What to Expect After Surgery
After the procedure you will generally spend five to seven days in the hospital. The first 24 hours will be in the intensive care unit. You will have a breathing tube in temporarily and one to two chest tubes which will be removed in the first several days. After the intensive care unit you will be moved to step down. Cardiac nurses and personnel who have special training in the next portion of your recovery staff this ward. You will retain at least one IV line and will be on a heart monitor for the duration of your hospital stay. Adjustments to your medications and treatments will be made. The focus on your stay here will be on strengthening. You will need to get up and out of bed, sitting in a chair during the day. Your lungs work better in an upright position, so it makes it easier and more comfortable for your breathing. Therapists and their assistants will take you for walks in the halls to help build up your strength. You will be given a breathing exerciser, called an incentive spirometer, to help build up your pulmonary reserve and prevent postop pulmonary complications. It is very important that you work with this on an hourly basis.
Once you and your surgeon feel you are strong enough to go home, your nurse will provide a written list of the medications you are to take. Do not resume your home medications unless you have been specifically instructed to. Most patients will be discharged with a home care nurse to visit the following day. They will review your medications, check your wounds, listen to your lungs and check your vital signs. They are a good source of information and provide regular reports to our office. You will have an office visit with us in ten to fourteen days. Some patients (depending on their convalescence and family support system) are not discharged directly home. For patients who need additional physical therapy, rehabilitation or the transitional care unit is an option. This will be evaluated near the time of discharge and coordinated with the case manger at the hospital.
Post-Op Activity Instructions
Activity: Stop any activity immediately if you feel short of breath NOT relieved by rest, notice irregular heartbeats, feel faint or dizzy, or have chest pain. Rest until the symptoms subside. If they do not subside within 20 minutes, notify your doctor.
Incision Care: Avoid soaking in baths until your incisions are healed. Avoid extremely hot water. Shower in the morning and clean incisions 2 times a day with soap and water, peroxide or wound cleanser. Avoid lotions, creams, and ointments on incisions.
Dress: Wear comfortable, loose fitting clothes that do not put undue pressure on your incisions.
Diet: Regular home diet. No added salt. Switch to low fat, low cholesterol diet when appetite returns. Constipation is a common complain after surgery due to inactivity or pain medication. Any over the counter laxative is acceptable such as: milk of magnesium, stool softeners, fiber supplements, enema or suppository if needed.
Rest: You need a balance of rest and exercise for your recovery. Plan to rest between activities and to take short naps as necessary. Resting also includes sitting quietly for 20-30 minutes. Rest 30 minutes after meals before exercising.
Walking: This is one of the best forms of exercise because it increases circulation throughout the body and to the heart muscle. It is important to increase your activity gradually. Walk at your own pace. Stop and rest if you get tired. Each person progresses at a different rate after heart surgery. In cold weather, wear a scarf or mask around your mouth and nose.
Stairs: Unless your doctor tells you differently, you can climb stairs. Take them at a slow pace. Stop and rest if you tire. When using the handrail, do not pull yourself up with your arms. Use your legs.
Sexual: You can resume sexual relations when you feel comfortable. For many people this is about 2 to 4 weeks after discharge, unless instructed differently by your doctor. Please ask your nurse for more detailed information, if needed.
Driving: You can ride as a passenger in a car at any time. Avoid driving, outdoor bicycling, or motorcycle riding for 6 weeks after surgery. This time period is recommended to allow your breastbone (sternum) to heal. Also, your movements might be limited and slow before the 6 weeks are up. When traveling, be sure to get out of the car every 2 hours and walk around for a few minutes.
Lifting: You should not put too much strain on your sternum while it is healing. Avoid lifting, pushing, or pulling anything heavier than 5-10 pounds for 8 weeks after surgery. This includes carrying children, groceries, and suitcases, mowing the grass, vacuuming, and moving furniture. Don’t hold your breath during any activity, especially when lifting anything or when using the rest room.
Work: Check with your surgeon before returning to work, but most patients will begin to feel like returning to light work 6 to 12 weeks after surgery.
When Can I Resume Certain Activities?
Patients having minimally invasive or robotic surgery, can resume all activities typically after two weeks.
* Keep in mind that all of these activities need to be in the 5-10 pounds or less weight limit until 8 weeks after surgery.
** Visitors: Limit your visitors for the first couple of weeks. If you get tired, excuse yourself and lie down. Your visitors will understand.
****For patients having a robotic or minimally invasive operation, you may resume normal activities in two weeks****
When Should I Call the Office if I believe I am Encountering a Problem?
No refills on prescriptions will be called in after 4:30 p.m. Monday-Friday. Call for Prescriptions during regular business hours.
Cardiac rehab combines a multidisciplinary team with individualized exercise. The goal is to promote life style modification to reduce the need for further cardiac procedures and to return you to your usual activities faster. We strongly recommend that you attend. Phase I of cardiac rehab is offered while you are in the hospital. Phase II and III are on an outpatient basis and need to be ordered by your cardiologist.
Here is a list of local facilities that offer rehab:
- St. Vincent’s Cardiac Rehab
- St. Vincnet’s East
- Trinity Medical Center