Homeward Bound What can I expect when I am discharged from the hospital? Do not How do I care for my incisions?

Transcription

1 Hmeward Bund What can I expect when I am discharged frm the hspital? Yu can expect t stay in the hspital 4-5 days. Befre yu leave, yu will learn hw t care fr yurself at hme. A friend r family member shuld be present the day f discharge t hear instructins with yu. Yu will receive prescriptins fr medicines. Yur medicines may change after surgery. Yu may take sme different nes. The dses f sme may change. Please nte the names, dses, and times f yur medicines. D nt take the medicines yu were taking befre surgery withut checking with yur surgical team. Please bring yur insurance card if yu plan t fill yur prescriptins at the UW Hspital Pharmacy. Yu need a respnsible persn t drive yu hme and stay with yu fr ne week. It may be helpful t have smene stay with yu fr the first week r tw after yu g hme. Sme patients may want r need t stay at a place fr mre rehab r skilled nursing care after discharge frm the hspital. Yur cardiac surgery team will wrk with yu t assess yur needs. Yur case manager will help arrange fr special needs like Hme Health, a nursing hme stay, r Meals n Wheels. Mst patients have fllw-up visits with their surgens at 1 week and 4 weeks after surgery. Yu will als have scheduled clinic visits with yur primary care dctr and cardilgist in the first few weeks after surgery. Hw d I care fr my incisins? While yu are in the hspital, yur incisins are cvered t avid irritatin frm the telemetry leads r heart mnitr. After discharge, a dressing is nly needed if drainage is present. Small amunts f a thin, light red fluid may drain frm the chest tube sites. This is nrmal. Cver the chest tube sites with dry gauze and change daily until the drainage stps. If the drainage appears infected (may be thick yellw with a bad smell), please call yur surgen s ffice right away. Als call the ffice if yu have any drainage frm yur chest r leg incisin (if yu have ne). Drainage frm these sites is nt cmmn. At first, the incisins may be red and swllen. The redness and swelling decrease as they heal. Signs that an incisin has becme infected include increasing redness, warmth, sreness, thick yellw drainage, and fever. Please call the surgen s ffice if yu have any f these signs.

2 Keep incisins clean and dry. D nt put intments, pwders, r ltins n them. Shwer daily with yur back t the stream. Use a mild, fragrance-free sap. When washing, avid rubbing yur incisin. Pat the incisin dry. D nt take ht shwers r baths. Tub baths, ht tubs, and swimming pls are nt allwed fr 30 days r until yur incisins are fully healed. Any staples r sutures will be remved at yur first fllw-up visit. What d I check every day? Weigh yurself daily. Measure yur bld pressure and heart rate daily if yu have a bld pressure cuff. Write yur weight, bld pressure, and heart rate (pulse) daily in yur Weight and Vital Signs Recrd. Bring this t yur first fllw-up visit. All patients retain water after heart surgery. Yu will be n a fluid restrictin and lw salt diet fr a few weeks after surgery t help yur bdy get rid f the extra water. Yu will likely be n a water pill (diuretic) when yu g hme as well t get rid f the extra water. This helps yur breathing. Yu may have mre changes t yur diet (lw fat r lw chlesterl) based n yur heart cnditin. Hw active shuld I be? As yu heal yu will slwly feel strnger and mre independent. This may take weeks t mnths. Be patient. Give yurself time. Each day find a balance between increasing yur activity, and getting enugh rest and sleep. Deep breathing helps yur lungs recver. Use yur incentive spirmeter at hme fr 3 weeks t help yur lungs heal. Walking is a gd safe way t exercise after heart surgery. Be as active as yu feel yu can be. Please see belw fr activity restrictins after heart surgery. Call yur surgen s ffice if yu have questins r cncerns abut yur recvery. Pain medicine may cause yu t becme drwsy, dizzy, r lightheaded. D nt drive, use machines, r drink alchl while taking pain pills. D I have any activity restrictins after heart surgery? All patients have restrictins after heart surgery. Yur breastbne (sternum) is a brken bne that cannt have a cast n it. It takes abut 12 weeks fr a brken bne t heal. Yu will have an 8 pund weight restrictin fr the first 6 weeks. In ther wrds, yu shuld nt lift mre than 8 punds during the first 6 weeks after surgery. This is abut the weight f a galln f milk. Starting the 7 th week after surgery, the amunt f weight yu may lift is increased frm 8 punds t 20 punds fr 6 mre weeks. D nt flex r extend yur shulders ver 90 degrees. D nt push r pull with yur arms when mving in bed and getting ut f bed. 2

3 Avid reaching t far acrss yur bdy. D nt hld yur breath during activity. Brace yur chest when cughing r sneezing fr the first 2 weeks and as needed. Avid lng perids f ver the shulder activity. If yu feel any pulling r stretching in yur chest, stp what yu are ding. D nt repeat the mtin that caused this feeling. Reprt any clicking r ppping nises arund yur breastbne t yur surgen right away. Avid twisting mtins and heavy lifting until 12 weeks frm surgery. This includes but is nt limited t these activities: Snw shveling Lawn mwing Glf Tennis Hunting Fishing Running (walking is safe and encuraged) Bike riding Mtrcycle riding Cntact sprts (sccer, ftball) Weight lifting Bwling Vacuuming Sweeping D nt drive fr the first 4 weeks t help yur breastbne heal well. When 12 weeks have passed since surgery, yu may resume yur nrmal rutine activities. Call yur surgen s ffice if yu have questins. 3

