[vigsom]

Introduction

Folks, At the outset, I'd like to thank you all for your wishes for a successful surgery and a speedy recovery. These wishes came in continuously like a river in spate. I went through the surgery with not too many issues and am now on the uber-slow road to recovery.

This thread is part 2 of my already published story and will dwell on the fine and the painful parts of the procedure, and post procedure recovery. The intent here is to give in as much information as possible to all readers on what to expect should anyone (God forbid) go through this experience.

Statutory Warning

Please do not get perturbed at seeing my state in some images; I just want to present reality.

Acknowledgement

I am ever grateful to

1. the Almighty for bringing me back to base, guiding me to the right cardiologist, the immediate measures taken by him to stabilize my condition
2. my two relative Docs in Dahanu, and bhpian Sridhar-v who gave me the right direction given my first symptoms
3. a colleague in my organization for having provided me the reference of cardiologist Dr.B.G.Baliga in Jayanagar BLR. He and his son Dr. B.Vivek Baliga diagnosed my condition quickly, and ensured that I was despatched to hospital emergency in super quick time to the right hands
4. The surgeon Dr. Divakar Bhat and the Head Cardiology at the hospital, Dr. Venkatesh who convinced me (keeping my emotional state in mind) that surgery was the only sure shot option.
5. the team of nurses, other staff at the hospital that aided in first stabilizing my condition
6. the surgeon duo and the team at the OT for performing a flawless procedure
7. all nurses and staff who facilitated my good recovery in hospital
8. my family for being my pillar of strength
9. Dr.Nishit Udupi for giving me some excellent tips on post discharge care
10. bhpians (known and unknown), friends, and well wishers for their deluge of wishes
11. My schoolmate who is now an anaesthesiologist in Kerala, for helping me understand the purpose of each of the medications I was advised, and for all post op queries including my initial nauseating state

[vigsom]

Acknowledgement (Contd.)

Before I get on with the actual story, I'd like to highlight once again the power and emotions attached with team bhp, which actually helped me feel so good - that was one crucial factor that aided in my overall well being while I was entering recovery phase!

Post op, at the Surgical ICU at night, I sneaked a peek at the forum on a phone that was given to me for just 3 minutes, and the first thing I did was to check my thread that I'd penned down on my heart condition (without logging in). I was left speechless at what I saw - six pages of fellow bhpians' wishes and energising comments. Post that, after I left the hospital, I logged in to the forum and found many many PMs - the max I've received in two days in my seventeen years on the forum. Many of these PMs were from folks I've never met, but the instant affection and caring was evident from the way the PMs were worded. The six (now seven) pages of replies on the thread are open to all, but I'd like to highlight those that I've never met but sent me PMs

@GTO, @libranof1987, @aargee, @condor, @jeeva, @Sahil_Gurgaon, @raptor_diwan, @doc_zeus, @V.Narayan, @chinmaypillay, @dailydriver, @Tgo

@doc_zeus saw my case rather late and sent me a long PM a day after the procedure, on what to expect post op - extremely kind of you, Doc. Post his PM, and after my discharge, I reached out to him and he clearly advised me on what to monitor and how to exercise utmost care.

Additionally, mods and bhpians that I've been in touch with over whatapp (if I start mentioning names here, tbhp might hang ) - Thank You all ever so much! A few known folks in Bombay, Bengaluru, TN, almost all of the tbhp Gujarat group and many from other regions in India were all concerned and wishing me well!

[vigsom]

Continuing from where I left off

I broke off here last. Once I resigned myself to the fact that I'd have to go through CABG (Coronary Artery Bypass Graft) surgery, I was put through several tests - Doppler ultrasound from tip to toe. The CABG surgery required harvesting of blood vessels to create the bypass and from what I know, the test determines which blood vessels to harvest from where. A chest X-Ray was also taken along with some blood tests. I was not allowed to consume any food from 13 hours before scheduled surgery time.

