Archives for category: Complications

I have lived another year, it is not my birthday on 8th July it was the first anniversary of my by-pass operation. Is it a milestone or millstone across my chest.

The scar is still red and raised it appears like I have an earthworm attached between my mammory glands image

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I have had numerous suggestions on how to make it less visible:
Cover it -do not wear low cut tops
Bathe topless – sunshine is good for healing
Bio oils – rub in
Vitamin E oil- buy best capsules you can, burst a capsule rub in the oil and take one also

 

Recently I read an article by Robin Korth called the Naked Truth where she talks about a man’s reaction to her aging body. I quote

“As I looked in the mirror — clear-eyed and brave — I claimed every inch of my body with love, honor and deep care. This body is me. She has held my soul and carried my heart for all of my days. Each wrinkle and imperfection is a badge of my living and of my giving of life. With tears in my eyes, I hugged myself close. I said thank you to God for the gift of my body and my life. And I said thank you to a sad man named Dave for reminding me of how precious it all is.”

I believe I have earned my scars, wear them do not cover them, it does not upset me and I am not going to spend money on buying clothes to suit you. Look away. Number two well hum. Bio oil has caused allergic reactions and had no effect on my carotid scar, so I am sticking with Vitamin E, literally and time, scars do fade and change with time.

Am I back to me? Are you well? You look so much better!
I could write a whole book on words – sentences not to say to people who are ill or convalescing. Simple rule do not tell me – ask me how I am, then try and listen or the conversation is over. Let us talk weather, soccer or the latest book.

Well no, I am not me not the one you new two years ago, I am like my house, we have torn bits out of it, created new better spaces, the snag list is long and new problems, needing renewal an repair raise their heads. I mean to say in the foundations and walks of me, that you know I am creating, building and renovating me, as I am today. Within the mess an chaos I transmute into an iteration of the me I want or hope to be.

They talk about post-traumatic disorder for soldiers but they now also recognise it for people going through cancers and other illnesses. You wake up in intensive care after the operation the trick is knowing and living with the body and person who you wake up as, learning as a child does what this body can do, what the mind an heart can comprehend. The best advice I can give is give yourself a hug and say thank you to your spirit guide, God whatever that you have that extra year(s).
Live large my friends.

 

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This is written for Women, whether you are having the operation (or looking after someone).

You will have a scar 6 – 10 inches long running down the middle of your chest and for some people there may be longer scars on one or both legs from just below the knees to the ankle. You will not be able to drive for upto 8 weeks, you need to sleep sitting up, you cannot make a cup of tea or coffee because you cannot lift a kettle. You are going to be in a lot of pain and discomfort and this could go on for months (or not).

REMEMBER this is NOT medical advice

So I am going to give you my shopping list and things to do:

To do list:
Get someone to clean and iron for when you come home you will break your ribs again if you do it too quickly. If you have a garden and it’s summer either ignore or give the responsibility to someone.
Have the numbers of people who will act as taxi drivers and the number of a taxi firm.
You will need some cash for things, so visit a cash machine.
Make sure you have a phone one that has credit and does skype/FaceTime and email/whatsapp is best. Learn to use it and remember the charger.
Get waxed everywhere, it makes stitches, stickers, bandages much less painful to remove.
Make sure you have stocked up heavy goods at home.
Fill the freezer ( more advice in later blogs).
Change the bedding
Organise a list of friends, family and relatives to visit, help,etc
Sort out your clothes so that they are easy to locate and easy to put, choose the bigger loose comfortable stuff. Shirt type tops dresses are best as easy to slip on.

Find or buy and put in a safe place:
A thermometer, paracetamol, ibuprofen gel (tablets not recommended), cream for babies bottoms,pen, paper, post it notes, baby wipes or facial wipes, antiseptic gel, tissues, favourite perfume, some personal care treats.

I used a couple of 500ml mineral water bottles for drinking as jugs were too heavy. I kept one in the fridge the other by the bedside, add a few pieces of lime or lemon rind, it makes it really refreshing.

Vitamins: vitamin C (500mg minimum), a general multivitamin, vitamin E capsules, take them if you believe. The Vitamin E capsules can be squeezed and the oil used on the scars, better than Bio-oil in my view and the recommendation of Plastic surgeon.

Pillows:  you are going to need three or four so make sure you have them to spare just for you. I also used a V shaped pillow to keep me supported. There are many available choose the one you like. This is not the one I bought just an image.

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BRAS

This is a nightmare, they tell you to buy a soft bra, I bought a masectomy bra, sports bra, wireless bra – DO NOT WASTE MON£¥. If you have great mammory glands not an A/B size you need to take care in choosing your support. My absolute favourite is GENIE type bra or equivalent from ASDA(Walmart) or other stores I paid 6.99. Or look for tops with support, never for work for my size but you may be OK. Get a size larger because your weight will go up initially due to the fluids in the operation, then You will lose weight. Anything too tight is painful, since I could not get a painless bra and other complications I ended up with red sore places under the breasts – baby bum (bb) cream worked a treat! Soaked soft dressings in the freezer also helped ease redness and heat in he wound or frozen peas in a plastic bag and then a sock all worked.

