Saturday, June 20, 2020

Series: Open Heart Surgery. After ("Stuff" and precautions)

This is the final post on the open heart surgery series.  If you want to look back at the others, here are the links:

Series: Open Heart Surgery.  Before (Planning).
Series: Open Heart Surgery.  During (Stress Management).

This post will address - as the title implies - the period of time following the surgery. The main focus will be on creature comforts that will make your life easier/more comfortable in the days following the surgery.  I will also provide some basics about sternal precautions, adaptive equipment, and exercise, but you will get most of that info from your treatment team prior to leaving the hospital, so obviously, defer to whatever specifics they give you.
I'm just some chick.
I mean, The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

As far as a general idea of what to expect while you're in the hospital, you should refer to the Stress Management post.

So.  Creature comforts.

I had been hospitalized for several days in February for pancreatitis.
That sucked for me.  But to my benefit for my cardiac surgery, and to the benefit of anyone reading this that needs to plan for something similar, it was a learning experience.  Specifically, I was able to identify:

1) what sucked
2) how badly it sucked
3) how long the suckiness lasted
4) what could be done to diminish the suckiness.

There are many things that you will not be able to do anything about.  You're going to feel sick, and low-energy, and in pain.  And while there may be nothing you can pull out of your overnight bag to help with those things, you can put them in the hands of your doctors and nurses and let them work their magic.

But as far as the little corner of the universe that you DO have control over, here is a packing list.  For some items, I'm including links to specific items I purchased, but this is not a sponsored post, there are no affiliated links or whatever.  Get what I got or borrow things or purchase elsewhere.  You do you.


FOR IN THE HOSPITAL

Phone and charger: The outlet may be on the wall behind your bed, so bring the longest cord you have.
Toothbrush, toothpaste: hospital will provide both, but they will be crappy.
Deodorant: ditto above.
Dry shampoo: you may not even care about the state of your hair at this time, but if you do, this will help.

This kind of product is available anywhere.


Hairbrush
Ponytail/clip: when I'm on my back for days on end, my preferred style is what I like to call the "hospital-bed top-knot".

I present to you the "hospital-bed top-knot". Pay no attention to the grey.

Hospital gown: The first few days I was so sick, what I was wearing was the furthest thing from my mind.  But when I was in the hospital earlier in the year, I hated the struggle to keep me arse covered, keep it from falling off my shoulders, and the difficulty trying to wash up at the sink.  So I bought myself this gown that I found on Amazon.  It's actually made for someone having a baby, but it worked perfectly for me as a heart surgery patient. The staff had no problem with it and they found it actually made things easier for them.  I thought washing at the sink was easier in this gown than it was in the standard-issue hospital gown.  And it was more discreet, as it had snaps down the back.  The only problem is that if I sat on it wrong, a snap or two would open occasionally. I just learned to pull the excess fabric to the back prior to sitting and that seemed to solve the problem.

Perfect access for wound care.  If you thought anything else, get your mind out of the gutter.  

Travel pillow: I brought a travel pillow with me because it was small enough to fit in my overnight bag, but a big standard bed pillow would also be great.  You definitely need something to improve your comfort, because those hospital pillows?  It would probably be hard to design something that would be less comfortable.  I suppose you could fill a sack with Legos or something.  Nope.  I stand by my original statement that nothing could be less comfortable.  Bring something from home. In fact, if you want to get super fancy, put a couple drops of lavender oil on whatever pillow you bring.

This looks like the one I used.  I love it!


Slippers:  The hospital will provide you with those one-size-fits-all socks with the non-slip treads on them.  I am positive that whomever designed the hospital pillows designed these socks, because they are scratchy, knobby things from hell.  Non-slip footwear is required whenever you get out of bed, but my feet prefer to go commando in bed, and I was too sick and impaired to put those socks on my feet every time I needed to get up.  Slippers were perfect.  The ones I already had at home needed to be pulled on around the heel, so I bought these slippers that I could slip on, but had just enough of a little lip in the back that they stayed on well.

These are the ones I got. Make sure your slippers fit well so they stay on securely.


Eye mask: I'm not an eye mask wearer at home, but I brought this with me and used it quite a bit.  It really did help.  This specific one was nice because it didn't sit flat against my eyes, it has kind of a dome, so I could actually open my eyes when wearing it.  Not sure why I need to open my eyes while wearing an eye mask, but hey, I pay the big bucks for all those extra features.

Ear plugs:  My eye mask came with ear plugs, too, but my ears always reject ear plugs.  My ears are rebels.

This is the set I used, and it worked well.


Jacket: I had known that I was going to have drainage tubes with this surgery, I was just not prepared for what that really meant.  I thought they would be little bulbs, not the ginormous Frankenstein tubes with the boxes that I saw emerging from my body when I woke up.

No no.  Not this.  Not in your wildest dreams.


I had three of these babies.  If you want to see the tubes coming out of my body, see the "during" post.

