Chapter 12. Graduated from the ICU room, transfered into Intermediate IWS room

The Requirement for a patient to pass the ICU room is quite hard. As it’s known, after undergoing the cardiac surgery, the heart would swell and blow a lot of blood and other body fluids. Therefore, any cardiac surgery patients’ body in the ICU room would be “holed” in some place.

For me personally who underwent Bentall procedure surgery, there were 10 holes, 2 channels and 1 incision. All the ten hole are: 3 holes in my left neck, 3 holes in the right neck, 3 holes in the abdomen (above the diaphragm, so it was still around my chest cavity), and 1 hole in the left thigh (supposedly this hole was the most dangerous one, and if I’m not mistaken it is named ABB – perhaps an abbreviation of Arteri Besar Berbahaya (The Dangerous Great Artery)… hahaha). One of the channels was the respiratory channel which its diameter was 1 cm, inserted in my mouth to my chest, aimed to reduce the shortness of breath which might descend to a cardiac surgery patient who was just operated. The other channel is the “jumper”, as a tool for me to pee which was given a kind of pipe which would flow to a kind of plastic bag – the function was to ease the patient when he wants to pee he doesn’t need to get down from bed.

The last, my incision extended along 22.5 cm that was once used to open the chest cavity from the chest that was below the neck (but it was still below the top button of a guy’s shirt – so the operation trace couldn’t not be seen when we wear a shirt) to 5 cm above the diaphragm.

It is said that a heart which is just being operated will blow a lot of blood and other various fluids, which will be released from the three holes located below the lengthwise incision. A doctor said, “The idea is like this…it is impossible to wait until the operation is done, the heart blood dried and all the fluids stops flowing, to sew the chest…” Therefore, soon after the surgery is done, the opened incision in the chest has to be closed first, so the blood and other fluids released out through the three holes in the abdomen that has been made for it.

The three holes in the stomach (actually it’s not stomach, because it was still above the diaphragm, by definition it was still around the chest cavity) was further connected to the three different kind of pipes and connected to the “blood washing machine” that looked like a car battery, but more slender and white . Every day the nurses and nuns must complete the report form about how much the blood and fluids which flowed from the patient’s body were lasted, by taking a plastic tube that about 1.5 meters long which would be measured with released from the patient’s body holes in his abdomen. Thus, the nurses and nuns could guess the amount of blood and other fluids that were still dripping from my chest.

As I recall, at the first day I gain my consciousness, the amount of my blood and other fluids that came out of my chest were as much as 600 ml (I knew it when some nurse was asked by her friend), at the second day, it lasted only 500 ml, at the third day, it lasted 400 ml, and so on. If I’m not mistaken, if the fluids which flowed out from a patient’s chest cavity was about 200 ml then the patient was “graduated” from the ICU room and was entitled to “upgrade” and moved into the intermediate room which was Post Ops room or IWS (Intermediate Ward – Surgical).

Considering that the Bentall procedure operation that involves the replacement of the aorta and aortic valve sleeves is quite dangerous than an ordinary bypass heart surgery, it makes sense if the blood which is released from the scar on the chest is a lot more too, therefore the patients who undergo this valve replacement stay longer in the ICU room. If the by-pass heart patients only stay about 2-3 days in the ICU room, the heart valve surgery patients can stay for 4-5 days in the ICU, and even it’s only for patients who have no complications. For patients who have complications – such as a high blood pressure, high blood sugar or the kidneys are in trouble – will certainly be much longer staying in the ICU room…

The day after I got hallucination, I saw Mr. Waluyo – a heart bypass patient from Lampung- was getting ready to leave the ICU room. So Mr. Waluyo only stayed 2 days in the ICU room and on the third day he was allowed to move or “upgrade” to the Post Ops room. It made sense if I felt a little envious of Mr. Waluyo who had “upgraded” faster than me.

Meanwhile, in my last days in the ICU, I suffered from what is called AV or AF (I just heard this term from the nuns). Apparently, AV means “atrium villirium” (to a point, I’ll check on Google later) which means the patient is having a very fast heart rate, probably around 120-125 beats per minute, which according to the measurement of ordinary people this is a very high heart rate. And unfortunately, I suffered from AV because I spoke. So the nurse told me not to talk a lot – even to the well wishers – who visited me in the hospital. “Don’t talk a lot for now, okay, Sir, Ma’am? Because the patient suffered from AV…,” so the nurse’s message to each my well wishers…

On the day 5, after the nurses and nuns saw the progress of my consciousness which was much better and the amount of blood and other fluids which flowed from my chest are lesser –  that lasted only 200 ml a day – then I was getting ready to be moved into the Intermediate or IWS room.

The preparation step was putting the oxygen tube behind my bed. The “blood washing” tube was tied to the bed; the IV tube which was in my left neck and right neck was put off, so there remained 3 tube in my abdomen, 1 tube was in the urine disposal, and one intravenous line was in the left thigh. I then lit up when I moved from the ICU room to the Intermediate IWS room (later I know what is the difference among the patient’s bed in the ICU room, in the emergency room, and in the Intermediate room).

The nurse who drove my bed then put it to the patient elevator and the front door of the elevator which heading to the patient guardian waiting chair was opened. Then the other nurse shouted.

Mr. Tri Djoko’s family,” no answer.
Mr. Tri Djoko’s family,” still no answer …
Finally, from the distance I saw my sisters Enny and Endang that afternoon were sitting on the patient’s guardian waiting room on the second Floor. I then waved my hand and called them…

Mr. Tri Djoko’s family…,” finally my sisters Enny and Endang heard this shout and immediately went to the elevator to go along the “transfer” to the third floor…. which was the Intermediate IWS room or better known as the Post Ops room…

I got a bed on the right door side, second from the right side…. or the nurses here called it “Bed number 9” after the nurses “transferred” me using a kind of board that looked like an ironing board and “moved” me out of the ICU type bed to the Intermediate IWS type bed …

I then smiled as one exam had passed today….. And now I had left the ICU room which according to a recent story I heard, it was a pretty scary room…. proved by me when getting hallucination there….. (To be continued)

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