The Long and Winding Recovery

My heart's surgery did not go so well. He has hyperparathyroidism, and secondary to that his calcium levels are extremely high. The calcium deposited in his coronaries. He was on the table from 0930 to 1447 - and on the heart and lung machine for 91 minutes. That's a very long surgery and a very long time to be on the pump. I was in the CVSICU when he came out of surgery. His chest tube was draining an extremely large amount of blood. He had already received 3 units of blood and 2 infusions of platelets. He wouldn't stabilize and kept bleeding no matter how much protamine, aprotinin, and blood products he received. I stayed in the CVSICU until after 5 to be with him. He was pretty volume depleted and was actively bleeding. To make matters worse, the hospital ran out of platelets and required an emergency shipment of them. My heart didn't have that kind of time so he went back to the OR. When they opened him back up, his heart was covered in clots, so they cleaned him up and cauterized all the bleeding areas. He was on the table the second time for almost 3 hours. That's a lot of anesthesia for an almost-80yo man. He had a very bad night. By 0730 this morning, he had received 8 units of blood meaning that he had not one ounce of his own blood left him in him. Apparently when someone receives this much blood, they're factors can change and they need to be retyped before further transfusions. To make matters worse, his BP was 186/104 and HR was 114 when I got to the unit. They ordered an emergency x-ray and discovered a large effusion in the left chest. I watched the doctor place a chest tube in the room. Immediately 800mL of blood ran out of it. My heart started to stabilize. The rest of the morning was spent trying to get the heart to hold his pressures without pharmacological help. This did not occur until after 1300. When I came back from lunch, my heart's eye's were open and he had a little color in his cheeks. I walked up to him and touched his arm and told him who I was. He turned his eyes to mine and held contact for a while. He's still vented so he can't talk. The nurse told me they were going to try to wean the vent off tonight, so he may be on his own tomorrow. That would be great. Taking the vent off is one more step to recovery. The next hurdle that the medical team has to address is whether or not he has long term brain damage due to the operation and pressure fluctuations. However, we'll cross that bridge when we get there...for now, he's alive and finally stable. (Yes!!!)

When I left the CVSICU today, my heart's son waved at me. I walked into the waiting room where the whole family was. My heart introduced me to all of them before his surgery, so they all know me. His son thanked me for being so dedicated to his father and told me that I would do great in whatever field of pharmacy I enter. That was so rewarding. When I left, his sister told me that it meant a lot to my heart and a lot to his family that I was so dedicated to him. This is the reason I went into health care. To know that I am helping someone is tremendously rewarding for me. I love my field...I love it more every day. :)