Happy days ! Loads of quiet sleep last night. I even slept through the coyotes yelling. Was awakened twice by Brittanys wanting to go outside, but John let them out. Breakfast (non-leather fried lightly egg and a sausage link), tomato/V8 juice, and then pills. We had bought a pill container allowing spaces for Morning, Noon and night for all meds for the week. It took us awhile to fill the box. Today for lunch we went to our neighbors, who ordered in Chinese as their oven/stove quit working. Yummy and a nice visit. I was so happy to be able to join their family again. Came home and slept hard for 2 hours !
Okay… after being on-line on my laptop again today, and calling some people by phone, I realized that many of you had not heard the entire story. Even those reading the blog would have missed on the beginning of this because John didn’t get it started till Dec. 4th.
So, here is a list of events starting in June that culminated in what happened. John will have to add and make corrections, but here you’ll have the whole story and not have to sort it out.
In June 2009 I went to the ER when my doctor in Cle Elum could not see me because the clinic was closed to participate in a funeral for one of their own. My Doc listened to my symptoms and told me to go in immediately and ask for all the doctors in ER to take my case. I was very run down and had red spots on my lower legs, indicating internal bleeding. They examined me, took an X-ray, and so on and the lead doctor decided to take blood for a culture. The lungs appeared to show “a bit of pneumonia” but nothing jumped out at them as to what was wrong. He admitted me to the hospital for further testing.
Two days later, the culture results indicated my bloodstream was full of bacteria – introduced, we suspect, in a late April dental cleaning. The “a bit of pneumonia” was fluid leaking into my lung from damaged cells. When infecting the heart this is called endocarditis. The bacteria grew on the valves of my heart — the mitral valve was the worst, and I had known for years I had a heart murmur and was advised early to take a high dose of antibiotics before any teeth cleaning or anything that opened my blood to potential infection. I had done that in April, but apparently I was run down and the antibiotic did not protect me.
I was very ill and had much fluid build-up which, along with my heart issues, made me have difficulty breathing. These symptoms were treated. I received a non-targeted or general antibiotic while cultures were done to determine the exact nature of the bacteria. There were four – all treatable with Rocephin – and as by then I was no longer in imminent danger of dying I could leave the hospital. I had to go in as an outpatient for 28 days for infusions of Rocephin that lasted ½ hr. This was done via a tube or PICC line from my elbow to just above my heart. That solved the bacterial infection.
Afterwards, I visited both an internal infection specialist and a cardiologist in Yakima. Visits continued till it was determined I had made enough progress to teach in the fall. Our classes begin in late September. I managed until the morning of the day following Thanksgiving – I woke at 3 A.M. with chest pains. First time, so I told John I was having a heart attack. We dressed fast and he drove me to ER in Ellensburg. They took me in and called an ambulance, sending me off to Yakima Regional Hospital. Once there I had my first operation (for which I was awake), to watch them search for a blood clot that lodged in an artery across and leading to the front of my heart. This was accomplished in the cardiac catheterization room where a long thin tube, called a catheter, was threaded into a blood vessel and then guided to and dislodged the blockage.
That was Friday about 6 A.M. I seemed to be fine on Friday but by noon on Saturday all my systems were shutting down. By late afternoon I was taken to the intensive care unit and I was put on life support. Tubes and wires and things I didn’t know about. It looked like I was dying. 6 days completely sedated. Two more of partial sedation – still with breathing and feeding tubes—but I was aware of my surroundings. The exact reason for my cardiopulmonary collapse remains a mystery.
At some point they found I was deathly “allergic” to Heparin, the major blood thinner used for all operations and even to flush PICC lines. An initial test for this came back negative – it was suspected in the shutdown – then later, a second test showed the very serious reaction. [This reaction is called Heparin-induced thrombocytopenia (HIT) and I discussed it earlier. JFH]
I started to improve and was moved to a different floor. Then my heart missed a few beats and I was back in the ICU, picking up a temporary pacemaker on the way. There were a couple of days of watchful waiting and plans to insert a regular pacemaker but my blood clotting ability wasn’t cooperating. While the wait went on I wasn’t eating well and started to deteriorate again (or more).
The death spiral was halted by inserting an intra-aortic balloon pump (IABP) to assist my heart pumping functions. [This too, I covered earlier. JFH] The IABP resulted, just a few hours later, in my general improvement. This was the expected result and it also indicated a good result from a mitral valve replacement. First I would have to live through an open heart operation – that probability was not real high. I was in intensive care with 24 hr supervision as they worked to improve my health. It wasn’t happening.
John and I and the doctors talked. This is the definition of between a rock and a hard place. I would die without the operation. I might die during it. Take your pick! John sat at home with the dogs and they took me from the ICU at 9 A.M. on Tuesday, 12/29/2009. The heart surgeon’s nurse called John at 3:30 to say she left the operation as they were closing my chest back up, that I was alive, and doing well.
The actual procedures – two by-passes and one valve replacement – normally take this team about 3 ½ hours. Because of being on a non-standard blood thinner the operation was extended another 4 hours – 3 hours with an open chest to visually monitor how I was doing, another after initial closing to watch the equipment that was watching me. I spent 2 ½ days sedated and intubated and closely watched. John spent one day away as I was aware and wanted to communicate and the nurse wanted me as quiet and still as I could be.
I was in intensive care until I left Jan 20th for a rehabilitation facility in Ellensburg. Had there been a room available in the care unit called “advanced care” I could have been moved. That floor remained full and none were sicker than me so I stayed put. That changed on January 18th and I was booted upstairs with little warning. I stayed for two days in that room. Then I came to Ellensburg.
I had to be in a skilled care facility. I lost much muscle mass and could not get up from bed on my own, nor walk once up. So, my leaving the facility hinged on my being able to get out of bed on my own, get to the potty on my own, and walking with the aid of a walker. I had physical therapy 3 hours each day. Even my tongue had lost muscle and I had trouble swallowing, food and pills. Some say that for each day of being down a 2 to 3 day recovery is required. I’m not there yet but I progressed enough to make it home. The great day arrived for my departure (as you heard in Saturday’s blog), and now I’m home and getting better each day. I will go back to outpatient physical therapy 3 times/week at the rehab center.
Thanks for caring and asking.
Nancy