Packing for Hospital
There are two stages to this process before the operation and after – admission & recovery.

Admission
No jewellery, no nail polish, had you hair dyed and cut, all waxed and threaded, been to the dentist. Now packing – the wash bag toothpaste, brush, floss, hairbrush, hair ties, face cream, lip gloss or a small tin of Vaseline, body lotion, wipes, small pack tissues, roll on unscented anti perspiration, baby wipes, small bottles of body wash, conditioner, shampoo. You need flip flops and or slippers, the former to avoid getting foot fungus, so many people complain I thought I would tell you.

Clothes: night clothes any 2 sets, underwear 3, socks, set of day clothes and a shawl.

Food: a late night snack, drink of your choice.
Medicines take them with you.

Entertainment
I took my ipad and phone, little bit of cash and credit card. Check the credit of minutes on your phone I racked up a £300 phone bill and T-mobile never warned me or told me madam you are well over your limit. Buy a package of extra minutes or do missed calls. As my daughter said it was a small price for your sanity!
I had loaded it with Apps, books,and games. I bought wifi when I got there!

Recovery

Pack a larger back with night dresses or pyjamas that open to the waist, I had five kaftans made with zips down the front in soft cotton, the best thing ever, i lived in them. For day wear loose easy to slip on soft tops and joggers. Good walking shoes. Get them to bring in things that make you feel good.

For food anything high in potassium as your levels will fall dramatically, dates, bananas also prunes, linseed to make your bowels move ASAP you are out if intensive care! Dry biscuits if you have nausea.

Bed Sores
When my bottom and bottom of my spine began to get sore I got an air mattress, a special cushion and a swimming ring. The first two came via the district nurses, the latter I bought. I also used the bb cream. If you let the sores actually develop it will take a very longtime to recover, so take early precautions.

I was rarely hungry and I only wanted sweet or spicy food, for the first time in my life I got told eat anything, but you need nutrition & protein to mend and recover. So here is

Chicken Biryani

800g – 1 kilo of chicken pieces on the bone
1 tablespoon each of ground ginger and garlic
1 teaspoon ground cardamom green
Juice and rind of a lime
Salt to taste
2 teaspoon Kashmiri chilli, if you do not have mix cayenne and paprika
Mix together well
Leave to marinate for an hour

Now add:
1 teaspoon turmeric powder
1 teaspoon garam masala
1 tablespoon each of coriander & cumin powder
500 ml yoghurt
Piece of cinnamon
3 cloves
3 bay leaves
1 tablespoon tomato purée
Optionally add fresh coriander stalks and chopped green chillies. Leave to marinate again for as long as you can overnight is good.

Rice:
Basmati rice only otherwise make Paella.
Soak 2 cups of rice in cold water
When ready to cook fill a pan of cold water add, salt, 2 bay leaves, 4 cloves black, teaspoon pepper pods, cinnamon stick,2 brown and 4 green cardamoms. 1 tbsp toasted cumin or caraway seeds. If you do not want these spices in the rice put in a piece of muslin (bouquet garni)
Bring to boil add drained rice and cook for about 7min take. Couple of grains out, press down and if no hard bits drain immediately, if not give a minute more try again. It must not be totally cooked.

Make a purée of 2 large onions or use eazy onions can, 1 inch ginger 4cloves garlic, 2 green chillies, some coriander stalks and mint leaves if you have.
Now take a large casserole or pan with a tight lid, add a teaspoon of coconut oil
Add whole spices: bay leaves, cloves, cumin, cardamoms
Fry until they sputter, now add powdered spices – 1 tbsp garam masala,1tsp each turmeric, chilli powder salt to taste.
Stir fry for 30 seconds. Keep heat high add onion mixture stir well for 3-5 minutes, now add chicken pieces a couple at a time, until all in now add remaining marinade, stir well. Cook for 5 minutes, add some of the rice water or stock about a small cup full.

Now layer half of rice on top, sprinkle with garam masala, roast onions, herbs. Now add another layer of rice, spices onions and herbs. Over the top you can add saffron dissolved in 4tablespoon warm milk. Put on a tight lid.

Cook on a very low heat if possible put a griddle pan under the pot and allow to cook for 20 minutes. Check chicken is cooked. I have left it in a low oven for an hour at 140C. Eat with plain yoghurt.

To serve decorate with herbs, roasted onions, boiled chopped eggs. I also do a chunky salad of red onion, tomatoes, cucumber & lemon juice. Seasoning to your taste.