4 There are many things yu can d while yu are healing and getting strnger. D as much as yu can based n hw yu feel and yur weight restrictin. Belw are sme examples f light activities: Light husewrk Seeing friends Walking Shpping Are there any cmmn experiences after heart surgery? Heart surgery is a stress n the bdy. It takes time t recver. There are sme cmmn experiences that many heart surgery patients have after surgery. Yu may have nne, sme, r all f these. Many patients have shrtness f breath. This can be frm extra water in yur bdy, anemia, r the stress frm surgery. Having shrtness f breath with effrt is cmmn. Call yur surgen s ffice if it gets wrse. Anther cmmn experience after heart surgery is decreased appetite r fd tasting different. Patients smetimes have a metallic taste when they eat. There is n knwn reasn fr this. It may be frm medicines used during the surgery such as anesthesia r the bdy s respnse t stress. Eating small meals thrughut the day may help. Eat whatever yu can, but keep in mind yur fluid restrictin and lw salt diet. Prtein is needed fr healing. It is helpful t eat high prtein meals fr a few weeks after surgery. If yur appetite decreases r yur sense f taste changes, yu can expect it t return t nrmal several weeks after surgery. Patients ften have sleeping prblems. They may have truble falling asleep r staying asleep. Patients smetimes have strange r vivid dreams. There is n knwn reasn fr any f these. Mst patients find that their sleeping prblems g away in a few weeks. A sleep aid may be helpful fr a shrt time. Please talk with yur surgery team abut medicines, if yu are having truble sleeping. Changes in md, such as depressin r feeling very emtinal, are cmmn fr peple wh have just had heart surgery. This seems t be due t the stress f the surgery. It is best t share yur thughts and feelings with smene. Patients with strng emtinal supprt tend t recver mre quickly. If yu are having prblems cping r need supprt, please talk with yur dctr r nurse. Peple mst ften feel better and mre like themselves within several weeks after surgery. 4

5 Here are sme ideas t help yu heal and feel mre psitive abut yurself and yur recvery: D things that yu enjy and are within yur limits. Take it day by day based n hw yu feel. Get tgether with family and friends. Talk abut yur feelings. When may I return t wrk? Everyne recvers frm heart surgery at their wn pace. When yu can return t wrk will depend n hw yu feel and the kind f jb yu have. Many patients start t feel ready t return t wrk between 4-6 weeks after surgery. Yu may find it helpful t start back t wrk part time r n a reduced schedule until yu are fully recvered. If yur jb requires heavy lifting (greater than 30 punds), yu have tw chices. Yu d ther wrk at yur jb that des nt require heavy lifting r yu wait t g back t wrk until yu are able t d heavy lifting. Mst ften weight restrictins are lifted at 12 weeks after surgery. If yu need paperwrk filed fr yur jb, please bring it with yu fr yur surgen t cmplete. When and whm t call fr help? Call 911 if yu Have chest pain that is different than yur incisinal pain r seems like angina. Have severe shrtness f breath. Are fainting r feel like yu are ging t faint. Have a fast irregular heart beat while at rest fr 10 minutes (feel yur heart racing). Are uncnscius. Call yur surgen s ffice during the first 4 weeks after discharge if Yu feel shrt f breath. Yur legs r feet are swllen. Yur heart rate (pulse) is less than 55 r greater than 120. Yur weight ges up r dwn by 2 punds during 1 day. Yur weight ges up r dwn by 5 punds during 1 week (7 days). Yu have any f these signs f infectin Pus (may be thick yellw drainage with a bad smell). Warmth. Pain r sreness. Redness. Temperature higher than F. 5

6 What are the cntact phne numbers? The phne numbers fr the surgens ffices during business hurs (weekdays 8:00 am t 4:30 pm): Dr. Shahab Akther Dr. Takushi Khmt Dr. Lucian Lznschi Dr. Nilt DeOliveira Dr. Satru Osaki After hurs/weekends/hlidays, call This will get yu the paging peratr. Ask fr the cardiac surgery resident r physician assistant n call. Leave yur name and phne number with an area cde. The physician r physician s assistant will call yu back. If yu live ut f the area, please call t reach the paging peratr. Fr questins abut appintments, please call the Cardilgy Clinic at during business hurs (weekdays 8:00 am t 4:30 pm). Are there special precautins fr patients wh have had a heart valve replaced? Take antibitics befre any dental wrk (cleaning), surgery, r majr tests. Yur dentist r dctr can rder these fr yu. Always take them befre yur visit. Watch fr signs f infectin. It is pssible t have an infectin arund yur heart valve (bacterial endcarditis). If yu ntice any signs f infectin, call yur lcal dctr right away. Signs and symptms may include: Chills, then heavy sweating. Temperature greater than 101 F. Lack f hunger and weight lss. Fatigue and weakness. Jint pain. Yur health care team may have given yu this infrmatin as part f yur care. If s, please use it and call if yu have any questins. If this infrmatin was nt given t yu as part f yur care, please check with yur dctr. This is nt medical advice. This is nt t be used fr diagnsis r treatment f any medical cnditin. Because each persn s health needs are different, yu shuld talk with yur dctr r thers n yur health care team when using this infrmatin. If yu have an emergency, please call 911. Cpyright 4/2015 University f Wiscnsin Hspitals and Clinics Authrity. All rights reserved. Prduced by the Department f Nursing. HF#7248 6