Lucky in Oz

Nona Update

Mom is doing really well. She spent that one night in ICU, as per protocol. Then she went into a high dependency cardio-thoracic unit. She was there two nights, not because she’s highly-dependent, but due to the fact that the ward was full to capacity so there wasn't a private room to which to move her ... until today. So, now she is in the room where she'll stay until discharged which will happen Sunday or Monday. (It is Thursday afternoon now.) The drain tubes, pacing wires, IV, etc. etc. have all been removed and she's no longer on any morphine. Yesterday she started getting up out of bed to go potty and today she’s started doing exercises the physio assigned and walking laps round the ward. Tomorrow he wants her to try the stairs. Everyone is pleased – her cardiologist, the surgeon, the physiotherapists and she herself. She is meeting all the targets at the best-case-scenario end of the spectrum ... which is great ... but I keep reminding her that she must not push herself (you know how she is, if you know her, that is); there is no prize – no sauté pan or set of high-threadcount sheets – for doing more / better / faster. Anyway. I digress. Once she is discharged, I’ll be bringing her back for the cardiac rehab program. They’re “fast-tracking” her so she can get through the exercise instructions and lectures in 3-4 weeks and get home. (They put her in the “under-60s” class – so even in rehab she’s an overachiever.) Here’s the photojournalistic chronicle (except that photojournalists don’t take pictures with their phones. Ahem. Yeah, sorry for the crappy photo quality.)

  Before surgery, in the CCU, with a glass of wine. We love Aussie hospitals!

  Hospital wine list.

  With her little side-kick, who was mostly interested in glove balloons, TV and Nona’s chocolate mousse.

  In the ICU after surgery. (Must have been 6 or so hours after surgery because the breathing tube is removed.)

  Scar face chest.

  Scar face arm. (They took an artery from there).

  Two days after surgery and looking good ... except for the IV line in her neck is freaky. (Frankenjane.)

  Three days after surgery and all the extra parts have been removed. 

Make it a Double (Nona's Bypass)

They told me the surgery would be about three hours. I went in early this morning to take all her stuff from her room in the CCU, give her a kiss and walk with her gurney to the elevator. The surgery was scheduled for 8 AM. I got back to the hospital at 11 AM and my phone rang while I was in the elevator – it was the surgeon calling (after exactly three hours) to tell me it went fine. The anaesthesiologist met me in the ICU waiting room to tell me there was "no drama" and that her heart muscle was functioning better already with the grafts in place. (Hmmm ... now I realize I’m not sure if it was a double or triple, actually; one artery from her arm was grafted bypassing her right coronary artery and a mammary artery was grafted in two places bypassing two sections in her left anterior descending artery (the “Y” I described in the earlier note) – so I’m not sure if it is technically a double bypass since two arteries were involved (the RCA and the LAD) or a triple since there are three grafts . Here’s a good visual aide, BTW. I like this picture because it looks like the model her surgeon (much more handsome than in that photo) showed us. Anyway, tomato, tomahto at this point. The upshot is that all the new plumbing is in place and working.) After about an hour in the ICU she started waking up (they kept her sedated on purpose while her body was warming back up to normal temp). She was still intubated but alert enough to wink at me ... she kept on winking but I told her to relax and wait until she could talk since we hadn’t worked out a winking code ahead of time and I had no idea what she was trying to communicate. The ICU specialist, the anaesthesiologist and her surgeon all checked in with me and assured me she was doing well. All visitors are kicked out of the ICU for a couple hours in the afternoon so I went and wandered around and made my daily visit to patient services (we’re pre-paying for all her procedures and care in chunks – her US Airways / United Healthcare overseas insurance, BUPA, and the travel insurance company are actually both claiming to be primary ... so we’re just paying with her credit cards (think of all those miles!) until they figure it out for once and for all and then we’ll start submitting claims). When I got back to ICU at 4 PM they had taken the tube out of her windpipe and she was alert and talking. She said that she felt better than she had expected she would. (She’s still on a bit of morphine, so we’ll see what she says tomorrow.) As per the protocol for coronary bypass patients, she spend the night in the ICU then assuming all is still well, will be transferred out to a regular ward in the morning.

Thanks all for your thoughts and prayers. It is a relief to have it over with! Despite my joking about “medical tourism” it was so totally NOT elective surgery. Every once in a while over the past week I’d show up at her bedside to find her on a nitroglycerin drip or on oxygen and would be reminded that her condition was serious. With that RCA totally blocked and two branches off the LAD pretty compromised they were nervous about any and all chest / arm pains and it was nerve-wracking. So, PHEW! Glad that’s over!  I think I’ll have a glass of Shiraz myself tonight!

Medical Tourism

A friend wished stress-free holidays for us ... apparently my house guest's heart did not get that memo. Indeed, I took Lucky Mom to the ER Monday; she had been awake off and on Sunday night (thinking she ate too much at our holiday BBQ) and felt blah all day. We got to the ER around 5:30 PM and blood work confirmed that she had had a heart attack. She had an angiogram the next morning and has two lesions; her right coronary artery is completely blocked and the other lesion is in her left anterior descending artery – limiting flow to the two vessels that branch off of it. (I am not certain of all of the terminology – but I have her angiogram on a disk ... I could upload it to uTube for the medically curious. Kidding. Mostly.) Angioplasty (stents) is an option, but the fact that that one lesion is at a “Y” complicates things. After a few conversations with her cardiologist and a surgeon (including visual aides – diagrams and a 3D model of the heart) it looks like she is going to have bypass surgery. I picked the ER (Cabrini Private Hospital) to which to take her sort of randomly – it is close and I thought we wouldn’t have as long a wait at a private hospital. But apparently it was a lucky pick since it is a level 4 ICU / CCU (Coronary Care Unit). The surgeon is a cardiothoracic & transport surgeon at The Alfred, a major public trauma / teaching hospital and also has privileges at Cabrini. So, she's in great hands. And! She gets effectively a 30% discount on what would be a cheaper rate than the states anyway! Not to sound glib, but to see her sitting in her hospital bed, chatting and sipping Shiraz ... it's as if she is one of those medical tourists. (Yes. Shiraz. Red wine is on the menu for patients.) So. She'll probably have the surgery on Monday, be in the hospital for another 6-8 days, then come home with me to rest here for another 3 weeks or so before heading back to Boston. She bought trip insurance, so between that and her regular benefit plan, which has overseas coverage through BUPA, she covered for the medical and transport. Apologies in advance for (1) late holiday cards and (2) duplicates (triplicates) of this message in your email inbox and on my Facebook page. I’m covering all my communications bases.