Surgery went well!

[Mommy_of_3_in_AL..RN]

So dad had his open heart/double bypass surgery today. Things went as expected, and they found no suprises. They harvested a femoral vein and one from the shoulder area. He was extubated about 6 hours post op and did well with that. When we visited after extubation, he was still very groggy, but managed to ask for bacon and eggs!! I told him i didnt think that would be part of his diet for a while!! He has had several runs of VTach and Low BP, and is on amiodarone and dobutamine, but is looking better. He is also on albumin, and nipride as well as a few other drips. Drains look good..putting out average amount of drainage. UOP is great, breathing is great, and he is resting comfortably. They plan to get him up in the morning (i think that will be interesting). The only concern/question i really have...why does he not have a PCA pump..i would just think that after having his chest cracked he would. I know while intubated they cant push the button, but what is the reason to not have one after extubation?? I am just thinking that if someone cracks MY chest..they better give me one!!!!!

[SFRN]

You know I work in a cardiac surgical ICU and rarely do the cardiac pt.'s have a PCA...however, pt.'s that have undergone any type of major abdominal surgery will def. have a PCA.....usually the cardiac pt.'s can have their pain managed with IV meds initially and then Percocet or Vicodin once they can take oral meds....

[BelleKat, BSN, RN]

Supposedly a sternal incision is less painful than a thoracotomy or abdominal wound. Also IV narcs would complicate extubation. Prayers that your Dad continues on his path to good health.

[haras regnurps]

Believe it or not patients that have had their sternum sawed open do not hurt nearly as much as Thoracotomy incisions or Abd. incisions. They use far less pain meds during their entire hospital stays than some C-section patients. It has to do with the nerve endings in muscle and skin anatomically. When I worked post open heart my patients always complained more about having a late chest tube pulled than the pain in their chest. !

[haras regnurps]

ps

glad that your Dad did so well

hang in there and try and relax a little.

He may need you alot during the next few months especially after he goes home. Might be a good time to get the whole family on a exercise routine that would help him immensely.

[CHATSDALE]

i have cared for cardiac vs gall bladder [old fashion] and this very old woman was admanment that the gb was more painful

glad that the surgery was a success...some uncomfortable next few days

best wishes

[Mommy_of_3_in_AL..RN]

Yeah that is what i was told. I have dealt with a good many abdominal patients who are on PCAs, and seem to be in severe pain, but i really dont have much cardiac experience. It just seemed to me that an opened sternum would be worse..he hopefully will have the chest tube pulled tomorrow, so maybe he will have enough meds on board to deal with that.

Sad thing is, he was more worried about having to shave and have a foley:)