PAIN: well under control with half of the meds used prior. The "pain" or discomfort is no longer white, hot and searing, but very local, intermittent, unexpected. Pain is usually occurring with small movement or increment in movement even if one minute ago you were perfectly comfortable. Location of pain has and continues to be localized at device sight on left chest wall and under left breast on rib cage. Occasionally, the incision at the top of the sternum (breastbone) will pain me. Pain usually, when it strikes quickly,is a 7 out of 10 and really not mitigated well with pain meds after 4 hours. That is why I have used prescription strength motrin for breathru pain. By tomorrow afternoon I hope to have transitioned to Aleve as suggested by my doctor.
MOVEMENT: much easier. Got myself settled in bed last night with much less issue with the pillow placement. Pillow under left arm continues to be a godsend even when I am sitting here eating or typing. Even last night at a Super Bowl Party I felt more comfortable sitting and leaning forward on the arm of the sofa than to have my arms in my lap. Left arm range of motion is within normal limits above my head and out to side tho the sensation of pulling at device and wire occurs at ends of ranges.
SLEEP: elusive again last night. I do believe this is a function of the fact that I do not sleep on my back at all. I am exclusively a left side sleeper. I have not retried the failed sleep on the right side position ( and had been practicing this preop) and might consider buying one of those bed/body pillows for tonight. If not, I may just try again to lie flatter like normal, with one pillow.
ELIMINATION: back to normal
CANDIDIASIS (yeast infection from antibiotics): under control but not gone. May need prescription med.
APPETITE: wish it were less. I am trying to watch the caffeine and salt intake and drink more water. I bought Mrs Dash last night to use in cooking.
I have my wound check on Thursday morning though again my understanding is that my sutures will "dissolve" or are internal only. I do have steristrips and maybe they will come off by then. I do believe I will have adhesive marks for quite some time. Will post before and one week after pictures this afternoon when my friend comes over to help me take the after pictures. Hope to show the lateral view as well as the front view so you can get an idea of the dimension of the device bulge. This is the question I had preop that no one seemed to be able to satisfy with pictures.
Renee
Monday, February 7, 2011
Saturday, February 5, 2011
Bad Night= Good Day???
Had a great deal of trouble getting comfortable last night. 2 vicodan didn't even cut it. Had about 4 hours sleep. If contemplating this surgery, have lots of pillows at your disposal, all densities required from soft and squishy to stiff and thick. Its weird that the same setup doesn't work night to night, or day to day. One little movement can just set you on a downward spiral (to quote my dear friend Cyd).
Since it was a rainy day and exercise was on the "to do" list we went to some local stores to walk around. Got to try out the Daisy Fuentes seamless camisole that I purchased at Kohls. You can see it herehttp://www.kohls.com/upgrade/webstore/home.jsp;jsessionid=fGgnNN6TvG06pSLplsTKwMms75z0ll2ycJH4SfyQnGdMG1Blp4Ry!-1305738932!1999540316. Gave me some extra warmth under my oversized fleece. Also found some soft undies at Nordstroms. Shimera is the brand. Seamless and easy on/off. Especially comfortable for lying around. No time for Spanx I am afraid.
The other thing to be prepared for is the nearly inevitable candidiasis from antibiotic use. Prepare for that with some over the counter medication. Better to have it handy me thinks.
Hoping for a good night's sleep tonight. I really need it.
Oh, BTW, I set off the security alarm at Tuesday Morning!!! The saleslady said it might be my keys, but then it dawned on me......YIKES!
Since it was a rainy day and exercise was on the "to do" list we went to some local stores to walk around. Got to try out the Daisy Fuentes seamless camisole that I purchased at Kohls. You can see it herehttp://www.kohls.com/upgrade/webstore/home.jsp;jsessionid=fGgnNN6TvG06pSLplsTKwMms75z0ll2ycJH4SfyQnGdMG1Blp4Ry!-1305738932!1999540316. Gave me some extra warmth under my oversized fleece. Also found some soft undies at Nordstroms. Shimera is the brand. Seamless and easy on/off. Especially comfortable for lying around. No time for Spanx I am afraid.
