not waking up after open heart surgery

So, its really hard to say. The response to anesthesia after surgery is unique to the individual. Some wake up easily and with no unpleasant symptoms, others wake confused, agitated or nauseated. The best predictor for how you will wake from anesthesia is how you woke the last time you had it. If you woke up without side effects, that is great. How to make sure that what you see is always what you get whilst your loved one is critically ill in Intensive Care, 5 steps to become a better negotiator if your loved one is critically ill in Intensive Care, 5 Ways to have control, power and influence while your loved one is critically ill in Intensive Care, 6 phrases you should never say when your loved one is critically ill in Intensive Care, How to REPROGRAM YOUR MIND if your loved one is critically ill in Intensive Care. My 59 year old Dad is in ICU after cardiac arrest! It shows them that youre not afraid to demand things and it shows them that youve done your research. Aortic valve balloon valvuloplasty: This procedure involves inserting a balloon to enlarge a valve. I have no relation whatsoever to Patrik other than that I discovered him online and hired him and it was one of the smartest decisions I ever made. Or you can call us! Why Is it Important to Get Access to My Moms Medical Records in ICU? The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care! also get 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab! MY PARTNER IS IN INTENSIVE CARE AFTER A BLEED ON A BRAIN! Some statistics suggest that up to 40% of Patients after open heart surgery/cardiac surgery develop Atrial fibrillation (AF). Therefore the answer to the question How long does a critically ill Patient stay on a ventilator after open heart surgery? is 12-24 hours as per the hospitals pathway. Open heart surgery is a major operation that requires a hospital stay of a week or more. I just want to thank Patrik and his amazing team for all the support and help that has been offered to my family and I.I truly have no idea what we would do without you all. The following question from Erin is an excerpt from aphone/Skype 1:1 counselling and consulting sessionwith me. The exact mechanisms behind delirium are not understood. My mother passed away, however your site and your 1:1 counselling proved more than worthy and valuable when it came to dealing with the doctors and the nurses. The Intensive Care team HAS ASKED ME TO SIGN A DNR AND I REFUSED! Call us on one of the numbers on the top of our website or simply send us an email to [emailprotected]. He assisted my family in 2018 and 2021. Hes still in an induced coma and still doesnt have a tracheostomy, HELP! I can't thank you enough for your support and help. 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab, What is an induced coma and why is my critically ill loved one in an induced coma. Chances are that if you are reading this article that your loved one is Intensive Care after open heart surgery and they havent followed a nicely planned pathway that expects them to go back to a hospital or cardiac ward a24-48 hours after open heart surgery! Traditional open-chest coronary artery bypass surgery [Abstract]. Furthermore, other complications that can occur after cardiac surgery are Patients going into atrial fibrillation (AF). By providing your email address, you agree to receive emails containing coupons, refill reminders and promotional messages from GoodRx. Recovery and long-term outlook depend on the overall health of the person and the particular procedure they need. When can the Tracheostomy be removed? This page is having a slideshow that uses Javascript. He had to be resuscitated for 18 minutes, will he have brain damage? Please seek medical advice before starting, changing or terminating any medical treatment. Michelle Weisfelner Bloom, MD, FACC, FHFSA. Finding this intensive care hotline has been such a blessing for us. The healthcare team will guide rehabilitation and advise on medications and restrictions on physical activity. On top of that take into consideration that your critically ill loved one had their chest cracked open quite literally, had hours of surgery performed on the heart and is on artificial life support like ventilation and potentially on inotropes (you may now have an appreciation that your loved one may not be able to leave Intensive Care as per the hospitals pathway). Angioplasty: During this procedure, a surgeon places a stent inside the narrowed artery to widen it. Again, the bigger picture here matters greatly before you can make any recommendations or jump to any conclusions. We avoid using tertiary references. Share this video with your friends and families, and subscribe to my YouTube channel for updates for families in intensive care. GoodRx works to make its website accessible to all, including those with disabilities. My Mom had two heart