Sternal Precautions
Every day during my stay in the hospital, I met with an occupational therapist. She drilled into me the precautions that I needed to take to protect the incision site (and bones, etc.). This became my focus for learning for the time I was in the office:
- Protect your sternum - Hug a pillow to your chest or cross your arms over your chest when you laugh, sneeze, or cough. (Side note - don't cough or sneeze unless you have no pain threshold....)
- Be careful when you get into or out of a chair or bed - Hug a pillow or cross your arms when you stand or sit. Do not twist as you move. Use only your legs to sit and stand. You will need help in and out of bed for a while.
- Ask when you may take a bath or shower - You may need to use a bath chair if you have trouble getting into or out of the tub. Do not use a grab bar. The shower chair is your friend for a few weeks.
- Do not lift or carry anything heavier than 5 pounds. 10 pounds is the combined limit with both hands but watch for the lever effect (don't hold heavier items out from your body).
- Keep your arms down as much as possible. Do not put your arms out to the side, behind you, or over your head. Do not let anyone pull your arms to help you move or dress. Do not reach for items.
- Do not push or pull anything. Examples include a car door or a vacuum cleaner.
- Do not drive while you are healing. Your surgeon will tell you when it is safe for you to start driving again.
The occupational therapist came by on day one with a tooth-brush, toothpaste, deodorant, and a wash-cloth. How great it was to start back to personal hygiene. Admittedly, I spat out my toothpaste a little too hard (causing a little collateral damage to my occupational therapist) and swooshed the mouthwash a little vociferously but it felt great the day after my surgery to get cleaned up!
Blood Pressure and Heart Rate
Mostly likely because of (or related to) the fact that I ain't got rhythm* (see my earlier blog post), my heart rate and blood pressure didn't quite get into the ranges that they would prefer. Rather than hold me in the hospital or mess around with my medication, they chose to discharge me. Still, my metrics are not in the perfect zone but we're slowly dialing in the meds to make it right.
INR Checks
Checking your blood's ability to coagulate probably sounds as enjoyable as it actually is. To be fair, I've been for a few INR checks and they have gone great (from everything being dialed in correctly, with a few changes to my dosage to keep things going in the right direction).
One thing I've seen with few nicks that I've had to my fingers during cooking etc has been that my current INR (around 3) definitely impacts my coagulation ability. It seems weird but a simple knife glance caused a cut that bled for quite some time (sorry if you are readying during dinner).
I'll continue to have regular INR checks but my mechanical valve allows for the INR readings of 1.8 to 2.1 (which is lower than many mechanical valves).
Click Click Click
Get ready to be grossed out (actually it's not that gross but I figure some warning about a passage about hearing someone's heart could be TMI). My heart valve is loud. There, I've said it. My wife and kids can hear my heart valve while they are watching the TV. I can't really hear it unless I take a large breath in deeply and open my mouth (weird huh??).
It's not like some audible reminder that my heart is beating is all that bad a thing, but I find it odd/funny/weird that people around me can hear my heart. I wonder when I go back into the office, if people will hear my heart asa they sit around me, or in conference rooms!! Perhaps that's my new party piece :)
Event Monitor Number 2
Ok so as you know, I passed out which caused an acceleration to the path to surgery. Well, if you pass out, and nobody knows what the cause is (even if we are all pretty sure that the issue is due to a congenital heart defect), they suggest that you cannot operate heavy machinery or drive a car until 6 months has passed. My cardiologist (who was the physician who said that I cannot drive after the passing out incident) said that given that we've had the surgery, he'll be happy to declare me fit for driving if we have another event monitor (this is the real-time heart telemetry being sent to a central monitoring facility that identifies anomaly in my heart's rhythm). He also wanted me to wait until I had my baseline echo-cardiogram (post surgery). So the next steps for me are to completed the event monitor (which I'm wearing now) in place until the echocardiogram can happen. I'm thinking that I can be driving by mid-February!
Back to Work!
Today is my last day of medical leave. Tomorrow I return to work after 7 weeks of being away. I'm feeling great about going back because I really trust that my team has been doing great things in my absence and when I get back, I'll be right back into the fun and games. Of course it's easier for me to go back to work when I can do it from home and doesn't require any physical lifting. I'm officially on "light duty" until mid-March and my wonderful employer have interpreted the as working from home.
* Obligatory reference to Phineas and Ferb can be sort of explained here:
Good luck, Steve, for your first day back at work.
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