Hannah’s recovery from heart surgery | Day 4

Showers and other shenanigans

I got back to the ward at around 8am.  Hannah was awake and said hello.  She still had the nasal prong oxygen but no longer needed the additional waft from the oxygen mask (I think that stopped last night before I left) and her O2 Sats were still between 98% and 100%.  Getting up & mobile and doing all the physio breathing exercises obviously helps.

It looks like the morphine (hasn’t had any since yesterday morning) is finally working it’s way out of her system as she’s a lot more alert.

Pain-wise, she is quite sore/achy of course, but managing on Paracetamol and Diclofenac.

Hannah managed to walk into the bathroom again to use the toilet and this time she sat in the shower (and even stood in the shower for a bit) for a proper wash (excluding wound areas of course).  She said that felt great!  She then got dressed in proper clothes rather than PJs and sat in her chair for ages – had a bit of breakfast, only a few Coco Pops but then had some chocolate (her favourite – Lindt – that Simon’s mum bought her).  She watched a bit of telly and even had a bit of banter (mostly by giving her sister the evil eye!) with Charlie 🙂

Charlie has been a fab big sis this morning, helping Hannah get dressed etc. 

When she was on the floor, putting Hannah’s support / anti-DVT stockings on for her, I said “You’re being really good” and Charlie shot me an annoyed look, saying “She IS my little sister!”.  

The physio came and got Hannah to do some more of her breathing exercises and listened to her chest.  She was pleased with how she’s doing and said she’ll send a colleague round to have a look at her on Monday. She obviously still needs a bit of oxygen support because the pneumothorax is preventing her from opening her lungs properly.

So far, so good.  It’s 10.45am at the time of writing this and we’re just waiting for the (slightly later as it’s the weekend) ward round.

A good day – lots of hard work for Hannah

I’ve picked up writing this blog again at 10pm as Hannah has settled down to sleep for the night.

Hannah has spent most of her time out of bed in her chair today.  She’s watched telly and DVDs, she’s had a lot more conversation (her voice is still really weak though as she can’t quite fill her lungs properly yet) and we’re seeing the old HanBan re-emerge…she smiles lots, she laughs (soundlessly as she can’t get enough air in her lungs to laugh properly yet) and gives raised eyebrows and annoyed sideways glances to anyone that says or does anything embarrassing or that she doesn’t approve of in some way.

At one point in the afternoon, as I’d already fallen asleep in the armchair (not that comfortable for sleeping!) while Hannah had a nap in her bed, I went back to parents’ accommodation to have a quick power-nap and pick up my overnight bag (my turn to sleep on the ward tonight).  In that time, Hannah had obviously woken up from a very brief nap, because when I my alarm went off after 40 mins sleep and I checked my phone, I noticed Hannah had been on Facebook and started ‘liking’ various posts I’d put up about her progress and other people’s posts/comments about her.  She’s definitely starting to feel better!

Funny moment of the day

Hannah was saying goodbye to Nanny (Simon’s mum) and Auntie Nic (Simon’s sister).  Charlie was going back home with them so she said “Can I get a kiss and a hug?” and at that point, Hannah dropped her head on her chest as if taken by a sudden exhaustion!  Sisterly love…nothing changes! heehee

Oxygen

Every hour, she’s done the breathing exercises with the incentive spirometer; she has to do 10 deep breaths every time and we only count a breath if she reaches at least as high as the highest she previously reached.  The volume she’s managing to breathe in is slowly increasing as time goes on!  Hannah’s also had lots of walks up and down the ward, accompanied by a portable oxygen tank.  At first we just did one walk up and down the ward, then we increased it to two each time.  It wore her out every time she did it so we’d do it when she wanted to go back to bed for a nap, then she’d go and sleep for half an hour or so before getting back out of bed and into a chair.

When she did spend a bit of time in bed towards late afternoon, watching telly, she sat up as though she was in a chair, so her lungs were still filling nicely.

As the day progressed, each time she got up and walked, she was stronger and needed less support, even though the activity wiped her out.  She is determined to get home as soon as possible and doctors are starting to talk about ‘home’ as something that may be on the horizon for early next week.  One of the doctors told her today during ward rounds that he doesn’t want to make her feel bad, but most other kids at this stage of their recovery from heart surgery are running up & down the ward…I did tell him that she would have been more active sooner if she’d not been so zonked out on morphine and other sedatives and that she’s really going for it now she’s actually awake!

