How To Know If A Scorpio Care

Last month, Part IV

From 26/08 to 07/09. Niguarda rehabilitation. From day 8 to day 22 "corNovum.

Niguarda, Department of Cardiology 2 . Here begins my journey of rehabilitation.

is transferred from the intensive care unit, not without some apprehension, however, know that that is common to other patients, but the doctors will treat me as good as cardio2 in intensive care? But I still feel "very" bad, are not stable. Here (ICU) are much more controlled, I have a pretty nurse at my disposal 24h/24h. Beyond (the ward) are abandoned and alone in the room. The doctors go through the guided tour in the morning, but then you do not see any more ... And if I get sick?

Obviously the doctors know what they do. First are completely aligned with the ongoing therapy, the patient's condition (there are special meetings for each patient between the teams of the two departments). And then, our conditions that we sometimes seem to be so poor, strange, special, indeed very often follow a path of "accidents" typical of the transplant. For example, I've had some difficulties with water retention. A bit 'of renal failure. I thought I would be a case of concern, to keep particularly eye, was actually one of the frequent consequences of the clinical course of a transplanted organ. None of that fact.

And in fact, have been followed so excellent doctors and nurses from the cardio2. Indeed, I must say that the return to a more intensive and less known is vital to recovery. It made me feel less sick and convinced me to be in an upward trend in recovery every day. Resuscitation is often due to uncertainty. We are in a new environment with strangers, and we are in worse physical condition. The return to the department is therefore desirable and is an integral part of the transition the rehabilitation phase.

The concept of rehabilitation, however, perhaps it is not absolutely clear to all people, especially those who have never switched from a major invasive procedure such as this. I intend to as "rehabilitation" that sum of all activities designed to bring the state in which the individual is out after surgery, to a physical / clinical perfectly normal. Having said so, it may seem a rather broad concept, and above all very ambitious. Obviously, the rehabilitation goes through several phases and covers different aspects of our bodies:

• From clinical point of view, it is essential that all our bodies return to their optimal functioning. General anesthesia, opening the sternum, the displacement of organs like lungs, the real organ replacement, extracorporeal circulation (ECC) and in general all the trauma caused by the intervention, can create situations that make of failure. I speak of the kidneys, liver, lungs, heart, etc.. All organs are affected in one way or another intervention and should be "resettled" in the days after surgery. In part, this recovery takes place automatically by our body, is in part helped by drugs.
• From physical point of view, I mean to the muscle-bone-joints, etc.., the body suffers a lot of days when you remain motionless in bed. In my particular case, since even before the transplant was "flattened" because of my unstable and equipment that was connected, I spent about three weeks before I tried (and I could) to sit down again to bedside.

Well, while I call rehabilitation "clinic" is run mostly by our doctors, and we live in a rather passive rehabilitation "natural" depends to a large extent on us, on our willpower , from not being discouraged, the effort to do things that seem unattainable. Get on board before bed, then stand up, with the help of a couple of people, and sit in a wheelchair. Then begin to stand alone. Then take the first steps with the help of a walker. Then, arm in arm with one person. Finally, start to walk alone, and to regain the security of your legs.

In these early days of rehabilitation in cardio2 I did, from day 8 to day 22 after transplantation, have not been without some problems. First, continued to have muscle and joint pains. Stiff neck, sore shoulder. Some nights I have had great difficulty sleeping at night. For four or five nights I've had hallucinations. Here I report some post on Twitter.

• 29/08: Understanding the whole person if you are sore or if it is a hallucination and it 'was your sister sick near you woke
• 31/08: The usual hallucinations nurse me wake up around 0530 and told me that "he" had pain. Every night someone
• splits 01/09: When I woke up a few minutes ago with my back on fire, the doctor said "now that they wake up, 'cause they got a little liquid preoperative heart!" (?!?!?)
• 02/09: ok for now awakening to technical modifications without hallucinations: the bladder to empty it was just mine, all right! Now try again to sleep
• 9.2: Ok to clear what technical second awakening 'that never once does not empty ... I'm retracing friendship with my kidneys. I think I have two:)
• 04/09: Almost forgot, the hallucinations are gone. Now I always wake up with my bladder and only singing "... remember me!"

