications. I probably looked like a sick Borg from Star Trek TNG. Lots of tech to keep me alive at that time.

I asked the nurse for a pen and paper so that I could communicate. The first things I wrote down were “What is my condition?”; “Keep this here”; “I Want to Cough”; “Chest Hurts Slightly” and “Tired”.

As I now recall, one of the first tubes withdrawn from me was the breathing tube going down my throat. That was a nice removal and it allowed me to talk…. and eat, though I was not very hungry.

I have to say that my time spent on the 5th floor intensive care unit of Kaieer Moanalua was for the most part, despite all the tubes and stuff connected to me, very pleasant. Nurse Chelsea and later nurse Pat (I think that was his name who told me about the local Jimmy Buffett Pau Hana Parotheads club) were most excellent caretakers.

I slowly recovered over the next 36 hours in intensive care before I was transferred back to the cardio telemetry ward on December 31.


Various IV tubes with medications pumped into me during intensive care.