recovery for open heart surgery Most patients spend the first night in ICU and then transfer out to the cardiac stepdown unit the next day. Usually you will spend another 4-5 days in the cardiac unit before going home. While in the hospital, the nurse or cardiac rehab person will make you walk at least 3 times per day in order to help you get your strength back. Uusaly no lifting or return to work or anything strenuous for at least 2 months if not longer. You should be enrolled in outpatient cardiac rehab where they will monitor you on a weely or semi weekly basis. You should be walking at home... better yet at the Y or something so someone can watch you... initially you will be walking at the rehab center.
Good luck with the surgery, I have worked with open heart patients for the last 5 years so I would be happy to answer any more questions you have! When you leave the hospital after heart surgery, you will be given instructions on how to care for yourself during the first phase of recovery which lasts about six to eight weeks. Those who have had minimally invasive surgery may have a shorter recovery time.
Typical instructions include:
Care of your incision
Bathing:
Place soapy water on your hand or washcloth and gently wash the incision up and down. Until the scabs are gone and the skin is completely healed, do not rub the incision with a washcloth.
When showers and baths are permitted, they should be limited to 10 minutes. The water temperature should be warm - not too hot or cold. Extreme water temperatures can cause faintness.
You will be told how to care for your incision(s) before you leave the hospital. It is important to:
Keep your incision(s) clean and dry.
Use only soap and water to cleanse the area.
Do not apply ointments, oils, salves or dressings to your incision unless specifically told to do so.
Eat a healthy diet to help healing.
Call your doctor if signs of infection appear:
Increased drainage or oozing from incision Increased opening of the incision line
Redness or warmth around the incision
Increased opening of the incision line
Increased body temperature (greater than 101 degrees Fahrenheit or 38 degrees Celsius)
Relief of pain
Some muscle or incision discomfort, itching, tightness and/or numbness along your incision are normal after surgery. You should not have pain in your chest similar to what you had before surgery. You will be given a prescription for a pain medication before you leave the hospital.
If you had bypass surgery, you may have more pain in your legs than around your chest incision if saphenous vein grafts were used. Walking, daily activities, and time will help to lessen leg discomfort and stiffness.
Call your doctor if your sternum feels like it moves, or it pops or cracks with movement.
Swelling - for those with vein grafts taken from their legs
You may return home with some swelling in your legs and feet, especially if you had vein graphs taken from your legs. If you notice swelling:
Place your feet up higher than your heart level when resting. One way to do this is to lie on your bed or couch and put several pillows under your legs. Or, you may lie on the floor and place your feet on the couch. Try this three times a day for one hour to relieve swelling. (Note- recliners do not adequately elevate your feet).
Do not cross your legs
Walk daily even if your legs are swollen
Hospital support hose may be suggested
Call your doctor if swelling in your leg(s) become worse or painful and/or associated with increased fatigue and/or shortness of breath.
Medications
You may need medications after surgery. Your doctor will tell you if you need these medications until you recover from heart surgery or lifelong. Make sure you understand the names of your medications, what they are for, and what times to take them. Only take the medications that are prescribed when you are discharged from the hospital. If you want to take medications you were previously on for other conditions, discuss this with your doctor first.
Driving
Your doctor will tell you when you may resume driving. This usually occurs about six to eight weeks after surgery, however, time may be shorter if you had minimally invasive surgery. During this time, you may be a passenger as often as you like.
Activity
For the first six to eight weeks:
Gradually increase your activity. You may do light household chores, but do not stand in one place longer than 15 minutes.
Do not lift objects greater than 20 pounds (your doctor may give you a different number if appropriate). Also, do not push or pull heavy objects.
It is OK to perform activities above shoulder level, such as reaching for an object or brushing your hair. But, do not hold your arms above shoulder level for a longer period of time.
You may climb steps unless they have been restricted by your doctor. You may need to rest part of the way if you become tired. Do not climb up and down stairs several times during the day, especially when you first arrive home. It is better to plan activities to go downstairs in the morning and back upstairs when it is time for bed.
Pace yourself - spread your activities throughout the day. If you become tired, rest and schedule unfinished activities for another time.
Walk daily. Your doctor or cardiac rehabilitation specialist will give you guidelines for walking when you return home.
Check with your doctor to confirm activity guidelines.
Diet
You should eat a healthy diet to help you heal. Your doctor will tell you if you should follow any special diet instructions. It is common after surgery to have a poor appetite at first. If this is the case, try to eat smaller, more frequent meals. Your appetite should return within the first few weeks. If it does not, contact your doctor.
Sleep
It is important to get enough rest or you may feel overtired and irritable. Unfortunately, many people complain of having trouble sleeping for some time after surgery. Normal sleep patterns should return within a few months. Call your doctor if lack of sleep begins causing changes in behavior or if normal sleep patterns do not return. For more tips on what to do if you cannot sleep, click here.
Work
You will need to take time to recover, usually about six to eight weeks (may be earlier with minimally invasive surgery). Your doctor will tell you when you can return to work. If you have the flexibility at your job, ease back to your work schedule. If possible, start back at half-time and gradually increase back to your normal routine.
Emotions
To help relieve the emotional blues:
Get dressed every day
Walk daily
Resume hobbies and social activities you enjoy
Share your feelings with others
Visit with others. Limit your visits to 15 minutes at first. Then increase them depending on how you feel
Get a good night鈥檚 sleep
Join a support group or cardiac rehabilitation program
It is common after surgery to feel sad or blue. These feelings should go away after the first few weeks. If they do not, call your doctor.
Sex
Many patients and their partners feel nervous about resuming sexual activity after heart surgery. The amount of energy it requires to perform intercourse with a spouse or regular partner is similar to climbing about one or two flights of stairs or walking about one half mile (0.8 km) at a brisk pace. If you cannot perform these activities without becoming tired or short of breath, please allow additional recovery time before resuming sexual activity. For the first six to eight weeks, use positions which limit pressure or weight on the breastbone or tension on the arms and chest.
Keep in mind that a sexual relationship has both physical and emotional aspects
Talk openly with your partner
Allow a gradual return of sexual activity
Have sex when you are rested and physically comfortable
Create realistic performance expectations - it may take time to return to an active sex life
Be caring honest and loving with each other
Soon you and your partner will return to a satisfying emotional and physical relationship. Anxiety on the part of either partner, as well as some medications, may interfere with sexual arousal or performance. So, discuss any difficulties with your doctor.
Mental Functioning and Heart Surgery
Some people become frustrated during recovery from heart surgery because they feel they are not as sharp mentally as they were before surgery. These cognitive changes are normal after heart surgery. The entire body, including the brain, was seriously stressed during surgery, especially if the surgery involved stopping the heart and circulating the blood through a heart-lung machine. With time, in most cases, normal cognitive functioning returns. Patience is needed to avoid the frustration that can accompany this side effect of surgery. You should not force yourself to work or perform mentally stressful tasks, such as balancing a checkbook in the first couple of weeks after surgery. Click here for more information on cognitive function after heart surgery.
What is cardiac rehabilitation?
For many people with coronary artery disease, a cardiac rehabilitation program provides an excellent opportunity to begin an exercise program, learn about your heart disease, and learn strategies to change your lifestyle to prevent further progression of your disease. Your family doctor can give you information about programs in your local area (cardiac rehabilitation is covered by most insurance companies) or you may go to the American Association of Cardiovascular and Pulmonary Rehabilitation* website to search for a program, or call the Cardiac Prevention and Rehabilitation program at the Cleveland Clinic Foundation 216/444-9353. Click here to learn more about choosing a cardiac rehabilitation program. |
