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.

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.