This is what I bought, only in grey.

Obviously, the jacket has not been created that could tuck those drain boxes into little pockets.
However, I did find it useful anyway,  See, the hospital gown they used had a little pocket to hold the telemetry monitor.

Something like this.  This is not a picture of me. I am not an elderly man with a cane.

Anyway, like I said, I wanted to use my own gown, which did NOT have a telemetry pocket.  I hate the way the monitor pulls the hospital gown forward and down. So I was able to wear the little jacket and slip the monitor in the pocket.  That being said, a little pouch of some kind that you could wear around your neck or sling over your shoulder would work just fine.  I just wasn't prepared for my post-op reality.

So that's pretty much it for the contents of my overnight bag.  I think I also had some lip balm, Tic-Tacs, and a couple of magazines.  I didn't bring any books, because I knew I would be lacking in powers of concentration, plus I always have some loaded on Kindle and Audible if I really wanted to read.  Magazines were perfect for the last day or so.  Prior to that, I couldn't so much as watch TV, honestly.

I had gotten a couple things for home, as well:

FOR IN YOUR HOME

Tote: This lightweight tote really helped me in my first couple of weeks home.  I used it to cart around my phone, glasses, pulse oximeter, journal, medicine, etc.  You have to be careful not to overload it, as usual sternal precautions include not lifting anything over 8#. But better to have all that crap in one tote that you can slip onto your arm, than to try juggling all of that when walking around, especially when you may still be a bit unsteady on your feet.

I liked this one because it was so lightweight, had lots of compartments, and was on sale.


Wedge: I bought this wedge to help position myself comfortably for sleeping in my bed.  Lying flat on your back can be uncomfortable and make it harder to breathe after open heart surgery.  This really helped.  In fact, I just stopped using it, and I'm one month out now.

You can position it like above, or upright for a more reclined/seated position.


Tank tops: I'm not much of a bra-wearer in normal times anyway, but I certainly wasn't going to start fussing with one after joining the Zipper Club.  I have a bunch of tank tops that I always liked to wear under my scrubs for work, and these fit the bill for post-surgery recovery. A little bit of stretch, low cut so they don't bother my scar much, and just enough structure to lend a little support.

Not sure if this is the brand I have, but it looks similar.


I think that covers it insofar as products for hospital and home.  I did not use any adaptive equipment, but many people need it and find it very helpful.  Here are a few things to consider:

Toilet seat riser: This is a device that - you guessed it -raises the height of your toilet seat.  You don't want a commode over your toilet, or a riser with armrests, because you are not supposed to push up through your arms after open heart surgery. Armrests would just be tempting the devil.


Toilet seat riser



Shower bench: The first few times you shower, it will be difficult.  My first day home, in fact, I asked my sister to wash my hair, and even so I was exhausted after the whole ordeal.  Using a shower bench helps to conserve your energy, and if you are having any problems with balance or extreme weakness, a bench will keep you safer.

Again, forego the armrests so you can forego temptation to push through your arms.


Power recliner:  This would be a pretty pricey item to buy for your post recovery time, but it would make your life easier. I have a recliner, but it's just the kind with a lever on the side to pull to get the footrest up or down.  It was more than I was allowed to push/pull, so in the beginning I had to get someone else to operate the lever.  That got old pretty fast.  Then I learned how to keep the footrest up and just kind of straddle the footrest when I wanted to get up or down, lol.

We all need a decent recliner in our lives.  It might as well be a power one!


STERNAL PRECAUTIONS

Because your chest has been opened up and then wired back together, you will need to follow sternal precautions to allow the cartilage, muscles and skin to heal properly.  Again, I will defer to your specific treatment team for your specific parameters for your specific body and surgery, but in general, here is what you will need to follow:
1) Do not push through your arms to rise up or lower down to/from any surface, including chair, bed, car, shower bench, etc.  Generally, the higher the surface, the easier, so getting in and out of a low car will be more difficult than getting on and off a higher chair like a kitchen stool. If anyone assists you, they should give support at your back, not pull through your arms.
2) Do not push/pull/lift/carry anything more than 8lbs, which is roughly equivalent to a gallon of milk.
3) Brace your sternum  (incision area) with the heart pillow you got at the hospital (or any other pillow, really) whenever you need to cough or sneeze, or if you get a case of the hiccups.  Also clutch this when getting up off a chair or out of bed, at least in the beginning.  And try not to sneeze if at all humanly possible.  Because, my God in heaven.  Hurts like a mother f-er.  Sorry for the "language", but my God.
4) Don't raise both arms overhead at the same time, and don't reach both arms behind your back at the same time.  One at a time is okay, though.

I'm not going to cover incision care here, but inspect your incision daily, and follow the washing instructions given to you by staff.  And don't soak in a tub while you're healing.

