| Recovery
time is different for each patient and each operation. The usual
stay in the hospital after heart surgery ranges from 3 to 5
days. You will usually see your surgeon for follow-up in the
office. 2 to 3 weeks after discharge. During this time, keep
in touch with your doctor and follow his or her instructions.
The following post-op instructions are provided for your
review.
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| General
Post-Operative Instructions |
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Many questions arise as to what you should do or should
not do after discharge.
The
following are answers to the most common concerns and questions.
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While the sternum (breastbone) is healing, avoid lifting
greater than 10 pounds, or pushing/pulling activities with
your arms. Complete healing of the breastbone takes 6-8
weeks.
- Showers
are permitted but tub baths are discouraged for 4-6 weeks
or until your incisions are healed. Avoid extremely hot
water which may cause you to feel dizzy or weak. You may
gently wash (don't rub) your incision with soap. Do not
use creams or lotions on incisions until they are healed.
- Avoid
driving a car until you see your surgeon for follow up.
He will examine you and let you know when it is safe to
begin driving. Your reaction time will be delayed due to
weakness, fatigue, and/or medication. You do not want to
risk hitting the steering wheel and injuring the sternum.
When riding in a car for long distances, stop every 1-2
hours to stretch your legs. This will improve circulation
in your legs and help prevent swelling.
- Do
not cross your legs while lying in bed or sitting. This
puts pressure on the veins under the knees and slows blood
flow. If your legs or feet swell, you should put them on
a chair or stool while sifting.
- Sleep
the number of hours that you normally slept before your
surgery. Do not stay up very late one night and try to "catch-up"
the next. However, if you do plan to stay up late, take
a nap beforehand.
- Avoid
isometrics: straining to move your bowels, pushing/pulling
heavy objects, or working with your arms overhead. These
activities disproportionately elevate blood pressure and
put an added strain on a healing heart.
- It
is important to space and pace your activities to minimize
fatigue. If your feel tired, STOP, and rest for a while.
Don't push yourself to finish a task.
- A
rest period should be taken at least once a day for a few
weeks and, initially, preferably twice, morning and afternoon.
Napping is not necessary, but resting is. Be sure to dress
daily in street clothes. You are on your way to recovery!
- Stair
climbing is not discouraged. Avoid pulling yourself up with
a handrail, and go slowly.
- Use
your elastic stockings during the day and remove them at
night. You should wear the stockings for at least 2 weeks
after discharge or more if your ankles are still swollen.
The stockings aid blood flow and help reduce swelling in
the legs. It is easiest to put the stockings on before you
get out of bed in the morning
- or
the day, however most people put them on after a morning
shower. They should fit snugly.
- Your
may notice a swelling or lump at the top of your chest incision
which could take several months to disappear.
- Most
patients experience incisional discomfort in the sternum.
This discomfort will decrease in time, but may reoccur when
when you overextend yourself. Your physician will prescribe
pain medication.
- It
is important to distinguish incisional discomfort from chest
pain (angina) you may have experienced prior to surgery.
Contact your physician if you are experiencing chest pain.
- If
your chest or leg incisions do not appear to be healing
(i.e., redness, drainage, swelling, or tenderness is present),
notify your physician.
- Take
your temperature every morning for one week after discharge.
Notify your physician if your temperature stays above 100
degress F for more than a day.
- Check
your weight every morning for the first two weeks. If you
notice a sudden weight gain, notify your physician.
- When
you are upset, your heart works harder. It is best to anticipate
and avoid situations, people, or topics of conversation
that make you tense or angry.
- Remember
that your diet, medications, and exercise are prescribed
specifically for you. Do not expect your friend or neighbor
who has a heart condition to have the same prescriptions.
- Keep
a record of your medications and medical history with you
when travelin
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| Valve
Surgery Post Op Care |
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Tell
any doctor or dentist who treats you that you have had your valve
repaired or replaced. They may prescribe antibiotics before procedures,
especially dental work, to prevent an infection from settling in
your heart. It is possible that you will be taking Coumadin, an
anticoagulant, commonly called a "blood thinner." Coumadin causes
blood to take a longer time to form a clot.
There
are several points you should know about Coumadin:
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You
will need regular blood tests (prothrombin time) to regulate
the dosage of Coumadin. Your physician will arrange these
test for you.
- Look
for signs of bleeding while you are taking Coumadin. Notify
your physician if you have:
- any
abnormal bleeding
- red
or black bowel movements
- pink
or red urine
- severe
headaches, abdominal or lower back pain
- faintness
or dizziness
- red
or "coffee ground like" vomitus
- excessive
bruising
- excessive
nose bleeds
- yellow
or jaundice skin
- any
symptoms that concern you
-
Take your Coumadin at the same time every day. NEVER make
up for a missed dose by taking double the dose.
- Don't
take aspirin, any medication containing aspirin or any "over-the-counter"
medications without first checking with your physician as
this can cause bleeding while taking Coumadin.
- Excessive
alcohol intake may also cause bleeding while taking Coumadin.
Check with your physician about drinking alcohol.
- It
is a good idea to carry a wallet identification card indicating
that you are taking Coumadin.
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| Recovering
from Open Heart Surgery is a Family Affair |
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Open
heart surgery is an event that affects the patient, spouse, children,
and significant others. It is similar to the ripple effect in a
pond when a stone is dropped. Many waves occur before the pond eventually
calms. In addition to the physical recovery that the patient undergoes,
there is an emotional aspect of adjustment that the patient, as
 well
as family, experience.
Facing
the possibility of changing one's lifestyle can be quite overwhelming.
