Walking After A Heart Bypass

He had the bypass Friday and took his first walk on Monday. I took him for a stroll along the ICU corridor. He was wearing his hospital gown and was wrapped in thin hospital blankets. He had on sky blue totes type socks ove knee high compression socks. He had to push his IV stand which he was still attatched to.

It took maybe ten minutes to walk about fifty yards. He did really well, more of a shuffle than a full walk, and it was clearly both tiring and painful, but he did it and I was really proud. He looked really frail, and older, but was determined to build his strength.

The hospital was really cold. It was 95 degrees outside but I was wearing jeans and a cardigan. It took a few blankets to keep him warm. The nurses were really sweet, they brought him blankets fresh out of the drier, still toasty warm.

His oxygen connectors kept disconnecting from his nose, working their way around his face, pumping fresh oxygen into his ears, so I needed to keep moving them around. I worried that I'd disconnect a wire, or knock a scar as I did it, so was absurdly careful.

Recovery From A Double Heart Bypass

Three days after the operation he was doing really well. He had his catheter taken out which made him feel far more human. He still had to pee into a jar, the nurses needed to measure how much fluid was coming out in the traditional way compared to what came out of the chest drain.


The big celebration of the day was that he farted. Yes, that's a major step apparently, it demonstrates that your digestive system has kicked back in. It was past time to move him out of ICU, but with no beds available I had no problem with the level of extra care he was getting where he was. The ICU nursing system was great, he started out with two full time dedicated nurses, came down to one full timer and now he was down to sharing a nurse with another patient.

He was getting more attention than he wanted. A 'tech' came by every hour to take his blood pressure and record his blood oxygen and to 'poke' him for a spot of blood to check his blood sugar. The nurse came by every hour to check his pain level on a scale of one to ten and adjust his medication as necessary.


Blood was a bit of a problem. They needed to take more than the drop every now and then, to be sent off for liver function tests mostly, that required finding a vein which wasn't easy. Having poked and prodded his inner elbows, forearms and the back of both hands the nurse felt he was torturing him so went to get another nurse to try. She had the same results so a third nurse came with a torch designed to highlight veins. It took a couple more attempts but she got it. It was hard to watch. He was compliant and polite, but it hurt, it was uncomfortable and really he was just too tired to be poked around.

His blood sugar levels were too high. They wanted it to be below 140 and he was tending around 160. This made no sense to me as in England the aim is for something like 7 so there's obviously a different scoring system. The shock of the operation on the system, as well as the glucose drip rather than real food for a couple of days was the cause. It wasn't alarming, just another minor worry. My mum developed diabetes partly through age and weight, but also as a result of high blood pressure medicaion she took for ten years so I was concerned that it was another complication waiting in the wings.

A priest came around to give him communion. He was a nice guy, and very surprised that my father knew of the town in Kenya he was from. They had quite a chat about post-colonial Kenyan politics and religion, which perked him up a lot. It was good to see him that coherent. He was off the morphine drip, but still on some fairly heavy drugs, which the Americans tend to refer to as narcotics, and I think were codeine based. They tended to make him dopey and vague.

He was up to eating real food, and the food was pretty good. He had plenty of choices each day and it was all presented in an appetising way. I ate pretty well too during my time at U of M Hospital. There were a wide range of visitor and employee dining options, which is helpful when you know you're going to be eating exclusively at the hospital for a week or so.

Immediately After A Heart Bypass

I arrived on the Sunday following the bypass surgery on Friday. My flights got in early and desipte scheduling some tight connections I made them all and so did my luggage. I was a little flustered at immigration when the guy asked me the purpose of my visit. He'd have been happier if I'd just said 'leisure' I think.

My Dad's wife was waiting for me and we drove straight to University of Michigan Hospital. It was weird walking through the airport doors and not seeing him. He'd had a good night and his blood loss had stabilised well. I asked her to explain what he looked like just so I could prepare myself. I was worried that I'd be upset when I saw him and he'd get upset and there would be a horrible cycle of tears. I find it easier to cope if I know what I'm up against.

I had to show ID at the Cardiovascular Centre reception. I was glad I had a Michigan driver's licence as anything else tends to cause problems. They printed me a badge with my photo on. That small level of security requirement made me very tense, I hadn't expected it, it felt strange to have to sign in at a hospital.

We went up to the ICU where we were met by another reception desk. We had to call through and the nurse came to get us. He was in the first visible room. He was recognisable as himself which was reassuring. I held his hand. I wanted a hug but it obviously wasn't possible. He looked healthier than I expected. I had expected him to look small, frail, pale and old. He looked quite fat! It was a result of all the fluid pumped into him during the operation.

He had a dressing on his neck where the bypass machine had been. Other than that there were no visible signs of his surgery. He was hooked up to a lot of machines. He had a morphine drip, a saline drip, a glucose drip, and an insulin pump all leading into his hand. He had three chest tubes going into two chest drains. He also had what looked like a little battery pack attached to a couple of wires - they were pacing wires which ran directly into his heart in case a re-start was required.