EXERCISE

Exercise is going to be an integral part of your recovery, but it is important to follow the specific instructions given to you by your treatment team in terms of what exercises you should be following, as well as the timeline.  And at some point into your recovery period you may get involved in cardiac rehab, as well.  I will be meeting with my surgeon for my follow-up appointment soon, and I plan on asking about that.  But in the beginning, I followed the walking protocol I was given which started with one ten minute walk a day, then increased to two ten minute walks, then one 15 minute walk, and then increasing the number of minutes per day in one minute increments till I reached the end goal (where I am now) of 40 minute walks. My first few walks? I needed someone to accompany me, and I didn't travel far in the ten minutes, let me tell you.  But now I'm walking on my own and going two miles in the 40 minutes.  Not bad, one month out, if I do say so myself.

"Just put one foot in front of the o-therrrr..." Sing it with me!

"Take me home, country roads..."  Are you still singing?




I couldn't get the cows to sing with me.


That's okay.  Just keep on walkin'!

And that's a wrap!  I hope this was helpful to all of you out there who will be going through something like this.  I have heard from a lot of you, and I wish you the best!  Please feel free to leave me a message below, or to contact me through the Mended Hearts forum, or message me privately or through Facebook or whatever.  Or send me an owl.  The point is, if you have any questions, I am more than happy to help.  It's not an easy thing to go through, so we could all use all the support and information we can get.  Am I right ladies?  And gents? 

Godspeed!




Sunday, June 14, 2020

Series: Open Heart Surgery. During (Stress Management)

Last week I started a series on planning for and dealing with major surgery.  In my case, it was open heart surgery, but I imagine this could apply to other surgeries, as well.

The first post focused on the planning phase, so go check it out if you want some tips on what you need to do plan for such an event.

My initial intention was that the second post in the series would just be about what to pack to ensure a more comfortable hospital stay.  However, in giving it more thought, I'm switching gears to discuss stress and anxiety, on how that can impact you and what you can do to get a handle on it.
I'll include a few pictures from the hospital.  Some are gross, so look away f you're squeamish.  You have been warned.


STRESS
There are so many things out of your control during this phase, sometimes frighteningly so, that I think it wise to get a handle on self-calming techniques so that stress and anxiety do not become a runaway train for you. Allow me to provide a review of some times that could leave you feeling anxious:

On the shuttle bus from the parking garage to the hospital.  Starting to feel nervous.


PRE-OP
This is the period of time that you are being prepped for surgery.  You might want to think of this in two parts.  There is the time that a host of professionals are getting you ready in a curtained-off bay, and then there is the prep time in the actual OR before you are put under.

The prep time will include changing into a hospital gown, a review of your vital signs, sometimes peeing in a cup, getting an IV line started, and a multitude of redundant questions about your name, date of birth, why you are there, what allergies you have, what medications you are on, when you last ate and drank, history of reactions to anesthesia, and more.  You will be asked these questions again and again and again by different disciplines, including techs, nurses, nurse practitioners, physician assistants, residents, fellows, doctors.  Don't be surprised if the janitor asks you a few just for good measure. The point is, expect it, and try not to get upset that you just answered the same question for the last three people who walked through your curtain.
You may or may not have your support person with you at this time, depending on hospital policy and current climate (my surgery took place during the pandemic, so having a support person was not allowed).  *See end of post for clarification on this*
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

Once all of that is done and the surgeon is ready, you will be wheeled in to the OR.  It will be cold.  There will be lots of lights and gadgets.  There will be a mass of people milling about.  All of this can be pretty overwhelming, so this is a good time to start putting into practice any calming strategies that work for you (I will review some resources later).  In addition to all the sights and sounds, there may be more procedures to go through, none of which you will be able to see very well as you will be flat on your back.  With my surgery, they still needed to install some catheters and measuring devices in my wrist and neck, as well as "way down south" (be sure to take care of any landscaping needs prior to heading to the hospital).  I didn't care so much about the wrist and neck doo-dads, but they thankfully put me under prior to inserting the Foley catheter.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

Photo from Quora

This whole period of time when you're in the OR but still pre-anesthesia can almost feel like an out-of-body experience, because you are just lying there on the OR table and there are so many people all around, but for the most part they are not talking to you, just to each other as they complete their tasks. They are all working on some piece of you as you stare up at the ceiling and listen to their murmuring. So again, some calming breaths and peaceful thoughts would be really helpful during this stage.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

Anyway, at some point they will mercifully bid you good night, and that cold OR is the last thing you will remember before waking up in the ICU.

POST-OP/ICU
For me, this was the most stressful time of the whole ordeal, soup to nuts.  Having a better handle on stress management could have helped me tremendously during this phase.  And I thought I knew all about it.  I teach it to my patients for crying out loud.  Problem was, I hadn't really practiced any of it, which I should have done.  I will share my personal experience with you, not to scare you, but so that you can figure out what techniques would work for you should you ever need to go through something similar.
And this is where the pictures get kinda gross.

