S is for Surgery

Today marks two years since Den’s LVAD surgery. The time has flown by and carried us along it’s winding path. We have adapted to our new lifestyle as best we can. We celebrate every milestone possible…for we know not when it will be the last one we have. We do not live in fear of Den’s passing, we are sure it will someday happen. But until then, we cherish every moment we have together. Happy Anniversary, My Love!

April 18, 2016

Neither of us slept last night, I know Den was scared out of his mind. My job was to keep him calm and distracted so his nerves didn’t get the better of him. As for myself, I was so scared that this would be our last night together, but I couldn’t tell him or let on that this was on my mind. During the night Den’s peripheral IV site was removed. All he had was one IV bag overnight…the new heart med that he had been getting since arrival. That was done around 2AM. Den had lots of anxiety all night long, but he was not depressed.

I had taken most of Den’s belongings to the car during the night, so all I had in his room was his walker, the laptop and my busy bag. When they came to get him at 5:30AM, they told me I could not walk with him over to the new building. Well, this sent me into a tizzy, every other time he had gone for a procedure or test, they let me walk with him. Why was this different? But arguing was not going to help either of us. So, I walked to the car, put his walker in and called Roberta to let her know he was no longer in his room. I told her where to meet me, so we could be with him while he waited to go into the OR. It only took me about 10 minutes to sprint to the car and then to the 5th floor waiting area in CCD (the new building). Roberta found me at about 6:30AM and by that time I was a basket case! I had already asked through the speaker several times if I could see him, every time they just said soon. I don’t know how I got it back together in time to see him, but I did. Roberta and I got to see him for about 15 minutes before they came to take him to the OR. The OR nurse, Lelani talked to all of us and took my cell phone number. She said that the OR staff would call either the desk in the 7th floor waiting area or my cell to give us updates as the day went on.

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They came to take Den in to the OR at 7:30AM. And the procedure started sometime around 9:30AM, after getting him prepped, sedated and intubated. Roberta and I did our best to pass the time. I made a set of hand warmers for Den for after surgery. Roberta kept telling me to try to sleep, since I hadn’t the night before, but sleep was not in the cards for me that day. We played cards and tried to read our respective books, but I was too anxious to stay on any one thing for very long. Several times we got updates, Den was doing well and they were still working. Roberta went to get something to eat, but I just could not eat. My stomach was in knots and I was even having a hard time drinking water. At 2PM, Roberta and I were asked to go into a consult room. I know I was white as a sheet…the procedure was scheduled for 8-12 hours…it had only been 5 hours! What had gone wrong? Was he alive? What was I going to tell the family if it had all gone horribly wrong? I held it together as best as I could…thankfully, Roberta was a calm voice when my heart and mind were in absolute turmoil!

Dr. Jeevandandam, the surgeon, came in a little while later (he didn’t keep us waiting long). He told us that the procedure went according to plan, Den was alive, but would be sedated for at least 24 hours, but could be longer. He told us that he had also repaired the mitral and tricuspid valves in Den’s heart and replaced Den’s aortic valve.  Den was still in the OR, but would be going to the ICU with in the next hour. We could go see him at 4PM. I know I sat down hard on the couch because Roberta thanked the doctor and he told us we could stay in the consult room as long as we needed. Roberta insisted that I eat something now that we knew Den was OK and on his way to his room. I only ate about half of the sandwich we shared….I really was not hungry. I was very anxious to see him to know for myself that he was alive and on the road to recovery.  So when we were done eating, we went to the 8th floor ICU waiting area. Roberta let them know we were there. It wasn’t until almost 6PM that we finally got to see Den.

I remember my first impression…his hands were warm! His hands had been very cold for over a year! This was a good sign that the LVAD had improved his circulations. He was intubated and on the ventilator, he had 2 arterial blood lines, one in his right wrist, one in his groin. He had a very large central line in his neck. The Foley catheter was back. The LVAD monitor he was connected to was on a cart at the end of his bed. They had 5 IV bags running. And 3 chest tubes draining fluid from around his heart.  Just after Roberta left to go home, they did an EKG to check Den’s heart. They also took 4 chest x-rays. The nurse told me that Den was getting Nitrox, this was a medication that is given thru the vent to keep the blood pressure in the lungs low.

The staff in ICU had been told that I would be staying with Den while he was there. I did my best to stay out of the way…I lived on that couch for 7 days. I did help the nurse get the compression boots on Den. These boots inflate and deflate to keep blood clots from forming in the legs when a patient is immobile for long periods of time.  Den seemed to be trying to wake up, so his sedation was increased to keep him still during the night.

His nurse stayed in the room with us all night. Den’s LVAD was on the lowest speed setting. (It would not stay there for long.) And it kept alarming for “low flow” every 10 minutes.

Den got blood drawn every 4-6 hours that night. He wants to wake up again around 8PM. He seems to be gagging, has bit his tongue on the left side and responds to the nurse and to my voice. They upped his sedation again. The nurse had to start an insulin IV, Den’s blood glucose was dangerously high and still rising.

The doctors came by around 9PM to see how Den was doing. They told me the plan was to wean him off the Nitrox by 6AM and try to get him off the ventilator around 7AM. So the nurse started weaning….by 1AM he was off the Nitrox. Den’s chest tubes were draining well and all his other stats were stable.

Around 2AM, Den’s core temperature started to rise. They gave him Tylenol and packed him with ice. They also added hand restraints to keep him from touching the ventilator tubing or anything else. 20160418_205057

It was a very long night. Hopefully tomorrow would be better for us both.

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