The other thing to be prepared for is the nearly inevitable candidiasis from antibiotic use. Prepare for that with some over the counter medication. Better to have it handy me thinks.
Hoping for a good night's sleep tonight. I really need it.
Oh, BTW, I set off the security alarm at Tuesday Morning!!! The saleslady said it might be my keys, but then it dawned on me......YIKES!
Friday, February 4, 2011
One More Dressing Tip
Left arm in first
Left arm out first
Trust me, you will only it the "wrong" way, once. LOL
Left arm out first
Trust me, you will only it the "wrong" way, once. LOL
Got Up and Got Out!
Post Op day 4: today I get to take a shower. Had a great night's sleep=9 hours! Feel really rested and was able to get up from my semireclined sleeping position in the bed all by myself. Had to roll right and push up with right arm ( I sleep on the left side of a queen bed). No pain in that activity and in general today much less discomfort. No hot, searing pain.
Shower went well. Used antibacterial liquid soap from hospital, disposable washcloth and clean towel for drying. That will be my habit until all wounds are healed. Husband had to wash my back, but I could wash my hair ok. No shower chair needed, tho it would have been nice to have.
Since surgery I have been wearing soft flannel button down jammies.
Preop prep: I went thru my closet and found all the button down tops, or easy on tops ( large holes for head/neck vs turtlenecks) and placed them all together on the ironing board. I did not want to have to figure this out on the fly and while in pain. I also purchased several jogging sets, soft, thinner sweatshirt material for lounging around and receiving guests or taking walks. Included in this preparation was the necessity of bra wear. I have purchased several seamless bras with wider chest bands in hopes that they will not reproduce pain when I am finally able to wear one. Also, seamless camisoles for those times when I have to be public and possibly not able to wear a bra. Note that some left side seams may need to be covered with a softer material like moleskin over the area where the incision is on the left chest wall. This can be accomplished with iron on interfacing so no sewing required. I will continue to endeavor to attach pictures of these items and suggestions, but that ability continues to escape me here.
When a brand or item of clothing works you will be the first to know. These have not been issues with the traditional defibrillator or pacemakers that we are all used to.
Clearly the thinner you are, or the less need for a bra, the easier this transition will be. Of course, many of us are already looking for these items given the hassles at the airports with underwires LOL.
Ah, also spending some time stretching arms overhead, resting hands on my head and I took a 1/4 mile walk today. No real shortness of breath. I am short of breath with stair climbing and I think that is more related to not being able to take a deep breath on a consistent basis. Shallow breathing doesn't cut it when exertion is called for.
Shower went well. Used antibacterial liquid soap from hospital, disposable washcloth and clean towel for drying. That will be my habit until all wounds are healed. Husband had to wash my back, but I could wash my hair ok. No shower chair needed, tho it would have been nice to have.
Since surgery I have been wearing soft flannel button down jammies.
Preop prep: I went thru my closet and found all the button down tops, or easy on tops ( large holes for head/neck vs turtlenecks) and placed them all together on the ironing board. I did not want to have to figure this out on the fly and while in pain. I also purchased several jogging sets, soft, thinner sweatshirt material for lounging around and receiving guests or taking walks. Included in this preparation was the necessity of bra wear. I have purchased several seamless bras with wider chest bands in hopes that they will not reproduce pain when I am finally able to wear one. Also, seamless camisoles for those times when I have to be public and possibly not able to wear a bra. Note that some left side seams may need to be covered with a softer material like moleskin over the area where the incision is on the left chest wall. This can be accomplished with iron on interfacing so no sewing required. I will continue to endeavor to attach pictures of these items and suggestions, but that ability continues to escape me here.
When a brand or item of clothing works you will be the first to know. These have not been issues with the traditional defibrillator or pacemakers that we are all used to.
Clearly the thinner you are, or the less need for a bra, the easier this transition will be. Of course, many of us are already looking for these items given the hassles at the airports with underwires LOL.
