New scar

Today I am exactly one month post-op!  I have been home for two weeks as of yesterday.  Woo hoo!  These small milestones are really landmark achievements for me as my sense of physical capacity, strength and activity slowly begins to normalize.  I am now walking to the end of the street two times a day; I've ascended two flights of stairs; I've prepared my own meals (occasionally); I can nearly take a shower independently; I can sneakily open the refrigerator doors; and I tend to have one big outing or errand each day.  With all of these milestones achieved, I immediately have expectations of myself that I can do whatever I want, but alas, I am still plagued with fatigue, take two naps a day and am painfully tired in the evening.  "You did just have a major open heart surgery," I remind myself, "really, Emily!"

 Last week I had my three-week follow-up appointment in the surgeon's office.  I passed with flying colors!  All vitals are good: heart rate, blood pressure, temperature; my laboring with the incentive spirometer has paid off: lungs are clear; and most exciting, all tape and sutures were removed: it was an unveiling of my new scar.  As you can see, my scar looks fantastic!  Free of scabs and a nice healthy pink, it measures 9 1/2 inches which is about an inch and half longer than my last scar (an extra half inch at the top and an extra inch at the bottom).  It is hard to see in the picture but the new incision line runs alongside the right edge of my old scar, with the exception of the top three inches.  Because the top three inches of my old scar were so wide, it appears that whoever closed me did a little handiwork in which they removed some of the old scar.  It is hard to tell how that bit will turn out; it looks a little funky right now, but time will tell.  I think it's a keeper.  It was also established at my appointment that I am quite anemic (I never had a blood transfusion, but probably could have benefited from one) meaning it will take a couple of months for my blood to repopulate and for my energy levels to get back to normal.  Never a patient person, I have decided to give my blood an encouraging turbo boost by eating lots of red meat (gasp!) and even liver (yum!).  Now, I have always admired the power of food on many levels, but the day after I ate half a can of liver pate (it did smell like cat food) I had amazing color in my cheeks for the first time in two weeks, giving me a new-found respect for the healing power of food!  Thanks food!  You are great! 

The final bit, and best bit, of news I received from my appointment is that the longevity this surgery has afforded me until my next operation is much greater than originally thought.  Because Starnes widened the aorta and aortic root with the Bentall procedure, relieving pressure off the valves, the new valves could potentially last me another 15 to 20 years, as oppose to 10 years, which was the original prognosis.  Celebrate!  Good news, indeed. 

What's next: take it easy, keep up the physical activity (they want me to walk a mile by the end of the month), keep taking naps (yes, please!) and in two weeks time I will visit with my cardiologist to start weaning me off ALL of my medications.  Nice!  My father-in-law has incentivized my mile challenge by offering me a pie once I reach that mile.  That's all the incentive I need; here I come, pie! 

Introducing Wiggins

It's two and half weeks post-op and I've been home nearly five days in a row now.  That's my longest stretch of being home since the surgery.  I think it's a good sign.  I feel that I'm on the real path of recovery now.  It feels really good.  My days at home are balanced with TLC and good rehab.  Having a mom as a psych occupational therapist has ingrained in me an unconscious ability to self-assess my abilities and limitations at all times, both cognitively and physically.  So I balance my days with varying levels of cognitive activity: jigsaw puzzles, crossword puzzles, crafts, movies; as well as physical activity: walking down the block, standing, napping, showering.  Since I am basically walking around with a broken bone in my chest (they crack the sternum in half as part of the sternotomy and wire it back together) I am on sternal precautions for six weeks.  This puts a major damper on my physical and social life.  No driving, no swimming, no twisting, no lifting, nothing! I'm not supposed to even open the refrigerator door right now!  You can imagine how that impacts my late night hankerings.  They become not so secret.  But the silver lining on this temporary dependency means I am becoming much closer to those who help to take care of me.  It's interesting—I think I fought so hard for so long to assert my independence that I was a physically capable and responsible adult since my last surgery.  Moving abroad and living in London for three years was the ultimate embodiment of that assertion.  To now be so dependent on others, at age 31, could be demoralizing and frustrating.  But it's not.  These past few days I have felt nothing but gratitude and humility at the endless, selfless care displayed by my parents and Ryan.  To be served and cared for by another is the ultimate act of love; it is the ultimate blessing in the world.  I am profoundly blessed.

The displays of support and encouragement from friends and family that have been pouring in this week are an extension of this as well.  The cards, flowers, balloons, edible arrangements, social media messages, food, and gifts have all enveloped me in a blanket of love.  Thank you!  Perhaps the BIGGEST embodiment of this has been the arrival of a giant teddy bear in the mail.  When I say giant, I mean the biggest teddy bear you have ever seen...life size...my size...60 inches tall!  This giant teddy bear has brought much entertainment and laughter to me and really everyone this week!  He has unexpectedly become an important part of my recovery.  So without further ado, I would like to introduce....WIGGINS!  (named in honor of one of my doctors at the hospital)

Hello new friend!