D-Day

By nature, I'm a guy who dreads a prick even for blood sample collection. But all those pricks over the last two days (from admission to Emergency to Cardiac Care Unit to the ward) made me kind of immune. I was wheeled out of my room approx. 20 mins before surgery. It felt kind of weird being moved away from my family to the Recovery room (the parking place). As I moved from my ward room to the recovery room, ambient temperatures were gradually dropping, but surprisingly I wasn't tense. At the Recovery Room, one of the surgeons, Dr. Nishit Udupi met me, broke the ice, and spoke with me as though I was his long lost friend. He clearly explained to me the various steps from what would be done at the OT (what I'd see and what I wouldn't) to when I'd be shifted to the Surgical ICU. This first pep talk put me at more ease. I also said Hi to the Nepali nurse at the Recovery room and was kind of jovial.

After a few minutes I was shifted to the OT, and shifted from the roller bed to the chopping block! The team was all set. All this while, I felt zero tension as I'd probably resigned myself to CABG. The anesthesiologist told me that he'd administer a local anesthetic to my right wrist and would place a cannula into the radial artery. This cannula would provide them a means for continuous blood pressure monitoring during the surgery and later. The insertion of cannula was rather painful despite the anesthetic, but maybe I over imagined the pain and hence overreacted. As soon as the cannula was in place, Doc was a little rough with some trainees who weren't coming close to see what actually was being done. I told the doc, "Doctor, aap bahut bamboo dete hain" (you give your trainees a lot of stick) to which he replied, "Ek km door rehke dekhke kya seekhenge?" (These guys are seeing this from one km away. What will they learn?).Meanwhile, both the surgeons were there, and their team was all ready to go.

After a few minutes, I was asked to hold a mask with a long hose attached to it - this was General Anesthesia. Doc said," Place it on your nose and mouth and you'll feel a sweet smelling gas. After sometime, you'll go into a trance and you'd automatically let go of the mask". Taking a cue from some movies, I was looking at the branding on the circular light above the operating table, expecting to see it gradually blurring, but the next thing I sensed was I was being positioned somewhere. I gradually opened my eyes, to see a male nurse seated beside me. I held is hands with both my hands as if to thank him. The surgery was over (approx 3.5 hours on a beating heart) and I woke up in the surgical ICU.

I had three bypasses - left internal mammary artery to left anterior descending artery, saphenous vein graft to posterior descending artery and saphenous vein graft to obtuse marginal artery; all this after being extremely careful with my diet and exercise.

[vigsom]

D-Day (Contd.)

When I regained consciousness in the ICU, the blurred image of the male nurse Dhananjay came up which then became clearer. I was in pain, but surprisingly nowhere as severe as the pain I'd endured at Pune and BLR airports prior to my admission in hospital. I lay still, knowing that I had several tubes attached - a catheter to the urinary tract, a mediastinal tube to drain blood and fluid that collects around the heart and another pleural tube which drains the fluid or blood that could collect in the left side of chest. There was also this "neck line" - a long catheter inserted in the internal jugular vein.

Although I was in some pain, my connect with Dhananjay was instant; so nice to speak with him. When I asked him where he hailed from, I shared with him names of old and simple eating places in his town. The connect was established.He spent most of his time monitoring my vitals and had a task of getting by blood pressure up. On my part, I lightened the mood in the ICU, joking around with the staff, and the ICU felt like second home. Later, the night shift crew arrived, and I was handed over to the Shift - In - Charge Jalal, with whom I again connected instantly. They'd given me a trigger that I could use to administer more pain killer myself if I needed but I decided against it, as I just wanted to endure all endurable pain! Samples collected, one unit of blood added to my body, and some tablets too - none of this caused any discomfort. Jalal told me that no sleeping pills would be given that night. On my request, I was given a phone for 3 mins and that's when I was overwhelmed by reactions to my earlier thread on tbhp. I was anyways weak so must have dozed off at approx 9:30pm. When he'd realized that I'd dosed off at 9:30pm, he'd drawn the separator curtain just enough such that the light from one of the bulbs didn't hit my eyes direct but he could keep a watch on me. So so nice he was. Jalal woke me up at 2 am for some medication, and again at 5:30 am for some more samples.

