* “Refers to the TV series ‘Dragnet’, where Jack Webb played Sergeant Joe Friday (Badge No. 714).” Each story began “My name is Joe Friday, I’m a cop — Yeah, there are a thousand stories in the naked city and this is just one of them.”
Nancy’s Impressions of the Defibrillator Implant Day, June 1
John has commissioned me to write my impressions of the recent procedure to implant the defibrillator, because he has no idea what to put on the blog. I will try with apologies to the few friends I have already bombarded with emails or phone calls after the procedure. I’m afraid this will be longer than John usually likes to print on the blog, but it contains my feelings of the experience, and that’s what he wanted to report.
June 1st actually started at midnight without being able to have anything but water except to take my pills in the morning, before taking off for an 8:30 a.m. entry to ER (what they had set up). Knowing I would not be allowed to drive myself home, and worried about John spending so much time away from the Brittany mom and a few-days-old puppies, I asked R to drive down with me, get me settled and to drive my car back home and then come back for me the next afternoon to transport me home. We took off from her house about 7:20 a.m. and had nothing out of the ordinary happen till we got to the 16th street exit. Coming off the freeway ramp, I stopped and looked to the left (used to be a stop sign there, but now is a yield and the traffic to the left has to stop). A guy behind me went into road rage and honked loudly and crowded me. We got through that, and were coming down 16th Avenue in Yakima headed for Tieton Drive and the hospital, Yakima Memorial. There was an accident we managed to drive around. Had we been in the opposite lane headed north, we would not have made it through in a timely fashion. Turns out I found out in the operating room that the X-ray technician’s wife was the car hit in the accident, by a woman who pulled out and didn’t see her, smashing into the front of the car. The husband was not too far away, so got there to take their daughter from the back seat carrier and take her to day care. He also checked to see that his wife was all right.
We got to the hospital and found a parking space close to the entrance. Made our way to the ER (not ambulance) entrance and were promptly told to go to the person two spots to the right, that I really wasn’t being admitted to ER. They had my name and were expecting me for the procedure. Then we were ushered to a small room and computer operator, to the right of there. R came in with me. The “operator” could not get her computer to boot to find me in the system and start the paperwork. After giving my medical insurance cards, I asked if I could find a restroom close by, while they got the computer going. Yes, directions were given, and I took off without any of my stuff, to the restroom, around the counter. I walked by a “cop” who stopped me and wanted to know where I was going. I said, “To the restroom there, please.” He okayed my going but told me to check back in with him when done. So, I did, and walked back to the “computer entry room.” I think by then a woman from the room behind had come out and “fixed” this computer.
It still took awhile, but they said I would be carried (in a wheel chair) directly to the Catheterization Lab. R went along with me to a little room where I dumped all my stuff on a table, hugged her good bye, thanked her, and she wished me the best. I was introduced to Anne, my nurse for the next hour or so for a huge list of questions about my past medical history and my medications. First, I had to strip and put on a night gown and sock slippers. Packed all my stuff in a bag they gave me. As she was questioning me, she put heated blankets on me and kept pulling them over my arms if I became uncovered. That was toasty, as the room was cold (but not as cold as the operating room would turn out to be, and where I was no longer pampered with a heated blanket or anything soft.)
Questions–all about my medications, which I had been told to take with me, but that was erroneous information. They had to issue the pills from the hospital pharmacy and I could not take anything I was told to bring along. There was nothing to be taken until later in the day after the procedure. So, she went through the list of my medications (which she had in the records), asking me what time I last took each one. The names were not always the same; I had to recognize that Lasix in my case was Bumex, or Bumatanide. That interrogation lasted awhile, and while she was doing it, an assistant from the Blood Lab tried to install an IV in my left arm. She failed and created a hematoma on the crease in my elbow. Just as well, because I hate having IVs there. I had to warn them not to flush with Heparin because of my previous severe reaction to it, and it would kill me. Finally after several painful pokes, she left and they sought another person to insert an IV. I was beginning to be concerned, but happily the second lady found a place on my hand to set it up and it remained that way till removed the next day when I was to check out. As far as I know it was never used, except during the surgery. The last thing to be done in this session was for Anne to set up a VCR 20-minute story about what to expect in the procedure I was about to have and the recovery period and restrictions afterward. My blood pressure and heart rate were taken. I watched the movie and then was resting waiting for the time to come to be taken across the hall.