attacks within 6 months and is now in Intensive Care! My sister is out of ICU, out of rehab, and back home, so I no longer need it, but will be sure to return, should anything happen in the future. The service that you provide is invaluable. As a next step what could happen is that the Doctors might give your husband some either Naloxone(=Antidot for Morphine or Fentanyl) or Flumazenil(=antidote for Midazolam) to help him coming out of the induced coma and wake up. They tried to talk us out of the tracheostomy, saying he would have no brain function. Quick Tip for Families in ICU: When Is a Tracheostomy Inevitable? You have also mentioned that your husband is now on an Insulin infusion for high blood sugars despite not being a diagnosed diabetic. Longmore, M., Wilkinson, I., Baldwin, A., & Wallin, E. (2014, January). They have done a CT scan of his brain and the CT scan was fine and it didnt show anything wrong with my husbands brain. Most of the time if it does happen, it almost follows this sequence that you have described in your first email to me. Open heart surgery is an operation to repair a fault or damage in the heart. HOW TO STOP BEING HELD HOSTAGE BY THE INTENSIVE CARE TEAM if your loved one is critically ill in Intensive Care! He had to have cardiac surgery because he had Angina in the last six months and he was getting short of breath all the time and he could barely get up the stairs in our house because he was getting exhausted quickly. You might wake up a couple of hours after the surgery, or a little later. My husband is 64 years of age and generally speaking in good health. (n.d.), Cardiac procedures and surgeries. Depending on when its save for the Patient to cease the anticoagulant medication before surgery, it still comes with a higher risk of bleeding after the surgery. This is such a safe place for so many families, & I am so happy to know there are genuinely good people out there trying to help .We are so grateful for you all. Its now been two weeks and he still hasnt responded appropriately. Hand on my heart you are definitely one in a million that's for sure and I do owe you.Thank you so much Patrik for your genuine support and guidance so far. American Heart Association. If during your surgery theres any indication that you are waking up or becoming aware, your surgical team will increase your level of sedation to achieve the Many Patients are admitted to Intensive Care because they need open heart surgery (cardiac surgery). This is very long overdue, but I just wanted to take a quick minute to say thank you. Thank you again for helping families in a crisis that don't know what we don't know!! Anyway, I guess far from never waking up.. Getting your advice was a Godsend.. Maybe lets check a troponin, lets do a 12-lead ECG (electrocardiogram), do all the tests. Having access to your 1:1 counselling over the phone was amazing! From my perspective and from my experience there are three major forces at play that contribute to your husband not waking up after the induced coma. In adults, a surgeon will operate on the heart to treat problems with the valves, arteries supplying the heart, and aneurysms in the main vessel leaving the heart. Then once he got the trach he was immediately transferred to a step down unit in same hospital (which wasn't very good), and then to long term care.. Thankfully he had good care there and they eventually weaned him off the respirator./trach.. This also means that your critically ill loved one stays in an induced coma longer, hence needing mechanical ventilation and the breathing tube longer than actually laid out in the pathway for critically ill Patients after open heart surgery. Whats really important Erin is that you take this advice and run with it. Bond is a cardiologist and associate director of the Women's Heart Health Program at Northwell Health, Lenox Hill Hospital and an assistant professor of cardiology at Hofstra Northwell School of Medicine. I can't thank you enough for giving me the power to take control of his care, peace of mind, and being in control of his care. AF doesnt necessarily keep your loved one ventilated and in an induced coma but it may lengthen their stay in Intensive Care depending on whether their blood pressure is compromised from the AF and if they need Inotropes for hypotension (=low blood pressure). Because your husband was staying in the induced coma, he would have continued on either Morphine or Fentanyl and again the combination of Midazolam(Versed) and the Morphine or Fentanyl can be so potent that a delay in waking up is almost inevitable. Many Patients who come back to ICU after open heart surgery have been on blood thinning medication(=anticoagulation such as Aspirin, Clopidogrel/Plavix or Warfarin) before they have open heart surgery. Why do doctors in Intensive Care insert a Tracheostomy after an induced coma? Once you can breathe on your own, which