26 Comments

1. Enscout:

Our eldest is a perfusionist. They are the folks that run the ‘pump’ that keeps the body going during the time the heart & lungs have been stopped for repairs.

He’s only been at it for about 5 years, but I gather that he’s very good at what he does (he has to be). The group that he works with has ‘pushed’ him into doing more ped’s than adults. He now does them almost exclusively – little premees & such. Clinically, the transition was never a problem for him.

Emotionally, however, he’s struggled. “When you work up an adult, everybody involved knows you are dealing with a sick or diseased body. The outcome, although sometimes in doubt, has certain expectations. Dealing with newborns is different emotionally. Families with high expectations about bringing a new life into the world are devastated”.

Jun 17, 2009 - 9:15 pm 2. programmer:

For what it’s worth, I have had two open heart surgeries and neither was as described above. Must have different doctors in Oklahoma. My memory of waking up after the first one, after the tube down my throat was taken out, was coughing out crap, and then the most wonderous thing in the world: Fresh, clean air to my brain, perhaps the first in a couple years (my heart valves had been failing for a while). I can not adequately describe the feeling. My doctor, somewhat sarcastic at best, remarked that he was looking forward to talking to me now that my brain was getting an adequate supply of oxygen. The second, a few years later, after I had somehow blown out the first valve (perhaps lifting really heavy weights wasn’t such a good idea), was much more challenging for the doctors, but I floated along in and out of unconciousness, and remember moments of great compassion and kindness by the staff. Again, different place, different people.

Jun 17, 2009 - 9:17 pm 3. john joseph jay:

programmer:

for what it is worth, i have very little quarrel with the surgeons and the surgical team. they were optimistic & upbeat, and i think they did a pretty good job.

as is probably readily apparent, i am not as enthusiastic about the care i received from hospital staff. i had some excellent nurses, but i also was treated to some pretty indifferent care, especially on the night shift. again, the issue was not so much pain, as how can that be avoided. it was that the nursing staff simply was not very attentive to issues of comfort, and the “skills” exhibited by nurses in what is called “transport,” e.g., in and out of bed, were simply bordering on ineptness in some cases.

physical therapists and transport people, rarely seen any more in hospitals out my way because of salary issues, know how to do it right. nurses, apparently, do not. the first nurse who put me in bed simply scooped my legs up, swung them into bed, as my upper body flopped against a partially raised bed.

oh, yes. it hurt. the day after surgery.

again, i have little to complain about regarding the cutters, they did a pretty good job from what i can tell. the hospital staff fell far short in some respects, …. , simply not enough skilled people to go around.

john jay

Jun 17, 2009 - 9:48 pm 4. Pascal:

Programmer. My late dad’s brother is due for a valve replacement in less than a month. After reading the main entry I was worried for him until you added your testimony. Thank you.

The “good” news is they are experimenting on him with a non open chest technique that enters through the groin. The old goat is so strong and persistent he was able to impress his surgeon and review panel that he was up to surviving the ordeal despite him being 90.

Jun 17, 2009 - 10:28 pm 5. bob:

Try this one on for size–
Pam Reynolds

Jun 18, 2009 - 1:41 am 6. Doug:

I recently read that everyone suffers some memory loss following open heart surgery.

Jun 18, 2009 - 2:17 am 7. programmer:

Doug, What were we talking about?

Jun 18, 2009 - 5:58 am 8. programmer:

Pascal,
A good support system helps. My wife, son, and daughter were with me both times almost around the clock. It would be naive to assume that did not make a difference in my care. When someone is loved and cared for, the karma spreads. Just my two cents.

Jun 18, 2009 - 6:00 am 9. programmer:

Pascal,
One more thought. I’m not sure what your belief system is, but please take no offense if I ask God to bless your uncle. Heart surgery, of any kind, open heart, laparoscopic, or other, is a traumatic experience for the body to deal with. Much depends on the quality of the surgeon and the care providers, but a good attitude helps greatly, and it sounds like your uncle has a good attitude. Once again, God bless him, and his family.

Jun 18, 2009 - 6:10 am 10. mwalls:

As someone who counts himself very fortunate (surgery to resection colon, found burst colon, and perforated intestines), programmer is right a good support system of friends & family is a huge help.

From you’re description, I’m guessing you were at Intergris (similar to my experience), my cutters were hero’s.

Jun 18, 2009 - 7:12 am 11. Doug:

Programmer:
I forgot.

Jun 18, 2009 - 8:34 am 12. Doug:

I have run into nothing but saints (with a single exception from the mainland) in the nursing corps.
Surgical Teams @ Straub Clinic in Honolulu are World Class.
-
mwalls:
What caused that disaster to happen?

Jun 18, 2009 - 8:41 am 13. mwalls:

diverticulosis, sigh…

Doc was there to cut out the damaged portion, damage was not as expected.

Jun 18, 2009 - 9:07 am 14. Mad Fiddler:

For decades we’ve seen Clinical psychologists and psychiatrists shown to be incompetent to judge or predict the behavior of convicted sociopaths – charming demons. Duke University for many years gave full academic credentials to a Department of Parapsychology.