The most important was a 3-cm pericardial effusion. (Liquid that forms a wall between the heart and that covers it, the liquid is not compressible, by definition, creates a resistance around the heart that prevents it to expand freely). This payment has been reduced / eliminated through a catheter that is introduced into the heart, and through which the liquid is exhausted. After 24 hours, and 750cc. of fluid (almost a liter, you got it!), the catheter was removed. It 'was a painful operation, but the benefits were felt immediately: The heart has pumped much more efficiently in the first few minutes.

Another little problem was a blood clot (actually a ball of 6 / 8 cm.) That has formed due to the removal of the pacemaker I had placed at the left chest. For this clot are returned to the operating room on the 12th day after transplantation, sleep again, and I obtained the "clean pocket. " Intervention stupid but intubated / stub / scared and I spent a day quite ugly, stupid, a few lines of fever, etc..

Other procedures that have been subjected, as "routine" for all transplant recipients are the endomyocardial biopsies. During my stay in cardio2, Niguarda, I was subjected to the first two biopsies per week.

On 07/09, a clinical picture of stability, have been discharged and sent to the IRCCS Maugeri Tradate to continue my rehabilitation process.

from 08/09 to 06/10. Rehabilitation to betray.
From day 23 to day 51 "corNovum.

IRCCS Fondazione Salvatore Maugeri of Tradate . I arrived and I met with three other transplant recipients: Francesca (50 years or so, Marsala, transplanted in July), Xavier (65 years, with approx. Puglia lived in Argentina, transplanted two days before me) and Remo (55 years, with approx. Ligurian hinterland, transplanted in July). I have divided (and still divide) the room with Xavier, who also knew as early as Niguarda.

Institute Maugeri how to structure probably write another article the next day, after I resigned, and accompany with some photos. For now, I tell you that apart from the first days of acclimatization necessary, I found myself quite well.

My rehabilitation process has been more than satisfactory, both subjective and objective. My muscles, my joints, my body in general has taken steps consistent-visible almost every day, gaining agility, strength, endurance.

I started with breathing exercises sessions (09.30 am, duration 30 minutes) (slow movements with the goal Main "stretch" and loose joints, tendons, neck, back, legs, etc.).. I remember the first few days I still had the stiff neck and back and leg muscles were totally subdued.

few days later I went to the sessions of gymnastics "free body" (11:00 am, duration 30 minutes), which is done as an alternative to breathing. Plus I added exercise bike or carpet sessions (10.00 am, duration 30 minutes). With the exercise I managed to recover nearly 100% of the movements of the whole body, almost without feeling any pain, except to the sternum. By bicycle and the carpet, I was able to regain strength and muscle tone, endurance, but more importantly, some confidence in my abilities cardiovascular. In addition to these exercises, I started to go for walks outside the hospital or outside. To get to the room I got into the habit of doing the 4 floors of stairs.

Last Friday I loved the exercises for the arms to do with weights of 1 kg Nothing particularly challenging, but it is a beginning to strengthen the arms.

The children (two children) came to see the last two Saturdays, and with them I also have the opportunity to give two balls in the garden ...

Even in a more strictly clinical (not sure if it's the right word) the results you see are: the pressure that initially tended to be high (130 / 90, even 150 / 100) now stabilized at normal values \u200b\u200b(120/80, 110/70). The frequency (heart rate) is around 75 bpm at rest, and stood at 94 to 96 bpm during exercise (cycling, carpet). The values \u200b\u200bof oxygen are always good (97 to 98%).

a rather negative aspect, but from what I understand, very common in our transplant was the "awakening" of the CMV (cytomegalovirus virus or mononucleosis), of which I have already written here . This virus has forced me to make an antiviral drug for 21 days (2 times a day intravenously) called CYMEVENE. The intravenous therapy is finished on 7 / 10. The infectious disease of the Niguarda but decided to let me continue therapy by orally for three months because the virus has not been completely eradicated.

Day 5 / 10 to do a biopsy Niguarda (negative result). Unfortunately, the same day in the afternoon, doing an ultrasound, there has been A new pericardial effusion requiring the return of Tradate Niguarda, shelter and pericardiocentesis (removal of fluid within the pericardium). The procedure went well.

On 11/10, I did the angiography, or an examination of the coronary arteries. Good result. Coronary good and free. The same day, I did ultrasound monitoring to see this famous spill that I have already drawn twice. There's been a little while but still good. It is not excluded that the liquid to reform and that he ought to do later with the same procedure (pericardiocentesis). Let's hope not!

Day 12 October, resigned. You return home!