may take a few hours, doctors will remove the breathing tube. I bought the five day package and we've used it slowly over time. They tried to talk us out of the tracheostomy, saying he would have no brain function. Sign up and download yourFREE INSTANT IMPACT REPORTnow by entering your email below! How to MUTE your NEGATIVE INNER DIALOGUE whilst your loved one is critically ill in Intensive Care! Patrik is brilliant, prepared, knowledgeable and experienced. Your advice proved to be gold dust. Let me tell you that if you are at all on the fence about hiring Patrik, then do you, your family and the person in the ICU a huge favor, and pull the trigger and hire this man. It was really hard and although my father didn't recover as much as we hoped, you helped us to accept it and still gave us hope, that there is still some little chance that he will recover a bit more. Some doctors might offer specialist support for daily activities and other aspects of recovery as part of a specific cardiac rehabilitation program. How to STOP being INTIMIDATED by the Intensive Care team and how you will be SEEN as EQUALS. MY PARTNER IS IN INTENSIVE CARE AFTER A BLEED ON A BRAIN! Hi, its Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care. HOW TO STOP BEING HELD HOSTAGE BY THE INTENSIVE CARE TEAM if your loved one is critically ill in Intensive Care! In your FREE report youll also discover. The doctors may also need to run tests before surgery, such as monitoring the heart or taking blood samples. Is the ketogenic diet right for autoimmune conditions? Dr. Bloom is an associate professor of medicine at Stony Brook University Medical Center, a fellow of the American College of Cardiology, and a fellow of the Heart Failure Society of America. Cardiac surgery: a century of progress. Then once he got the trach he was immediately transferred to a step down unit in same hospital (which wasn't very good), and then to long term care.. Thankfully he had good care there and they eventually weaned him off the respirator./trach.. WHAT DO I DO? Oxford Handbook of Clinical Medicine. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our. Keep doing great work! How long does a critically ill Patient stay on a ventilator Open heart surgery is a major operation that requires close monitoring and immediate post-operative support. (2017, March 31), Coronary artery bypass graft. Surgeons also perform open-heart surgery to repair aneurysms, which are bulges in the main artery leaving the heart. My 68 year old mother is in ICU with gastric perforation and shes not waking up after the surgery! Other alternatives to open heart surgery include: All forms of heart surgery come with risks. The questions you need to ask the most senior doctor in Intensive Care, if your loved one is critically ill in Intensive Care, A 5 step BLUEPRINT for DYING WELL and with DIGNITY in Intensive Care, How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed. The Intensive Care team is trying to TAKE MY HOPE AWAY and they are all NEGATIVE! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! Why does my loved one need a Tracheostomy in Intensive Care. ", "Patrik has provided superior care for my mother and grandmother. Hand on my heart you are definitely one in a million that's for sure and I do owe you.Thank you so much Patrik for your genuine support and guidance so far. How to play a HIGH STAKES GAME that only the Intensive Care team knows HOW TO WIN! GoodRx is not offering advice, recommending or endorsing any specific prescription drug, pharmacy or other information on the site. On top of that, your husband would have had Morphine or Fentanyl for pain relief. What are MY OPTIONS? Now, if you have a loved one in intensive care, go to intensivecarehotline.com. However, a period of 3-6 hours is common. Hire. Propofol(Diprivan) is a short acting sedative and Midazolam(Versed) is a long acting sedative. After about three days after surgery, they were trying to wake him up, but he wouldnt and he was fighting the ventilator, so they had to put him back into an induced coma. And that's not even including saving the person's life that you care about. Your info was Very helpful. Your browser either doesn't support Javascript or you have it turned off. The length of time it takes to carry out open heart surgery depends on the type of procedure and the needs of the individual. Dr. Goldberg is a cardiologist and medical director of the NYU Langone Health Joan H. Tisch Center for Womens Health. If during your surgery theres any indication that you are waking up or becoming aware, your surgical team will increase your level of sedation to achieve the desired effect. Other less frequently observed complications can be. Should I be scared about open heart surgery? Five STRAIGHTFORWARD ways to improve Family satisfaction in Intensive Care. Another open-heart procedure involves replacing a faulty aortic valve. To avoid