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Foreword: Please Email me if you find any problems with this page.
First: This is amazing and still little known. For nothing more than a free coupon, you can save 90% (maybe more) on drugs. One of mine was $178. With the free coupon, the price is less than $19.Some give you a coupon for a specific quantity, dose and others offer a card that's good for most prescriptions. I prefer the coupons because it gives you an estimate of what you'll actually pay.
Second: eBay isn't good for buying many things but for some medical supplies, they excel. For example, some of the tapes mentioned below are $40/roll from a medical supply house. You can buy sealed surplus from those who didn't need it for $10. There are many other items available that are genuine items from respected medical manufacturers (dressings and such) at huge discounts. Just make sure that anything with an expiration date is not expired and that all dressings and such are sealed. When buying dressings (especially specialty dressings with special properties) you need to be careful with regard to the size and quantity. If you search for a part number of a dressing you want, you need to look at the quantity and size as well as shipping costs. The sellers may have the same part number for a single dressing or for a box of 10. A single is rarely worth the included shipping but you'll have to decide what's best for you. When buying multiple sealed dressings, try to order a size that will allow you to use most/all of what's in one or more of the individual packages. That will leave the rest sealed and as sterile as possible. When buying dressings for small incisions, you will likely cut larger dressings to size. Using an entire dressing 4" x 5" (for example) makes no sense for an incision that's 1/4" wide and 3" long. For a wound that';s producing very little discharge, you only need to have a piece of dressing slightly larger than the what the discharge can fill between dressing changes). When cutting dressings, use a clean, dedicated pair of scissors. Using a pair of scissors that have been used in the kitchen to open meat packaging or in the garden would not be a good choice. When buying multiple sealed dressings, try to order a size that will allow you to use most/all of what's in one or more of the individual packages. That will leave the rest sealed and as sterile as possible.
Statins:
Stroke: I don't often speak of anything regarding myself but I think this is important. I had a very minor stroke. I never lost complete control of my left side but it was like my hand and foot had lost all knowledge on how to do anything. They had to re-learn everything. It took about a month to get back to about 90% of the original function and that's the best it's going to get. That's not all that came with the stroke. There were severe sleep disturbances that require drugs to control. There were instances where I believe the brain was trying to re-route signals and got it wrong. This process evolved and some of the faulty connections broke but it was odd having your body function in strange ways.
Carotid Artery Surgery: This surgeon used a relatively new procedure that could only be done in a specially outfitted room that was only available at one hospital in the area. When carotid artery surgery is done, there is a possibility that a piece of plaque could break off and cause a second (possibly more serious) stroke. This procedure reverses the blood flow so any bits of plaque flow away from the brain. The other carotid artery is forced to push blood through the blood vessels from one side of the brain to the other (the side where the surgery is being done). The blood flowing from the site where the stent is being installed is passed through a filter and then fed back into the femoral artery in the leg/groin. This procedure reduces the risk of a second stroke from about 3% to just under 1% (if I remember the numbers correctly)
A note about stress relieving drugs...
Nuclear Stress Test: After the various tests, I was told that I had had a heart attack (news to me) and an artery in the back of my heart was 100% blocked.
