Pain and Agony — Not!

This may end up being a lengthy section but more to describe how I had no pain rather than to describe any real misery associated with the minimally-invasive Mitral Valve Prolapse (MVP) surgery. There simply is nothing to describe.

A few hours after surgery I had shaken off most of the anesthesia, and could think clearly and talk clearly. They had me on some pain medicine – Toradol to suppress pain. I asked the nurse about it every time she topped up my medicine: what were they giving me and why and was it more or less than last time. My knowledge of any medicines is extremely limited. They always patiently explained.

There were three pain medicine options, one of which was described as a form of morphine. I told the nurse "let's not use that morphine one". She assured me it was safe but since we had the other two to use, that was cool. She happily obliged my paranoia of morphine. Morphine to me is the devil. Some form of opium, right?

Morphine. That's what they always used in the war movies when the guy took a belly full of shrapnel or stepped on a land mine. Be it the Big War, WWII, or 'Nam, some sergeant was always sprinkling morphine in the gaping wound or punching another one of those handy vials into some guy's leg until he started babbling. Lots of screaming pain. – I wasn't having any screaming pain. I don't need anything that'll have me screaming with cravings when I want to stop using it. This may all be in my imagination but I'm sure it's rooted in fact and why bother when there are alternatives. But after I inquired they had no problem giving me a different less-daunting drug.

A Few Drugs

Two days after surgery I think I was down to mostly some Darvocet. I was never in pain. The first day or so there was a little discomfort in my chest. When they pulled the drain tubes from my chest, the discomfort went away. My throat was actually sore from the breathing tubes they had in my throat while under anesthesia, though hidden by the pain medicine. The return of throat pain became my indication that it was time to take another hit of Darvocet.

By 7 days after surgery I was down to one Darvocet pill every 12 hours. At 14 days after surgery I replaced the Darvocet with 500mg of Tylenol, a significant part of the Darvocet (but with some synthetic narcotic tossed in for the heavy lifting). The next day I dropped all medicines and felt just fine. (See table at bottom of page.)

My Pinkie!

So what physical limitations do I have? Let me put it in perspective. My wife who accompanied me on this little journey broke her little finger a week or so before we left. She had to have 2 pins put in the bone so it would heal correctly. This meant she had a sort of splint on the finger and it wasn't hidden by a shirt or anything, and she often elevated it so it was "obvious to the most casual observer" (a great saying I learned from my old friend JFS) that she had an injury. Everywhere we went someone would ask about Jan's pinky. Of course she had a long sad story about it and drew lots of sympathy.

Somewhere near the end of the story was "and I didn't need this to happen just as my husband was about to have heart surgery".

"Oh, my, your husband is having heart surgery?"

"Yes, this is him" she said to their disbelief as I stood next to her looking perfectly normal and animated, no twang of agony in my face, no stooping, no obvious discomfort.

"Oh, when is your surgery?"

"I had it 4 days ago" and you could just see that they thought this was some con going on.  

After a few minutes of discussion, the person would wander off, expressing sympathy for Jan's poor pinky finger, and with a certain mistrust for me, standing next to her, proclaiming recent release from major surgery yet showing no evidence whatsoever of pain or impairment.

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They shaved my chest and armpits (boys, you haven't felt that kind of naked in decades) but left the hair on my arms. Of course they put all this tape on my arms and later the otherwise kind and concerned nurses rip the hair out by the root when they slowly pull the tape off – is that a little joy I see in their eye? (or they ask you to do it – making it a sort of self-inflicted, character-building pain). They're lucky the nurses don't get hit more.

Someone ought to get 3M working on some tape for skin like that gummy stuff you can use to hang pictures on the wall. Pull the tab to the side and the tape lets go leaving the hair in place. If they were going to rip all the hair off my arm anyway, they might have gone ahead and shaved those too. Now I watch the little stubs growing back on my chest and underarms and stickling me.

You can shower when wearing these Steri-strips that seem to protect the wound as well as hold it closed. I guess real stitches are below in deeper levels of skin. They have a weird water-less soap in the hospital that you can bathe with the 2nd day, but the nurses make you wash yourself so it isn't any fun. It is kind of cool to not have to rinse off. Somehow I conned Jan into helping me bathe in the shower the next day, so that was kind of fun. However she made liberal use of her fingernails to keep me at bay ("don't stress your heart", "hey, they fixed my heart") but in my mind at least I could "remember those thrilling days of yesteryear".