Morning cuppa 

Taking in rays poolside

Talented musician, he prefers ragtime

Wiggins enjoys white wine with his Thai food

Exhausting work-out

Watching a scary movie

Here is the fabulously giddy moment of taking him out of his box (turn up the volume!):

Home: third time a charm!

Phew!  This last week was an unexpected rough one.  But everyone made it; we got through it!  And I am home again.  For the third time.  Rather than inundate you with too many details (they're not the fun kind) I'll sum up what happened this week and end with a list a things I learned from this week, cause let's face it, I've kind of mastered being a heart patient at USC Keck at this point. 

Exhaustion all around during 1st readmit

I had been discharged home Saturday August 29 as you may remember and was recovering remarkably well at home for three days when I started having some spikey fevers and mildly elevated heart rate (110s, normal for me is 60-80).  We called the doctor and they wanted me to come in and get checked out, so we did and they decided to readmit me for tests to make sure I wasn't having an infection.  After every test in the book (checking for blood clots, bacterial infections, lung issues) it was decided I had pericarditis (inflammation of the lining around the heart), something apparently not uncommon for women in their early 30's to have after open-heart surgery (I didn't know there was a club).  I came home last Friday, September 4 in the afternoon and was so relieved to be home.  The readmit was demoralizing and my spirits were low.  I had a fabulous dinner, delivered by Rolando, watched 'the Goonies' with my mom and went to sleep.

Slowly coming out of afib on 2nd readmit

Saturday morning I woke up as if from a super intense dream: sweating like crazy, heart rate running fast and something new: an irregular beat.  I tried to calm my body but to no avail.  After a call to the doctor, we immediately went back to the hospital and that's when things got crazy.  My heart rate was 188, irregular and I was throwing up to boot.  I was in atrial fibrillation.  I had a swarm of people working on me, all extremely quick, calm, and immensely reassuring.  It was some of the best bedside care I've had up to this point; the ETC (special emergency) crew was a rock star team.  They even put Ryan to work silencing all the alarms going off; it was a good team effort.  After about 3 hours my heart rate started to go down, slowly.  Once it was in the 140's they sent me up to the ICU for round-the-clock monitoring to get it back down.  The care continued to be incredible: everyone in the ICU treated me like family, we shared lots of laughter, and the surgical team, especially Dr. Wiggins, hovered attentively.  I felt well taken care of.  By Sunday morning my HR was still in the 120's and irregular so we decided on a little bit of cardio version (electric shock) to get my heart straight again.  And it did the trick, like magic!  My heart immediately went back into sinus rhythm and HR was in the 80's.  Yes!  I felt like a new person.  Pericarditis was determined to be the culprit of the a-fib, so with a little more aggressive treatment of the inflammation in conjunction with some precautionary treatment for a-fib, I was closely monitored for a day and then released.  I came home yesterday, Monday, September 7.

Today I am exactly two weeks post-op and while it hasn't been the easiest or expected path to here, I am feeling much recovered and am grateful to be home.  Here are a few things I've taken from this past week:

-I learned that little things help keep me grounded, sane, and feeling like a person: having my own toothbrush, favorite fuzzy pair of socks, my favorite lip balm, washing my face everyday, etc.
-I learned the therapeutic value of music: I usually don't have trouble sleeping, but I couldn't have slept without my peaceful tunes from Brandi Carlile, Frank Sinatra, Billie Holiday, and Middle Brother. 
-I learned that doing nothing is sometimes the best thing to do: I prefer being busy and productive usually, but I finally discovered how good it feels to sit, do nothing and be at peace with that.  Phew, that was a long time coming!
-I learned the importance of not being stoic all time: I really had to listen to my body on Saturday with the racing heart rate telling me to go back to the hospital, again, even though I really just wanted to power through it, stay home and finish my perfectly soft boiled egg for breakfast.  It was such a good egg.
-I learned the value of cursing: sometimes the f-bomb is just the release you need, and it sure helped me release some emotion on Saturday.  And then I felt so good after that! 
-I learned that saying "I'm scared" doesn't make me less brave, and actually, made me feel less scared once I said it.
-I learned that In 'N Out really does cure everything: I was having an emotionally low night last Wednesday and my dad and Jo's delivery of a burger with grilled onions, fries and a milkshake made me feel whole again. 
-I learned the importance of developing a personal rapport with the hospital staff.  I became friends with nearly every single person that helped me: from the surgeons to the phlebotomists, from the nurses to the x-ray techs.  Every readmit was consequently like a homecoming full of smiles, laughter, and jokes that I just couldn't stay away from them.  My positivity and my gratitude created a positive feedback system that yielded a wholly positive, pleasant and healing environment. 
-I learned the truth of being blessed with a loving, supportive family: that there are no limits to the sacrifice and love my family is capable of in supporting me.  And that the ultimate blessing is having a partner willing and capable of matching my strength in facing the ugly and scary, hand in hand together.  I love you, Ryan.  We did good.