Tag Archives: Fribillation

Back to the Emergency Room & Hospitalization

THROWBACK THURSDAY (#TBT)

Kaiser Moanalua

Kaiser’s Moanalua Hospital. File photo by Mel.

So like this blog has fell behind. My second hospital confinement is being labeled as “Throwback Thursday” since it happened more than 3 months ago now. I’m doing well today. But on January 10 I ended up in the emergency room only 5 days after being released. The following is a brief account of that time.

I was released from the hospital on January 5.

I started keeping a log of my meals, medications and more in a tablet starting on January 6. The following are brief summaries from entries I wrote in the log after my initial release from Kaiser Moanalua.

January 6: Took my morning medications: Oxycodone for pain; and then later Amiodarone, Low Dose Aspirin, Famotidine, Furosemide, Metoprolol, and Terazosin. At the time these and a few more for my evening routine were / are considered essential to my post-up survival. My evening meds included some of the above in addition to Atorvastatin and Warfarin. It was difficult at the beginning to get used to the medication names, dosages and times of day to take each one.

Meals were limited to small portions of fish, fruits, veggies and cereal with low fat milk during breakfast. In those early days after my initial discharge, things were tough.

Walking was a chore. I moved very slowly because my breathing accelerated and grew tired quickly after walking only a short distance. However walking was the key to my recovery as the doctors encouraged more walking many times every day.

Besides walking, PAIN was… well a pain! I was also encouraged to cough the mucus out that built up in my lungs after surgery. I was still required to hold the heart pillow against my chest. For the month of January, the pain level at every cough was a severe 6, 7 or 8 on the numeric pain scale of 0 to 10.

Pain was a constant companion after surgery for many weeks and is still around today but not as intense as it was in January.

Shortly after my release from the hospital I bought a blood pressure monitor. I also have a Pulse Oximeter which I bought for my Mom in 2014. I got it back after she passed away last year. The former device measures your blood pressure and the latter measures your breathing and heartbeat. The blood pressure monitor also gives out a heartbeat reading.

It is a good thing I had these devices at home.

January 6Pulse: 96 bpm O2 – 95: I learned early on that a pulse rate of 96 is considered high. That pulse rate was with me after my surgery and would spike higher when I walked around in the hospital.

January 7 — 8:00 am — Pulse 96 bpm O2 – 93 | BP 125/85 Later that day: BP 144/89

January 7 – 6:30 pm — BP 149/89 Pulse 97 bpm

January 8 – 5:30 am – I had a higher heart rate that morning when I walked a very short distance: Pulse 112 bpm. A blood pressure reading one hour later: 117/74 Pulse 102 bpm 10:30 am – Pulse 96 bpm BP 123/84 8:40 PM BP 120/83 Pulse 88 bpm

January 9 – 11:15 am BP 115/78 Pulse 90 bpm

January 10 – I had a hard time breathing that morning. Shortness of breath. I could hardly walk or move around without running out of breath. It was decided early that morning that I would be driven to the hospital emergency room. Sandra and I were originally going to take a taxi from the hotel to Kaiser Moanalua. That did not work out. I tried to walk out of the room and in the hallway but rapidly ran out of breath. I could feel the shortness of breath as well as my accelerated heartbeat. Had I continued walking I probably would have collapsed. Therefore I turned around and walked slowly back to the room.

We called 911.

The Oximeter reading that morning showed an O2 rate of 94 (normal) but a pulse of 112 bpm. The paper log stopped after the that for 2 days.

THE AMBULANCE RIDE: It took about 20 minutes (again) before the City’s EMS ambulance arrived. Two paramedics came up to the room and took me away on a gurney. Sandra accompanied me on the ambulance. She rode in the front seat with the driver. She was quite impressed as to how quickly the vehicle moved and more than that, how quickly other drivers in front of the ambulance moved out of the way. I was fully conscious and aware of where we were going. We raced up Keeaumoku St., turned left on Beretania than again on Piikoi to take the on-ramp to the H1 freeway. We got to the emergency room in about 15 minutes. All the way there I was hooked up to an EKG monitor as well as other devices while the paramedics read off numbers and communicated with the hospital.

HOSPITALIZATION…. AGAIN: I spent about two hours in the emergency room before the doctor on call decided to admit me and keep me “under observation”. I was taken to a nearby complex of small rooms where patients are placed “under observation”. It was not the same telemetry ward that I was in during my initial hospitalization. For the next two days I was hooked up to a constant IV drip of Amidarone (for heart fibrillation) among other medications.

I vividly remember is that while being moved out of the emergency room and to one of the observation rooms, they had my heart hooked up to an audio heart monitor. It played out each heartbeat which sounded like a Pong game gone wild. The chaotic heartbeat was a sure sign that something was wrong with me. If this was not treated I could have had a stroke. Fluid buildup in my left lung was also a culprit.

In time, the drug therapy worked and by the afternoon on January 12 I was discharged.

January 13 – Out of the hospital and back at “home”. 8:16 am – O2 94 Pulse 83 bpm. 10:00 am Blood test at Kaiser Clinic on Pensacola St.

January 14 – Walking more; down the hallway and to the lobby. Better than Jan. 10. Pulse sitting 99 bpm. At 3:10 pm that day I noticed higher heartbeat rates of 106, 108, 109, 111, 103, 97 and more just sitting in place after walking. I called Kaiser’s cardiology department and talk to Nurse Ruth. Can’t remember exactly what she told me then, but I think it was to keep monitoring and call her again the next day.

By this time I was taking Amidarone twice a day, once in the morning and again in the evening. Over time the Amidarone did its job. My heart rate, fibrillation eventually slowed down to “normal” levels.

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.