The End of a Very Long Day

It's 10:30 at night, and I'm home. Jim is resting as comfortably as possible in SICU (Surgery Intensive Care Unit) at the VA. I'll be back up there in the morning to spend the day with him. He is doing better than expected, and much better than most of the cardiac patients they normally get in SICU. Below is a synopsis of the Very Long Day (more details of the day follow)

• Arrived at 6:00am for chest x-ray
• By 6:45, looking oh-so-sexy in his hospital gown, pajama bottoms, and bright yellow socks
• 7:10 walked into the operating prep area, where he was hooked up to the first of many IVs.
• By 10:45, the vein from his leg had been harvested, his heart was isolated, and he was on the "pump" (heart/lung bypass machine)
• Around 1:00, the grafts were complete, everything looked good, and they were getting ready to take him off the pump.
• 1:30-ish met with Dr Bull who told us things could not have gone better. It was a textbook operation with no complications, nothing unexpected.
• Finally got to see him in SICU around 4:30. Stayed till about 9:00

My heartfelt thanks to our "OR Ambassador" who brought us the updates throughout the proceedure. The wait would have been interminable without that periodic reassurance that all was well.

Now for the post-op details.

Jim is surprisingly responsive. This is probably due to being accustomed to high doses of pain meds. He is still on a respirator which means he has a tube down his throat. This prohibits him from talking. It has not, however, prevented him from communicating! He does so by wiggling his eyebrows, opening or closing his eyes - they wider they're open the more adamant he is - squeezing your hand, nodding, shaking his head, or shrugging his shoulders. Sometimes these motions are very subtle, so you have to pay attention. Toward the end of the night, he was experiencing some pain in his right arm in the ulnar nerve area (funny bone). He had this operated on last year, but it still gives him trouble from time to time. I tried to elevate his arm a bit, but all the sensors on him are elevation-sensative, and moving it prompted a visit and friendly lecture from Gary, the night nurse. He assured us that Jim really wasn't that coherent and not fully aware of what he was asking. This had Jim rolling his eyes so dramatically, that I knew Gary was way off. After Gary left, I noticed Jim curling and uncurling the fingers of his left hand. I gently squeezed his fingers. He promptly forced my hand flat and started writing out letters in my palm, a la Helen Keller. Yay, Jim! I relayed the information to Gary, who propped up Jim's arm and adjusted the monitors accordingly.

He has 4 drainage tubes coming out of his chest: 2 for the lung/chest cavity in general and 2 for the area around his heart. There is very little drainage, which is a good thing. The tubes will likely be removed Thursday.

All of his monitoring levels are great: blood pressure, valve pressure inthe heart, heart rate, etc. He is not currently on any machines that are controlling these things, it's all Jim.

He will be in SICU till Friday, when they'll move him to "the floor" or the main recovery area. Before being moved, however, they will make sure he can walk short distances (this is something he will start TOMORROW) and perform basic tasks like getting in and out of bed.

There is an IV looking thing in his neck, leading into the carotid artery. A fibre-optic cable has been snaked down the carotid into his heart. This is what is measuring all the valve pressures.

There is an entire bank of monitors and medication dispensers, all of which feed into the main IV in his left arm.

There are two pairs of wire leads which are dangling out of his chest. These are wired directly into his heart and will be hooked up to an external pace maker if his heart starts showing signs of arrhythmia (not expected at this point, but better to be prepared). If there are no problems, these will be removed within 48 hours.

Jim looks GREAT! His color is leaning more toward pink than gray. His mom thinks it's better than it was on Saturday. I tend to agree. Now, he does have tubes coming from every imaginable point, and his chest is covered with iodine stains, and he's strapped to the bed so he doesn't inadvertantly pull something loose, but he looks wonderful to me.

Before I left, I asked him if he needed anything else. He nodded vigorously and started writing on my hand again: P - E - P - S - I. I got it after the second "P". Silly man. Obviously he's already on the mend!

IF YOU PLAN TO VISIT JIM IN THE HOSPITAL:

• If you want to visit but aren't sure if you should come up or not, you can call me at 801-654-1059. Cell phones are not allowed in the SICU, but I will be checking messages every couple of hours.
• Only two visitors at a time are allowed in the room
• No children under 14 are allowed
• Be sure to use the hand sanitizer on the wall outside his room before entering
• Visiting hours are 8:00am - 10:00pm with the exception of 7:00 - 8:00pm

I am so grateful that Jim is doing so well, and I am so grateful for all of you who are concerned about him and have been hoping and praying for his well being. It was pointed out to me this afternoon that Jim had no choice but to come through this with flying colors. He has people of at least 7 different faiths praying for him!

And now... bed. After all, tomorrow is another day