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Update on Richard's medical adventures
Jul. 10th, 2016 03:20 pmHe got a nice little Medtronic pacemaker installed on Friday and it went fine. The echocardiogram that they did before the procedure showed no additional abnormalities and good ejection fraction (60%). We had Dr. Schultz at Methodist Heart Clinic (highly recommended). His initial explanations were clear and his post-surgical follow-up was surprisingly hands-on. He said he had installed about 3,000 pacemakers, so I guess he knew what he was doing.
Since there isn't much else to do while sitting in a hospital room with an uncomfortable and grumpy patient, I watched the oscilloscope. The pacemaker is set to kick in whenever pulse rate drops below 60 bpm. Measurement is on a momentary basis, so there should never be more than a second between heartbeats. Before the pacemaker, there were some very obvious intervals of 3-4 seconds even in a time window of a couple of minutes. Once the pacemaker was installed, no more of that. The heart monitor displays the pacemaker beats slightly differently so you can see exactly what is going on. There is typically at least one pacemaker beat every minute. Sometimes these helper beats are very intermittent. Other times there will be a stretch of 30-60 seconds where pretty much ALL the beats are from the pacemaker. At these times Richard's pulse was precisely 60 bpm. So... working exactly the way it's supposed to. And he clearly needed it.
The biggest problem was back pain from the fall on July 3. X-Rays did not show any fractures, but there clearly is minor but painful bone damage (probably to the bone spurs that glue his spine and ribs together). The staff was very patient and did their best to find comfortable positions for him, but after a whole day of being shifted from bed to wheelchair to another bed or table he was in a lot of pain. He had a very bad reaction to the opioid-based pain meds (dilaudin), which just made him more miserable. Once the narcotics finally wore off, he was back to just Tylenol. From my personal experience I have always suspected that acetaminophen is just a big word for "placebo" but it does seem to work for Richard. Unfortunately the hospital nurses had never heard of doxylamine, an OTC sleep aid that works like magic on Richard. They gave him some other hospital type sleeping pill that didn't work nearly as well, so he had a bad night.
He was still very out of sorts when I went back to collect him on Saturday morning. However, he perked up a lot once he got home. His back still hurts, but now that he can move around on his own he is much happier. He's sleeping in a recliner, but that seems to work pretty well for him. The incision doesn't seem to be bothering him at all, and he is no longer having dizzy spells! It will probably be another month before his back has healed, but the next available date for the rescheduled hip surgery was in September, so he has plenty of time to heal.
Since there isn't much else to do while sitting in a hospital room with an uncomfortable and grumpy patient, I watched the oscilloscope. The pacemaker is set to kick in whenever pulse rate drops below 60 bpm. Measurement is on a momentary basis, so there should never be more than a second between heartbeats. Before the pacemaker, there were some very obvious intervals of 3-4 seconds even in a time window of a couple of minutes. Once the pacemaker was installed, no more of that. The heart monitor displays the pacemaker beats slightly differently so you can see exactly what is going on. There is typically at least one pacemaker beat every minute. Sometimes these helper beats are very intermittent. Other times there will be a stretch of 30-60 seconds where pretty much ALL the beats are from the pacemaker. At these times Richard's pulse was precisely 60 bpm. So... working exactly the way it's supposed to. And he clearly needed it.
The biggest problem was back pain from the fall on July 3. X-Rays did not show any fractures, but there clearly is minor but painful bone damage (probably to the bone spurs that glue his spine and ribs together). The staff was very patient and did their best to find comfortable positions for him, but after a whole day of being shifted from bed to wheelchair to another bed or table he was in a lot of pain. He had a very bad reaction to the opioid-based pain meds (dilaudin), which just made him more miserable. Once the narcotics finally wore off, he was back to just Tylenol. From my personal experience I have always suspected that acetaminophen is just a big word for "placebo" but it does seem to work for Richard. Unfortunately the hospital nurses had never heard of doxylamine, an OTC sleep aid that works like magic on Richard. They gave him some other hospital type sleeping pill that didn't work nearly as well, so he had a bad night.
He was still very out of sorts when I went back to collect him on Saturday morning. However, he perked up a lot once he got home. His back still hurts, but now that he can move around on his own he is much happier. He's sleeping in a recliner, but that seems to work pretty well for him. The incision doesn't seem to be bothering him at all, and he is no longer having dizzy spells! It will probably be another month before his back has healed, but the next available date for the rescheduled hip surgery was in September, so he has plenty of time to heal.
