Chapter Epilogue. Six months after the surgery

The large amount of readers of my blog about the heart disease I had, of course very encouraged me. That’s a sign that what I had been writing and sharing on this blog were appreciated by the readers, whether it was a would-be cardiac patient like Ms. Rika or a cardiologic student who was studying abroad like Mr. Fajar… and there were many more “silent” blog readers that have never given any comment.

To continue my previous stories, here I am going to tell the readers about anything I have experienced in the last 6 months after the cardiac surgery. For brevity, I recap anything I experienced from the first month after the cardiac surgery until the sixth month after the surgery.

Chapter 28. Conclusion

After writing a series of blog posts, you would be able to guess what my feeling was like. I felt like I have fulfilled a daunting task which in a long term I got stuck into a “procrastination” abyss which according to Betawi people it was “ntar sok tactic” which meant always promising … later… tomorrow… later… just tomorrow. Indeed, I’d often been asked, especially by my sister Enny, to immediately write down my experience of undergoing cardiac surgery because if I delayed the writing I would be more oblivious to the events that I had have been through: the pleasant, sorrow, joy, horror, and particularly what the feeling of being at the point of death was like…

And apparently after underwent the heart surgery, I unexpectedly suffered from a syndrome of forgetting people’s name or characters’ names, and popular terms that I have memorized them all before. Later from my discussion with the alumni fellows from SMA 1 Madiun, I discovered the syndrome that afflicted me, it was forgetting Roman numerals! It was discovered when my friends of SMA 1 Madiun filed a protest to me because I was wrong in writing Roman numeral I (one) which was mixed up with the Roman numeral II (two). You know whether I’m serious or not about this, don’t you?

Chapter 27. Inspired by “Scar Trek”

Before I underwent the cardiac surgery which was called “Bentall procedure”, I had a survey to various sources, especially through Google, YouTube, and primarily through http://books.google.com to find books in English about heart disease or cardiac patients’ experiences before, during, and after the surgeries. Of course I found some useful books and they fitted what I was looking for, but because it’s in Google Book I couldn’t see all the chapters of the books –I usually could see Chapter 1, 2 and 3 only– so I considered that writing the series of posts in this blog as a “fill in the blank” or writing anything that hadn’t been written by anyone before. Moreover, my articles were written in Indonesian language –the language that is used by 250 millions Indonesian– it’s possible that 10 or 100 people will inadvertently read my blog, isn’t it?

I also read a lot of books in English on Google Book, including from the ex double heart valve surgical patient, that he had undergone an “aortic valve” surgery and “mitral valve” surgery. However, the most remarkable of the person who wrote this book was that…. he recounted his experience passionately, which was of course meant to encourage the readers, especially to those who would soon undergo cardiac surgeries, which were usually always filled with doubt as whether to take the cardiac surgery or not… that in my opinion, the doubt came from the lack of information they acquired along the way… but unfortunately, this good book only showed Chapter 1, 2 and 3, while the other  chapters were hidden in Google book so I became curious about this book. Actually it’s not the matter of the price which costs USD 20, – but about the uneasiness for Indonesian to buy books on Amazon.com, especially for the state bank credit card holders like me. It might be easy for the credit card holders of foreign banks such as from some bank in the United States (you know what I mean)…

Chapter 26. There were many people asking about heart disease to me

Before “writing the book” or to be exact “write the series of posts on my blog” I’d been wondering, why did the God choose me to experience a heart disease and underwent an open-heart surgery to replace the aortic blood vessel and aortic valve – which is called the Bentall procedure? Why me? I said in my heart. A moment later, I could get the answer, as quickly as grabbing oxygen from the air. That the answer was because I love to write on blog… so if I had to suffer from a heart disease and undergo a cardiac surgery, I would write it all in a series of posts on my blog that may be useful to the readers of my blog… and with that I’ve done a humanitarian duty –that is sharing with the fellows…

Even during the writing of “the book” or the “series” posts I’ve received many questions about heart disease. Of course, from my friends, faculty friends, students or ex-students, relatives, acquaintances, or even new friends who came from nowhere that I had never known. I’m pleased to try to answer their questions, either orally, through comments on my blog, through Facebook messages, SMS, or via e-mail. Even in my heart I thought, the more you ask the better, because it means that my blog is read by many people and so many people need the information about heart disease from the standpoint of a laity cardiac patient like me…