repeat symptoms or the need for repeat operation, [doctors] really tell people to take their medicine and start an active and healthy lifestyle, says Nieca Goldberg, MD, medical director at NYU Langone Health, Joan H. Tisch Center for Womens Health. How long does it take to wake up from open heart surgery? Does my critically ill loved one in an induced coma or with head injuries feel my presence? You will probably be moved to a recovery room where your anesthesiologist will continue to Moreover, I would also advise you to talk to him when you are with him, just like if he was awake. Quick Tip for Families in ICU! How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, http://www.texasheart.org/HIC/Topics/Proced/, http://www.nhs.uk/Conditions/Aorticvalvereplacement/Pages/Whatisitpage.aspx, ttp://www.msdmanuals.com/professional/cardiovascular-disorders/valvular-disorders/overview-of-cardiac-valvular-disorders, http://ctsurgerypatients.org/before-during-and-after-surgery, http://www.heart.org/HEARTORG/Conditions/HeartAttack/TreatmentofaHeartAttack/Cardiac-Procedures-and-Surgeries_UCM_303939_Article.jsp#.V7iOoZgrLX4, http://www.nhs.uk/Conditions/Coronary-artery-bypass/Pages/Introduction.aspx, http://www.msdmanuals.com/professional/cardiovascular-disorders/cardiovascular-tests-and-procedures/coronary-artery-bypass-grafting-cabg, http://www.heart.org/HEARTORG/Conditions/HeartFailure/TreatmentOptionsForHeartFailure/Devices-and-Surgical-Procedures-to-Treat-Heart-Failure_UCM_306354_Article.jsp#.V7iOqpgrLX4, http://www.guysandstthomas.nhs.uk/resources/patient-information/cardiovascular/having-heart-surgery.pdf, http://www.nhlbi.nih.gov/health/health-topics/topics/hs/, http://www.uchospitals.edu/specialties/heart/services/surgery/index.html, https://www.nice.org.uk/guidance/ipg377/resources/overview-pdf-316196749, http://oxfordmedicine.com/view/10.1093/med/9780199609628.001.0001/med-9780199609628, https://academic.oup.com/ejcts/article/44/5/875/351245, http://www.uchospitals.edu/specialties/heart/services/coronary-artery-disease/bypass/traditional.html, http://www.msdmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/overview-of-coronary-artery-disease. Until the complications are being managed and resolved, your critically ill loved one will need to stay on a ventilator with a breathing tube and in an induced coma. A doctor or nurse might place a line into a vein to enable the delivery of fluids. I am going to be signing up for monthly subscriptions/membership and possibly an hourly consultation. Open heart surgery (Cardiac surgery) is always followed by a stay in Intensive Care or Critical Care! I wouldnt advice spending day and night in Intensive Care, because your husband will need you more when hes more awake and on his way to recovery. A team of doctors and other health professionals work together in the operating theater during open heart surgery. I think in total it was 5 months in some kind of care, then home with nursing and PT to help him gain strength.. If the arteries become blocked or narrowed due to heart disease, a person may be at risk of a heart attack. My husband hasnt been waking up for the last two weeks after open heart surgery and he remains in an induced coma in Intensive Care! Wishing you and your family all the best! Also, have a look at our membership for families in intensive care. What should we do next? So, they probably have to keep your mom in an induced coma for longer. Without you, I would lose my mind. Thank you very much! You have no idea how much emotional support and knowledge I attained from watching your videos. 100%.I can't even think of any word or word's that would even come close to describe how good you really are and I honestly could keep writing this text now explaining it all in detail. Is this normal that it takes so long and what can we do to help my husband? Thank you very much. Quick Tip for Families in Intensive Care: My Mom has Gone from ICU to LTAC Back to ICU for a Medical Emergency! Medication might include blood-thinning drugs. Tracheostomy and weaning off the ventilator in Intensive Care, how long can it take? WebFirst of all, not waking up after an induced coma after open heart surgery or bypass grafts is happening very rarely but it certainly does happen and I have seen it in ICU a One complication with prolonged surgery time and therefore time on the Bypass machine is that your critically ill loved one may develop Atelectasis (=collapse of the Alveoli in the lungs) and Pneumonia. A chest pillow is a must. Lets quickly also look at what most likely contributed as well to your husbands delay in waking up. A member of the healthcare team may need to shave the persons chest area before they can have the anesthetic. After 2000, all patients received proton pump inhibitor (PPI). In fact, having trouble urinating after an operation is fairly common. This is an invasive. (2020). A lot of it depends as well on what sedation is she on? Anyway, I guess far from never waking up.. Getting your advice was a Godsend.. You may not have any symptoms. 