Ah, also spending some time stretching arms overhead, resting hands on my head and I took a 1/4 mile walk today. No real shortness of breath. I am short of breath with stair climbing and I think that is more related to not being able to take a deep breath on a consistent basis. Shallow breathing doesn't cut it when exertion is called for.
Thursday, February 3, 2011
Take a Deep Breath
This surgery does tend to encourage shallow breathing. In the first 24 hours after surgery I was requesting the max dose of morphine as without it my breathing was very shallow and diaphragmatic only. There was no rib excursion and I was (and am) concerned about developing pneumonia. Today, chest is very tight like there is a band around the lower rib cage and it is difficult to get comfortable.
I was surprised that they did not give me spirometer ( clear plastic apparatus with blue balls that you attempt to float in a tube by exhaling into straw) to encourage deep breathing. I am sitting semireclined with arms resting on my head to effect mechanical rib raising and excursion to assist deep breaths.
And speaking of diaphragmatic..........like in some surgeries where you experience severe gas pain, I have hiccups on occasion that rock my world.
I was surprised that they did not give me spirometer ( clear plastic apparatus with blue balls that you attempt to float in a tube by exhaling into straw) to encourage deep breathing. I am sitting semireclined with arms resting on my head to effect mechanical rib raising and excursion to assist deep breaths.
And speaking of diaphragmatic..........like in some surgeries where you experience severe gas pain, I have hiccups on occasion that rock my world.
Words for the day
Ok, the words for the day
"stool softener"
Maybe TMI however a necessity to be taken daily from time in hospital to offset the constipation issues that occur with the use of narcotics and the result of lack of movement. I also have been cognizant of the fiber in my diet, and it just so happens that I love prunes!
I also forgot to mention that I was hypokalemic on my preadmission testing. That means not enough potassium which is imperative for heart muscle function. The lab norm is 3.5 on the low end but my cardiologist prefers a number closer to 4.0. I did take 20 mg supplemental potassium for 2 days before surgery as well as a banana a day for the week before. Level was 3.8 when I checked into the hospital but I am to eat a banana a day.
Slept well last night after several attempts at pillow placement. Actually took a picture this morning so we know how to set it up for tonight. Also called in to office for prescription strength motrin to help with the breakthru pain.
I hope to be able to post a picture on this blog to identify where most of *my* discomfort is. Don't know if it will be the same for everyone.
"stool softener"
Maybe TMI however a necessity to be taken daily from time in hospital to offset the constipation issues that occur with the use of narcotics and the result of lack of movement. I also have been cognizant of the fiber in my diet, and it just so happens that I love prunes!
I also forgot to mention that I was hypokalemic on my preadmission testing. That means not enough potassium which is imperative for heart muscle function. The lab norm is 3.5 on the low end but my cardiologist prefers a number closer to 4.0. I did take 20 mg supplemental potassium for 2 days before surgery as well as a banana a day for the week before. Level was 3.8 when I checked into the hospital but I am to eat a banana a day.
Slept well last night after several attempts at pillow placement. Actually took a picture this morning so we know how to set it up for tonight. Also called in to office for prescription strength motrin to help with the breakthru pain.
I hope to be able to post a picture on this blog to identify where most of *my* discomfort is. Don't know if it will be the same for everyone.
Wednesday, February 2, 2011
day 3 postop
I might have to have a clearer head to report on my hospital stay. Operation went well, lasted about 3 hours. They used propofol, versed and fentanyl ( with a zofran chaser for nausea) as my anesthesia. I don't think that I was intubated and came out of surgery a little loopey but awake, able to talk, no nausea and ready for a meal.
My surgery took place at Cooper University Hospital in Camden, NJ one of the locations of this multicenter study to seek FDA approval for this new device. I believe that it is meant to replace the traditonal device that requires its location under the left clavicle and has a lead that actually enters heart muscle.
So far there have been 175 cases completed, 320 are required for the study here to be complete. 65% are men, 35% are women so far. The regional biomedical engineer attends the surgery and met with me the next day for a portable EKG lying flat and seated to be used, I think, for my future followup visits, like as a baseline. I also had 2 chest xrays and will require more thru the next year.