Things to Come

I suppose we were sort of preparing for later in life. Her with her broken finger, me with my fixed heart; her driving the car (Dr's orders for 2 weeks – take advantage of it Tom), me riding shotgun and having her open the door for me; her opening the right door, my opening the left (her broken finger side); her bathing me, smacking my hands to keep them in their place; her telling me what and when to eat, my nodding and ignoring her the best I could. It was like we were an elderly couple, helping one another when the other's disability limited them, tit for tat. Geez, is this where we're heading?!

No Pain

But let's get back to the topic of pain. There just wasn't any. I've had far worse pain crashing my bicycle or straining/spraining a muscle. I was on pain medication after the MVP surgery, but I think it was pretty mild. My movements, motion, and mind after that first day seemed to be the same as before the surgery.

I really felt guilty that I wasn't worn out, in misery, subdued by drugs, straining to make it one more day hoping the next morning would bring relief. Others recovering in the hospital were bedridden and not very chipper.

I was feeling good, able to sleep, looking for things to do. My wife knows me well and never thought I was on happy-drugs in la-la land. It was just the normal me, maybe a little less stressed since I had nothing to do. If this was heart surgery, it was pretty easy to make it through as a patient.

Why?

Minimal invasion is surely the answer.

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I later thought I ought to get a pin to put on my shirt that said "I had Open Heart Surgery on August 5" – sort of like those "I gave blood" stickers. There's nothing about your demeanor to indicate that you've had this delicate operation. And if you feel you deserve a little sympathy, special attention, or a sigh from a pretty sales clerk, you're going to get nothing if you're standing next to someone with some lame injury like a broken little finger and theirs is all wrapped up in tape and being held up high to avoid contact.

Restrictions?

The only impairment I had was where they cut under my pect. Here a 2" horizontal slit went between my ribs. It seems they cut some muscle here. They said for the first week maybe to try not to lift my right arm much higher than my shoulder, although I could actually move it, but maybe it would be better to use the left hand to lift the right arm. I was able to move my arm virtually anywhere, but I didn’t want to put a lot of stress on the right pectoral muscle.

Even 14 days after surgery there was just enough odd feeling there to make me think there were some stitches holding things together and I should just let that muscle heal up nice and strong before putting a lot of force through it. The one-handed push-ups would have to wait. Meantime I'll made my football-player 15-year-old bring in the groceries, move the couch, and torque the bolts on the engine. That's stuff he should be doing anyway.

Two days after surgery I was able to walk naturally, swinging both arms, with just the slightest care with the right arm but mostly to keep the tape and Steri-strips from rubbing my arm or the shirt, not because any muscle was tender. Feeling in my right pect was dissociated but expected to return to normal as the underlying muscle, tissue, and nerves heal. I may be exaggerating this muscle thing, since there's no obvious slice across any real muscle, the cut actually goes "with the grain" of the muscle. I'm basing this on observation rather than known fact.

My pect was a little swollen, but I think that could be just because of the remaining Steri-strips that pull a little funny. You know, like you've seen on the late-night informercials where the women use clear tape on their faces to pull back and eliminate wrinkles or on their chests to "lift and separate" where gravity has worked against them. So maybe that's all this is: Steri-strips giving me a more robust pect.

But that's it folks: Be a little careful pulling the right arm toward the center of the chest.

Otherwise, I'm walking and talking like normal. If I fail to keep the pain medicine up, I'll feel some tightness in my chest or mild pain across the top of my chest. This doesn't grieve you any worse than a sore muscle would. But as my good friend Ms. KT said, the pain medicine is there to help, so use it and stay ahead of it so you're not waiting for the drug to kick in again. But I do like to test that it is still needed every day or so by checking if there is any difference if I delay the next dose another hour.

Taped Up

My cuts never hurt, though the Steri-strips that covered them could be a nuisance. The strips were to fall off in 2 weeks but meantime you look like a 3-year old found the Scotch tape and went crazy with it on the Ken doll. It must have taken half a bottle of Goo-Gone and a week of scrubbing to remove the glue from the Duct tape they put all over me to hold down wires and tubes and IVs.

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