Mended Hearts Open Forum

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  • 1.  Another Story

    Posted 02-24-2022 01:46
    Caution: Long

    I'm 78 years old, healthy all my life, athletic all my life, never smoked, very light drinker, no recreational drugs ( I hate that crap).I'm 78 years old, healthy all my life, athletic all my life, never smoked, very light drinker, no recreational drugs ( I hate that crap). I had been was weak and feeling amiss for years but all tests were fine with my heart. Finally, on my last visit to my Cardiologist (Interventionist) I said at that point his job was to prove to me that I did or did not have heart problems. He was a little hesitant but he said (great doc btw) that he had reviewed my case the day before and thought it was time to take a look. An angiogram was scheduled for a week later. It discovered that I had 100% blockage in my Right Coronary Artery (RCA) and 70% blockage in my Left Artery Descending (LAD). He subsequently recommended bypass surgery as he did not like the circumstances for stents. Saw the Thoracic Surgeon a week later.

    I was 60/40. After all, I am 78, I was functioning, albeit sub-par, and I probably wasn't going to die from the condition soon. I opted for the surgery mainly because I want to spend more time with my amazing wife of 54 years. I prayed about it as I'm a person of faith (Catholic) and I think it turned out to be the right decision.

    OK, here we go. Surgery 2/7/2022. As it turns out I had 100% blockage in another artery and 70% blockage in a fourth. I guess that makes me a quad. As everyone here knows, it's quite an experience. I had some familiarity with major surgery a few years back with an L4/L5 fusion, and I think that helped (I also think it was more major than this in some ways). Everything seems to gone according to plan and they wheeled me into the ICU while stile intubated. My poor wife saw me there, what a mess that must of been. Everything total blank while in he ICU but my wife said she said my name and I opened my eyes for the first time.

    On what the hospital calls Day 1 (the day after the procedure) I was moved into room 222 (this is the month of 2's). Memories of that day are pretty foggy but I was told that I was a bit troublesome, which is not my nature. I do recall feeling very uneasy, perhaps paranoid. There was no mention from the staff that day of personal hygiene or food. No one bothered to give me the lay of the land.

    On Day 2 I requested to be moved to another ward. The hospital was not pleased. They send two middle management types who acted very aggressive toward me. In retrospect I think perhaps a head nurse was changed, but I stayed in the same room. The psychotic hallucinations started that evening, the most terrifying ordeal of my life. I'm not going to go into detail because it's too soon to recall those memories (I perhaps never will) but it was a full fledged psychotic episode. Things were fine Day 3 except I was a little shaken, but they started again in the evening. I kept things to myself. On Day 4 I simply dreaded the night and couldn't imagine how I could possibly handle it. And, as it turned out, I couldn't.

    The hallucinations quickly became threatening, evil even, and that was it. I called the nurse and said I had to get out of that room. Things escalated quickly as I explained what I since learned was a bout of delirium, getting to the point that I threatened to walk out of the hospital telling them I would not stay in that room and I was not under arrest. Things calmed down eventually and they proposed to have a nurse stay with me in the room that night and as long as needed. I agreed to that and a very kind CNA arrived to babysit me.

    Now we're into Day 5 and things were settling down - because I had done some research and discovered the problem. A couple of years ago my Internist had prescribed Venlafaxine for depression. I was on 75mg 3x a day. He gave me a stern warning to never reduce the dosage without consulting him because it often had serious consequences. For some reason the hospital had me on 25mg 2x a day, an instant decrease of 80%. I had last taken one the night before the surgery (it was at 6:00am) so my Tuesday night I was down 350mg. I did some searching and I found many citations of psychotic incidents due to a sudden decrease in Venlafaxine dosage.I had them restore my dosage and things improved rapidly.

    I was very impressed by the professionalism and talent of the surgical team. And I was as impressed by the line health workers, the nurses, CNA's and orderlies who were truly empathetic and professional. I was not very impressed by the middle management that I had interactions with.

    Well, I'm home now and things seem OK. The pain in nowhere near as bad as I had anticipated and my wife takes great care of me. I'm really hoping that the rest of this journey will be uneventful. I'm pretty awed by the power of the brain and moving forward I'm going to pay as much attention to it as I do to my heart. Thanks for listening.

    Cheers,
    John Audette
    Sisters, Oregon




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    John Audette
    Owner
    Audette Collection
    Sisters OR
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  • 2.  RE: Another Story

    Posted 02-25-2022 04:45
    Hi John,

    Welcome aboard. Four years ago, when I was 67, I had a heart attack and emergency quintuple bypass surgery, followed by two weeks in a medically induced coma due to pneumonia complications.  I also hallucinated the entire time I was in ICU until the day they sent me to a rehab hospital to learn to walk become independent again after the coma.

    Your hallucinations may have been related to tour medication being reduced, but I learned through subsequent research that mine were as a result of the combination of the drugs they were giving me to keep me sedated, my presence in the ICU and my being an older person.  I learned that it is very common for older people like us to have these hallucinations and there's even a psychiatric diagnosis for it in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) called ICU Psychosis.

    I was lucky in that my hallucinations were not unpleasant like yours and like many other people.  They included me recovering in the Bahamas and helping the hospital administrator, who I imagined was both my thoracic surgeon and an old shipmate (I was never in the Navy), discovering an illegitimate child from my time in Korea (I was never in Korea), hallucinating a near death experience (maybe it was real??), a party in the hospital where my extended family attended and my aunt got frunk and threw up), a time and space machine that allowed my daughter and her friends to transport to and from the hospital to visit me, my daughter joining a motorcycle gang dedicated to helping others and doing good deeds, that I had the ability to text my wife and daughter because my hospital ID was hooked into the hospital wifi network, and many more.  In short, I was delusional, but not upset or unhappy.  Oh, and my male nurse was Jesus (and I'm a Jewish Zen practitioner).  They were so real seeming and totally unlike dreams that it took me a couple of weeks in the rehab hospital and conversations with my wife to figure out if any of this really happened to me.  I was stunned when I realized they all were hallucinations.  By the way, if you google ICU hallucinations, you'll find a blog space for people who share their ICU hallucination experiences, but don't do it unless you feel ready for it.

    Anyway, life goes on and my life quickly returned to normal after my release from rehab, including returning to work for two years until I retired.  I think yours will too.

    All the best,

    Ira


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    Ira Reid
    Hoboken NJ
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  • 3.  RE: Another Story

    Posted 02-25-2022 19:24
    Hi Ira....

    Thanks for your reply. I've read that there are different types of delirium. One, it sounds like what you experienced, is a dreamlike state. The other, which sounds like what I experienced, involves interacting with the hallucinations and is thought of as a psychotic incident. I interacting with the hallucinations and they responded to me. Really terrifying when they started to get angry with me. I do believe that mine were drug induced, most likely the sharp in dosage of one of my longtime prescribed drugs, with a possible contribution fro the panoply of others. Certainly something I never want to experience again. I cannot for the life of me understand how some seek this out with the use of psychedelics.

    Cheers,
    John

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    John Audette
    Owner
    Audette Collection
    Sisters OR
    ------------------------------