4 months after surgery

122 days since my surgery (4 months)

Four months ago today I went into the hospital and had open heart surgery. It seems like a distant memory and also feels like it never even happened. Unless I look at my incision scar.

My scar is actually getting much better - I have been using sicilone strips to help it heal flatter and smoother.

My niece is a cardiac surgical nurse at a children's hospital, and also has had some hip surgery in her past. She recommended these, and she showed me her scars --which you can barely see - that she used these on.  So I am hopeful they will help my scar get flatter.  Really the only part not flat is the top where the suture knot was.  Sometimes it is a little raised and then if I wear the silicone strips it goes down flatter. 

I am still waiting for my spot in the cardiac rehab program.  My friends on the AHA support group highly recommend I do it, so I want to. But it's been FOUR MONTHS! I can't believe how backed up they are!

Surgical Incision

 **WARNING** I am sharing photos of my incision and scar for people who want to know that to expect. These are not great photos, and they are personally awkward to share. But I want to help people.

So please do not proceed unless you want to see surgery scars that are not fun to look at. 

But they also aren't really that bad. 

Scroll down to see.

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Stop now if you do not want to see a big incision scar.

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So what you see at the very top is a lump that you have after surgery that will go down over time. It does, and they tell you this. But it is weird when you see it. 

The top of the incision is where they tie-off the stitches with a "suture knot." More on this in a later post. They actually sew you up from the bottom to the top. 

Woman have to wear a bra 24/7 for a month or so because the weight of the breasts will pull on the incision. The incision itself is about 6" long for women. Below the incision you see 2 scabs - these are from where the drain tubes were removed. These scab up and are there for quite awhile. 

There are so many tubes and lines and monitor patches they put on you, that your skin takes quite a beating. The adhesive is also almost impossible to remove. What looks like gray glue on my skin is all of the adhesive.

Honestly, this was not as bad as I had thought it would be. I was far more aggravated by the dang surgical glue. After 4 showers it was still there. I finally got some adhesive removal wipes from the nurse at my follow up visit.  Ask for those before you leave the hospital - you will need them.

Men with body hair might have an even harder time with the adhesives. I am not sure.

Below is a picture after almost four months.

The incision is all healed but is still a bit red and raised. Based on what the nurse told me before surgery, it will take about a year or so for the scar to heal into a less visible state. 

This photo doesn't show the drain scars but they are all healed up as well. They were big scabs for a very long time.  But once they fell off it was all soft new skin underneath.

The top of this scar is where the suture knot was, and it is more raised than the rest of the scar. This is where the silicone scar tape should help me. But again, this will take time.

I will take more photos in the coming months so I can share how the scar progresses.

Day 29

The tape from the gauze bandages pulls on my skin all day and is really aggravating. I switched to Band-Aids tonight and I put a small Band-Aid over the top of my incision and went over each of the drain scabs. It was way less irritating. I really want everything to heal up and I’m hoping that that happens soon.

The pain is definitely way better, but I’m still constantly aware of my chest muscles in my chest. Some of it maybe the healing of the incision and I just don’t know it. Feeling is slowly coming back to my chest area as well. My energy levels seem to be improving too. 

Lastly, I took my very last oxy. I’ve only been taking them at night when I’m falling asleep. I don’t like the way they make my head feel so foggy and disoriented.  And my nightmares and dreams have been really odd. We’ll see how I feel tomorrow.

I took a shower tonight and I think I feel the most normal today - the bandaids might be helping.  I’m a little more fatigued today but still feel 'better.;

Day 23 - Suture Knot Issues

Today I woke up and I noticed that at the top of my incision it looked more red and was like it was bleeding. I took a picture and sent it to the NP at the surgeons' office. She got back to me told me that’s my suture knot. 

In addition to gluing the outside of my skin, they stitched up the inside from the bottom to the top and the suture knot at the top is where they tied it off. 

She said it may poke through the skin and keep bleeding from time to time, but that it looked OK.  I can put a piece of gauze or a bandage over it.

I could actually feel something sticking out when I was washing it in the shower, and I asked if it would dissolve and she said yes, but not for another few months.