Although I knew I would awaken from surgery in the ICU still hooked up to the ventilator and unable to speak or breathe on my own, there was a vast gap between the knowledge of it and the experience of it. Once I "came to" more, I became increasingly aware of the tube down my throat.  Both the physical and psychological aspects of that really ramped up my anxiety.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

Eyes not open yet, but responding to commands.

To make matters worse, they weren't real enthusiastic about whatever numbers rule their world, so my extubation time kept getting pushed back by 15 minutes, again and again.  As each 15 minutes passed, I would become more alert, but then more anxious when they would decide to delay extubation another 15.  Panic started to set in, to the point one of my caretakers had to talk to me in that calming voice that you know means you're in trouble.  "It's okay, look at me, you're okay, you're doing fine..." Which was probably true for THEM, but for ME I felt like I couldn't breathe and was going to die. There, I said it.  I've heard of people who had complications coming out of anesthesia, and I just knew I was going to be one of those people.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

But you know what?  I wasn't.  Eventually, my numbers made my nurses and doctors happy, and they pulled the tube.  That, in itself, was horrendous, but at least it was coming out, and that was all I cared about.  They tell you to cough, they pull, and out it comes.  Easy peasy.  But it felt dreadful and there was much suctioning going on and throat pain and the feeling of drowning because you've got ick in your lungs that you're not strong enough to expel.  Cue more feelings of death and despair.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

When the worst of that passed, excruciating thirst kicked in.  I asked my nurse for a mouth swab, which is a little tiny water-soaked sponge about the size of your fingernail on a lolli-stick. She was kind enough to grant that wish.  But when that wasn't enough, I begged her in the name of God and all things holy for a cup of ice chips.  She said she couldn't do that, because it always got her in trouble.  I offered her up my first-born.  She didn't really want my first-born, but she was a kind and merciful soul, so she acquiesced. I chewed on the ice and I was in nirvana.  I would never want for another thing in my life.  Until I wanted to gulp the ice water that had collected in the bottom of the cup.  What is beyond nirvana?  Whatever it is, I found it.
Until I needed to throw up.  Someone passed by my room and I yelled in my post-ventilation tube throaty rasp, "I'm going to be sick!" He ran in and said, "I'll go find a basin, but here's the suction tube for now."  He handed me the tube and ran out the door.  When the vomit came (and it did come), I shoved the tube in my mouth, clamped my lips shut, and turned on the suction.  It did the trick.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

But from that point on, things got better.  I learned some things about my body in its current state.  I learned what it feels like to have plastic sleeves on my legs that inflate every so often to squeeze the legs in order to prevent clots.  I learned what it feels like to have a Foley catheter pulled from your body (not at all pleasurable).  I learned that I now had three enormous tubes coming out of my upper abdomen, each snaking its way to its own large plastic box that measured how much stuff was draining out of the spaces around my lungs and heart.  I think they use it to give me an oil change, too?  Not sure.  I learned that I still had a myriad of other tubes and lines in my neck, wrists, and arms, as well as ekg leads and the generic nasal cannula to provide still much-needed oxygen to my under-performing lungs.
(INSERT STRESS-REDUCTION TECHNIQUES HERE)

Chest tubes.  The Three Amigos.


So many monitors, so little time.

But I also learned that I had compassionate and professional care-providers who seemed to know a thing or two about what they were doing.  And that one by one, all the tubes and wires would be removed from my body.  Some before I left the ICU, some once I was installed in my room on the regular hospital floor.  For the first time, I began to feel less anxious and more confident.  This is an excellent time to mentally review all the goals ticked off, and fully realize you are making progress.
(INSERT PRAYERS OF GRATITUDE HERE)


HOSPITAL ROOM
There continued to be more stressful moments in the ICU, such as getting the first of the chest tubes removed, but having that first bit of confidence restored really helped me to manage the anxiety better.

However, there were plenty of stress-inducing matters to come.  I won't continue with a play-by-play, but I will fashion together a list of things that may cause you to feel increased stress, as well as suggestions for what may help.

Exhaustion
What you'll feel: Prepare to feel extremely low energy levels and just pure exhaustion, both mentally and physically.  Like, you didn't think it was possible to feel this poorly.
How to cope: Don't sweat it.  It's normal after something so traumatic to your body.  Give your body a chance to work its healing magic, and try to get as much rest as you can.  And a helpful tip: in your pre-hospital preparations, ask someone to be your liaison with family and friends.  In this way, you can connect with that one person by phone or text when you're able, and he or she can provide updates to everyone else.  You will likely be too tired to scroll through a bunch of different texts from well-wishers and provide very repetitive information to each.

Nausea
What you'll feel: Anesthesia and pain meds can make you feel nauseous, which will just add to your overall feelings of exhaustion and sickness. Besides the suction tube incident in the ICU, I got sick again as they were taking me to my hospital room, and continued to feel nauseous for awhile before it finally went away.
How to cope: Let your nurse know, and he or she can usually provide you with some medication to help.  Ice chips will also help (just don't gulp the water, lol!) .