Another battery pack in the pocket of his gown was connected to electrodes on his chest which sent his heart rhythm and rate to a screen above his head. A peg-like monitor on his finger tip sent his blood oxygen level to the screen. He had oxygen tubes leading to his nose. He'd had a shave and his hair was clean.

He was very tired and the morphine made him dopey. He couldn't concentrate and didn't remember the answers to questions he'd asked. The overall effect was that he appeared drunk. He was concerned that he looked old and ill, but I felt encouraged by how normal he looked.

I later found out that in ICU they control the visitors carefully, to reduce stress and over excitement for the patient, to prevent nurses spending too much time dealing with visitors rather than patients and, rather worryingly, to prevent unwanted visitors. Dad had been asked when he was alone if there was anyone he didn't want to visit, as the nurse explained that it was sometimes a problem when ex-wives or estranged family members came along and caused trouble!

Bypass Surgery

He had a double bypass, we'd expected a single bypass but they did two, which makes sense really, I suppose the risk of having two at once is much less than one now and one next year.

The bypass operation itself took four and a half hours, but he was gone much longer. The prep time and post-op must have taken a while. To make the wait time a little easier the next of kin is given a restaurant style pager which flashes and buzzes when it's all over.

I rang in to see how he was doing and was given a new number as he'd be going back to Cardiac ICU. I spoke to the desk clerk who told me she'd get a call half an hour or so before he arrived, she estimated a time for me to call back. I called back, still not out. It's stressful being a long way away in such circumstances, although even if I was waiting on site I still couldn't do anything.

When he was out and the buzzer went his wife was allowed to see him for just ten minutes. It was such a relief to know that the operation had been successful. I know that hopitals do bypass operations every day, but it's a big deal when it's your dad (mum/ husband/ wife/ brother/ friend/ ...).

He hadn't been cleaned up, which was a shock, there was still lots of blood around which looked like bruising. The priority was, of course, to get him settled safely into a high dependency unit, where the clean up could happen, but it's useful to know that in advance.

He had a rough night, losing a lot of blood. The anticoagulants he'd needed to prevent another heart attack the previous night were essential to keep him alive, but now, prevented normal clotting around the wounds. It took most of the night, but they managed to stabilise him by morning.

Cardiac Catheterization

I got up and looked at what I'd written down. I went to the computer and rang University of Michigan Cardiovascular. I was passed around a bit before I got through to the nurse treating my father. I asked how he was doing, she asked for the codeword. I didn't have codeword which did make me panic a bit.

I explained that I didn't have the codeword, but that I was in England and I was worried and I couldn't get the codeword because I'd have to wait until my father's wife was awake because I didn't want to wake her, gabbling away making little sense. The nurse took pity on me and sked what I knew. I talked through my understanding which gave her enough background to believe that I was who I thought I was andthat I was far enough away not to cause trouble, and re-assured me that he was OK, I shouldn't worry, he was in good hands.

I later found out he'd had a Cardiac Catheterization, which I had to look up because I think it's better know in England as a Cardiac Angiogram with the catheter going in through a vein in his thigh. They looked inside his heart and found one artery almost completely blocked. It was too badly blocked to make use of a stent to ease the blood flow. He needed bypass surgery, the two approaches are explained well by the BHF in this leaflet.

His surgery was scheduled for the following day, provided there were no emergencies to bounce him down the list.

He got bounced up the list, he became the emergency, having a heart atack that evening, hilst hooked up to all the machines. The gave him three shots of nitroglycerine to get him back on track. Id never thought of nitro as anything other than an explosive, so it sounded pretty scary. The Heart and Stroke Association in Canada had a sensible explanation of nitro in heart care.

He was pushed up the list to have surgery at 7am the next day.

The Phone Call

The phone rang at 1:17am. No-one calls with good news in the middle of the night. It was my father's wife. She was very calm and soothing, apologising for waking me, telling me Dad was fine, but he was in the hospital.

I sat up, she explained he's had a heart attack whilst working on a friends house. He was in the hospital in Ann Arbor at the University of Michigan Hospital. I got out of bed and went downstairs. I had to write it down other wise I was worried I might wake up in the morning and think it was a dream.

I didn't know what to ask, what to say. I was confused, frightened and upset. She explained that he was going to have a catheretisation. I had no idea what that was so I wrote it down. We agreed I'd call her the next day on her mobile as she couldn't call internationally from the hospital.

I looked up the hospital on the internet, it looked good. He was in the new, state of the art U of M Cardiovascular Center. I looked up flights, they would be reasonably easy to get and affordable. I went to the loo and stayed there a while. I looked up Catheterisation. They were going to send a probe in to look at his heart and see what was going on. It made me think of Fantastic Voyage. I was terrified by that film as a kid. I went back to bed, but didn't really sleep.