Hannah’s appetite is still not massive, but she is eating and everything that should be happening as a result of eating and drinking is now happening as it should.

Of course, after all the time of being on restricted fluids and begging for water, she now doesn’t want much to drink and the nurses keep trying to cajole her into drinking MORE as the fluid balance is going the other way.  Oh, the joys!  Not like it’s something we haven’t experienced before…

Once she’s got into the bathroom, she can now be left alone on the loo rather than needing someone there to make sure she doesn’t collapse off the toilet.  She’s able to stand at the sink and brush her teeth and needs only minimal support to reposition herself in bed or in a chair.

Hannah got more lovely cards today and was able to appreciate them a bit more as she was so much more alert.

Hannah had another X-ray today and they can no longer see the pneumothorax (nor, I think, the consolidation at the bottom of her lungs).  I can still feel the pneumothorax (and if the raised bit on her chest on exhale is due to that, I can still see it, albeit it’s got smaller / less noticeable), but it’s obviously nearly gone.  As a result of that, the doctors were happy for the last (huge!) cannula to be removed from Hannah’s hand.   So all she has now is the O2 Sats monitor on her finger and the oxygen prongs in her nose, though those should come off soon, too.  Because her lungs are now fine, they’ve started weaning her off the oxygen.  She was saturating at 100% most of the time on 2litres going in via the prongs.  She’s now saturating at the same levels on 1litre (dropping a bit after she’s gone for a long walk but then they pick up again straight away).

Tonight, Hannah’s lying in bed on her side, like she normally sleeps at home, rather than on her back sitting almost upright (good job she had so much sedation running through her system…nobody can sleep like that all night!).  The top of her bed is only slightly elevated.  Despite this less than optimal position in terms of lungs expanding, she’s still saturating at 98-99% in 1litre of oxygen through the nasal prongs.  considering that O2 Sats naturally drop when we’re asleep, that’s really excellent!

Oooh, in fact, as I’m writing this, she’s gone up to 100% briefly and seems to be mostly at 99%…and that’s with just the 1litre of oxygen, being very fast asleep AND lying down with her lungs all scrunched up as she’s lying on her side.  Excellent – onwards and upwards.  Fingers crossed!

Did I mention the amazing plaits I’d done pre-surgery?

Just about everyone in intensive care and on the ward has commented on what a great idea those 2 french plaits were and how well I’d done them.  They’re still in!  Ok, they’re looking a bit worse for wear and there will be some knots with the hair that’s out of the plaits, but for the most part, they’re still in place and stopping Hannah from getting her hair all knotted up and also keeping her cool.  I’m quite chuffed with myself! 🙂

Puke 🙁

So far, every day we’ve had at least one small vomiting incident while Hannah takes her tablets.  She’s never had a problem with tablets, having swallowed multiple ones (even large ones) in one go from a very very young age.  In fact, she’s insisted on having everything in tablet form rather than liquid form.  But every now and again, she seems to start choking on them when they’re still in her mouth and she can taste the bitterness as they’re starting to dissolve.

Tonight, it was my turn to ‘catch’ the vomit in a very tiny tray that had contained her tablets and was really not fit for purpose.  Luckily she didn’t throw up that much!  Bless her, she apologised to me (again!) 🙁  I did tell her that she has nothing to apologise for.

I keep pinching myself – is it really going this well?

I know we have a long way to go yet – even once Hannah’s home and then once she’s cleared to go back to school, it’ll be a while before she doesn’t get really exhausted and drained from simple everyday activities.  She has dark, dark circles under her eyes and is very pale (they were testing her for anaemia earlier, I believe…must find out the outcome tomorrow) and gets terribly exhausted very quickly, but she IS progressing more or less textbook fashion in terms of typical recovery from heart surgery (for kids, anyway – and as she’s adult-sized and has adult physiology, that’s really impressive).

Given our previous experience of her taking such a long time to recover as a baby (I know she was very weak before that operation, whereas she had this one at a time when she was doing really well) and our experience of Charlie being in and out in a week after her major surgery in 2001 and then spending a month in hospital again after being rushed in with post-op complications, I keep thinking “it can’t really be going this well”.   I’m waiting for some major set-back along the way…if it comes, I’ll be prepared, I guess.  For now, I’m just immensely grateful!