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Everyone has a different road to recovery, do not compare yourself to anyone else. I suddenly realised that I am writing about complications as if they are obstacles on the route, the point is that this is THE Route for me. It is my journey, good, bad, happy or sad. While there are things to be learnt on the journey and the trail may wander, it will not change. So I do not want you to think geez she had it tough, for me I have gained a lot from the process and this blog is a way of pulling that together. It is my conversation with myself, assessing the journey so far and into the future.

I relish the life I have, I read somewhere the Latin phrase Amor fati, loosely translated it means Love of one’s fate. Without the months of painful attempts of putting a foot In Front of another I would not have the love of walking that I now have. I love the fact I can walk freely in the cold, up an incline and for significant periods of time. A few weeks before this present obstacle I walked to and through the very park that I had failed to even get as far as the entrance for months. The very essence of breathing and walking have been opened up to my mind. How can I see this journey as complications only, as obstacles to be just overcome? I cannot. Instead they are part of the landscape on the road I travel.

To change my heart I need a new genetic history, I would have to have different parents, I do not want that so this is my history. I have beleaguered this point enough!

Let us get back to the tale, at one point the pain was soo bad that the GP had me readmitted to hospital, but two days later they had upped my pain medicines and sent me home. The breathing exercises continued and it seemed as if we were making real progress. All this time another part of the road was changing, while the lungs issue was like an undergrowth that had to be cut back. The new problem was a slow increase in humidity and temperature – the wound. It had continued to give out pus and was recovering slowly. Around it there was intense pain and I began to have severe night sweats.

Pain is not always pain. What does she mean? The implication is that when we move into a long term chronic illness we come so inured to the presence of pain that we do not realise the cause and nature of the pain has changed. We accept that this is the way of things.

So here is my advice keep a record of how you feel, record your temperature before you take paracetamol or other pain relief, when and how many you are taking of the pain killers.  If the trend changes, I was feeling better, now I am worse and its different because

I have night sweats, temperature, pain in my bones, redness, emphasis the new characteristics ignore the old. Doctors are simple souls, this is your life their 10 minute appointment . Make it simple for them, do not gve up, demand help!

Savoury Scones (healthier)

I never see the point of making a small quantity, be greedy or freeze or share. The secret to light scones is do not handle the dough for too long. Scones and soups are my clear the fridge recipes.

500g wholemeal and white flour mixed
1 tablespoon baking powder
1 teaspoon bicarbonate soda
1 teaspoon salt or half
Sieve this lot together.

Now add your herbs and spices, my favourite ingredient is red chilli flakes, I add a tablespoon, but you do what you like. Herbs I use together are:
thyme, parsley and oregano together
Sage with spring or red onions and parsley
Basil with sundried tomatoes and a hint of oregano or lemon rind
Coriander, capsicums, roast garlic, spring onions and maybe cumin

Fresh herbs I use 2-3 tablespoon of each, 2-3 teaspoons dried herbs.
Herbs vary I strength, thyme is bold, parsley is mild so blend carefully to your taste.  Mix  these into the flour.

I use up sour or fresh milk and yoghurt together to about 450 ml. Low fat yoghurt, skimmed milk, but if you are not worried about fat levels, go for it. I have used up all types of old cream, mascarpone and other dairy products. If the are not sour add a tablespoon of lemon juice.

Cheeses
I use a mixture of cheeses I do not stint on low fat cheeses adding a 200 g carton at times but I am much more restrained with the hard cheeses using between 50 -100g depending.
Cottage, ricotta, mozzarella, Parmesan, cheddar, feta,

Add the cheeses to the flour and herb mixture. You do not need butter or oil, trust me if you will eat them quickly, but if they are for keeping add two tablespoon of oil of you choice. I also add seeds sunflower, sesame, poppy a handful will do.

Now add the yoghurt/milk mixture to form a dough a soft dough, do not addit all. Get your hands in there, but if not use a food processor. If it’s too wet do not roll it out just put on to a floured metal tray using a tablespoon and pat them down. Other wise roll cut out place on metal tray ( no need to grease just put a light dusting of flour ). Put in a hot oven at 200C, gasmark 7 for about 15 minutes check them after 10 minutes. Take of tray if the bottom is baked, brown they are done.

Use as rolls, spread with butter, as they are, with chutneys, accompany soups really well.

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I was looking back at updates I provided to family and friends  and I noticed that every time I left hospital I was convinced it was the last. Every operation has it’s dangers and there are risks of complications. A CABG is a bigger operation so carries greater risk, in the coming I am going to go through some of the complications.

A week after my second admission to hospital I completed the walk from my home to the ASDA store over a mile away. This walk is significant it is my test walk, and I completed it in under 30 minutes and I got through the incline without problems. I felt that this was going really well, my HEART was well. Before my operation I had reached the stage that I had to stop about five times up the final incline and I was totally exhausted.

