Sunday, October 7, 2018

My first night in the hospital after open heart surgery


I spent the first night after surgery in the ICU.  I was alert enough to stand about 10:30 p.m. and then went "right to bed."

In a hospital bed, on my back.

I didn't have any sleep medicine, because I hadn't anticipated that I would need any.

After being zonked out on medicines for most of the previous day one would think it would be quite easy to sleep.  But then I learned that being zonked out on medicine is not, physiologically, "sleeping."  Your body still needs the same amount of sleep.

Good luck with that, Dan!!!!

I had wires and tubes sticking out of me,  One tube in the wrist, one tube in the neck, and one tube in the you-know-what.  I had what seemed like dozens of little stickies going to this monitor or that monitor.  I had a monitor on one finger.

But the worst was that our dead cat, Jack, was back, haunting me, kneading my legs, every few seconds.



"Jack" was actually a device that applied pressure to my calves.  He wasn't really my dead cat (an animal I adored by the way) or Jack the Ripper.  I was only kidding.  This is the best photo we have of one:


It would inflate and deflate, and basically feel like Jack, who liked to knead my legs too, even though I always hated it when he did that.  I liked Jack.  But my artificial "Jack" was a nuisance I couldn't get rid of.  It was necessary because it prevented blood clots.  When Jack used to knead me I could just wiggle my leg and say "go away, Jack." (True confession time:  Sometimes I said other things).  But ghost Jack wouldn't go away.  I "kneaded" him (har har)

With my ghost Jack, it would inflate about every minute, on alternating legs, then deflate.  When ghost Jack deflated he made a small whooshing sound.  So not only was ghost Jack kneading me all night long, but he was whooshing when he did it.  Every....minute....all.....night.....long.

My throat hurt.  From the breathing tube that had only recently been removed.  Ordinarily I sleep on my stomach and sides, but the only position I had for sleeping in the ICU was on my back.  To turn over would have been impossible and wouldn't have been smart---I would have had to use my arms which would have put a strain on my incision.

And there were all those tubes and wires.

In order to move even a little bit onto my right or left side I had to call for help.  Two people would come, grab a sheet that was under me, count to three and then at the same time hoist me in the right direction, and put a pillow behind me to support me.  That was better than nothing and was appreciated.  Even in my drug-addled state I also could see how much physical strength it required from the nursing staff to do this.  They were each lifting about 80 pounds.  I wonder whether doing push-ups is a part of nursing training.   My admiration for hospital nursing grew during this whole experience, and it started off high to begin with.

The first time two of them were leaning over me one said to the other:  "on the count of three.  So I said "is it one, two, three and go or one, two, go on three, assuming the two young people doing it had even heard of Lethal Weapon.  They looked at me like I was in some kind of drug addled state.  

It was obvious that attempts were made to minimize the disruptions to my sleep.  And, in fact, the whole set-up was noticeably better than a hospital (different hospital) stay I had about 8 years ago, where I was for only one night.  That is even the more remarkable when I compare the two operations I had for the hospital stays.  The previous one was elective, and didn't involve anywhere near as much surgery in terms of time, "systems" affected, etc.  This one was an assault. 

But, as I have mentioned in other blog entries, only people who are alive get to have a crappy night's sleep.  I'll take my crappy night's sleep.

I was hooked up to several machines.  I was told that there is a person who sits somewhere doing nothing but looking at screens.  This person's attention to the monitors isn't erratic in the slightest because she/he does nothing else.  Looks at a monitor, looks at another monitor, looks another monitor, etc. etc.

That doesn't even include my night-time nursing staff who were also monitoring me.

And if that wasn't sufficient, the hospital also allowed Vicky to sleep in the same room as me.  Her accuracy rate of "problem" or "no problem" is not going to be as high as will be the accuracy rate of the professional staff there, but it is greater than zero.  One of the principles of psychological measurement is that if you have a psychological test where each item has only, say, 80% accuracy, if you have 4 items on this test you are not going to be as valid in detecting a problem as you would be with, say, 10 items.  In other words, even though Vicky's intuitions about whether I was experiencing something serious would not be as accurate as the judgments (based upon training and expertise) of the professional staff, her input would increase the overall validity of "Dan's in trouble."

Not only that, but her "inaccuracies" would likely be false positives.  In other words, she sees something on the monitors that she believes could be a problem when there really isn't one.

She would alert the nursing staff when she was worried about something.  They would respond immediately and check things out.  And each time told her that everything was OK.

In other words, and this is a crucial point for me, the hospital staff could have regarded her as a nuisance, or could have written her off as being just an "anxious spouse," etc., because her ability to add to the overall prediction of me being in serious distress wouldn't be as high as theirs is.  However, to see the big picture, that even with her inaccuracies she is adding to the overall validity of monitoring me requires a big picture understanding on the part of the people in charge.

The other thing that it does to have allowed her to be there through all of the nursing process is that got informal "training."  In a few days I would be released to come home.  There would be no nursing staff.  How do they make her into a more accurate observer and monitor of me?

A couple of times it appeared to Vicky that my oxygen levels were low and that my blood pressure had dropped, and she called the nursing staff who validated her observations.  They had already received an alert by that person who was monitoring patients, but machines can malfunction, even with all of the fail-safe mechanisms the hospital had.  Rare, I'm sure, but all machines can malfunction. 

So, how do they make her into a more accurate observer when I come home?  Answer:   By "training" her.  She received several "trials" comparing her thoughts to the thoughts of the professionals.   She is a more accurate monitor now than she was before the surgery.  She learned.

So, that first night I got a really, really crappy night's sleep.  And Vicky got virtually none--instead sitting by me and watching monitors.  I had no idea this was happening.  But the fact that when she saw that this is something she was allowed to do she did it.

I don't think a Target gift card is going to be enough to express my gratitude for her.  Buying her the entire Amazon river might get me closer.


Me the next morning, 24 hours after surgery, and after my awesome night's sleep:






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