Professional magicians such as James Randi, and the team Penn & Teller have very effectively criticized such academics as too eager to accept fraudulent tricks that any trained magician can duplicate. Randi and his associates have debunked a wide range of celebrated frauds, by infiltration and challenge.

Still, it’s always interesting to see the lengths skeptics go to debunk the phenomenon of “near-death experiences.” Most of the skeptics seem willing to make astounding assertions as to the workings of the brain, which are not by any stretch confirmable by present technology. Substituting pseudo-science for inexplicable testimony helps nothing.

Jun 18, 2009 - 9:22 am 15. Michael Tipton:

So after hallucinating, they took me back up to intensive care and put me in a strait jacket… I desperately tried to yell to them… but could not because those F**king drain tubes were blocking my breathing down to about 20% of normal…Finally a nurse came over so I told [whispered] to her that I knew she was not the enemy…

Jun 18, 2009 - 10:59 am 16. Kirk Parker:

“the most wonderous thing in the world: Fresh, clean air to my brain”

I have a friend who had a multiple bypass in his late 50’s. It was one of those where you go in for a checkup, the doctors says, “I think we need to do a bypass”, you pull out your daytimer to look at dates, and he says, “No, I mean this afternoon.”

So I visited him in the hospital the day after the surgery, and I was astonished by how much better he looked already.

Jun 18, 2009 - 11:44 am 17. Pascal:

Prayers greatly appreciated. Thank you again programmer.

Jun 18, 2009 - 1:41 pm 18. Marcus Aurelius:

While I have yet to experience anything quite like what is being described here I have twice gone under general.

The first time I was 10 or 11 years old and had my appendix removed. The anesthetist had to reinsert the IV and then usual schtick about counting back from 100, I can only remember I did not get too far. Then the next thing was coming back to. The biggest thing I remember about that was Jonestown — I remember having to stay inside for recess and reading the news mags about the recent disaster that was Jonestown.

About five or six years ago I underwent a wisdom tooth removal and being somewhat on the old side & have four teeth to get out I went to an oral surgeon and they put me under a general. Again same sorta deal, I had some music (somewhat ironically, the last song I recall hearing was “Lay A Garland” not really a song one may want to hear “Lay a garland on my hearse of the dismal yew…”) I brought in and and 100, 99, 98, 9….., then I came too and knowing it was over (what else would explain all the cr@p in my mouth) but it seeming so quick so I joked “When are we going to start”, needless to say I was unable to say that with the proper tone so as to convey my knowledge it was done. Oh well.

The distinct recollection I got was that there is a profound difference from sleep and general. Even when one is deep asleep one has a sense of time. When one awakes in the middle of the night one can get close to knowing what time it is, but one has none of that when under a general. It seem a blink to me when I last went under that general though my mother tells me it was more like 45 minutes.

I shudder when I hear those stories of things going awry under general and I’m not talking about death but the occasional story of the patient being paralyzed but not being rendered unconscious by the anesthetic. So, they feel what is happening to them but are completely powerless to stop it.

Jun 18, 2009 - 1:45 pm 19. presbypoet:

One of the members of the men’s group was in a horrible auto accident. He died.

He came to in the morgue just before they were going to embalm him. He tells a very interesting story of what he saw, who he saw, and what he was told.

My chief experience with pain is gall stones. That was enough. My father had several major heart surgeries. Still survives at 93. Since his first heart attack was when he was 17 years younger than I am now, clearly we are doing some things right with statin drugs. Major heart surgeries may be put off for years with the drug treatments.

Some amazing things. I had recurrent serious internal bleeding for 5 years. The surgeon wanted to explore, slice open the belly, and poke around to find the bleeding. With months long recovery. I was saved from slicing by a camera invented by Israelis. A “pill camera”, swallowed, that took thousands of pictures as it tumbled along my intestinal tract. They found an area of inflammation, said it was a thing called Crohn’s disease. Now take pills to reduce inflammation. Have not bled in 4 years.

So it may be our era of thousands of heart bypasses is just a phase, until we find a much better way, medication, or nano tech. Soon the “primitive” camera i swallowed, (they didn’t want it back), will be replaced with one with wings and a laser to cut whatever they find. A modern version of Asimov’s “Incredible Journey”

We live in interesting times.

Jun 18, 2009 - 2:29 pm 20. Doug:

They use “Versed” a lot for colonoscopies.
They call it “Concious Sedation” as it is an amnesia inducing agent.
Lots of stories and web pages about Marcus’ nightmare which was always my nightmare also.
My two experiences with Versed produced none of those problems.

Jun 18, 2009 - 4:18 pm 21. Marcus Aurelius:

PresbyPoet,

A variation on that story is the Japanese whose puffer fish is a little too toxic, but not toxic enough. They come back too on the embalming table or in the refrigerator.

Jun 18, 2009 - 4:39 pm 22. presbypoet:

Interesting question. Is it pain if you don’t remember it? So could we torture to question, then administer an agent so they would forget they were in pain.? Not that i am advocating torture, whatever that is.

