Jim and I have been together since 1977. Our son Aaron was born in 1982. Jim was 48 when we met, I was 28. In January 2004 Jim is 73, I am 53 and Aaron is 21.
The 20 year difference in our ages never seemed to bother people more than it did in that hospital setting. Doctors and nurses would either ask if I was his daughter, or they would just ask what my relationship to him was. One nurse asked me if I was qualified to help me bathe Jim. It took me a minute to figure out how one was qualified to help bathe someone, and then I said, well, I’m his wife. That seemed to be what she was waiting to hear. One nurse said “You aren’t the same age as your husband, are you”. Aaron was with me in ICU when we established out relationship. When questioned I said I was the wife, and Aaron said he was the son. Even with the surgeon came out to tell me surgery was over he first established the relationship by asking me if I was his daughter. I said no, I was the wife.
Before I met Jim I lived in Boston, and there I was hospitalized and diagnosed with Borderline Personality Disorder in 1975. I was rediagnosed in 1995 after a particularly troubling episode in my life. Borderline Personality is an emotional disorder. Putting it very simply, Borderlines react more severely to emotional stimuli and have a more difficult time returning to normal. Borderlines also have trouble with abandonment issues, either real or perceived, and suffer seperation anxiety when seperated from a "major object" which can be a person, place, or thing. As you might guess, Jim was my major object". Borderlines also have a lot of other issues, but those two figured in more with Jim’s open heart surgery than anything else.
Before the surgery I researched the procedure rather thoroughly. Borderlines don’t like loosing control of a situation, and by not knowing everything, I would be loosing control. I don’t mean control of the surgery, but more in control of my relationship with my husband. I must admit I got a rather jealous or had lost control one day when I walked in and the nurse said he had already been bathed and shaved. I didn’t say anything, but that was my job.
Jim’s surgery was on the 15th and he didn’t recognize me until the 18th. He responded to my commands (say phooey, not shit) (squeeze my hand), but until the 18th he did not recognize my face as that belonging to his wife of 25 years. This caused major abandonment issues in my borderline mind. Between the 15 and 18th my visiting privileges were limited because it was ICU. But I did stay with him more than is generally allowed because I had to maintain what relationship I had, and fight to help improve it. He wouldn’t eat so I brought him things from home to eat that I knew he liked. When he had his stoke I sat on the stroke side despite advice to sit on his “good” side, and I worked that right arm and hand to remind him he still had it.
I didn’t want to leave him but in ICU I had to. There was no place to me to stay except in the waiting room and home was just a half hour drive. So Jim didn’t recognize me for 3 days. On the 4th day he phased in and out, but mostly after that he did recognize me as his wife, Sandy, although he can’t remember anything that happened in ICU and very little of what happened in his regular room.
I stayed with Jim every night in that regular room, from the 19th to 23rd. There was a couch for me to sleep on, but I instead sleep in his hospital bed. Usually he slept in his recliner, but there were times when we laid side by side in the bed. There we were, lying in bed, with my head on his shoulder, when the PA came in to remove Jim’s chest stitches. I opened my eyes and watched from 8 inches away. I wonder how many times the PA had had that experience. On those nights in the regular room Jim would have his psychotic nights. He would bounce from chair to bed to couch, and then hobble down the halls, holding my arm for stability. After he had his folly catheter removed he would start going before he got the urinal in place, or he would spill a trail all the way to the bathroom. I spent a lot of time cleaning up after him. In the wee hours he would sit on the side of the bed, I would stand in from of him, he would hide his head in my breasts and we would rock. We did this 2 or 3 times every night. And in this position the blood taking man came in one early morning, and while he took the blood, Jim just kept his head buried in my breasts (this is the only thing that Jim has done to shown what could be called affection to date). By staying up nights with him, sneaking in a few 20 minute intervals of sleep each night, I took some of the pressure off the nurses. One early evening before I got there Jim decided to head for the bathroom by himself, and defecated all over the floor. I arrived a short time later, and I guess those nurses were glad to see me. They never knew of the nighttime messes I cleaned up.
On Jan 22, 7 days after surgery, he was transferred by bus to the rehab center associated with the hospital. In fact, it was located in the building that was once the hospital. He shared a room with a man who had had a stroke and didn’t do much except move from bed to chair. He wife was with him quite bit, but not as much as I was with Jim. For fun, I left Jim alone that first night in the rehab center. They caught his “escaping” by using a laundry cart as a walker and heading for the elevator. They kept him at the nurses station all night and he talked his crazy talk. The next night the nurses bribed me with a six pack of root beer to stay the night with him. In was a Friday, “Monk” night, but he couldn’t get into it. Again he slept in the recliner and I slept in the bed. The nights got a little better, but we still didn’t get a lot of sleep at night. I took him out Saturday night and intending to keep him all night but at 11 pm the nurse called to tell me to bring him back or Medicare wouldn’t pay for the day. So I took him back. On Sunday I took him home for what I hoped was for good. I had 24 hours to return him if I changed my mind. Around 10 that night I changed my mind, primarily because I had no pain medication to give him, and I spent the night with him. I went home in the morning to get some food, a shower, a nap and a change of clothes. At 3 pm a nurse called me to say they had taken him by ambulance to the emergency room after he had developed chest pain, profuse sweating and shortness of breathe. I jumped in the car and went to the emergency room. Aaron me there and we decided he was in no great danger, so he left, and I stayed until about midnight. After all, I still had not really slept. At 3 am he was transferred to a room in cardiac medical. I went up that morning and again, spent most of every day and night with him. In this hospital the various departments of cardiac are located around the perimeter of a square. Cardiac medical was opposite the ICU, and his old “regular” room was just around the corner. Jim and I would walk around this square, stopping off at the ICU waiting room for a cup of cocoa.