Sutures will "dissolve" as they are internal. I have 3 incisions, top of breastbone, bottom of breastbone and on the left chest wall where the device is implanted. Pain is managed with morphine in the hospital with tylenol with codeine for breakthru pain. At home I am using hydrocodone ( as I don't take well to percocet) and motrin for breakthru pain. My biggest issue is sleeping well at night as I usually sleep on my left side and getting up from a totally lying down position.
If you are considering this surgery, please know that you will need assistance for at least the first week after your surgery. You will need someone to help you position yourself and move from sit to lying down and back again. Strong abdominals help, but your chest still "crunches" as you move and that causes the pain to escalate, albeit momentarily. The pain is a hot, searing type that occurs sharply and lasts if you are in the wrong position. For instance, on the night of surgery I attempted to reposition myself on my right side and nearly screamed out in pain. There is also the issue of the weight of the device and its lead that you experience the sensation of as you adjust yourself to gravity when you do sit. I know that the awareness of this sensation will decrease over time and suspect that this is one of the reasons that they tell you that you will be out of work, or temporarily disabled, for 8 weeks.
NURSING SUGGESTIONS: offer patient pillow for left arm to rest on while in bed or seated in chair; patient might be most comfortable in an elevated position with pillow longitudinally along the back (vertical) for support. Encourage patient to perform passive range of motion of left arm at some point in time. I started the next day. I also try to stretch the chest wall open while lying down. Still cannot lie flat today. And I have to remember to stand up straight.
There is no showering for 2 days after discharge, spongebathe and keep incisions dry.
Well, off for motrin administration and some sleep. Post more tomorrow. Expect reviews and suggestions for preop planning tomorrow or the next day.
My surgery took place at Cooper University Hospital in Camden, NJ one of the locations of this multicenter study to seek FDA approval for this new device. I believe that it is meant to replace the traditonal device that requires its location under the left clavicle and has a lead that actually enters heart muscle.
So far there have been 175 cases completed, 320 are required for the study here to be complete. 65% are men, 35% are women so far. The regional biomedical engineer attends the surgery and met with me the next day for a portable EKG lying flat and seated to be used, I think, for my future followup visits, like as a baseline. I also had 2 chest xrays and will require more thru the next year.
Sutures will "dissolve" as they are internal. I have 3 incisions, top of breastbone, bottom of breastbone and on the left chest wall where the device is implanted. Pain is managed with morphine in the hospital with tylenol with codeine for breakthru pain. At home I am using hydrocodone ( as I don't take well to percocet) and motrin for breakthru pain. My biggest issue is sleeping well at night as I usually sleep on my left side and getting up from a totally lying down position.
If you are considering this surgery, please know that you will need assistance for at least the first week after your surgery. You will need someone to help you position yourself and move from sit to lying down and back again. Strong abdominals help, but your chest still "crunches" as you move and that causes the pain to escalate, albeit momentarily. The pain is a hot, searing type that occurs sharply and lasts if you are in the wrong position. For instance, on the night of surgery I attempted to reposition myself on my right side and nearly screamed out in pain. There is also the issue of the weight of the device and its lead that you experience the sensation of as you adjust yourself to gravity when you do sit. I know that the awareness of this sensation will decrease over time and suspect that this is one of the reasons that they tell you that you will be out of work, or temporarily disabled, for 8 weeks.
NURSING SUGGESTIONS: offer patient pillow for left arm to rest on while in bed or seated in chair; patient might be most comfortable in an elevated position with pillow longitudinally along the back (vertical) for support. Encourage patient to perform passive range of motion of left arm at some point in time. I started the next day. I also try to stretch the chest wall open while lying down. Still cannot lie flat today. And I have to remember to stand up straight.
There is no showering for 2 days after discharge, spongebathe and keep incisions dry.
Well, off for motrin administration and some sleep. Post more tomorrow. Expect reviews and suggestions for preop planning tomorrow or the next day.
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