Marcus,
Perhaps more would recover if they had waited to embalm. We still seem to have a shaky idea of what life is, and when it ends. Some survive when others die for no reason. Or is there now a rush for organs, so who cares if you cut a few corners? Or if you are the Chinese government.

Jun 18, 2009 - 5:42 pm 23. Herb:

I had 4X bypass about 7 years ago. Versed is a remarkable drug. It erases everything. Last I remember is blessing myself on the way in; the next thing is being upset with the nurses talking about the guy (?) in the next bed. I thought it was a gross violation of protocol. Kicked the end of the bed. They looked at me and said I needed 30 more minutes of the endotrachial tube. 20 Min later I was spitting it out and gagging. It took me 2 months to get rid of the bruises on my wrists from the restraints. You got any idea how much it takes to make 2.5IN velcro yield? Mine was popping. I got a hell of a gag reflex.

That was the worst part. Freaking brilliant surgeon. (First transplant in GA (BSEE from U of Mo Rolla Maybe better if it were BSME, But who cares) Good RN’s Good LPN’s, not an awful experience. But the pump head was awful. Took me 3 weeks to get where I could breathe and think right.

I think a lot of the people here are “in the zone”; go see a Doc who will look at the pump and the piping my pump’s fine the pipes are a problem.

Jun 18, 2009 - 5:43 pm 24. fred:

My 75 year old mother had emergency open heart surgery back on April 24th. She had a congenitally defective aortic valve – a bicuspid valve instead of the normal tricuspid valve. In the months and weeks before the surgery, she was fading and yet refused to do anything about it. Fought with my Dad, who wanted to get her to a doctor and hospital ASAP. Finally, she was having blood clots in her left leg and was collapsing on the floor. She had to go by ambulance to one hospital – a local one – in order for her kidneys to stabilize so she could tolerate cardiac catherization. Once this point was reached, they zipped her over to Catholic Medical Center in Manchester, NH, where they have excellent surgeons and program for cardiac surgery and care. We breathed a sigh of relief on the day of surgery, because the cardiac cath showed she had no blockages, which increased her odds from 50-50 to 70-30. She was very ill and would have been dead within days.

I just sent a thank you card to the surgeon and his team (he is himself a Canadian expat who left a hospital in Toronto to found the program at CMC and is very critical of socialized medicine). He wrote me back and said the thank you card made his day.

Mom was in, all totaled, both hospitals for over a month. She’s home now and recovering nicely. She gets visiting PT and OT care, along with some nursing. In fact, this past week both the surgeon and nurse discharged her. Dad still has to manage her and he’s in charge of her medications.

The shock of seeing one’s mother in the bloated condition after this surgery cannot be adequately expressed. A week later, she was coming out of the fog and was hallucinating and saying things that made no sense at all.

She says she remembers nothing from the time the ambulance got her into the ER at Exeter, NH hospital back on April 20th. She was under morphine a lot of the time. It’s amazing that for most of the better part of three weeks she remembers not one of us visiting her and being in her room.

Under socialized medicine she would not have been given this second chance at life. She would have been given the morphine drip and this past Mother’s Day would have been a very gloomy one for all of us.

Oh, and I forgot to add that right after surgery they could not bring her back. She had flatlined. A very large blood clot had traveled up from her leg and went into her heart. They were able to find it, had to open her up again, and got it out. They were then able to bring her back. I think about the timing of this. If this clot had moved before surgery she’d be dead. If it happened hours after surgery, she’d be dead. We were most fortunate. During that long day I often left the waiting room and my family to spend time in the chapel. Many Hail Mary’s, both in English and French. Irony of ironies, the hospital is only a few blocks away from the French neighborhood my wife’s dad grew up in (he died in Feb. ‘05). I thought of Ted a lot and asked him if he had any pull in the heavenly domains.

Jun 18, 2009 - 7:46 pm 25. john joseph jay:

friends:

first, my, shall i say, heartfelt thanks to richard fernandez for seeing something in my post, and printing and linking it.

i have gotten a good deal of traffic at my little shop, (whose circulation is nornally in the 10’s, laughing), so i appreciate very much what richard has done.

second, i have enjoyed this comment thread very, very much. i read at the experiences of others, and marvel, especially the next preceding post from fred, no. 24, and those other comments talking of the effects of pain killing drugs.

they are a mixed blessing, aren’t they?

my surgeons were good. my recovery proves this, i think. my nursing care was “sketchy,” to say the least. the hospital i was in utilizes “c.n.a.’s” to a very great extent, and they simply cannot match the skills of an older r.n. young nurses do not have the nursing skills of older hands, it is just that simply. nor are they as attentive.

but, i have enjoyed this thread tremendously, and i hope that it has been of some service. it has been to me, as i have taken to heart many of the things said in here.

Jun 19, 2009 - 10:13 am 26. cmblake6:

I can see this as a comparison to our current national existence. Having been dead 30 years ago, I can more than most see it.

Jun 20, 2009 - 8:10 pm

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