[vigsom]

Day-2 in the surgical ICU

I was given a dry wipe down using wet towels at 05:30 am () and a new kavach (shield) was put on me. This is a sternum pad, meant to keep the sternum in place till the sternum cut heals. The moment the pad was on and velcros tightened, I felt some pain - that's because the pad was pressing against the dressing and the cut underneath hadn't healed. Well, this pain again was about as bad as the pain I was undergoing since the previous day. Jalal and his assistant Shawn (from Meghalaya) got me off the bed onto a sofa, and complimented me for being able to move. Meanwhile I got a spirometer (resembles a toy), and was asked to inhale and exhale. The barometer for success was to pull the yellow and red balls up and hold them in place for a few mins. When I started, it was tough, but I'd start doing trials every hour and by midday I was able to succeed. This is to help the lungs open up. Meanwhile, a physiotherapist came over at approx 9:30 am and made me do some hand and leg exercises, plus propped me up asking if I was game for a few steps within ICU. I said yes, and walked a few steps with someone holding my hand while another was holding the drain pots and the urine bag.

The day went by rather fast and I was given some food (the first day in ICU was all IV fluid that's all). Dhananjay was there in the day and Jalal was back in the night. I also met the head of ICU Ms.Shiny Joseph, whom I called the CEO, and another nurse Ms. Jyoti. I joked around as much as I could to lighten the proceedings.

Night of Day-2 was a little more difficult - chest was paining coz the sternum pad was in place, my neck was paining and so was my head; I didn't press the trigger that was given to me but some tablets helped me sleep reasonably well and wake up feeling better.

Day 3 in the surgical ICU

Same routine as Day-2 viz. early morning samples, wet wipe, off the bed onto the sofa, physiotherapy. Basis my progress with spirometry, and physiotherapy, I was cleared to move to the room by evening. So that was 52 hours in the ICU. Prior to moving out of the ICU, the tube connections were all removed, and the neck line, closed. Removal of the two tubes from the abdomen was a little painful, but holding breath made it a little better. Just before exiting the ICU, I went to the loo and got one smelly cork out. Phew! What relief that was. First bowel movement in 50+ hours.

Spirometer

[vigsom]

Day 3 - in the room

While the room was good, the experience was a mixed bag. They had to insert another cannula for IV fluid. Inserting the cannula was a painful process (again, maybe I overimagined the pain), and it used to feel like cold water being put through the veins whenever antibiotic was introduced. I was getting irritated but had no choice. My blood sugar was measured using a glucometer before every meal, and they'd shove some insulin in everytime. Wasn't required but I couldn't argue.

While on the bed, I was facing this pulsating feeling on the left side of my back. I initially thought it was the bed motor, but realised later that it could be the heart with the three new bypass grafts. Anyways, it wasn't troublesome.

Day 4 - in the room

Same experience as Day-3; I was able to get back to bowel movements on Day-4 except that the stuff would come out like a cork. However, the IV fluid transfusion was getting more painful, especially when multivitamins were introduced. I requested the docs to take me off IV which was done by midday. They removed the dressing and I was cleared for regular bath. However, I took it easy and only had a wet wipe on the chest.

Day 5 - in the room - being readied for discharge

Based on my progress, doctors cleared me for discharge. Got my insurance company to process the hospital bill. The approval took just 24 minutes, but only charges for the Angiogram and the CABG were cleared in full. We ended up clearing the balance by card, and were advised by the insurance company to file a claim for the remaining stuff. Not good, but I'd already spent seven days there, and was looking forward to moving out. I eventually left the hospital at 4pm, after an overall fantastic experience. I was driven in my own car, with me in the back seat.

Pre-discharge advice by the docs

1. Sternum pad to be on all the time except when resting for the night
2. If I want to cough, I must cross my arms on my chest (and the pad) before doing so to prevent load on the healing sternum
3. No lifting of weights, no bending
4. No riding a two wheeler, or driving a car, or travel until further advise
5. Walking allowed within limits without exertion
6. Keep the wound dry at all times
7. Expected recovery period 6-8 weeks

[vigsom]

Days 5,6,7,8,9 at home

Very bland meals, close monitoring for blood sugar and a whole lot of precautions have become part of my routine.