Pain
What you'll feel: Pain.  Duh.
How to cope: Communicate with your nurses.  Each person is different in terms of pain thresholds and what types of medication they can tolerate.  It may be a little trial and error, but the goal is to find what works for you.  And you may never be completely pain free.  Maybe you will, but don't get upset if you're not.  The goal is not to keep people completely free of pain, but to keep it well-managed so they are comfortable. I can also tell you that in hindsight I think I would have done better with feeling a little more pain in order to feel less groggy and just so OUT of it.  It's a trade-off and you have to figure out what you can tolerate.

Sleep
What you'll feel:  You may become sleep deprived due to lack of good, deep sleep. Between the meds you're on, need to pee, vital sign checks every four hours, an uncomfortable bed, and the noise/lights/bustle of the hospital, it's unusual to get more than a quick doze here and there.  This at a time when you need more sleep than a three-toed sloth with a hangover.
How to cope: Ask your nurse or tech to keep your door closed, which helps more than you would think.  Close the window blinds. Bring an eye mask and possibly ear plugs.  Also a comfy pillow or a travel neck pillow.  Play around with the settings on the bed.  I found I was most comfortable with both the head and knee section of the bed raised, and it kept me from sliding down in the bed.

Hopelessness
What you'll feel:  You may feel like you'll never be back to normal.  I've never been one to put a whole lot of stock in "normal", but at this time it was something I longed for.
How to cope: In my hospital room, there was a white board on the wall for each bed.  There were pre-printed things on the board like date, nurse, doctor, etc, and the nurse would update the info as needed.  One of the items was goals.  I found this very comforting and motivating.  The goals were often simple, but left me feeling like I was making progress.  Things like walk 3x/day, use the spirometer 10x/hour, manage pain, wean off oxygen.  Some of these were things I could DO, and cross off at the end of the day.  It helped me feel more in control and less anxious.

Day before discharge, I still had one chest tube to go.

Toileting
What you'll feel: You will probably need to pee a lot due to medications aimed at keeping your fluid levels down.
How to cope: This can be difficult when just the act of getting in and out of bed can be a monumental feat.  In the beginning, you will need help, and will probably need to use a bedside commode instead of making the trek to the bathroom.  As you recover, you will be able to get to the commode without help, and eventually even be able to walk to the bathroom without help. Bottom line, just ask for assistance.  Also, don't even bother with underwear, at least not in the beginning.  It's just one more thing to make your life difficult.  You sexy, sexy thing, you.

Mobility
What you'll feel: On the topic of getting back and forth to the potty, walking is a big deal when recovering.  It is important on so many levels, yet feels impossible in the beginning.  When you've got chest tubes poking out of your body and their accompanying drainage boxes and the pulse ox on your finger and the heart monitor weighing you down and your body freshly torn asunder and stitched back up, it seems impossible that someone would expect you to WALK anywhere.  But they do.  And you will.
How to cope: Know that they will not expect you to fly solo.  They may give you a walker.  They will hang your drainage boxes or carry them for you.  They will monitor your oxygen levels and heart rate, and constantly ask you how you feel, and they will be with you every step of the way. Sometimes your nurse, sometimes an aide, and occasionally PT and/or OT will accompany you.  Take it slow.  Breathe.  Be honest about communicating when you've had enough or if you're scared.  I tend to be someone to bite off more than I can chew, but there were a few times I could not meet their suggested distance.  It was okay. There were other times I was able to do more than they asked, so it all balanced out.  Soon you'll be back to running marathons.  Or at least, I don't know, walking to the freezer in your kitchen for ice cream without help.


So those are the main things that came to mind.  If you have questions about other aspects of the hospital stay, let me know and I can try to address it.

As I said at the start of the post, I will add a list of resources on stress management.  I will also add some basic pointers right here so if you don't feel like looking at other websites or apps you don't need to.

Stress Management 101
Stress is your body's reaction to perceived danger.  It's the fight or flight syndrome.
How it works in a nutshell is that your brain perceives danger, and reacts by activating the sympathetic nervous system, which prepares your body for fight or flight.  This is survival mode, so the things that are needed most for survival are hyper-awareness and muscles-at-the-ready to fight or to run.  Your heart prepares by beating faster, your digestive system prepares by closing up shop.
This is all great, and serves us well, but the problem is that on a primal level, we don't really know the difference of danger as in, a lion is about to pounce on us, or danger as in, I never paid my electric bill and I'm afraid my power will get shut off, or danger as in,  I'm scared because a surgeon is about to cut me open.  Stress is stress is stress as far as our body is concerned.
So that means regardless of the stressor, our body will react by sending adrenaline and cortisol coursing through our system, and we will be left dealing with a jackhammer heart, racing thoughts, and rapid breathing, even if there is no big hairy lion for miles.

So stress management, then - quite simply - is learning to manage our stress.  We have to let the brain overrule the body as to whether or not we are actually in immediate danger.

With me so far?