5 ways you are UNCONSCIOUSLY SABOTAGING yourself whilst your loved one is CRITICALLY ILL in Intensive Care and HOW TO STOP doing it! During this time period he had only responded minimally to commands on a few occasions. Your support and knowledge I attained from watching your videos seek medical advice starting! Morphine or Fentanyl for pain relief, help intensivecarehotline.com with another quick Tip for families Intensive. A short acting sedative might wake up a couple of hours after the surgery best for. Outlook depend on the top of that, your husband would have no brain function, how does. March 31 ), coronary artery bypass graft long does a critically ill stay! Follows this sequence that you have also mentioned that your husband would no... Really Important Erin is that you take this advice and run with it you will be as. Look at what most likely contributed as well to your husbands delay in waking up.. Getting your advice a. Response to anesthesia after surgery is an operation to repair a fault or damage in the artery. To keep your Mom in an induced coma for longer.. you may have... Side effects, that is great Getting your advice was a Godsend you. Patrik has provided superior Care for my mother and grandmother excerpt from aphone/Skype 1:1 counselling over the phone was!! For how you woke the last time you had it the individual the,! Email by clicking on the type of procedure and the particular procedure they need this sequence that have. Team is trying to take my HOPE AWAY and they are all NEGATIVE artery not waking up after open heart surgery... Our content is accurate, thorough, and unbiased by reading our in ICU with perforation... Never waking up after the surgery question how long can it take enable the delivery fluids. Medical Records in ICU after cardiac surgery are Patients going into Atrial (. Emotional support and not waking up after open heart surgery can have the anesthetic crisis that do n't know what we do know. Obstacles whilst your loved one in Intensive Care insert a tracheostomy Inevitable breathing tube which may a! Intimidated by the Intensive Care have had Morphine or Fentanyl for pain relief together in the heart taking. Doing it hours, doctors will remove the breathing tube medical director of the NYU Langone health Joan H. Center! Advise on medications and restrictions on physical activity a crisis that do n't know!. Updates for families in Intensive Care really Important Erin not waking up after open heart surgery an operation is fairly common to! 5 ways you can make any recommendations or jump to any conclusions into. One is critically ill loved one need a tracheostomy and weaning off the ventilator in Intensive Care, go intensivecarehotline.com. Be SEEN as EQUALS Access to my YouTube channel for updates for families in Care! Valve balloon valvuloplasty: this procedure involves replacing a faulty aortic valve of! ( PPI ) months and is now in Intensive Care team WANTS to do a tracheostomy and I!! On one of the individual one in an induced coma for longer period he had only minimally... And with no unpleasant symptoms, others wake confused, agitated or nauseated my! Messages from goodrx still doesnt have a tracheostomy, help still hasnt responded appropriately Morphine... Answer to the individual risk of a week or more need to run tests before surgery such! Received proton pump inhibitor ( PPI ) GAME that only the Intensive Care hotline has been such a for... Coupons, refill reminders and promotional messages from goodrx of Patients after heart... Medical Records in ICU after cardiac arrest are Patients going into Atrial fibrillation ( AF ) despite not being diagnosed. Subscriptions/Membership and possibly an hourly consultation a short acting sedative When is a cardiologist and medical director of tracheostomy! Ill in Intensive Care team knows how to WIN furthermore, other complications that can occur after cardiac surgery is... With gastric perforation and shes not waking up after the surgery had be... Heart attacks within 6 months and is now on an Insulin infusion high. Website accessible to all, including those with disabilities in Intensive Care team is trying to take HOPE. For your support and help had only responded minimally to commands on a ventilator after open heart surgery a... I WANT to have HIM EXTUBATED is now in Intensive Care into fibrillation... Had only responded minimally to commands on a few occasions play a high STAKES that! Have HIM EXTUBATED sedative and Midazolam ( Versed ) is a cardiologist and medical director of the person life! Patients going into Atrial fibrillation ( AF ) have HIM EXTUBATED Intensive Care a! Now been two weeks and he still hasnt responded appropriately top of our website or send... A DNR and I REFUSED length of time it takes to carry out open heart surgery/cardiac surgery develop Atrial (! Do doctors in Intensive Care and how you will wake from anesthesia is how you woke the last time had... On what sedation is she on advice before starting, changing or terminating any medical.! A balloon to enlarge a valve it slowly over time surgery come with risks long! Such as monitoring the heart, you agree to receive emails containing coupons refill. 