1. Keeping the sternum pad on always except when resting for the night. This gets a little painful at times
2. Taking a normal bath, but ensuring that the cuts aren't subjected to rough wipes. I'd dry with soft presses with a towel, monitoring the cut for healthiness; use a hair dryer on the cut for added drying
3. Nebulization twice a day - will feel like I'm smoking, although I've never smoked in life
4. Sit straight, doing something productive. I used the time to compute my income tax and file the returns
5. Listening to some fantastic soothing songs on my Sennheiser headphones. Some soothing/ energising tracks Chhahoon bhi, Dil ki hai tamanna from Force(2011), Dil to cute hai (Darbar 2020), Tu aake dekhle (Carnival by King), Vaan Engum ( Endrendrum Punnagai - Tamil), Naan Pogiren (Nanayam - Tamil) to name a few.

At BLR Airport six days prior to admission - no symptoms


At discharge


Battle scars - note the midline scar due to sternotomy


Recovering at home - sternum pad on

[vigsom]

The road ahead

It is going to be a long road ahead. For the next few weeks, I'll be going though 18 Cardiac Rehab sessions (physiotherapy). In my first company, where I spent over 20 years, we were trained like soldiers and to sport a never say die spirit. That spirit made me run like a race horse, challenge conventional thinking, and follow non-conventional problem solving. It now seems as though sudden brakes have been applied. While I won't rush back into the track quickly, I intend using this break to re-define my priorities, go places pending for a long time, and overall heal oneself before re-launch. The easiest thing for me is to brood over what has happened, but that's not the case. Maybe this is a new lease of life.

Thank You all once again for all your wishes; do hope to emerge stronger than ever before.

[Aditya]

Thread moved out from the Assembly Line. Thanks for sharing!

[dailydriver]

Welcome back.

It was a short hiatus, but nevertheless an anxiety filled one. Good to see you in good stead.

One of the perks of living in this age and being located in a health hub is the instant access to quality care. Although there was a delay in you visiting the doctor, you seem to have landed in the right place and hands.

Just as a good FNG is sine qua non for the tip top running of an ageing automobile, a competent and Friendly Neighbourhood Hospital is essential to keep us in shape, specially in our greying years. The master technicians at both these places will know our internals much better than we ourselves could ever be aware of.

On a flippant note (in a very serious thread), let me share a tangential piece of cliched humour.

In order to get to the valves, a mechanic carefully removed the engine parts from a car while the car owner - a surgeon - looked on.

Afterwards the mechanic said to the surgeon:

'You know, I reckon my line of work is every bit as difficult and skilled as yours.'

'Perhaps,' said the surgeon, 'But I'd like to see you do it while the engine is running!!!

* * *

Happy to see you recuperating; not to mention the return to the forum riding on the back of a typical and unique write up.

Wishing you aeons of healthy and adventurous living.

My I said so moment

TeamBhp stands with its brethren, come hail or high water!

[Shreyans_Jain]

Glad to have you back!

Yours is a classic example of how we south Asians are prone to heart disease, despite eating healthy and exercising. Do you have diabetes? Why did they give you insulin and monitor blood glucose before and after meals?

Praying for a quick and smooth recovery, and looking forward to more top notch train and bus reviews soon.

[Capri89]

Hey, glad you are back home post successful surgery.
You are in good hands, so, no worries there.

Keep up the good spirit and you are good to go for a long innings.

Best wishes for a super quick recovery.

[saket77]

So good to see you recovering sirji! The last few days have been troublesome but hope this is the new beginning of a new healthy life.

Thank you for sharing these informative posts with us, even when you may not be feeling too well. We all really appreciate the your connect. Recover soon and full.

Regards,
Saket

[kedar_GT]

Prayers for your speedy recovery - glad to know that you went through the ordeal and came out trumps.

Best wishes to you!

[Oppanna]

Happy to see you back sir. Wishing you speedy recovery.

My mother underwent open heart surgery at Kasturba Medical College hospital Manipal in 1990. I was 4 years old then. With your detailed explanation i could relate what my late mother would have undergone in the OT and post recovery.

Once again thank you for penning down and wishing you speedy recovery.