So to combat that rapid breathing?  Nice, slow, deep breaths.
To counteract the hyper-awareness? Mindfulness.
To alleviate the tension in your muscles? Muscle relaxation.

I will summarize each of these three things very briefly, and provide links in case you want to learn more.

Pursed-lip breathing is a way to get your breathing under control by filling and then emptying your lungs with nice deep breaths, to break the pattern of the rapid breathing,  To do this, just breathe in deeply through your nose like you're sniffing a flower, to the count of 2, then exhale through pursed lips like you're blowing out a candle, to the count of 4.  Repeat.  And repeat and repeat.

Mindfulness is the opposite of being hyper-aware and having racing thoughts.  It is being hyper-focused on the here and now.  Go through your senses one by one.  What do you see, smell, feel, hear?  Not just a cursory inventory, but really immerse yourself in each, one by one.  A helpful acronym here is STOP:
S is for Stop.  Stop the roller-coaster of thoughts and emotions.
T is for Take a breath.
O is for Observe.  Observe everything around you, but not in a racy-racy way.  In a thinky-thinky way.
P is for Perceive.  How do the things you're observing impact you?

If you're too geared up or just feel too unpracticed in mindfulness, there are some shortcuts you can take to counteract the physical effects of stress:
Listen to calming music
Look at pictures or artwork or videos (like a clip of ocean waves) that soothe you
Segmental relaxation: starting at your toes and working up to head/neck/face, squeeze a muscle group tight-tight-tight, hold, and then release.  Feel the heaviness of the muscle groups.
Prayer
Guided imagery: think of a place that is very relaxing to you (for me it's the ocean).  Close your eyes and picture yourself there.  Then use a modified mindfulness technique, by going through the senses to more deeply recall that place.  What do you see, hear, feel, smell?

So that's the basics, and you can do pretty much all of it with just mind and body, no apps required.  But if you want to learn more, or have some music clips to choose from or meditation guides, here are a few things you can check out.  My personal favorite is the app Calm.

General info:
Web MD
Mayo Clinic
American Heart Association

Books:
Why Zebras Don't Get Ulcers
The Relaxation and Stress Reduction Workbook

Apps:
Headspace
Calm

That's it for now, folks!  This was a lot of information.  My next post will be a brief one that will just focus on some products and tips that could make your life easier/more comfortable during your hospital stay.  See you then!


*PS: I'm now realizing I need to clarify something.  As far as having a support person, I DID have one.  My amazing baby sister Veronica.  She drove me to the hospital and we took the shuttle bus over, and found our registration area/waiting room.  I think they did not allow her back to rejoin me after the initial pre-op prep was done, but I'm hazy on that.  I know that they allowed her to visit with me for about 15 minutes once they settled me in the ICU, but I don't have any recollection of that.  She tells me I was able to nod and squeeze her hand.  I'll have to take her word for it.  And she took the ICU photos (at my earlier request).  After the 15 minutes, they sent her on her way, and from that point on I was not allowed any visitors.  She was also my "liaison" that kept all my peeps updated on how I was doing.  Her help and support were immeasurable.  Thank you, Ron!


Tuesday, June 9, 2020

Series: Open Heart Surgery. Before (Planning).

Three weeks ago today my chest and my heart were cut open and my heart was shut down for about 40 minutes, placed on bypass so the surgeon could make some repairs.

It all went well, they tell me.  But now I'm in this recovery phase, where I'm supposed to sit around and do nothing so my body can recuperate.

"It'll be relaxing" they said!

Ugh.

In the weeks and months leading up to the circled date on the calendar, I prepped meals for the freezer, I deep-cleaned, I organized, I made lists of activities I could do from a seated position. So I was prepared, I thought, to sit and recover.



But I just don't do well with sitting.  It's beautiful spring weather and I want to be doing big ol' projects, getting my hands dirty!

Sigh. My body has been very quick to tell me when I've done too much.  There is no cheating.

Anyway, my sister suggested I write about it on my blog.  She said it would give me something to do, AND maybe help others who are going through something similar.  I thought that made a lot of sense.

So here I am.  I'll write a few posts, with an eye towards passing on what I have learned from this experience.  I bought a few products along the way, so I'll share how they helped or didn't help.  When possible, I'll include links to specific things that worked, but this blog is not monetized, so I gain nothing from your clicks.  So don't even worry about that.

I'm thinking I'll organize this in a before, during and after kind of format. I'll try to just put a little bit of info in each post.  More bite-sized than all inclusive.  Otherwise this thing would be a novel.  But not in a good way.

And let me know if you have any questions!  I'll be glad to answer to the best of my ability.  Plus if I'm engaged in answering questions, I'm less likely to get myself into trouble.


BEFORE

How did I get here?
A couple days before Christmas, I went to the emergency room at the advice of my primary care doctor.  I was having pain in the general vicinity of my chest, and really high blood pressure.  Although I was pretty convinced it was something GI-related, I was being worked up as a cardiac patient. In the end, I was right.  The pain was from a weirdly located stone lodged way up in my liver, but in all the testing and poking and prodding, they found a pretty serious heart problem.



