This is Part 8 of my notes about my recent open heart surgery. To read what has come before use these links: Part 1 – Part 2 – Part 3 – Part 4 – Part 5 – Part 6 – Part 7
I had my Quadruple Bypass Open Heart Surgery on a Thursday Morning. Four days later, on Monday, the doctors were ready to discharge me from the hospital. However, they had one condition. I would need assistance 24/7 for the first week. I live with my wife and son, but my wife works full-time and my son attends college. So the requirement for constant assistance was a deal breaker.
I have Charcot Marie Tooth (CMT) disease. Before the surgery my mobility was greatly diminished and I was a fall hazard. CMT affects the extremities, particularly the ankles and feet. I wear ankle foot orthotics inside of my shoes for support. Without them, my stability and stamina, particularly with my legs and feet, is very limited.
After open heart surgery they have you use a walker for the first few weeks. Having CMT adds to the need to use a walker. But the real kicker is they took a large vein from my left leg to use for the bypass. They tunneled three arteries to see which was the best, then they took the one they wanted laparoscopically. The vein they took runs from just above the ankle up the back of my leg into the bottom half of the thigh. This creates a bit of trauma to the leg. And in my case it upset my CMT.
That left me in a special category where a longer healing process would be needed. Thankfully the solution was straightforward. I was transferred bed to bed to another hospital 18 miles away for inpatient rehabilitation. Beyond having 24/7 assistance I would receive intensive training showing me how to do everyday activities like using the bathroom, showering, climbing stairs, and getting in and out of bed.
All of the activities above seem pretty easy and normal until you are introduced to “the tube.” Take both hands and hold them to your chest making kind of an X with your arms. Now imagine someone with a whole roll of packing tape going around and around your torso mummifying your arms in place. You are now in the tube! Now, let’s do the things you do while remaining in the tube.
For an example, the nurse showing me the tube said to get into and out of bed, in the tube. Without a lot of help from the arms. I said, “that won’t work.” She said “yes it will.” And I proceeded to learn how to get in and out of bed without using my arms much. It did work. But it took practice and strengthening. It was mostly method and a lot of confidence. And that was the key to the value of inpatient rehabilitation. Education and hands on learning.
Their rehab gyms had furniture in them from daily life. There were beds and bathroom setups. There were different shower types and toilet setups. And there was my favorite – the sofa that was really low to the ground. That took practice and exercise to build the strength necessary to get up and down from that sofa without causing harm to the incission on my chest.
Their rehab gyms also had model kitchens, laundry areas, a car, and even a full size metro car (subway train) to practice all the activities you could encounter during the course of the day. They introduced me to grabbers (mechanical devices you could use to pick things up off the floor), they showed me add-on tub rails and toilet rails, they taught me so many common sense practices that would keep me safe and in one piece – and most of all upright, without falling.
The best thing they gave me was confidence. By practicing and continuous exercise during the week they let me experience doing things I didn’t think I could do. And they pushed me to do things that I couldn’t do before the surgery. With my left leg trauma the doctor didn’t want me ot put on my AFO’s until the wounds healed. That left me in hospital socks, no shoes (to wear shoes I need the AFO’s). Prior to surgery I didn’t walk without my AFO’s more than the short trip from my bed to the bathroom. In rehab they had me pushing the walker all over the ward in my socks. Before I was discharged I did over 1000 feet in my socks pushing the walker without rest or sitting down.
The therapists who did the physical and occupational therapy were top notch. They were fun and demanding – pushing me to build stamina and do things safely. They were patient when I did stuff wrong, continually correcting me until I got it right. They never once made me feel embarrassed or “less than”. They helped me hang on to what little dignity and decorum on old guy could have pushing a walker in shorts or sweats.
After a week in rehab I was ready to go home. And I could be home alone for 12 hours or more safely and without worry. In my next post I will document the transition to home.