Bypass Surgery: After surgery, I was in very little pain from the actual operation but as always, this body of mine was going to make things difficult. The pain from surgery required only a couple of days of pain medication. Possibly due to something done in surgery (or maybe not, no clue) i developed an unbearable pain in my right shoulder. IT was at a very tiny spot. Nothing would alleviate the pain. Dilaudid only stopped the suffering because it made me sleep. No one had any answers or help for the pain. After about a day and a half of suffering, I found that elevating the arm on a pillow or two made the pain stop. The discovery was accidental because the pain didn't stop when elevated. Initially, there was no reduction in pain. After about five minutes, the pain began to subside and after ten minutes, the agonizing pain was gone. Something similar happened to my left abdomen. It was, again, agonizing. After another day of pain, I tried elevating my left arm and with similar results to my right shoulder, the pain began to subside. I don't know why elevating an arm made my abdominal pain stop (and didn't care). I was just glad it stopped. The reason I include these examples is because you may want to try something similar if you have the same strange problem. One thing you will have to accept about the surgery is that you will have many restrictions as to what you can do. You will not be able to use your arms for much. You won't even be able to clean yourself after a trip to the restroom. Prepare to have a significant other or a hospital employee do it for you. This will continue for weeks, depending on your surgeon's instructions. When you begin to self-serve, you will have to be careful. If using your right hand, I was told to grab your right shoulder with your left hand to keep the sternum from separating. For me, I was retaining too much fluid after the surgery and had trouble clearing my lungs. Coughing was initially very painful. I was given a soft pillow to hold tight against my chest when coughing but it didn't allow intense coughing without much pain. I later got (for a different reason) a thick, relatively hard foam cushion. THAT allowed me to put much more pressure on my chest and allowed more intense coughing with very little pain. This should be common sense but... if you have visitors who are sick or simply have been around someone who was sick, tell them to stay FAR away (don't even come to the hospital). Going though this without being sick was difficult. Fighting something like the flu would make it a living hell. Following surgery, you will have to endure a few things that are unpleasant but not significantly painful The first is the breathing tube that's inserted into your airway. That was very uncomfortable and I kept asking (motioning) for it to be removed. They waited a while and I kept motioning for it to be removed. I was likely as annoying as a drunk who keeps repeating something but I was till somewhat sedated and it was uncomfortable. Before surgery, you will likely see your anesthesiologist. Ask him/her about the tube and how long it will be (after waking) before they remove it and why they have to wait. That will save you a bit of anxiety (it's always good to know what to expect). The rest of the odd things you'll have to deal with are more strange/surreal than painful. The first is the removal the the chest tubes used to drain and allow monitoring the drainage from your bypass procedure. There will also likely be wires that can be used to connect a pacemaker or other device directly to the heart. I had a tube in my neck. I don't know what it was for. There was an arterial line (in an artery, not a normal IV in a vein). I think it was used to monitor blood pressure directly. It was one of the more painful IVs I've ever had. It was inserted in an artery that was not visible from the outside so it was sort of hit and miss with a large needle. This IV was held in place by a suture so it could not pull out.
Diuretics:
Incentive Spirometer: I'm a technical person by nature and if something has markings to show a level of performance, I want to know what the goal is. With this, no one could tell me what I was supposed to reach on the display. The answer I got was 'everyone is different'. If I would have known that I was going to have such an issue, I would have ordered/purchased one in advanced to see what my normal baseline was on it. The one I had to use was an Airlife Incentive Spirometer 4000 ML. You may find one at a local drug store. If not, you can buy them online for about $10. Buy a new one, sealed on its original packaging if you buy from eBay or other online retailer. In the hospital, this thing will likely come in contact with other things on your tray (they always want it within your reach) so I'd recommend being able to wipe the mouthpiece off with an alcohol based mouthwash before use. Keeping it in a ziplock type bag may also be a good idea. The last thing you want to do with a healing sternum is to get a respiratory infection from a dirty spirometer (now that's a sentence that I never could have guessed I'd ever write).
Harvest site:
Preparing a Wound to be Bandaged:
Wound Dressing: If you have particularly oily skin where the bandage will be located, you may want to prepare the surrounding area before applying the tape. Cleaning the area where the tape will be applied with rubbing alcohol will remove the oils and allow the tape to adhere better. When doing this with an alcohol prep pad (preferred) or gauze dampened with rubbing alcohol, be sure not to let the alcohol to drip into the wound. Have only enough alcohol to lightly dampen the gauze. If your fingers will have to touch the adhesive part of the tape (best to avoid), remove the oil from your fingertips as well.
Specialty Dressings: One of my incisions had its dressing fall off too soon and it opened up quite a bit. To help it heal, it needed to be kept clean and naturally moist. The nurses added a small amount of calcium alginate material (directly in contact with the open wound) to the standard dressing (gauze and tape). At home, I had to dress it for several more weeks. I had a dressing called Aquacel AG extra hydrofiber (cheapest at ebay). These remove, absorb and gel the wound exudate (discharge) and help produce the best healing environment for the wound. For the wounds to close properly, they can't have a hard scab (as they will develop if left to open air), which prevents a relatively deep wound from closing. Bear in mind that there are many types of specialty dressings, the Aquacel was what I had. Calcium alginate is a material made from seaweed (at least in part). The 'AG' in the name indicates that it has silver (the element) in it. Ionic silver is supposed to have broad spectrum antibiotic properties. Manuka (Leptospermum) honey is another type of wound dressing that's supposed to have special anti-bacterial properties. Do your own research to decide if you want to pay slightly more for a dressing with ionic silver or Manuka honey or whatever the latest/greatest is at the time. The dressings mentioned above are typically applied with no antibiotic cream. If a wound gets infected (hot, red, green discharge...) contact your doctor. A special antibiotic cream may be needed for nasty infections and they may require a prescription. For me, Mupirocin was prescribed. It may have been used instead of a more common antibiotic cream due to the risk of MRSA in a hospital environment.
