"Mental Preparedness"

[Lasker]

Hello All,

Thanks to all of your who were so kind as to respond when I posted my initial question under "valve selection." Now that I am comfortable with a biologic valve and choice of surgeon and hospital, I think it is time to move to the presurgery forum to post my next question.

I will enter the Westchester Medical Center on Wednesday, December 10 for a followup catherterization to image the coronary arteries so that a determination can be made as to whether bypass should be done at the same time as replacement of the aortic valve. Five months ago the condition of two arteries was borderline. On the next day, December 11, the surgery will be performed by Dr. Richard Moggio.

My thoughts are turning to the hospital experience and some suggestions that I've read on this website about waking up in the cardiac intensive care unit. Some of you were aware of the breathing tube when you awoke, and cautioned not to fight it. I am wondering what exactly can one do to relax into the situation. Others spoke of being mentally prepared for the experience of awakening.

I would like to prepare myself by hearing your specfic
suggestions. Perhaps there is a particular thread you could point
me to, or feel free to make your suggestions here about useful techniques, method, exercises, etc.

Thanks so much,

Lorraine

 

[Ross]

Lorraine that is kind of difficult to answer because everyone is so different. In my case, I was so sedated that I didn't know I was fighting the tube. Most people are sedated like that. I've been tubed so many times that I can tell you that when you are lucid enough to know it's there, try to resign to it and breath with it instead of trying to breath off cycle against it. It's really really hard to describe what I mean, so I hope you get the jest of what I'm saying. I'll let others elaborate on the waking experience because I didn't get along well at all with the Anesthesia and my entire case was not the norm.

 

[Lasker]

Thanks for your prompt reply, Ross

I'll try to "breathe with it" but hope that I will be sedated.

Lorraine

 

[Kim]

Lorraine,
I was on the venilator for 5 days following heart surgery. I vaguely in my subconcious remember hearing my surgeon tell me "to work with me and I will get that tube out of there." I can honestly say other than that, I have no recollection of the tube at all. I don't even remember it being removed. My cardiologist and surgeon knew I was terrified of the breathing tube. I requested to be sedated enough to not remember it. I don't know if they complied with my request for the sedation or if I was just so sick that I don't remember.
Good luck and I will keep you in my prayers.

 

[RickKiem]

Lorraine, I have been having the same concerns and wasn't quite sure how to pose the question. I hope that you get some good advice that I can also use to help me through this also. I hope that everything goes well for you.

Rick

 

[ALCapshaw2]

Lorraine,

IF your lungs are in good shape (non-smoker, no lung diseases, reasonably good condition), more then likely, the breathing tube will be pulled before you become aware of your surroundings. That was my experience for two surgeries.

'AL'

 

[Lasker]

Dear Al,

I'll take heart from your response, because, by your definition, my lungs are in good shape.

Dear Rick,

We'll be following this thread together to learn what we can to smooth the way.

When is your surgery?

Lorraine

 

[Lasker]

Dear Kim,

I'm sorry to hear you were so ill after your mitral valve surgery that you had to be on a ventilator for five days.

Actually, it is for a mitral valve prolapse that I was being followed by echocardiography, and that is how a more recent and suddenly severe deterioration in the aortic valve was discovered. There is a small chance that the mitral valve would need repair during the upcoming surgery.

I trust you are well now. Thanks for your wishes,

Lorraine

 

[Gnusgal]

I don't know how to explain how to "mentally prepare" for the breathing tube. I've had two OH surgeries now where I woke up aware of the breathing tube. The first time I was unprepared. I had been told about it, vaguely, but didn't know what to expect. I ended up choking on it repeatedly. My husband (then boyfriend) had to remind me in my sleep to breathe.

My second experience was completely different. I remember the few times I became aware of the breathing tube and would start to choke I would mentally tell myself "breathe, Niki, and then they'll take it out." I guess it worked. I didn't have nearly the bad memory of that time as the first one.