Chapter 25. Back to work and teach again

As I mentioned earlier, I was finally allowed to go home after inhabited the ICU, Intermediate ISW+ IMW rooms and the treatment room at Harapan Kita Heart Hospital for 29 days. With a note, 15 days after the surgery I was actually allowed to go home, but apparently I quietly got a gastric bleeding (internal bleeding) that finally made ​​me passed out in my house bathroom. As a result, I stayed at my house only for one night and the next day I was rushed to the ER of Harapan Kita Heart Hospital. From the ER then I was transferred to the IMW Intermediate room for a week, and then transferred to the treatment room in Building II Floor 5.

Actually, since before the surgery I had prepared the required permission letter in order to be allowed to off-working and teaching. I asked the permission to the office for 2.5 months from February 8, 2011 (H-2 of my surgery) until April 16, 2011. Meanwhile, to the college management, I asked permission for off-teaching for the first 4 weeks of the lecture period (the first meeting to fourth meeting). So during my “house-boarding” at Harapan Kita Heart Hospital I always recalled and thought in my mind of when should I start to work and teach again? Did I have to stick to the original plan, which came to the office after 2.5 months off-working and started teaching at the 5th meeting of the lecture period?

Chapter 24. There were still a blood thinness and heartbeat problems

A cardiac surgery, whether it is a bypass surgery (CABG = Cononary Artery Bypass Graft) or Bentall procedure surgery (PTCA), is not a “panacea” that once an action is taken then the problem is finished. As with other techniques in the world, a heart surgery also leaves “side effect”. As is known, the ex-bypass and Bentall procedure surgery (valve surgery, in slang) remain serious side effects to be noticed. The ex-bypass surgical patients mostly suffer from constant coughing. While the ex-valve surgical patients, because they had to take blood-thinning medicines Simarc, then their blood thinness should be monitored so as not too thick and not too thin, its INR (International Normalized Ratio) value should be between 2.00 to 3.00 –though for my case it had better to be between 2.00 to 2.50 because the INR value that is ​​greater than 2.50 will cause a bleeding in my stomach…

Basically the blood thinness that was thick would please my gastric but encumber my mechanical valve in working. The same if the blood thinness which was too thick would delight my heart –because the St. Jude Medical No. 27 valve that I used required decent blood thinness– but it was very painful for my gastric –because a bleeding could occur. So during the rehabilitation phase II and III I decided to go to the laboratory which was located in Building I Floor 1 to check my blood to measure the INR value. I even took the blood checking 2 times per week –in Monday and Friday– in order to set a “pattern” for my blood-thinning medicines Simarc dosage that I should take per week…

Chapter 23. Following the rehabilitation phase II

Each ex-heart surgical patient in Harapan Kita Hospital was expected to follow a full rehabilitation program – phase I, phase II, and phase III – so that after the rehabilitation program was completed, the patients could return healthy and in shape as they were before the surgery. In the rehabilitation program phase I they were taught exercise, riding static bike, and walk on foot while the patient were still wearing the baby blue patient suits. In the rehabilitation Phase II, the patients were required to wear uniforms in the form of dark blue jersey pants with red stripes on the sides, sneakers, and red-white shirts which on the left arm there was the words “Cardiovascular Rehabilitation”. The purpose of this phase II after I finished with it was to strengthen the leg muscles, therefore in this phase II I was taught exercise, riding static bike, and walking 1000 m, 1200 m, 1400 m, and the next day up to 1600 m, 1700 m, and 1800 m. For the patients who had already walked as far as 1800 m, the next time they were allowed to use a treadmill for 25 minutes, with a speed of 3-4 km/h…

If in the rehabilitation program phase I the patients were still staying in the treatment room in Harapan Kita Hospital, so in the rehabilitation phase II the patients had been discharged from the hospital and back to their home –­for the patients who lived in the Greater Jakarta area– or back to Bidakara guesthouse or boarding houses –for those who came from out of town. Actually, for the patients in the city and out of town, ranging from the rehabilitation program phase II would spend a lot of money, which was used for the taxi transportation and food allowance during the rehabilitation for the patients who lived in the city. The transportation also required to use taxi because the ex-heart surgical patients certainly hadn’t been so fit to take public transportation such as city buses or trans-bus in Jakarta. For the patients from out of town, the rehabilitation program phase II period was quite heavy too, because the patients and one or two relatives should stay in Bidakara guesthouse which was located next to the building II, or live in boarding houses in the township, which both options still required an outlay cost which wasn’t little.