A Test Walk – this is a walk that tests your heart and you do regularly, it needs to include an incline or inclines, my route has a couple of gentle inclines and one though it is not very high it goes on for more than 200 metres. The target pace is one that gets me there in about 20 minutes, and I know that I can complete the inclines without resting or loss of breath if all is well with my heart and lungs. I always kept a record of the time and performance on the test walk.

Obviously a two mile walk may be too easy for some and too hard for others, choose something you will do regularly all year round.

A week later I was having problems walking at all and I was in an agony of pain, again! Complication 1 – allergies or side effects to medication
Complication 2 – pleural effusion, fluid build up in the lungs,

Symptoms of Pleurisy

Pain in the chest
Pain in the muscles of the chest
Persistent cough
Fever & General malaise
Pain is worse on inhaling and exhaling deeply or coughing

I always thought pleurisy was a complication of tuberculosis and kills poets, novelists Catherine Medici, Benjamin Franklin in history, what was I doing with it in this present time? So I cannot breathe, cannot walk and I am doubled over in pain, hand me that paracetamol and tromadol NOW!

The Cure – if pleurisy is not severe just painful take diuretic tablets and painkillers. You cure it by deep breathing and coughing. So to cure yourself you have to cause yourself lots of pain every hour by taking six deep breaths and coughing up anything that will move out. Masochism, I went to see a physiotherapist who used to torture me, she made me breath properly! Stand straight! Walk fierce! She also said I did not breath correctly, it’s true. I also had massages sitting up, and used steam with olbas oil. I chose not to use diuretics, probably a mistake, but I was wary of medicines after my latest experience.

There are different types of breathing- to learn more read yoga books, watch videos, read self help improvement volumes and writings to get the technical words, this is my experience. Breathing correctly is an important skill that I had to learn and practice.

Breathing 1

To breath without pain, breath in the stomach.
The stomach goes out as you breath in and goes in as you breath out. How did I do it so wrong and not notice? This type of breathing was the only way to reduce the pain of pleura friction. I used to put hands on my stomach and watch them go up and down.

Breathing 2

To clear the lungs of the fluid and push it upwards, breath deeply fill every bit. First empty the lungs breath out, do the last hoo to,get the last bits. Now breath through the nose fill the stomach, get the lungs full,the rib cage should come out. Now the sternum ( The scar area) your breasts should be pointed, juste when you think no more. Do a last couple of sniffs to get more in. Now breath out through the mouth, regulate the flow let the air come out, keep going pull in the stomach as if you are going to get in to a pair of jeans that are too small. Empty the lungs pull in that rib cage, now just as it feels like it’s done do a couple more hoo, hoo, out for those last bits of air. Do not let the shoulders rise, they actually increase lung capacity, but it feels like it. Breathing in front of a mirror helps.

If you feel phlegm cough to get it out, look up, controlled coughing. Or take a deep breath and let out in a controlled huff sigh

Breathing 3
Inflate the lungs. For this exercise I am trying to open the lungs only. So I put my hand on each lung rib cage so I can feel it move. Breath out, pull the stomach in, now breath in through the nose, do not inflate the stomach just feel the burn as you open up the lungs, start at the bottom and then fill to the top. Sounds simple but when it hurts where the pleura ( lung lining) rubs and causes pain you only breath in The top of the lung.

I also walked regularly through the day, sometimes for only 5 minutes, other times much longer. Walking was the only way I could last waiting for the next dose of painkiller. Things seemed to be improving, the length and distance of walking was improving slowly. After a time it seemed like I would get periods without pain. Surely I was getting better now?

My appetite was severely reduced I wanted highly flavoured food, sweet, spicy or sour. So the recipe I liked was Tom Yum Soup – vegetarian or chicken not prawns.

Quick Tom Yum Soup

Bouillion soup powder or stock cube, litre of water
Add finely chopped:
ginger or galangal 1 inch
3-4 garlic cloves
1-2 stalks of lemongrass
2 chillies
4 kafir lime leaves
Many times I added frozen garlic and ginger and bottled lemongrass to make it quicker and as it was painful chopping.

Add to the liquid and set to boil for at least ten minutes.
Now add vegetables of your choice or what you have finely chopped: carrots, broccoli, pak choi, mushrooms, baby sweetcorn, mangetout, capsicum. Again I added chopped stir fry packs to spees things and I did not have energy

Let them cook for a couple of minutes.

Now add tofu or cooked chicken.
Now add flavours : juice of 2 limes, 1 tbsp sugar, 2 tbsp soya sauce, 2 tbsp fish sauce
Taste and adjust to your personal taste.

Chopped: bunch of Basil leaves, coriander. Keep some for decoration.
Put in a bowl and enjoy.