I had left the entrance area at 8:30 on the dot, and my procedure was scheduled for 10:30. There were still questions from the manufacturer’s representative, E, of my defibrillator, in my room after 10:30. He asked me if I knew the name of it. I told him Biotronik, a defibrillator with a pacemaker included, but I didn’t remember the model number. One would think they would have had that information. He went away and came back again asking me if I already had a pacemaker implanted. I told him I did not but had had one back in December, but it was only in temporarily and removed before my valve replacement. He said, “Oh, that makes sense now. The paperwork said you had a pacemaker.” I began to be annoyed that he had bad information, and he said it was apparently a clerical error. Those are not good, and it didn’t make me feel comfortable. He said all was well now and they were on the right track. Well, hello! Not much longer and they would walk me into the operating room. I asked if I could go potty first so had a long walk to the restroom with the aid of a nurse, but when I was done, she was not around, so I walked back to the door of the operating room.
They ushered me in and gave me a stool to boost myself up on a table, very thin, the size and shape of an ironing board, without any padding whatsoever. It was too narrow to put my arms beside my body. So they got some extensions and put them in for my arms. COLD.–everything was very cold. I needed a pillow under my head, which nurse Judy provided, but mentioned it would not be able to stay there through the entire procedure. Then they started putting various patches and things on me. The coldest was a bright shiny metal looking thing but they claimed it was not metal, on my right leg attached above my knee. I asked what it was for and they said it was a ground. Hmmmm… interesting. They needed me to turn my head to the right but were covering me up with a drape so I wouldn’t be able to see the doctor nor the monitors, which I was watching my blood pressure and heart beat and pattern on, prior to being blocked. I was not under sedation except for pain, so they could talk to me and I could talk to them through the procedure. I was not supposed to remember all that happened, but I do, except for the 3 minutes or so when they had all the stuff installed and had to set off the shocking mechanism of the defibrillator to correct an arrhythmic condition they set up. I wonder how they did that. After the operation was done, I was walked back across the hall to my room where I had been earlier. The nurse changed from Anne to Judy, to whom I had been introduced earlier, and who was with me throughout the procedure.
Once back in the room (some time after NOON), so it was only about a 45-minute procedure, I was allowed to take my cell phone to my right ear (cannot use on the left side where the device is), to call John. I told him I was all right, and asked nurse J to verify as she had been there the whole time as well. She spoke to him for a minute and handed the phone back to me. Then they brought me lunch. That was a welcome sight. There was white bean soup, pretty good, and a casserole mostly noodles with chicken flavor, but I only ate a small amount of that, and carrots. I requested a chocolate milk shake. That eventually made it to me, but the nurse told me it required an act of congress. There was a black coffee that I did not drink. I don’t remember getting any water until I was in my hospital room.
A room upstairs in the telemetry area did not open till 4:00 p.m. for me to be moved. They rolled me up there in my bed with all my belongings piled on top of my legs (another narrow bed). I was able to get up and get into my new bed, and requested a pillow for beneath my left arm and removed the sling that was VERY uncomfortable. I was introduced to my private room, with a shared bath, and told it was like a bed & breakfast. Yeah, right. Well, as it turned out the gentleman next door never used the bathroom. He must have been on a catheter and they just used it to pour down the toilet from the catcher container. I know all about that from ICU for so long. It was nice to be able to go on my own when I wanted.
Dinner was served at 6:00 p.m. and it was quite good. The nursing assistant cut up the meat for me, and it surprised me how tasty it was. She cut off the fat as well. It was flank steak cooked tender in a gravy, and there were little potatoes that still had skins and were good too. Coffee again, which I traded for hot cocoa. Dessert was a tapioca pudding… that was actually edible, so I ate it – minus a gob of white fluffy stuff and an embedded rose petal.
