Tag Archives: Kaiser Permanente

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.

 

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.

 

Bypass Avenue: Heart Attack!

The First Sunrise of 2016

I was lucky to see the first sunrise of 2016 on January 1. Thanks to the medical staff at Kaiser for saving my life and letting this happen. This is not the best sunrise picture I ever took, but perhaps the most memorable as I got this 2 days after my bypass surgery taken from the balcony area of Kaiser Moanalua hospital.

For many years one of the things that I have done was wake up early on the first day of the new year to get photograph of the first sunrise of the year. Capturing the first sunrise of 2016 almost did not happen.

HEART ATTACK

On the morning of December 26, 2015 I woke up at around 5:45 am. Got out of bed, got in the car and drove to Ala Moana Beach Park, Magic Island to do a walk around the area and perhaps take a photo of the setting full moon that I missed on Christmas Day night.

Camera in hand, I started my walk just fine for about 20 yards. I was on the paved Magic Island jogging trail when I kind of felt my chest tighten and heighten in pain. The level of pain was not very great. I continued walking for a few more feet when I decided this doesn’t feel normal.

I did an about face and slowly walked back to my car. I found it kind of astounding that I was also running out of breath. I had only awoken about 45 minutes before this happened. “Am I having a heart attack” I silently asked myself as I struggled a few more yards to get back to my car.

I got there and immediately turned on my cell phone. I was kind of debating whether or not to call 911 or simply drive the car home and rest in my apartment. By the way I am one of the last persons on earth to have bought a cell phone. This occurred in March of 2014. I did not tell anyone about my cell phone or its number except to a few close relatives and friends. Little did I know that the cell phone would be instrumental in saving my life.

While seated in the car, I called my friend Lisa. As I vaguely recall now, her line was busy. So I waited for a few moments, still in some mild pain. I decided against driving home and instead called 911. Here in Honolulu the 911 operator asks if you want police, fire or ambulance. I said “ambulance”. They switched me over to the ambulance dispatcher. The person on the other side told me to stay in the car and turn on its emergency flashers.

Ambulance on the street

The ambulance took 20 minutes to get to where I was. File photo by Mel.

The ambulance took 20 minutes to get to where I was. Parked car, emergency flashers on, parking lot. The nearest ambulance place is about 2 miles from Magic Island. Why did it take so long? If my heart attack was massive, I probably would have been dead before they arrived.

While waiting for the ambulance to arrive, I did call Lisa again. I vaguely remember any conversation I had with her, but I think for the most part she asked me to stay calm and don’t panic.

EMS’s ambulance finally arrived. They opened the back door of the ambulance and surprisingly I could walk out of my car and sit in the gurney. Before I did that I made sure my car was secured. Turned off the flashers, got my stuff (cell phone, camera, wallet, bag). I locked the doors.

The paramedics loaded me onto the ambulance after I sat in the gurney. They laid me down, stuck an IV needle in me, hooked me up to a blood pressure and oxygen machine, an EKG reader and who knows what else. I was also given a nitroglycerin pill that I had to hold under my tongue until it dissolved.

The paramedics also asked me a lot of health questions, including whether or not I drink or smoke, to which my answers were in the negative. I was conscious for the whole ride on the ambulance… from Magic Island to Kaiser Moanalua Hospital near the Salt Lake area of Honolulu / Pearl City-Aiea.

The ambulance arrived at the Kaiser Moanalua Emergency Room in about 20 minutes from my pickup. Since it was an early Saturday morning, there was no traffic on the H1 freeway.

EMERGENCY ROOM AND ADMISSION

Kaiser Moanalua

Kaiser’s Moanalua Hospital. File photo by Mel.

By the time I got to the Emergency Room, I was feeling a little better. I think the nitro kind of help relieve my heart attack stress.

Anyways I was wheeled in and transferred to one of the emergency rooms. Nurses promptly hooked me up to a number of machines, had some kind of IV going and there I was. Heart attack victim laying on a bed, high tech machines reading out numbers and making strange little beeping noises that were relayed to the main desk I think informing the nurses that I was still alive.

While at the emergency room they ran a series of blood tests. They also gave me something to swallow to check if it was a bad case of heartburn. Turned out it wasn’t. After about an hour the blood test results were returned and the emergency room doctors determined that I had a “moderate heart attack”.

Therefore I was admitted and wheeled out of the emergency room and on to the third floor which is part of the cardio telemetry area of the hospital. The hospital would take good care of me from this point going forward.

After several days and a big operation (which will be covered in the next post), I would be able to see my first sunrise of 2016.

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