POD 1

So, post op day one.  I stayed late last night and she was still intubated.  She had some persistent chest tube drainage that was getting in the way of extubating her.  I just called and the chest tube drainage has dropped off.  Now she is on a CPAP (continuous positive airway pressure) trial and assuming that she does well with that (she will), they will extubate her in the next hour or so.  I'm going to grab some breakfast and head over there.

The Arcade in downtown Cleveland ca 1898. 
The original shopping mall. 
Now sadly, it's  pretty much empty

11:00 pm EST -  Very good day.  Kelly sat up for about 5 hours today.  She is very alert - not much different from her usual self - a little drowsy anesthetic overlay but not much.  Believe me, if you didn't know that she had just had extremely complicated, major heart surgery, you would never know.  Very little pain.  There are a few tubes that need to come out prior to leaving the ICU but that will all happen soon.  Then Step Down. This means a step down care level from ICU - it's good  - a few thought that this was demeaning but believe me, this is good.  A few days in step down and an outpatient follow up and we will be ready to go back home.  I don't anticipate further problems from here on and so do not know how much more I will post.  A story without drama and conflict is boring but right now, a boring story with lack of drama and conflict is just fine with me.

One thing Kelly asked me to add was a description of some of the surgery that I had gleaned from the surgeon.  Per Wierup is his name and he's from Sweden.   He is very soft spoken but extremely confident, "I am one of four surgeons in this country who can do this operation", "This needs to be done fast.  I am fast."  I know to some of you this won't make much sense due to the  jargon but this is part of what he explained to me about the operation.

The surgeon replaced 10cm length of her ascending aorta with a 2cm length dacron graft by pulling down on the ascending aorta from the innominate artery, sewing to the graft and then sewing back to the heart.  ("We can't prove that this is better but we think it is.")  He was worried that we would see subsequent CTs and only see 2cm instead of the 10cm he cut off - as if we were paying by the cm.  He did some more stuff including cutting muscle away from her interventricular septum.  But what blew me away is that he repositioned the mitral valve by moving two papillary muscles, little muscles about the size of your little fingertip, that work the mitral valve, along with their attendant chordae tendineae, strings that go from the papillary muscles to the cusps of the valve leaflets.   "I moved this one from here to here and this other one from here to here."  He explained it very clearly almost like a carpenter explaining how he moved a door from this part of a wall to this other part.

Sleep well.