Surgery was scheduled for 7a with an arrival time of 5:45a for prep. Since Wake Forest is a 2 hr drive from home, we stayed at an airBnb apartment 5 min from the hospital, which certainly made for an easier morning! I had already been through the pre-surgical prep once for my diagnostic procedure, which meant I knew exactly what to do upon arrival (change into my lovely gown, pee in a cup so they could verify that I wasn’t pregnant, then sit and wait to be hooked up to the IV). Prior to surgery I was given a cocktail of oral meds that would assist with pain control. I joked with the nurse saying "oh, is this breakfast?!" As the anesthesiologist gave me my first round of relaxing meds, I requested my “party hat” (hair net) and said "let's get this show started!" If you can't change it, might as well embrace it :)
My surgery was performed by two surgeons, Dr. Matthew Edwards and Dr. Maureen Sheehan, who also happen to be triathletes (sweet!) I was referred to Dr. Edwards by Maureen, who is a fellow Smashfest Queen teammate and just joined the WF vascular surgery team in May. While I've communicated with Maureen over the past several months, our first real "meeting" was on the surgery table! I was nervous for the surgery, but also more than ready to move forward. In my mind, I would get to dream about riding my bike in all of my favorite places while the surgeons did their work :) Prior to surgery, I signed off on two different procedures, an iliac artery patch angioplasty and an interpositional graft replacement, and was informed it would be a game day decision as to which I received. The procedure itself took 2 hours and went as ideal as possible in that the surgeons were able to complete their work in a minimally invasive manner. I received the iliac artery patch angioplasty, which means they opened up my right external iliac artery, scraped away the scar tissue that was restricting blood flow, then closed it back up using a bovine graft patch.
Post-surgery, I was transferred to the post-anesthesia care unit (PACU) where I vaguely remember talking briefly to the surgeons, then Jordan and my dad. I also remember feeling really hot, to the point that the nurse stripped off all my blankets and gave me a cool rag for my forehead, and being introduced to my new friend the magical green button (my words, not theirs, it delivered patient-controlled analgesia). I was told to push it often and had no problem doing so. Later on when I was more awake the surgical intern came by to visit and let it slip that my surgeons had snuck off for a midday bike ride (to which I thought “good for them!”) I was only supposed to stay in the PACU for 45-60 min, but ended up staying 4 hours because there were no rooms available on the unit I needed. The nurse was kind and apologetic for the hold-up, but I just told her “it’s not like I’m in a hurry to go anywhere.”
Around 2 PM, I was transferred to my overnight room and the rest of the day I drifted in and out of sleep. At times it felt painful to keep my eyes open! When I wasn’t sleeping, I relaxed with my dad and Jordan and attempted to color in one of the three books I was given from family (reality: I kept falling back asleep mid pencil stroke). Around 4 pM, my surgeons stopped by to visit, which was wonderful because (A) its always nice to talk with them when you are actually fully conscious and (B) they quickly upgraded my diet from NPO (no food by mouth) to regular which I wasn't expecting and (C) they delivered great news!
I quickly asked the inevitable question: “What does my recovery look like?" Being a triathlete himself Dr. Edwards just smiled, knowing that I’d be itching to get moving again quickly. In our earlier conversations we had talked about a recovery period of 4-6 weeks, so when I was told I could resume running and swimming in TWO WEEKS I was ECSTATIC !!! Cycling will require the longest recovery time of 4 weeks, but I am in NO way complaining. Turns out they were able to pull back my muscles to expose my artery rather than cut through them. I wasn't informed of this potential, but probably because it's a rare occurrence. Intact muscles equates to less time required to heal, and thus my return to activity would be a lot quicker than originally expected. If you can't tell, I was (and still am) BEYOND thrilled with that news!
As I waited for dinner to arrive, Jordan took me for my first walk down the hall and back. It was short but nonetheless a big mental victory. For dinner I ate chicken Parmesan, mac and cheese, bread, and apple cobbler (forgot the veggies, oops) which I split with Jordan because the doctors told me to not eat too much. I was warned to avoid getting sick and throwing up, which would have put significant stress on the surgical site. Thankfully I didn’t have any problems and I definitely had a healthy appetite!
It's safe to say I didn’t sleep well in my first ever overnight hospital stay. I drifted off to sleep around 10p after receiving a dose of pain medicine. Sometime later I was awoken by a phlebotomist who chimed “Good morning! Time to draw some blood!” Here I thought it was maybe 6am, but when I looked at the clock it read 1 AM! At 3:30 AM the nurses came in to take my blood pressure, temperature and weigh me (??). A hour later my machine started beeping loudly at me, so I called the nurse in to fix it. Then two people came in and said “don’t mind us” as the one nurse proceeded to teach the other about the PCA machine (yes, at 4:30 AM). At 6am, my machine started beeping again (uggh). Then I received an early morning visit from a vascular surgery intern, at which point I gave up on sleeping. The first thing he asked me was “how are your feet?” to which I quickly responded “Um, is there something wrong with them??” I get that my blood vessels run all the way to my feet but at 6am it just came across as an odd thing to ask!! Side note: while the middle of the night interruptions were not desirable, I want to be clear is saying how wonderfully awesome the nurses and staff on 5th floor Reynolds were to me!
Around 7 AM Jordan made a trip to the hospital Starbucks, then had me up and walking the halls. After 3 laps I was ready to sit down but another member of the vascular surgery team saw me and said “Keep walking! It will be a while until we get to you." After breakfast the nurses took away my magical green button and switched me to oral pain meds (oxycotin). The good news is that meant being unhooked from my machine and being able to walk uninhibited. I was told to go home the boxes I needed to check were: eating regular food, transition to oral pain meds with pain well-controlled and be up and walking. Since I had already checked those boxes, we began discussing discharge. It seemed quick but my surgeons also agreed that I was doing exceptionally well and free to go home when I felt ready. So just like that, we prepared for discharge!
Ironically, after being encouraged to walk throughout the morning, I had to wait 45 minutes for a wheelchair to arrive and transport me to my car upon discharge. Silly for sure, but I understand that the hospital has policies for a reason. After a stop over at Whole Foods for lunch, I slept the majority of the drive home. Coach Jim was kind enough to deliver dinner (including the most delicious chocolate cake!) and I spent the rest of my evening icing my incision area, curled up on the couch under the supervision of my sweet puppies.
Kristen Chang is Registered Dietitian Nutritionist (RDN), Certified Specialist in Sports Dietetics (CSSD) and triathlete residing in southwest Virginia with her husband and dogs. Follow along as she shares favorite fueling recipes, general wellness and sport nutrition tips and stories from her athletic endeavors.
Iliac Artery Repair & My First Overnight Hospital Stay
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