Friday, September 12, 2008

Two Week Follow Up

On Tuesday Denise and I had my follow up visit with my surgeon. The only downer about the day was I didn’t actually get to see him. That was definitely a disappointment. However, I did have the opportunity to finally put a face to a voice when I got to meet Susan. She’s the one who runs the office taking care of all the scheduling and insurance matters. Every time I call she’s juggling this and that or on another call but she’s always given me her time and on this day was even able to make it over from her office to meet me in person.
Susan and I finally meet!

Dr. Reemtsen was in the OR working on another human who needed a life saving intervention so I’m not going to wallow in self pity but I was looking forward to seeing him. Of course it’s really no hardship being looked after by Anita and Vicki. They’re the pediatric cardiac surgery Nurse Practitioners who help take care of his cases. I‘ve had the utmost respect and confidence in these ladies from the beginning and have felt extremely comfortable in their care.

Anita was an ICU nurse for many years prior to becoming a NP and has now worked for over a year; most, if not all of it, under the guidance of Vicki and Dr. Reemtsen. The day before I was discharged Vicki told me how she and Dr. Reemtsen recently came over from Los Angeles Childrens Hospital in order to set up a successful pediatric cardiac surgery program at UCLA. A big factor in her decision to leave Children’s was the challenge of building a successful program as well as the opportunity to continue working with a top-notch surgeon in Dr. Reemtsen.
Anita and Vicki two weeks after surgery!

As far as my check up everything checked out A-OK. My heart sounds good, chest and lungs are clear, the incision is healing well and the holes from the chest tubes are now stitch-less and closing up. Two weeks after surgery the heart muscle has healed to the point where bleeding is highly unlikely, there’s no rub or murmur, swelling of the ankles or anything else I need to be concerned about.

So naturally the conversation turned to pain. What’s your pain like on a scale of 1-10? This one is a tough one to answer because there really is no horribly intolerable amount of pain in any one specific area. In comparison to my broken elbow a few years ago this is nothing. That said everything from the waist up is uncomfortable. This is especially true under the shoulder blades and in the sternum area. I was reminded how my body was spread out and opened up on the table for a long time. As if I really needed a reminder! I was also reminded that I’m going to be sore and uncomfortable for a good 6 to 8 weeks as this is how long it takes for the breastbone to fully heal. It will also likely take that long before all the aches and pains work themselves out and I’m feeling normal again. Along those lines it could take as long or longer for the numbness and tingling in my right hand to go away. I’ll write more about this soon but it’s not uncommon and is a result of irritation to the nerve caused by the position they put your body in on the table.

I mentioned in my last post that Adam Pick the author of “A Patients Guide to Heart Valve Surgery” suggests in his book that the single most important factor for people to consider prior to undergoing open-heart surgery is the confidence they have in their surgeon. The story of how I got Dr. Reemtsen is an interesting one and one I will detail when I get around to continuing the background as to how all this came about but for now suffice to say I’m extremely happy the stars aligned and our paths collided.

Unlike Adam who had to search through many surgeons before finding the one he wanted, I only had one visit with one surgeon before I felt like “If this has to be done, he might as well be the guy”. Thinking back to that day I remember leaving his office feeling like I had asked some good tough questions about the necessity of some aspects of the procedure and that I had really made him think in terms of whether he would do what was being asked if he was me. In addition, I had the feeling that he really understood what I was going through on a family level in terms of the risks and fears when it comes to having young children and a wife that depend on you being around. Dr. Reemtsen and I are about the same age and he has 3 kids. Specifically with regards to the Cox Maze procedure (which I’ll talk about more another time) I asked him to put himself in my shoes and tell me if he would do it if it were him. His answer was a thoughtful but confident yes and in fact he said he uses that analogy in every aspect of every procedure.
Dr. Reemtsen and I 3 days after surgery

Another big factor in feeling comfortable with him was that he was able to relay what needed to be done, the risks and what I could expect in a way that was immediately at my level. I’m a pharmacist with a pretty decent level of understanding for medical issues and his description and our discussion about what was going to happen took this into account. I did not feel like an idiot, nor did I feel like he was treating me like a less educated patient who could really only comprehend the basics.

Finally when it became obvious that he deals more with the pediatric patients I asked whether that would make any difference in the OR. Do you get used to working on the little ones so you get a little rusty on the bigger ones type of idea. His answer was no and in fact he then drew a line on the white board with one end representing the toughest of his tiny heart cases and the other end the easiest, least complicated cases. He then drew an X very close to the latter end and said this is you. He didn’t say it like, “yours will be a snap” but rather he made it clear he had the confidence in himself to know he could handle pretty much anything my heart was going to throw at him while recognizing that nothing in his business is routine.

I remember walking out of the visit feeling secure. Scared as hell since the ball was now rolling towards actually having this done but confident in knowing that he was the one who would have my life in his hands. It was not until after the surgery where nearly every discussion with every caregiver turned to a similar question in the form of “how did you get Dr. Reemtsen”. The question always phrased like or followed by “he’s one of the best and usually only deals with the difficult pediatric cases”. In fact one fella who worked in the ICU actually asked if I was a friend of Dr. Reemtsen and if this was how I got him as my surgeon.

How our paths crossed is a story of its own and I’ll save that for when I pick up where I left off in “A Racing Heart and a Realization” post. It was an interesting journey to say the least but ultimately I, unlike Adam, hit the bull’s eye with my first arrow when it came to finding my surgeon and I couldn’t be happier with the care I’ve received from start to finish.

For those of you coming into this little open heart surgery discussion a little late you can find all the posts easily by clicking on the Open Heart Surgery Labels at the bottom of this post or by clicking on the links under open heart surgery over on the right hand side of the blog. Those ones are listed in chronological order!


David Tripp said...

Did you like your card?


scubatripp said...

Yes I did, I'm not sure Morgan got it but we did.
Thanks for giving up your mom, today I think Morgan is going to make her swim in a freezing cold pool!

Rolf said...

My wife and I are big Brian Reemtsen fans, so I just came across your blog while sitting at my newborn son's bedside. So grateful for this man, his expertise and the many families blessed because of it.

scubatripp said...

Rolf, I've just read a small part of your story and want to wish everyone the best of luck and hope everything works out. Your comment actually spurred a quick post on my blog. You instantly made any and all of my current troubles seem pretty insignificant again.

Good luck and be strong!