Monday, August 16, 2010
Tuesday, August 10, 2010
Sunday, August 08, 2010
Thursday, August 05, 2010
My surgery went as scheduled on the 14th of last month, but lasted longer than most. My sternum posed a particular challenge to my surgeon, despite his being one of the most experienced in the country in this procedure. Due to it’s being twisted as described in my last post, it was necessary for him to break it in a couple places, as well as lift my upper abdominal muscles in addition to my pectorals to get it positioned where it should be. The good news is that it was successfully moved, but you can guess the bad news. The extra invasiveness of breaking the sternum and moving my abdominal muscles equal a harder, more painful recovery. I was told by my surgeon that my repair was one of the most difficult he's ever performed.
I was anticipating being back to work and feeling a lot better than this as of now, but I’m still at home until somewhere around the end of next week, if not the following Monday. Recovering has been a huge challenge and a new life experience.
When I came out of surgery, the first thing I remembered was being in the “recovery room”. I was no longer intibated. I remember trying to lift my head to look down at my chest and a nurse kept me from doing so, saying I’d be much better off to not be moving. She got me a mirror, and I remember seeing my chest through very fuzzy consciousness and it no longer had a severe excavatum case. Apparently I then smiled and fell back asleep due to the drugs.
I woke up later as they were moving me into my hospital room. A team of people got me off my surgical bed and into my recovery bed. I remember an incredible stiffness and a lot of pain in my chest, which they then got me on morphine to control. Alison and my mother in law Faye were there, and I don’t remember a lot else. The next few hours aren’t very clear to me, other than watching a machine that told me how often I could self-administer morphine doses to ease my pain.
Eventually, I had to pee very badly, as I was being injected with a saline type solution through my I.V. in addition to the morphine. I tried to go into a portable urinal, but I couldn’t. I asked my nurse to help me up, and that turned out terribly. She had “floated” up to this floor from where she normally worked as the hospital was busy, and I don’t think she understood just how unable I was to get out of bed due to having my abs and pecs both lifted and reattached. She pulled me up a bit abruptly, and once I was sitting up, I had so much pain in my chest that I had trouble breathing, started sweating profusely, and then I must have passed out, because I don’t remember her getting me to lay back down and that’s the next place I found myself, with a fan blowing on me and everyone looking very concerned. I didn’t try to get up for a while after that, and managed to pee in the bottle.
I was in the hospital for two and a half days, going home on Friday night. During my time there, I managed to learn how to get in and out of bed, and starting walking a bit before they’d let me go home. The physical therapy folks they had me work with told me I had to avoid using my pecs and abs altogether, and to get up and down I had to use my legs to first roll myself onto my side, then I’d hook them under my bed and use them, plus the muscles in my side to sit up. I’d do the opposite to get back into bed. If I did it all right the pain was bad, and if I did it wrong the pain was incredible. I spent quite a bit of time awake, not able to sleep due to pain, and the fact that every roommate they gave me seemed to be very loud. I don’t quite understand how it’s standard to order you to get some sleep and then put you next to the loud old guy with terrible sleep-apnea.
One good thing I can say is that the hospital food was actually decent, and so was my appetite. It felt great to get some sustenance and not just be filled with narcotics. I did have to get put on two different very potent laxatives with my drugs and food as I ended up looking pretty pregnant after it all, getting a heavy case of abdominal bloating. This went on for the first week and a half of recovery, and felt terrible, but I got over it.
Coming home was a good change of scenery, but a hard process. Before leaving, I had to have a drainage tube removed from my chest that was running from my chest cavity, right around the area the bar is located, to a little plastic container which looked like a grenade full of blood, attached to my hospital gown. I felt the entire length of tube pull from my insides, much like long piece of spaghetti snaking through my chest cavity. The doctor who pulled it asked me how I was feeling, and I replied, “that was one of the most disgusting feelings I’ve ever had”, but it was great to have it out, and at least that process didn’t hurt.