Chapter 22. After a month in the hospital, I could go home

Home – this word with four letters apparently is extremely coveted by a patient who is being treated in hospital. Besides home, possibly “eating” is a very meaningful word to patients…

If the last days in the treatment room after my heart surgery I went through it by doing the exercise in the morning for the rehabilitation, eating tasty food which had high protein to heal the surgical wound, and sleep soundly. Then in the second treatment – that was the treatment I had since I got gastric bleeding – the last days were the stressful days…

During my second treatment period, in the treatment room in the building II Floor 5 I was placed with other patient in the treatment room 1. Sizable, as a bureaucrat of category IV/b I was placed in the treatment room class I. My roommates were switched. When on the first treatment my neighbor was – Mr. Saleh – a Papuan from Kaimana who always spoke Bahasa, both he and his wife. So on my second treatment room my neighbor was Mr. Jonardi from Lombok, and Mr. Zahedi from Bangka.

Chapter 21. Following the rehabilitation program phase I

Actually, the chapter about I followed the rehabilitation program phase I could be placed between Chapter 16 and Chapter 17, which it was after 10 days I was treated in Harapan Kita Hospital after my heart surgery, I then moved to the infirmary room in Building II Floor 6 – the exclusive floor for the ex heart surgical patients who were previously derived from the IWS room. But because after I came home I returned to the ER of Harapan Kita Hospital again, so the writing about this rehabilitation program phase I was put in Chapter 21.

Basically, all ex heart surgical patients at Harapan Kita Hospital had to restore all their fitness and health as before undergoing the cardiac surgery as soon as possible. Hence, since in the IWS room, every day the patients were looked in by the rehabilitation officer at their own bed. The first thing to be done by a patient was coughing and issued a ripple (secretion, mucus) from the chest cavity, because much ripple would cause a load to the lungs and consequently it was hard to breath alias tightness…

Hence, during the first 2-3 days in the IWS room I was told how to “cough well and correctly” which it was coughing loudly and at once, so the ripple could “jump out” of our chest cavity. After the ripple was out, it was up to us whether to swallow it into the stomach or release on a tissue.

Chapter 20. Graduated from the IMW, entered the treatment room

I forgot to tell that during I was staying in the infirmary room of the gastric bleeding I suffer which was called the Intermediate IMW room; I was required to have a ‘bed rest” meant all activities should be carried out on the bed. I hadn’t told that I wore elderly diaper with an aim to accommodate my feces in the diaper so I didn’t need to get down from my bed. The other purpose was so that the nurse could always check on my “feces color” that was released was blackish or not. Why it should be checked? Because if the feces color was black or blackish; it was a sign that there was a gastric or intestine bleeding….

As I mentioned earlier, my nose was inserted a plastic channel which elongated into my throat and ended up in my gastric. This channel installation was meant for the nurse – under the doctor in the room’s order – could monitor whether the bleeding in my gastric had stopped or not yet. The trick was, the outer tip of the channel was connected with a kind of measuring cup but more slender, then mineral water was poured in that measuring cup and it was lifted higher than my nose, as a result, the mineral water would flow down through my nose, down into my throat, and reached my stomach. After the nurse did this about 2 times or poured 2 cups of water, then the nurse would lower the hose tip which came out of my nose so that its position now was lower than my gastric. With the same principle, the water would come out of my gastric into the glass that had been provided by the nurse. If the glass got dirty or there was the blood, it meant that my gastric was still bleeding. Conversely, if the glass was clean, meaning my gastric had stopped bleeding….