This is the kind of thing I kind of wish I knew in advance. Because they told me I was glued shut. Nobody said anything about a suture knot. 

I’m guessing the suture knot is why there’s the lump at the top of the incision. I know they told me that that’s why they closed it off. I’m also wondering if as the swelling of the lump is going down, it’s somehow impacting the suture knot?

**WARNING** Gross photo of suture knot bleeding.

Do not scroll down if you do not want to see this photo. It is gross.

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You can see it is bleeding at the top, and there is a hard plastic piece I can feel there, too, 

Day Two. Wednesday.

Today I saw my incision scar.

They removed the incision bandage this morning and I got my first look at my scar. It actually wasn't that bad. I have photos elsewhere on the blog of the incision if you want to see it. But they use internal glue or something so the scar wasn't anywhere near as bad as what I was expecting.  

I had very little feeling in my chest, and across my chest. They told me it will take months to get some of the feeling back as nerves are cut when they open the chest for the sternotomy. It takes months for those nerves to grow back and some never will.  It was a strange sensation but not bad.

A word on pain killers.

They were giving me oxycodone 10 every few hours, along with Tylenol. I did not like how the drugs were making me feel and I asked them to stop giving them to me. I felt like I was in a woozy dream state, and I also had terrible dreams the night before.  I was taking the Tylenol and they gave me something else that was not an opiod.  But I was also not able to get comfortable, and the head NP on the floor came in to talk to me.

The NP explained that they felt it was necessary for me to be on them to ensure I was not in pain, and that without them I might feel pain that would hinder my recovery. They assured me that in-hospital use of opiods was safe and even necessary. We agreed I would go on the oxycodone 5 instead of the 10, and that I would let them know if I was feeling any breakthrough pain and needed more.

Shifting around in bed, or in the chair, was uncomfortable, and my back was sore from lying flat on it for so long.  (News flash: you will be sleeping flat on your back for a couple of months, so get used to it.) None of this was unbearable pain, but when the physical therapists came for me to take a walk, getting up out of bed and standing was uncomfortable - but I think it was mostly pain originating from the drains under the incision. 

Catheter out - able to go to the bathroom!

They took the catheter out today and I was able to go to the bathroom.  The physical therapy team came by and had me walk a little bit to show them I was able to do it. 

The nurses cleaned me off today with some wipes, but I felt damp and gross. Luckily I had brought my powder with me, so when I went to the bathroom I was able to powder up a bit and feel a little more dry and less gross. Hard to explain, but I wasn't able to shower yet.  And those wet wipes they use smell medicinal, and really leave you feeling wet and damp down in your nether area. (I say this as politely as I can.)

They took the saphenous vein from my left leg, and today I was able to really get a good look at my leg. Here are a few photos. My legs were both swollen, this one more so than the right leg because of the surgery they did to remove the vein.

So on the left is my inner thigh, and there are steri-strips covering the top incision. This was a small incision at the top of the saphenous vein. These have to stay on until they fall off. It took about 2 weeks for that to happen. 

The middle photo is the incision near the crease of my leg where they did the big incision. You can also kinda see a line that goes down my leg, following where the vein used to be that they used. 

The photo on the right shows the small incision at the bottom of the saphenous vein where they made a small incision there, also covered by a steri-strip. These didn't hurt, but I did not have a lot of feeling on my leg near the big incision. This is because some of the nerves were cut and I was told this would take time.

You will be getting up a lot to go to the bathroom.

They had me on a diuretic to remove the water from my system, and you can tell you are holding water by how swollen your legs are.  This means a lot of trips to the bathroom.  From the time I entered surgery to the time I was weighed the next day, I had gained 20 pounds. This is mostly fluid and it is from the blood and other "products" they give you in surgery. 

They also removed the drains today.

The drains from your chest are also removing fluids and blood and you see it in the bag next to your bed. I wish I had taken a photo of the drains, but I didn't. 

They have you hold your breath when they remove these, but it does not hurt. It feels a little strange, but there wasn't really any pain.  But I was very glad to have them removed and found that some of the discomfort I was feeling was gone when they were removed.