Don't Cross Contaminate:
Bandaging Tapes: Another wonderful (if that's possible) tape is Tegaderm. It's a clear tape that's extremely flexible. You've probably seen pieces of it used over an IV where it's inserted. This is available in many different sizes and shapes. It's even available on a roll but that's likely to be more difficult to apply. The most common types have a frame that surrounds the Tegaderm material. You peel off the various parts of the frame as you apply the tape which makes it very easy. This tape is waterproof. You can even shower with it. If you have a wound that can be covered by one of the sizes of Tegaderm available, it may make it easier to get the wound sealed off (so you can shower) than trying to put a bag over it. Unlike other dressing materials, you want to order the right size. If you try cutting this into smaller pieces, you'll likely end up with an unusable mess. It's important to get leg wounds sealed off and completely waterproof because when you wash areas like your back-side, bacteria laden wash-water will flow down and could contaminate the wounds. If you take an especially long shower, it's possible (no matter the type of tape/bandage) sweating could cause the tape to lift. Monitor any bandages on the lower body/legs until you know how the tape will perform.
Leg Presses: When practicing standing from a seated position, you need to do so from various seating locations (kitchen chairs, recliners, bathroom facilities...). Practice sitting down as well as getting up. For seats that allow you to sit far back and sink in, you may need to either avoid them or modify them. Remember, you initially won't be able to use your arms without risking re-breaking your sternum. For some chairs, a slight modification like putting a relatively thick pillow or cushion behind you will make getting to the edge of the chair easier. Remember, to get up without assistance, you need to get your center of gravity over your feet so you can press your body weight straight up. That's why you need to be near the edge of the seat when you attempt to get up. As a side note, this is much easier to do from a chair (or whatever you're sitting on) with a relatively high sitting position than one that's very low. In my hospital, they made you hold a pillow to your chest to help prevent you from accidentally using your arms. For that reason, I'd suggest that you practice leg presses while holding a pillow. It's more difficult to maintain your balance without extending your arms. It's best to be as well prepared for this as possible.
Physical preparation before surgery:
Dieting Before Surgery:
Rehab: There are multiple types of rehab. Most facilities have many types of therapists to help you through any post-op problem your having. Cardio rehab is slightly different than generic physical rehab because they almost constantly monitor your heart will exercising and other physical therapy. The facility I went to was more general but had a full medical staff like a normal hospital.. I needed rehab for several reasons. The breathing problems -previously mentioned were treated with breathing treatments every 4 hours as well as an inhaled steroid. It took almost two weeks before I could breathe without wheezing so bad that you could hear it across the room. For me, the problems that I had overcome from the stroke, regressed after surgery. Physical therapy helped greatly. One problem developed (do you remember I stated that this body hates me?) was that I would hyperventilate when I did anything requiring me to move significantly (including standing). After simply standing, I could hyperventilate for 15 minutes, even my O2 levels were 95%+. They couldn't find the reason for it (blood pressure wasn't dropping enough to cause the problem) so I told them to try something for anxiety. Even though I didn't feel anxious, it seemed like a panic attack (which I've had in the past). A weak anti-anxiety drug helped greatly. After about a week, the hyperventilation had gotten much less severe and I no longer needed the anti-anxiety medication. The medical staff attended to several items related to the surgery. The harvesting of a vein to make the graft was taken from my left leg left me with three incisions. One in the upper groin, one at the knee and one near the ankle. The one near the ankle was the only one that needed attention. It drained very slightly for about a week and a half so the dressings had to be changed about every second day. I also developed several blisters that were (I'm guessing) due to the fluid I was retaining. Two were painless. The third, (on the left foot) required more attention.
Other things to think about:
Don't Become Addicted to Pain Killers:
Don't Feed A Junky's Habit:
Don't Slip:
Take (only) what You've Paid For:
Budget Shower Seat:
Grabber:
Speak Up if You're Uncomfortable: As a side note, the recliner may be a good option to sit in most of the day. A hospital bed can be difficult to get out of if you have painful wounds. It's also easier for some to use a urinal from a seated position where there is a drop-off where the urinal will have to be positioned. This is especially important if the amount of urine will be more than a couple of ounces.
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