Six Weeks

Well, it's been six weeks since my surgery and I'm doing pretty darned well. I had my exercise stress test, a progressively more difficult treadmill session under close medical monitoring, that marks the beginning of my cardiac rehab today, so it was interesting to see where I am. Of course I'm in objectively terrible shape, but that's to be expected. My stress test results were good, right where the doctor said he likes them to be at this stage. There's a hard limit on my blood pressure right now of 160 systolic, but even when I reached exhaustion in the test it was only up to 145. This gives me a very safe buffer, as I won't be exercising at that maximal exertion level, but rather in a specific heart rate zone based on my tests. I'll get that number next week at a classroom session that's part of the programme. 

This good blood pressure during exercise (and good blood pressure beforehand) means that my medications are working well. I'm also tolerating them well, which I'm very glad about. 

The only concern the doctor had was that the lower lobe of my left lung didn't sound great, so I've been sent for a chest x-ray. Might be something, might be nothing. But if it is something and it can be treated (or expected to clear up on its own), that's great low-hanging fruit in my quest to get back to 4.5L of lung capacity. I got home from the test and checked with my incentive spirometer, and lo and behold I was up from 3.6L to 3.9L, thanks to my first session of intense exercise.

The six week mark is where the precautions regarding your sternum officially come off. I think that's crazy, because the bone is definitely not fully healed. Getting to 100% bone integrity is my top priority, because any complications about that could really cause problems getting back to the trumpet (which is still a long way away). So I've decided to be operating under the same rules as I have been, but allow myself to gradually nudge those limits outward. One of the nurses who I was asking today about caring for my healing sternum said that at this point it's really about listening to what my body is telling me. If I can, for example, reach above my head with no pain or discomfort, then I'm probably fine to do it. I will carefully and judiciously test my self-imposed boundaries at this point, but I'll play it safe to focus on the long game. Most of what I've read suggests that from six weeks to three months is the time in which things get back towards being normal, at least for folks who don't play the trumpet.

Good news: Klaus is coming home tomorrow. I've missed my dog a lot, and now I feel safe to have him at home. We'll keep him out of the bedroom entirely, as I think the only way he could hurt me at this point would be to jump directly onto my chest when I'm lying in bed. Kathryn will take care of the walking for now, but I got myself a running leash that fits around my waist, so I should be able to get started walking him safely soon. After six weeks away he'll be shaggy (he missed a grooming) and his nails will be long (time to get back to his bi-weekly visits to the retired cop/doberman breeder who runs a slick dog nails operation), but it'll be a big step towards getting back to normal to have him home.

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Update, July 6

I went for my chest x-ray this morning. They're walk-in only at the local diagnostic imaging place, so I crossed my fingers and went around 9:00. I literally had zero wait, a very pleasant surprise. Not long ago, around 1:30, I got a call from the cardiac rehab where a cardiologist had already reviewed the x-ray, and it turns out that I do have a small pleural effusion.

A pleural effusion is a buildup of fluid in the pleura, which is the membrane that surrounds the lungs. It prevents the lungs from expanding fully into the space that is holding the fluid. This is a common issue after surgery like mine. There isn't that much fluid built up for me, so the doctor said that it should clear up on its own and that there's nothing to be concerned about. I'm to go back in a month for a follow-up x-ray to make sure things have resolved themselves.

While of course this isn't ideal, the bright side is that I now know that the bottom of my left lung will open up more and get me back some air capacity. I'm still lacking a little over half a litre and I had previously thought that it was all way up high in my lungs, the area that I'm still hesitant to really work to expand due to my still-delicate ribcage, but now I know that that is not entirely the case.