Advice for Patients after Heart Surgery

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1 Advice for Patients after Heart Surgery Revised by the Cardiac Rehabilitation Team October 2005

2 Advice for Patients after heart surgery It is very important to remember that it takes time to recover from heart surgery; it can take some weeks to regain your normal energy and to stop feeling weak and tired. Many people find that they are able to be quite active one day, but feel washed out the next day. This is normal, but will improve with time. 1: It may take you a while to get used to being at home again Make sure you get plenty of rest at first. As a general rule, do what you can without becoming short of breath, and then gradually increase the number of such activities. Bathing/showering is fine as soon as you feel strong enough, (do make sure it is not too hot). Once you are comfortable walking round the house, household chores such as washing up, light cleaning, dusting and cooking are fine even small amounts of ironing (while sitting down) and light weeding in the garden are acceptable within this rule. Limit activities that involve pushing, pulling and lifting for at least six weeks. Limit your upper arm movements for the first six weeks, that means you need to avoid activities such as mowing the lawn, digging the garden, vacuuming and long periods of ironing, these can usually be resumed by 8-12 weeks after surgery. It is quite normal to feel emotional, up and down or quite irritable at times but these feelings should pass as your recovery continues. 2

3 2: If you have no symptoms or difficulties with general activity around the house, you can start going for short walks outside. Walking is the most effective exercise for you at this stage. Walk for a few minutes at your own pace on the flat the first time you go out, and increase this gradually each day provided you are not getting breathless or experiencing any chest pains. Some people will be able to increase faster than others. We advise you to increase slowly, by a couple of minutes each day, but if you find your walk very easy, then you can increase by more than that. When walking you should always have enough breath to talk in short sentences. If you do find yourself so short of breath that it stops you talking, please stop, and sit-down/rest, once you have recovered, you can carry on at a slower pace. Tackle hills slowly and steadily at first, resting whenever you need to. NB If you experience chest pains or heaviness in your chest during an activity, stop what you are doing, sit down and rest. Then follow the advice you were given while in hospital with regard to what to do if you experience chest pains or the advice given later in this leaflet about it.) 3: Provided you have no symptoms or difficulties with this, build up your daily walks increasing over the next few weeks to 30 minutes and then gently increase your pace each day. 4: The daily walk can then be speeded up, always avoiding undue tiredness, breathlessness or chest pain. (Walking at a pace that leaves you warm and slightly out of breath but still able to talk in short sentences is beneficial to your heart). Activities such as cycling, swimming and dancing can be resumed 6-8 weeks after the operation, golf and competitive sports such as squash, badminton, tennis and team games may usually be resumed after 12 weeks or so, but check this with your doctor first. 3

4 Things you may notice People who have had heart surgery have reported some of the following symptoms/problems following their operation. They are usually temporary and settle over a few days or a few weeks: A strange taste in the mouth An altered sense of smell Blurred vision or dots before the eyes muffled hearing Feeling hot and cold A sore or numb bottom Hoarse voice A change in the sound of the voice Constipation Sweating Loss of concentration If you experience any of these things please do not worry, If they persist or are causing you particular concern, please call the heart health team on the number on the back of this leaflet so that they can put your mind at rest. Wound Recovery: You were given some painkillers in the hospital, you may need painkillers for up to six weeks, so you will need to get more from your GP. Take them as prescribed for as long as you need and then slowly reduce the dose. Pain where the wound is, or across the front of the chest is likely to be due to the operation, discomfort in the back, shoulders or neck may also be due to this. Initially some areas of skin on your chest may feel numb to the touch. As healing takes place, you may experience pins and needles/sensitivity over the area. Sharp pains over the wounds and drain sites are also common. These usually lessen with time, and painkillers should help them. Some movements may cause clicking in the breastbone. This is normal after the surgery, but should have stopped by about 3 months. Please let your GP know if it hasn t. LEGS: If you had vein grafts taken from your legs, you may experience discomfort and swelling in your legs and ankles for a 4

5 few weeks. Putting your feet up on a stool when you are sitting and remembering not to cross your legs will help to relieve this. Wound Care: If you notice oozing or inflammation from or around any of your wounds, please contact your GP as soon as possible. This is to detect and treat any infection as early as possible before problems occur. You can shower or bath but please avoid using perfumed bath salts or oils, and do not rub soap directly onto the wound area until it is properly healed and do not use talcum powder. You do not need to cover the area unless your doctor or nurse has told you to. The surgeons use wires to help your breastbone to mend again, but they should not cause you any concern. They will not rust and they will not set off the alarms at the airport. We advise women to start wearing a bra again as soon as possible, as this will reduce strain on the chest wound. Returning to Work: Many factors affect how soon you can return to work, (such as the type of work you do). You can discuss this with your surgeon and your GP in more detail, as well as with the heart health team. It is important to be aware that getting back to work can be very tiring so it may be wise to ease your self back in gently over a period of a few weeks, or to delay your return until you feel really ready. Cardiac Rehabilitation: The Heart Health Team can advise you on how to manage your own heart health and how to use activity, diet and relaxation to improve your lifestyle. They aim to send you an appointment within 6-8 weeks of your discharge from hospital. Their contact details are at the back of this booklet. 5

6 Driving: You may drive 4 8 weeks after your operation. When you do resume driving, expect to feel some discomfort or heaviness around the shoulders or arms as you move the steering wheel. It is illegal to drive without your seatbelt on. You do not need to inform the DVLA, but you should inform your insurance company about your surgery. If you have a license to drive a Large Goods Vehicle (LGV) or a Passenger Carrying Vehicle (PCV) you must let the DVLA know about your heart surgery. You will not be allowed to drive these vehicles for a minimum of 6 weeks after your surgery, and You will have to fulfil the DVLA requirements for performance in an exercise tolerance test and have a check up with a doctor before a decision is made about whether you can keep your license. You will also need to discuss the situation with your employers to find out what their requirements are for your return to work as a driver. The same rules apply to train drivers and pilots. Air Travel: It is usually safe to travel by air 10 days following your operation, provided you have had no complications. Each airline has its own rules, so your must contact them beforehand. We advise you not to book a holiday for at least 6 weeks after your surgery, as it is unlikely that you will get the most out of your time away. You must inform your travel insurance company in advance of your holiday about your surgery. Sexual Intercourse: There is no fixed time to resume sexual intercourse. Research has shown that the effort involved in having sex and orgasm is no more than climbing about 20 stairs. You and your partner can start to make love again safely once you are walking and managing everyday activities. After open heart surgery it is important to find a position where your weight is not through your upper body / arms until 12 weeks after the operation. 6

7 REFERENCE INFORMATION The Heart Health Team will send you an appointment to come and see them after you go home. Their contact details in the interim period are as follows: Heart Health Team Contact NB: The team are not in the office everyday, if your query is urgent, please call your GP or NHS Direct ( ), otherwise leave a message on the voic and we will call you back. British Heart Foundation Website: Special Acknowledgements: With thanks to: Cas Shotter, Specialist Nurse Cardiology, Dr T Greenwood, Consultant Cardiologist and Dr R Kaprielian, Consultant Cardiologist. CHEST PAIN 1) If you experience chest pain that is unbearable Dial 999 for an ambulance Otherwise sit down and stay calm Take GTN (if prescribed) Wait 5 minutes 2) If the pain has gone rest If you are still in pain Repeat the GTN (If prescribed) Wait 5 more minutes 3) If the pain has gone rest and get advice from your GP today or tomorrow. If you are still in pain after this Stay Calm, and Dial 999 for an ambulance. DO NOT WAIT ANY LONGER. 7

8 NOTES 8

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