From what I understand after talking to my mother and husband who were with me all the time for both surgeries, I remember very little of the breathing tube. I used to think I remembered a lot, but I really don't. I only have little snippits, then I would go back to sleep.

Don't know if that helps or not, but I hope you will be prepared when your time comes.

 

[hensylee]

I didn't know of this site before surgery so had no idea of what was going to happen to me. One thing you have is the experience of all the vr members - take it and use it to your best advantage. Just knowing ahead of time will help you. As for me, I don't recall the tube being in or coming out. But hazily, there's a memory of waking to see my son above me and feeling 'loaded down' with paraphernalia - guess it was the tube. But my memory isn't unpleasant. I hope you can sleep through it, but if we think about things ahead, we are mentally preparing ourselves.

You will think of other questions before Dec 10, so be sure to ask them so you can have as much info prior surgery as you can get.

 

[bvdr]

The ventilator is programmed to inflate your lungs at a certain rate and a pre-set volume according to what your particular situation requires. The ventilator also has pressure limits set so your lungs don't get over-inflated. Every once in a while it will even give you a "sigh" to mimic normal breathing.

In order to do this there is a tube going down your throat with an expanded air-filled balloon around the outside of it to totally fill the space so you can't add to the pre-set air volumes. If you are awake enough, you will become aware of the rhythm of the machine. If you use your respiratory muscles to breathe in when you know a breath is coming you won't fight the machine. You won't be able to talk while on the vent so that may be frustrating.

While you are on the vent you arn't able to clear your own secretions so at times a small catheter will be used to suction you.

You will get the right amount of oxygen while on the ventilator and the staff's goal will be to get you extubated and breathing on your own as soon as it is safe to do so. I don't really remember much of being on it except when I was extubated and that was done quickly. I was very hoarse and very very thirsty. Water never tasted so good!

I was planning on trying to imagine I was scuba diving or something (since you can't breathe through your nose while on the vent) but I wasn't awake enough to imagine anything.

The staff said I was really fighting them and gave them a hard time the first few hours in ICU but I remember none of it. The first I remember is someone yelling at me to keep my hands out of the way so they could take the tube out. And from the tone of the voice I knew it wasn't the first time I was told that. Not a nice way to wake up but of course they didn't know I was so out of it and at least the tube was coming out!

You should do just fine.

 

[RickKiem]

Lorraine, My surgery is actually tommorow, Nov. 4th.. Looks like it will be an AVR along with an ascending aortic aneurysm repair. Wish me luck! We will be following up on your condition as soon as we are able to.

Rick

 

[Heather Fisher]

I woke up in ICU just as they were transferring me out of the OR. I didn't know to request anything to keep me "out of it" while on the ventilator. I remember I didn't like the ventilator but was resolved not to fight against it. My greatest difficulty was managing my secretions and felt like I was choking. Fortunately the nursing staff was there to suction. I only stayed on the ventilator for 2 hours total. If you are awake the test appears to be if you can lift your head off of the pillow. It is a wierd feeling to awaken and realize that you can't move your body, kinda like being paralyzed at first. Just try to relax and go with the flow. It's better knowing what it feels like before the procedure than getting a total surprise after surgery. Everyone's experience is different. Good luck you guys, you will do just fine!

Heather

 

[Lasker]

Dear Folks,

It was helpful to hear from you, Gnusgal, Hensylee, and Heather--I so much agree that it is better to know than to be surprised.

Betty, you must be a health professional to know and relate the ventilation process so well. I am concentrating on what you said, to use my respiratory muscles to breathe in when I know a breath is coming based on the rhythm of the machine. It is also useful to know that I won't be able to talk while on the vent, and that if I feel I'm drowning I may be saved by a nurse with a suction catheter. Since I already wake up hoarse and thirsty (as a mouth breather with sinusitis), there are nagging fears about these possibly unpleasant experiences, however minor they are in the total scope of things. Thanks so much.

I trust your responses were helpful also to Rick, whom we wish much luck tomorrow.

Lorraine