So on Christmas eve, I was told I was going to need open heart surgery. This surgery was going to take me out of commission for several months, as I wouldn't be able to drive or lift more than a gallon of milk for a month, and wouldn't be ready to return to work for about three months.
But because I needed to get the stone thing taken care of first, as well as do a bunch of other tests, the heart surgery wouldn't take place for months.
Plenty of time for an OCD anal retentive gal like me to plan (insert maniacal laughter here).



What to do first?
Like any self-respecting organization-aholic, I started making lists. I made lists of freezer meals I could prep, things I wanted to take care of prior to surgery, and  things I could do while recovering.  I wrote out what I would need to do in terms of my job, and who was going to be able to do what while I was recovering.




There was a lot of information and a lot of things to think about and plan for.  Keeping a notebook can be really helpful in these kinds of situations, although I found my planner had a lot of pages in the back that worked nicely for this purpose.

Here is a list of some of those items to take care of, for anyone who might have to plan a time of convalescence:

JOB
Will you need time off from work?  Let your manager know as soon as possible.  You night need to contact Human Resources to find out if there is any paperwork you or our doctor needs to fill out.
Will you be eligible for disability?  I hadn't been at my new job long enough, but I was able to request a Leave of Absence as an accommodation under the Americans with Disabilities Act.


If someone will be filling in for you in your absence from work, do you need to make them a list of your job duties, things to take care of or watch for so things don't fall between the cracks while you're away?

LIFE-PLANNING
Okay, I hate to say it, but you will want to make sure you have your affairs in order.
Major surgeries have risks, I don't care how good your surgeon/team/medical facility are, there are risks.
To that end, you want to make sure your basic life-planning paperwork is taken care of.  Or if that's something you haven't started, GET started.  Since I had recently gotten divorced, I hadn't redone mine yet, as it was just in my "get-to-it-later" list of things to do.  The surgery pushed it to the front of the queue.


So I went to a lawyer and had all the paperwork drawn up, including a POA (Power of Attorney), a will, and also a Medical (or Durable) POA.  The latter clarifies your wishes on medical issues.  In other words, pull the plug or continue life as a vegetable?  DNR or do everything possible to keep you alive?  I could get very specific here, but I think most people have a pretty good understanding of the basic gist of this kind of document.  It's up to each individual to determine where they stand on these matters. The point is, get it done.

HOUSEHOLD PAPERWORK
Get caught up on bills, and if you have any bills that are not on auto-pay, set that up if you can.  The last thing you want is a late payment fee because a bill didn't get paid when you were flat on your back in a hospital bed.

If you're like me, you have a stack of paperwork waiting for that magical moment when you have nothing else to do and an inspired need to file comes over you.  Yeah, no.  So anyway, now's the time to get caught up on that stuff.
Make a list of who to call for different issues that may arise while you're in the hospital, so whomever is at the house (adult kids in my case) will know what to do if the power goes out, or the hot water heater springs a leak.  That kind of thing.

HOUSEHOLD DUTIES
Find out from your surgeon what your restrictions will be post-surgery, as well as an accompanying timeline of those restrictions.  From there, you can better plan which of your usual tasks/chores will need to be delegated to others.
In my case, since I would not be able to drive for a month, I wanted to stock my pantry with as much as I could, knowing that I would still need to rely on others for runs to the store for weekly perishables.  I set aside a shelf in my basement to stock up on hygiene items, pet food, pasta/rice/beans, cereals, cleaning supplies, etc.
I made a list of chores that are done around the house, trying to include as many things as I could remember.  Cleaning the litter box, feeding the pets, tending the chickens, watering the flowers and vegetable garden, taking out the trash, sweeping the floor, cleaning the kitchen, cleaning the bathrooms, mowing, weed-wacking, grocery shopping, etc, etc.  You get the point.



Then delegate.  Lucky for me, my kids are all grown and three of them still live at home, so that made it pretty easy.  But figure out what people in your life will be able to help.  Friends, relatives, neighbors, folks in your church.  And there's always hired help if you can afford it. Know that whatever list you come up with will probably be very fluid, as life has a way of changing your best laid plans, so be flexible. Also, recovery is not an all or none timeline.  You will gradually be able to take on more tasks as time goes by, and of course that will change the list, too.

MEALS
I knew I was not going to be able to lift more than eight pounds for many weeks, and would have very low endurance.  So I wanted to have some meals at the ready that my kids could pull out of the freezer and heat up for dinner.



Pinterest is a great source of ideas for this kind of thing.  I did a bunch of bulk cooking one day and knocked out over a dozen meals.  Some were complete casseroles in aluminum
pans, some were a mix in a freezer Ziplock bag, which is great for saving on freezer space.  Here are some of the things I prepped:
Storage bags: taco meat, sloppy Joes, spaghetti sauce, chili
Casseroles: chicken spaghetti, fritattas, shepherd's pie, mac-n-beef, baked ziti


Anyway, that's all I can think of for now.

