Heart Surgery

Summary

Developed to help the healthcare professional provide discharge instructions to heart surgery patients, this program reviews the steps leading to discharge and the first few weeks of recovery at home. It also covers temporary restrictions, safe activities, incision care, and emotional issues. The importance of reducing risks to maintain long-term heart health is included.

Note: Another version of this program, "Heart Surgery: Getting Ready to Leave the Hospital," is also available. This shorter program focuses on the most basic discharge concepts and excludes information on long-term risk reduction. It is ideally suited for patients with shorter attention spans.

Details

Introduction

Your recovery from heart surgery does not end when you leave the hospital. There are many things you will need to do on your own once you leave.

Preparing For Discharge

• Discharge meeting:
  • Information your healthcare team will go over includes:
    • Discomfort you may have after leaving the hospital.
    • What you can and can't do over the next few weeks.
    • When you can resume your normal activities and return to work.
  • It may help to have a family member present to hear this information, too.
  • You will be given a written discharge plan that will include guidelines about:
    • Incision care
    • Diet and nutrition
    • Physical activity
    • Medications
    • The date for your follow-up appointment
  • Medications will be discussed:
    • New prescriptions
    • Changes to ones you have been taking
    • If prescribed Coumadin, you will be tested to make sure your dosage is at a safe level before leaving the hospital.
• Going home:
  • Try to relax and close your eyes 30 to 45 minutes before you leave the hospital.
  • Someone will need to pick you up and drive you home:
    • Splint your incision with a pillow or other soft object when placing the safety belt across your chest.
    • If the passenger side has an airbag, sit in the back seat.

Recovering At Home

• Arriving home:
  • It is important not to overdue it when you first arrive home.
  • Limit the number of visitors during the first few days until your strength increases.
• Temporary Restrictions:
  • Tub baths
  • Activities where pressure is placed on your sternum or breastbone:
    • Your sternum needs time to heal.
    • Do not lift anything heavier then five pounds, including:
      • children
      • groceries
      • pets
      • laundry
  • Activities that could cause you to strain and open up your incision site:
    • Raising your arms above your head.
    • Opening windows, car doors, and sliding glass doors.
  • Other restricted activities may include:
    • Heavy housekeeping
    • Climbing stairs without assistance
    • Gardening
    • Lawn work
    • Certain sports
  • Some of these activities may be restricted for only a week or two. Others may be restricted until you return for your follow-up visit.
• Safe Activities:
  • At home you will be advised to maintain a comfortable level of activity which you may increase over time.
  • Taking short walks.
  • Minor household chores or repairs.
  • Light computer work.
  • Non-strenuous golf putting.
  • Riding in a car for short distances.
  • Sexual activity when you feel comfortable.
  • Consult physician before resuming any activity you feel uncertain about.
  • Talk to your physician about home visits from their health care team.
  • Balance your activities with rest.
  • Continue your Controlled Coughing and Spirometry exercises as your healthcare team directs.
• Develop a basic routine will help you keep track of everything:
  • Keep careful records of your activities.
  • You may be asked to weigh yourself every morning before breakfast:
    • Try to wear the same amount of clothing.
    • If you notice a rapid weight gain, generally two to five pounds, within 2-3 days, you could be retaining fluid and should contact your healthcare team.
  • You may also be asked to take your temperature once or twice a day and record your results. You should contact your healthcare team if your temperature rises above 100 degrees.
• Warning Signs:
  • Rapid weight gain
  • An increased temperature
  • Pain, tenderness, burning or warmth in your chest which may spread to your jaw, neck, or arms
  • Breathing difficulties
  • Excessive nausea
  • Sweating
  • Return of pre-surgery symptoms
  • Never be afraid to contact your healthcare team, go to the hospital, or dial 911
• Coumadin users:
  • Take extra care not to cut yourself.
  • If you do cut yourself, take care of the wound quickly.
  • Call your healthcare team if bleeding doesn't stop.

Incision Care

• Cleaning Your Incisions:
  • Use warm water and antibacterial soap.
  • If strips of tape were used to close your incision, your doctor will let you know how and when you can wet and remove them.
  • Do not apply any lotions or powders until your incisions are completely healed.
• Check daily for signs of infection:
  • Don't be alarmed by:
    • Minor redness
    • Bruising
    • Numbness, soreness, or itching
    • A lump at the top of your chest incision, which will disappear in a few months
  • Signs of infection include:
    • Increased swelling around the incision area
    • Tenderness and soreness
    • Drainage
  • If you feel you are developing an infection, or your incisions are not healing as they should, call your healthcare team.
  • Bypass Surgery may require removing a vein from the leg, which is often the most uncomfortable incision.
    • Keep your legs elevated to keep the swelling down.
    • Place a pillow under your legs when you are sitting in a chair, or lying in bed.

Beyond Your Immediate Recovery

• The stresses of recovering from heart surgery, and readjusting to everyday life can take it's toll on your body and mind:
  • It may stir up emotions and cause your mood to change.
  • You may experience:
    • Depression
    • Sadness
    • Irritability
    • Anxiety
    • Memory loss
    • Lack of concentration
    • Unusual dreams
• Your spouse or loved ones may experience feelings of depression as well.
  • They may also feel the need to be over-protective of your well-being.
  • Talk with each other about your feelings.
  • Communication and the support you give one another is very important.
• Protecting the long-term health of your heart:
  • Maintain a healthy lifestyle.
  • Reduce your risk factors—things that can cause and increase the damage to your heart:
    • Abnormal cholesterol levels
    • Smoking & second hand smoke
    • High blood pressure
    • An inactive lifestyle
    • Being overweight
    • Diabetes
    • Stress
  • Most risk factors can be controlled by making some lifestyle adjustments:
    • Increasing your physical activity
    • Making healthier food choices
    • Quitting smoking
    • Finding ways to reduce stress in your life
  • Making lifestyle adjustments can be difficult, especially at first.
    • Start slowly.
    • Don't get discouraged by setbacks.
    • Stay committed.
  • Attend cardiac rehabilitation:
    • It can help you develop the skills you will need to properly care for your heart and live a healthy life.
    • It is also a great opportunity to work and share with others learning to make similar adjustments.

Conclusion

Remember, recovering from heart surgery does not stop when you leave the hospital. There is still a great deal you'll need to do in the short-term and long-term. Recognizing and following these guidelines can help you enjoy a healthy, active, and long life.