Morning Routine in Intermediate Care
The pattern had become familiar by now - the night shift nurses arrived at 5:30 AM and had to wake me for the daily ECG. After another snooze, a whole new team of nurses arrived for the day shift. Unlike previous days, there was no X-ray scheduled today.
I was gotten ready for the surgeon's visit, who arrived with a big team of doctors and students in tow. He asked me if I needed the oxygen anymore. I gave an honest shrug - "I don't know." He told me he would check and, after confirming my oxygen levels were good, ordered the oxygen removed. Then came the good news: they were preparing a new room for me in the standard care ward.
The Move Across the Hall
No sooner had I finished my breakfast than a team of nurses arrived to move me to my new room. The journey wasn't far - all the way directly across the hall!
The transition brought several welcome changes:
- Oxygen line removed: No longer needed, confirming my lungs were recovering well
- Heart monitor upgrade: The continual monitoring equipment shrank to a portable Phillips MX40-2C4 that I can carry around my neck. It still sends all the data to the central nurse station, but I'm no longer tethered to a bedside machine
- Mobile pacemaker: I still have to carry this around as well, though they mentioned it would be removed in the next day or two
The Temporary Pacemaker
The mobile pacemaker I'm carrying around is an Osypka Pace 203H - a German-made temporary external pacemaker commonly used after cardiac surgery. The device has electrode cables that were threaded through my chest wall into my heart during the operation, allowing the medical team to control my heart rate externally if needed.
The Osypka unit monitors and can pace my heart to maintain a steady rhythm during the critical early recovery phase. To my knowledge, it hasn't needed to actively pace yet, which is a good sign that my heart is maintaining its own rhythm well. The cables will be removed in the next day or two once the surgical team is confident everything is stable.
I have to admit, when I first saw the name "Osypka" on the device, my mind immediately went to oscypek - that delicious Polish smoked sheep's cheese from the Tatra Mountains. At least if I'm going to be tethered to a medical device, it can remind me of one of my favourite cheeses! Though I suspect the German engineer Dr. Peter Osypka who founded the company wasn't thinking about Polish mountain cheese when he named it.
Life in the Normal Ward
Now I'm in a nice quiet room alone. No more beeping machines, though there are still plenty of nurse visits, tests, and medicine to take. The quieter environment is a welcome change after the hectic intermediate care ward.
Physiotherapy and Breathing Exercises
The physio took me for a walk down the corridor, which went well. My mobility is improving daily.
She also gave me some more advanced breathing exercises to do, and I'm now using my Mediflo Duo respiratory exerciser at level 3 of 5. These exercises are crucial because of the discomfort and reduced activity - the temptation is to breathe superficially, which is bad for recovery. Shallow breathing allows bad stuff to build up, leading to coughing (which rates 10 out of 10 on the pain scale, even in the special braced position) and worse possibilities like infection if I don't do the breathing exercises properly and keep my airways clear.
The Mediflo Duo is an incentive spirometer with adjustable resistance levels that helps improve lung capacity after surgery. Starting at level 3 indicates good progress - it provides enough resistance to challenge the lungs without being overwhelming during this early recovery phase.
The "special braced position" I mention is essential for managing pain during coughing, standing up, or sitting down. They provided me with a recovery gilet (a padded vest), and the technique is to fold your arms across your body with your hands tucked into your armpits, essentially hugging yourself tightly. This braces and supports the chest incision area, reducing the stress on the sternum and making movements much more bearable. Without this bracing technique, even simple movements would be excruciating.
Despite the pain, I'm committed to doing the breathing exercises regularly. They're an essential part of preventing complications.
Progress Summary
Day 5 marks a significant milestone in my recovery:
- ✅ Moved to normal ward
- ✅ Oxygen support no longer needed
- ✅ Portable monitoring equipment
- ✅ Increased mobility with corridor walks
- ✅ Advanced breathing exercises
- ⏳ Temporary pacemaker still in place (removal soon)
The steady progression from intensive care to intermediate care and now to the normal ward shows good recovery. Each day brings more independence and fewer machines, though the vigilant medical monitoring continues to ensure everything heals properly.
Learning to Move Safely
I should mention that I did manage to get myself into and out of bed on a couple of occasions today, but I don't recommend rushing this milestone. The movement requires not just getting upright, but also spinning around - a complex manoeuvre that puts considerable strain on the healing sternum.
I've decided to work with the nurses for a few more days to master the progression: first, sitting upright confidently; then, standing up by myself; and finally, the full bed transfer. Getting in and out of the chair using the brace is manageable now - the pain is fine. But the bed is still a bit much with that additional twisting motion required.
I also realised I'd been forgetting an important step: adjusting the bed controls to put it in the optimal position before attempting to get out. The right bed angle can make a significant difference in reducing pain and strain during the movement. It's these small techniques that the nursing staff know from experience, and it's worth taking the time to learn them properly rather than powering through with extra pain.