I've got nobody else to vent to, so here you guys go.
Dad is 80, was told about 2 years ago that he had mild aortic stenosis, would probably need a TAVR in the future. He's a control freak that is deathly afraid of any form of anesthesia, so when things progress to the point that he's winded after walking 50', he still wants to put it off. A few months ago his VA cardiologist tells him that things had progressed and he's at moderate to severe aortic stenosis, shit can't be put off any longer.
I take him in for his pre op cardiac cath and they find 2 80% blockages and 1 90%. TAVR is off, he needs a CABG, triple bypass. 2 days later we've got an appt with a cardiothoracic surgeon who shows us the imaging from the cath and it's fucking obvious that shit is not good. He says dad's lucky he hasn't already. had a heart attack. Aortic valve replacement, triple bypass an while they're in there, a left atrial appendage closure to prevent his afib from throwing clots. Hunky dory.
Surgery was this past Friday. Other than his neck immobility delaying things, surgery goes as planned, no complications. He's sedated, intubated and sent to the ICU, where he is expected to be for the next 24 hours. We come to visit him the next morning. He's still fully sedated and intubated, dead to the world. Every time they dial down the sedation in prep to extubate him, his BP tanks and he starts fighting the ventilator. Resume full sedation and everything is cool, he stays that way for the entire weekend.
Monday comes and they order a head CT checking for a stroke. All clear so they check his chest. Bilateral pleural effusions, right lung collapsed. No fucking shit they can't get him off ventilation. He has a history of pleural effusions that I brought up in the pre op appts, why did they not check for this sooner?. Diuretics are resumed (he had been off his torsemide since 24HR pre op), meds are added to boost his BP and he is slowly weaned off sedation as tolerated.
Yesterday I grab my mom and we make the hour drive to the hospital. He's still intubated but now his eyes are open and very occasionally he's responsive. I ask him if he's in any pain and I got a slight grunt and shake of the head once. Occasionally I remind him to blink and he does so. Very disturbing overall and he sometimes looks like he's crying, but it's his eyes watering from blinking so infrequently.
Talk to the cardiothoracic PA about things and giver general ICU consent to do what they need to. Plan for the day is a bronchoscopy and chest tube. Things go well and they successfully extubate him around 9pm last night. I grabbed mom after work this morning to see him.
We get there and he's away from the ICU for another CT. When we can finally see him, I am met with the most disturbing thing I have ever experienced. He's awake and responsive, but it's like he has aged 20 years and developed advanced dementia overnight. Greatly delayed responses, erratic and extremely slurred speech, severe UE weakness. What responses I get from him are almost child like. The man who raised me is nowhere to be found.
I talk to the ICU attending and that was the reason for the CT, checking again for a stroke. Only the primary report was in, but it looks clear. Neuro consult has been requested and we'll hear from them later today. They're doing cultures on the fluid from the chest tube and what was suctioned out during the bronchoscopy, but have started antibiotics just in case.
The ICU Dr. says that most likely this is all because of the anesthesia and extended sedation. That recovery will just take more time than initially expected. I want to believe that, but part of my mind keeps wondering if this is how things are going to be from here on out.
Over the last few years I have joked that that I'm the parent nowadays. Now that it seems to be coming true, I just don't fucking know if I can handle it. Then again I could just be overreacting to things not going as expected.