Here I would like to mention the ICU waiting room. It was in this ICU waiting room that waited 5 hours for my husband to come out of surgery. I made some friend during that 5 hour wait and we met there again for a few minutes each day while we waited to be let in to ICU for visiting hours. When I had nothing to eat or drink I found refuge there, and when Jim and I went on our walks, we found harbor there. Sometimes I had to raid another waiting room for cocoa, and sometimes I brought some from home. But the waiting room had the hot water and the cups, and the hospital will never know how important that waiting room was during my stay there.
After he recovered from his pneumonia, he left Cardiac medical and was released to the care of a rehab/nursing center just 11 miles from our home. I brought him home fist to get showered and shaved and repacked, and I took him to his new room. This new center had a rule about no overnights, and this was a relief to me, but it didn’t take Jim log to find out that he could call me a 3 am and I would drop everything and drive up there. After 8 pm and before 6 am I had to park on the other side of the building and walk through a wing of aphasic (well, they couldn’t talk, just grunt) patients in order to get to Jim’s room.
On February 4 Jim was released. I had previously picked up the prescriptions that had been faxed into the pharmacy from the first rehab center release. But pain medication wasn’t included so I gave him some Ketrolac I had had for my knee and wrote a note to his doctor asking for vicoprofen. I got the prescription, then got the medication, and everything was fine.
At home he could not get comfortable in poor excuse for a recliner we have so we borrowed one from a friend. On Feb 13 we saw his (our) regular family doctor. I explained how the swelling in his vein-harvested leg was not going away, and that we had 5 more 40 mg. Lasix tablets left. I had read about bumetanide and asked if we could try that. She responded with a prescription for 80 mg tablets of Lasix and 1 mg tablet of bumetanide. She also wrote a prescription for a hospital bed, so he can sit up (so he can breathe) and keep his leg elevated at the same time. The bed arrived that night and he actually slept that night.
I knew Jim’s stoke was caused by an embolism which was released when the aorta was unclamped after surgery. I suspect an aortic embolism also caused his kidney problems, and why he had all those renal scans. The eye doctor found an embolism lodged in his optic nerve, which is causing a permanent blind spot in his eye. Our doctor told us her report listed pulmonary embolism as the reason for the lung scans.
On Saturday we bought a pill holder that dives the day into morning, noon and evening. Because Jim takes half a Lasix, half a Lopressor and half Lozol in the morning and the other half at night, I figured I could use an organizer. So I got it, and filled it for one week. I pulled out one day for him the next morning and told him to take the morning pills. When I looked later, all three boxes were empty. He had taken the whole days worth that morning. Later Sunday, February 15, (the 1 month anniversary of the surgery), I bought Jim a supplement called coQ10. This supplement is supposed to help heal and strengthen a post-bypass surgery person. It is expensive, but from what I read it seems important. What else if Jim, taking one month after surgery? Well, because of the pulmonary embolism he takes 2 puffs twice a day on in inhaler called budesonide. He takes a 50mg tablet of Lopressor, (metoprolol taertrate) which slows down his heartbeat. His 50mb tablet of coumadin (warfarin) controls the viscosity of his blood. The Lozol 2.5 mg (indapamide) helps control his blood pressure. He takes 80mg of Lasix to help bring down the swelling in his legs and he takes 20meq of Potassium of replace the potassium the Lasix removes. He takes 1 mg of bumetanide to increase the effects of the Lasix (and makes him pee every 20 minutes) He takes a 325mg tablet if aspirin, and he has a 200/7.5 tablet of vicoprofen (hydrocodone ibuprofen) for pain and a 15 mg. tablet of temazepam to help him sleep. I try to add to that a daily multiple vitamin, and of course the coQ10 I just bought.
In August, 7 months after surgery, a festering sore to the left of his navel finally broke free and exposed one of the blue leads that was left in Jim's body after his surgery. He pulled on it but it would only come out an inch or two. So I called his surgeon's office and we went in at 11. The nurse consulted with a PA, and they decided to pull it out, since the nurse had seen Dr. Cook pull one out just the other day. So she pulled and pulled but it only came out a few more inches. She finally gave up, and called another PA, who asked which side it was on and then told her to cut it off. She freaked out and said he had better come. She had seen the Dr. Cook pull out a lead on the left side of the body. Jim's lead was on the right side. Right side leads and stitched into the heart, left ones are not. Dr. Cook had failed to tell her this. Had she pulled any harder or any longer, she could have killed him.
November: Jim is on Lopressor, Coumadin, MS Contin (morphine)and Generlac (for constipation caused by the morphine) We cleaned up after three hurricanes in August. He got a little chain saw and cut up the fallen trees and I hauled the pieces to the sink hole. He has oxygen for the night, but after I burn the piles I rake up, he find he needs oxygen to help overcome the smoke. He continues to sleep in the relainer in the living room. Our greatest weekend was in August when we drove our son to Moody Air Force Base and spent the weekend with him there. He still slept in the chair at the motel, but he didn't take his usual afternnon naps and we even went to a restaurant.
On Surgey3
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