Tune in next time for my thoughts on what's helpful while you're in the hospital.

Tuesday, December 31, 2019

20-20 Vision

As of tomorrow, we will have a new month, new year, new decade.

While it won't necessarily be a clean slate for me, when I look back on the past decade, it comes pretty darn close.

Because, lemme tell ya', the twenty-teens  and pre-teens were a bitch.

There were so many many things going on in my life and the lives of my children.  

A short list, in no particular order...

driving lessons, marital troubles, homework battles, college, counselling, new kids in the family, soccer games, high school, surgeries for the kids, surgeries for myself, IEP meetings, braces, hormones, graduations, teenage relationships, animal acquisitions, animal deaths, children moving in (sometimes not my own), children moving out, new old friends, middle school, divorce, proms, downsizing, building fences, building chicken coops, Reactive Attachment Disorder, Post Traumatic Stress Disorder, runaway ponies, moving, mental health issues, re-entering the work force, death of my mother, Residential Treatment Programs, changing jobs, new old name... 

I honestly don't know how I made it out alive.

But here I am, alive and well.
More grey hair than a decade ago.
Healthier in many ways than I was a decade ago.
Ok, parts of my body are literally falling apart and in need of replacement, but that aside...

So with all the change, did anything stay the same?

Yes.
Resoundingly, yes.

My own inner strength and stability.
God in my corner.
Children and animals all around me.
My own unique, creative perspective.  It is mine alone.  Everyone has their own, I get to claim mine and I will be forever grateful for it.
Hope.
Love.

This time ten years from now, I will be on the cusp of 65.  
An empty-nester (except for maybe Bella?).
Retired (in the name of all that is good and holy, please). 
By the grace of God, still in my beautiful home, petting the ears of a dog as I sit by the fire (as I am at the moment), gathering eggs, and enjoying creative pursuits. Only not all at the same time.

As long as my things-that-stay-the-same list.... you know.... stays the same, I can weather whatever the twenty-twenties throw at me.  I've seen worse.

So bring it.









Tuesday, November 5, 2019

You Can Take the Girl Out of the Funny Farm....

You can take the girl out of the funny farm, but it seems you can't take the funny farm out of the girl.

A couple of years ago, I posted that I was closing up shop on my Funny Farm blog.  Because of life changes.

Like divorce.
Like moving.
Like saying goodbye to all the farm animals.

Well, here it is two years later.  I am in a home about a third the size of my old one.  I am on an acre, as compared to the seven acres on the farm.

And so I thought I was done with all things Funny Farm.

But I was wrong.  It just won't leave me without a fight.  Not the Funny.  Not the Farm.

SO I'M BACK!

I think?

I had started another blog to showcase some of my creative pursuits.  Birdsong Bits and Pieces.

And although I enjoy it, there was always a piece of me that missed my Funny Farm blog.  So I think I want to try to get back to it. Not to sound cheesy, but it was like home.

OK, that was pathetically, ridiculously cheesy.  My apologies.

Anyway, with all that being said, allow me to illustrate why I said the Funny Farm isn't giving up without a fight.
And I promise I will go back and fill in the blanks later about my new place and my Amish neighbors, and where I am with kids and critters, but here is what happened this morning.

*clears throat*


My son woke up and looked out the window to see the neighbor's cow staring in at him.

Consequently, I woke up to my son knocking on my door to let me know the cow was in our yard and he (my son, not the cow) had to leave for school.



Sadly, this steer is being raised to feed the neighbor and his brood, so the only name he has is "Jersey" (which is, surprise, surprise, his breed.  No points for creativity).

I said "Good morning, Jersey, what are you doing here?"
He just looked at me and peed.
It's an effect I have on some, I don't know what to tell you.


He thought briefly about making a run for it, but then remembered what a good back scratcher I am.

I really am, it's true.



So after a little scritch-scratchin', he allowed me to fashion this leash into a heifer halter.  OK, I know he's a steer, but heifer halter has a nice ring to it, doesn't it?

My daughter went to Penn State (before transferring to Temple) for a year and all I got was this lousy dog leash.
Sheesh.






As it turns out, Jersey has not been halter trained.
Nor leash trained.
Nor don't eat the neighbor's roses trained.















Son: "Are you sure you've got this?"



Me: "I'm not sure of anything!"


































"Come on Jersey.  You can do this."










We made it to the gate!  We're home free!




































Right?

Just...
A few more....
Steps.....

And one big push.







He's in!

I shut the gate.
Chained it.
Reclaimed my leash.

Walked around the field to look for where he got out.  Found an open gate, so I shut and chained it, too.
My work here is done.

Not too shabby,

This was before coffee.








































So yeah.

Like I said, you can take the girl out of the Funny Farm...






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