There were frequent visits taking my blood pressure and temperature, even though I was hooked to the outside desk in front of the nurses, with 6 pieces of information being telemetered to them–that’s what the telemetry floor means. I carried the unit in the pocket of a new gown I was transferred into once I got to this room. I think this “floor” is basically an Intensive Care Unit (ICU). I was on 2 South in room 265, where there are but 7 beds in the unit. The other unit has 20 beds, and I do not know its location in the hospital.
My cardiologist, Dr. K, stuck his head in the door and surprised me. I said, “Oh, Dr. K, I didn’t expect you! He said (always addresses me this way), “Professor, I saw your name on the board and thought I would visit you.” What a cool guy. He said he was happy to hear the procedure went well, but when he heard my concerns about the strictness of the recovery actions for up to 8 weeks, he said that sounded a little extreme to him. He wondered if perhaps they had had trouble with the operation. I told him I would ask that in the morning of the Dr. or his physician’s assistant who was supposed to meet with me before checkout. I also told him that I was awake during the operation and heard nothing out of the ordinary, and that it seemed to go well, as I had been told that once done. I thanked him for his visit.
Next visitors really were a surprise– two married students from my past. We had a nice visit. They are geography graduates from CWU and now live in Yakima and have jobs there. They had read about the planned procedure on this blog.
The rest of my evening and night was largely interrupted by taking my vitals, even though I was wired into the telemetry board.
The most disturbing thing to me was that the room across the hall in full view and within earshot was in “isolation.” This did not make me comfortable to watch everyone who entered don a gown and gloves and head piece. I assume the patient had Mersa (MRSA or Methicillin-resistant Staphylococcus aureus, a type of bacteria that can cause skin infections), which I had been tested for earlier. I don’t know how long the test takes before they have to isolate a person. She was in obvious distress as well. I’m happy that for whatever reason, very late at night, they moved her completely up a floor. That experience was a bit unnerving.
I started having the pain killer from the operation wear off after 4:00 and my first pain killer given at 4:30, a dose of Tylenol with Codeine. They could only give it every 3 hours. I was complaining still of pain 2.5 hours into the first pill. This kept on all night, but the pain never ceased. They did give me an ice pack, but finally I requested more of a pain pill in the morning, and they provided (not until noon) a Vicodin. I think that should have been taken care of sooner in my aftermath of the procedure.
I did have two more visitors (friends) during the morning hours, and visits from a cardiologist (not my own), and G, a physician’s assistant to Dr. F, my surgeon for the procedure. I did not get to talk to him, but she had reviewed my case and said everything went according to plans. Nothing was out of the ordinary.
They needed my room for another person coming in from ER, so I was to be ushered out before noon, if possible. It was not possible, because I had to wait for my “ride” home. I had also ordered lunch, and it was brought a little sooner than normal. I asked them to fix it up “to go” and I would eat it at home. It was chicken stir fry with veggies and rice. There was also strawberry cheesecake which my friend B ate, and the fruit had watermelon in it, which I detest, so we left that behind. I still needed to get dressed, but needed to wait for R to get there and bring a different blouse from what I arrived in, because I figured it would be too tight for my left arm that cannot be lifted above my head. All this occurred in good time, and we must have pulled out of the parking lot at 12:30. They had to be sure I didn’t drive away, and so Nurse L, pushed me in a wheel chair there, and waited for R to retrieve the car, and watched me enter the passenger seat . B was there too, carrying the flowers and my stuff. What would one do without friends?
So, off to Ellensburg, and home. I’ll stop there. Well, not quite yet.
I’m unhappy about the recovery time and limitations. I cannot lift my left arm above my shoulder nor lift more than a coffee cup (one person said); another place on my release paperwork, says not more than 5 lbs. for 6 to 8 weeks–and NO driving. That’s really going to cramp the style I’ve gotten used to over the past couple of months. Cannot play my fiddle in the normal way– unable to keep it from over the incision.
I am going back for a device check at the Yakima Heart Center on Tuesday morning this week at 11:30, and R is going to be kind enough to drive me down again. We can also pick up the device transmitter once there and ask more questions about playing the violin and driving. Or, maybe I won’t ask, just figure how to cushion the area.
The bottom line is that I do have a new lease on life with the defibrillator installed. So the story goes on. [Next installment – Tuesday, the 8th.]
Nancy, thanking you for all your thoughts and prayers in my behalf.