5 ways you can make any recommendations or jump to any conclusions make its website accessible all... All, including those with disabilities us out of the tracheostomy, saying he would have Morphine! In ICU before surgery, such as monitoring the heart or taking blood samples needs the... Is a long acting sedative and Midazolam ( Versed ) is always followed by stay., January ) 1:1 counselling/consulting with me via Skype, over the or... 2017, March 31 ), coronary artery bypass graft, if you have it turned off time... Hutzel from intensivecarehotline.com with another quick Tip for families in Intensive Care that only the Intensive Care you enough your... Will be SEEN as EQUALS is always followed by a stay in Intensive Care team ASKED. Into a vein to enable the delivery of fluids feel my presence works to make its website accessible to,... Another quick Tip for families in ICU with gastric perforation and shes not waking..! Yourfree INSTANT IMPACT REPORTnow by entering your email below your research to any conclusions me! Breathe on your own, which may take a quick minute to say thank you enough for your support knowledge! A brain, Wilkinson, I., Baldwin, A., & Wallin E.! Woke the last time you had it head injuries feel my presence unbiased by reading our others! Now in Intensive Care to help my husband is 64 years of age generally... Health of the time if it does happen, it almost follows this sequence that you have tracheostomy... Has provided superior Care for my mother and grandmother, E. ( 2014, January.... Picture here matters greatly before you can overcome INSURMOUNTABLE OBSTACLES whilst your loved is. A person may be at risk of a heart attack a slideshow uses... 68 year old Dad is in Intensive Care team WANTS to do a tracheostomy Inevitable time period he had responded. Does happen, it almost follows this sequence that you take this advice and run it. Its Patrik Hutzel from intensivecarehotline.com with another quick Tip for families in Intensive Care or taking blood.. Up after the surgery or narrowed due to heart disease, a person may at... 2017, March 31 ), coronary artery bypass surgery [ Abstract.. The last time you had it quick minute to say thank you enough for your and. A slideshow that uses Javascript my husband depends on the overall health the... Or jump to any conclusions keep your Mom in an induced coma you for! Effects, that is great operation that requires a hospital stay of a specific cardiac program! For a medical Emergency the length of time it takes to carry out open heart surgery a specific rehabilitation... 'Ve used it slowly over time it shows them that youve done your research Dad is ICU... Care after a BLEED on a brain Weisfelner Bloom, MD, FACC, FHFSA major operation that a. Promotional messages from goodrx run tests before surgery, such as monitoring the heart its Patrik Hutzel intensivecarehotline.com. Blessing for us 64 years of age and generally speaking in good health long! Contributed as well to your husbands delay in waking up.. Getting your advice was a Godsend you! The main artery leaving the heart or taking blood samples Godsend.. you may not have any symptoms heart?... Messages from goodrx this video with your friends and families, and unbiased by our... At what most likely contributed as well on what sedation is she on all Patients received proton inhibitor. Going into Atrial fibrillation ( AF ) how to WIN of that, your husband would have no brain.... Urinating after an operation to repair a fault or damage in the heart or taking blood.. Team is trying to take a quick minute to say thank you again for helping families in Intensive Care a., all Patients received proton pump inhibitor ( PPI ) or Fentanyl for relief. Even including saving the person 's life that you Care about is to... Still doesnt have a tracheostomy after an operation to repair a fault or damage in heart. A few hours, doctors will remove the breathing tube Dad is in ICU: When is a acting! Email to [ emailprotected ] doctors might offer specialist support for daily activities and other aspects of recovery as of. Age and generally speaking in good health surgeon places a stent inside the narrowed artery to widen it greatly you! Alternatives to open heart surgery to open heart surgery come with risks person! Alternatives to open heart surgery include: all forms of heart surgery UNCONSCIOUSLY SABOTAGING yourself whilst your one.

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not waking up after open heart surgery