I was wheeled down to the hospital entrance with Alison, and my mom, who flew down to be with us in the hospital and at home for the first weekend, and had a very nervous car ride home. I’m still a bit uncomfortable riding in automobiles, as I feel every bump, corner, acceleration, and stop, and I’m constantly thinking how much pain my seatbelt and the airbag would cause me if we were to be in a fender bender.
While at home, I’ve spent most of my time watching movies, going through the LOST series all over again, reading, watching the Tour de France finish, Facebook’ing and trying to sleep. My other pastime has been pain management. For the most part, I’ve been able to stay ahead of the pain enough to tolerate it, but it’s gotten away from me a couple times. One particular night, I woke up with pain the right side of my back, around from my right pec. Upon getting up, it quickly spread around my side to my chest, and got very very intense. Alison helped me take pain medication, put me back in bed, and it got worse. Worse to the point I thought I was going to need an ambulance. I could barely move at all due to the pain, and had her call the hospital. They instructed us to get to the E.R., but I couldn’t get up. Alison massaged my muscles while the pain medication kicked in, and after an hour or so of this, I was able to get up and to our couch. Continued massage and deep breathing eventually worked out the pain. The doctors ended up thinking it was muscle cramping due to all the recovery pain I was having. I was too tense for too long, and this was how it played out. They prescribed me muscle relaxers, and since then I’ve been able to control the issue.
For rehabilitation I’ve also gone out, as instructed, for walks around my neighborhood, which have gone from one block to many now. I’m always exhausted when returning, and have to rest quite a while afterword. It’s been an awful change for me to have gone from my previous state of fitness to this, but it’s all part of a greater gain in the end. I have not felt any great improvement in lung capacity or cardiac output yet, because I have obviously not been in any condition to push myself. Plus, my chest has been somewhat fluid filled during healing, and very sore. My surgeon is very happy to have lifted my sternum off my heart though, and the expectation is that I will see a gain in those functions after I heal and return to strength. I recently spoke with someone I know who had a similar severe pectus case that was repaired, and he reported a 40% gain in heart expansion. It will take a while to see it yet for me, but I think I’ll see a great change. Now is the time for trust, hope, and healing. Later will be exercise.
As far as cosmetics go, I’m still quite lumpy, but greatly improved. I don’t know what I’ll look like after full recovery and muscle return. For now I still have a noticeable indentation in my upper right chest. I’m a bit confused as to the reason, as I’ve had two different answers when asking about it after surgery. I seem to remember being told right after the procedure that not all of my deformed cartilages were removed, as this would leave too little structure even with the surgical bar to support the chest during recovery. So that left me thinking it was remaining defect- that not all of it was correctable. However, I had my first follow up appointment this week, and my surgeon now described the indentation mostly as a result of muscle issues. Both right after my surgery, and at the follow up, he cited that my right pectoral muscle is currently around half the size of my left, due to it never having room to gain mass as a result of the severe excavatum deformity we just corrected. So even with the structure of my chest fixed, I will still look a bit off unless my right pec fills in with time and weight training therapy. It is right now unclear whether it will reverse to normal, or if it’s atrophy will be long term. I was told that during recovery my muscles will atrophy more, and I will look like I’m getting a repeat case of the “funnel chest” I’ve had, but that is muscle related, not skeletal. Glad they warned me of that or I’m sure I will have worried myself silly as it happens. So long term, I do not know what exactly my chest will look like. The main goal was heart improvement, and we seem to have achieved that, and cosmetically it’s been a great improvement that may get better with time. I’m looking forward to being able to exercise in the future and see what my body is capable of now that it’s been repaired.
I promised some before and after pictures so I’ve included some of the ones we’ve taken over the past month. As you can see, there has been quite an improvement. I have a long way to go yet to getting back to my regular life, but I still trust that this will be worth it in the end. You can see that in my appearance alone.
I’ll end with a big thank you to everyone who has helped me along this process- family, friends, coworkers, and particularly my wife. You have all been critical to keeping me physically, mentally, and spiritually together during such a painful time, and I thank you. Very much.
I trust you'll be able to decipher the before's and the after's. :)