Some alterations take place immediately, such as diet changes and
smoking cessation. Other changes may be more gradual, such as building
up to and maintaining an exercise program, or incorporating long
term stress management. Of importance to all those involved is realizing
that the patient does have control in initiating the changes and
in maintaining healthy new habits. This is the patient's responsibility.
Spouses, children, and significant others often struggle with the
impossible task of making sure the patient never deviates off course
and stays on the "straight and narrow'. Remember, others can assist
and encourage, but only the patient can do!
Many lifestyle changes that occur as a result
of having open heart surgery have a direct impact on the entire
household. When a patient is forced to make changes for health reasons,
very often all minds start to think along the same lines. This is
especially true for others who might possibly be predisposed to
coronary artery disease. Therefore, if the recovering patient has
stopped smoking, family members who smoke are now motivated to quit.
And when meals now need to be prepared in a heart-healthy fashion,
chances are those who dine together will also be making these changes
out of practicality for the cook resulting from a renewed awareness
of the benefits to the heart.
Recovering from open heart surgery creates temporary
role changes and responsibility shifts among family members. When
the recovering patient returns home, he/she will have temporary
physical limitations and dependencies which the family members compensate.
The husband will need to shop and carry packages for his recovering
wife who can neither drive herself to the store nor lift heavy packages.
The son or daughter will have to mow the lawn and take out the garbage
for their recovering father, who now has to limit exertion while
he rebuilds his strength.
Just
as the family needs to coordinate efforts in assisting the patient
during his limitation phase, so should they enable him to increase
his independence and regain his level of self reliance. This proves
to be a very delicate balance and can be a cause of friction. Staying
informed of the doctors recommendations on how the patient should
progress can minimize the stress of this transitional period for
both the patient and family.
Recovery
will be a challenge for the open heart surgery patient and his/her
family. There will be days of high energy and of fatigue, accomplishments,
moments of temptation, feelings of exuberance and even days of feeling
blue or angry, all of which are a part of the physical and emotional
healing process that takes place.
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Tips
for your continued successful recovery:
- Encourage each other to express and discuss your feelings.
Open communication can minimize misunderstandings.
- Seek support by talking with others who have experienced
similar circumstances. Sharing common concern can be reassuring.
- Reach out for help. Having to focus on changing several
habits can be overwhelming. Behavior modification groups
(i.e. Smoke Enders) provide structure as well as the mutual
support helpful for success.
- Become knowledgeable about your condition.
- Be inquisitive, attend lectures, and explore literature.
Being informed can reduce anxiety.
- Begin and maintain an exercise program for your physical
and mental well being. Exercising with others can create
added motivation.
- If you are feeling emotionally overwhelmed,
seek professional advise. A trained counselor can help you
to cope more adequately with your concerns. Consult your
hospital social worker or physician for this service
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Remember,
recovery takes time. All of those involved will adjust according
to their ability to assimilate the lifestyle and role changes
which inevitably take place. Sharing your feelings and discussing
ongoing issues can make for a smoother transition for all.
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| Sex
After Surgery |
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There
is a great deal of pleasurable sexual activity that is not sexual
intercourse. Being near someone, holding, fondling, caressing, are
all activities that enhance closeness and pleasure. Since these
activities require very little energy, you may engage in these anytime
after discharge from the hospital. Many couples find that this expression
of love allows them to return slowly to a full sex life with confidence.
Sexual
intercourse requires slightly more energy, therefore a waiting time
of 1-3 weeks is generally recommended. Another consideration will
be position. With sternal incision, a modification may be necessary
in order to prevent injury to the sternum or incisional pain. Exercise
will strengthen the heart and overall physical condition. So as
you engage in the home walking program and witness firsthand increased
endurance and confidence, you will know when you are ready. The
energy expenditure for intercourse is the equivalent of walking
briskly or climb two flights of stairs. The heart rate rarely rises
above 120 beats/minute and blood pressure elevations are similarly
mild and transient.
The person recovering after open heart surgery
may be more conscious of his or her heartbeat, breathing, and muscle
tension. This awareness is normal and is no cause for alarm.
Fear of performance and general depression are
two psychological factors that can greatly reduce sexual interest
and capacity. These are considered normal during convalescence and
in most cases disappear within 3 months. If depression continues
after 3-6 months, professional counseling should be considered.
Various
medications may affect sexual drive and/or function. If this occurs,
consult your physician. Often a change in medication or dosage can
remedy the problem. Never stop taking any prescribed medication
without your physician's approval.
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Ways
to prepare for the resumption of sexual activity:
-
The first step is to exercise as mentioned above.
- The
second step is to be tolerant of each others emotions. For
a brief time following open heart surgery, emotions are
delicately balanced and subject to rapid mood swings. Try
to keep day to day events in perspective and remember that
a good sense of humor is a good ally.
- The
third step is to try to adjust mutual sexual expectations.
Emotional response as well as physical responses sometimes
make the resumption of sexual relations fearful and that
is normal. Therefore don't expect too much at first. Some
general guidelines:
- Be
relaxed and rested before intercourse. Avoid sex if you
are fatigued or upset.
- Choose
a position that does not restrict breathing or require prolonged
muscular support.
- Maintain
a comfortable room temperature and familiar surroundings
and partner.
- Speak
with your physician if you are experiencing any chest pain,
angina, shortness of breath, rapid heart rate, or extreme
fatigue in relation to sexual activity.
- Wait
at least 1 hour after a meal or alcoholic beverages before
having sexual activity.
- Open
communication is important between partner
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