Going Home After Heart Surgery

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1 Going Home After Heart Surgery

2 2 3

3 Recovery Recovery usually takes 8 to 12 weeks, but you will get better at your own rate. Many things affect how quickly you recover. Some of these are: how active people are before surgery, the kind of surgery they have, and their age. When you get home you might be surprised by how tired you feel. This feeling is normal. Your energy level will improve over the next few weeks. Things you can do to help with your recovery include the following: Exercise Rest and relax Eat a balanced diet Keep your pain controlled Take your medications as prescribed Take care of your incision Share your emotions and feelings Exercise Why Exercise? For the first 6 to 8 weeks after your surgery your body is healing. During this time exercise is needed to increase your strength and improve your circulation. A gradual increase of your activity will help you feel better. It will also help you heal faster and regain your confidence more quickly. As you increase your activity, remember it takes 8 to 12 weeks for your breast bone (sternum) to heal. Do NOT lift, push, or pull objects that weigh more than 10 pounds. Do NOT vacuum, mow lawns, or carry heavy groceries or laundry until your doctor lets you. Do NOT move your arms or shoulders forcefully. Limit activities that involve using your arms above your shoulders. Otherwise, you may: Be driven in a car anytime. Drive your own car in four weeks after your CABG surgery. If you had valve surgery, wait six weeks after your discharge from hospital. Your family physician will provide approval when appropriate. Fly in an airplane. Have sex when comfortable. Gradually resume previous activities over the next 3 months. Return to work in 2 to 3 months. 4 5

4 How to Gradually Increase Your Activity Plan your day to allow time for both activity and rest. Start with the same amount of activity and walking that you were doing in hospital. As you are able, gradually increase your activity level and the amount that you walk each day. Start with a comfortable distance (for example, 1 block). Please refer to your Cardiac Surgery Patient Guide (Red Booklet) Listen to your body. It will tell you when to stop what you are doing and when you are ready to do more. If you notice that you sweat, feel short of breath, or feel very tired when exercising, stop and rest. You may have increased your activity too fast. When you feel better, you can try again more slowly. If you do not feel better or if you can not increase your activity, call your doctor. Sexual Activity Sexual activity uses the same amount of energy as climbing up two flights of stairs at a normal pace. When you can climb 2 flights of stairs without getting tired or short of breath, you may return to your normal sexual activity. To protect your healing breast bone, do not use positions that put pressure on your chest or that need support from your arms. Use a position that you and your partner find comfortable. Try not to have sex after a large meal or exercise. If you feel tired or tense, wait until you are more rested. You might find that your sex drive is reduced in the early recovery period after heart surgery. This usually improves as you begin to feel stronger. Rest and Relaxation Rest is an important part of your recovery. Here are some guidelines to help you rest and relax: Take things one day at a time. Get eight hours of sleep every night. Alternate rest with exercise. Plan two 30 to 60 minute rest periods each day during the first week at home. These can be naps or just relaxing times. Diet You might have a change in appetite after surgery. This will improve as you begin to feel better. You might find that small meals are more pleasing to you. Good nutrition speeds healing and lessens fatigue, so try to eat a balanced diet. The diet you follow at home is an important part of your recovery and overall health. Restrict fluids to 1500mLs each day (to be re-assessed by your family physician). Eat a regular diet (discuss a change to healthy heart diet with your family physician or cardiac rehabilitation program). If you have diabetes, eat a diabetic diet. If you have questions about your diet, your doctor can refer you to a dietitian in your home area or you can call HealthLink BC (8-1-1) and speak with a dietitian. Also, your cardiac rehabilitation program might have a dietician. 6 7

5 Pain People vary in the amount of discomfort or pain they feel. You might have pain from the surgery for a few weeks but it will gradually get better. Your doctor will order medicine to help you feel comfortable. Keeping discomfort and pain under control will help you recover. Please take your pain medication as ordered. Acetaminophen (Tylenol) is often recommended for pain control. Sometimes, stronger medications for pain control might be needed such as narcotics. Narcotics might make you feel drowsy or dizzy. Please do not drive or use power tools while taking narcotics. Talk to your family doctor if you have any questions. Constipation is a common problem with narcotics. To avoid constipation, eat foods that are high in fiber or roughage. Such foods include bran, and fresh fruits and vegetables. You may also try Senna, a laxative that you can purchase at your local pharmacy. Continue taking the Senna while you are using narcotics or until you return to a regular pattern of bowel movements. Medications Do not stop or change your medications on your own. Your family doctor may change, reorder or stop them for you. Please do not take any other medicines or over-the-counter remedies unless you have checked with your family doctor. Ask your doctor or nurse for information sheets about your medications. Blood Thinners Anticoagulant medication is often called blood thinners. They do not really thin the blood. Instead, they stop blood from clotting as fast as it usually does. You might be on an anticoagulant if you have an artificial heart valve or atrial fibrillation (an irregular heart rhythm). People who take anticoagulant medication for a long time are advised to wear a MEDIC-ALERT bracelet. Ask your doctor or nurse about this. Water Pills If your doctor asks you to take a water pill at home, please weigh yourself each day. Try to do this each morning after you go to the bathroom and before you get dressed. Record your weight. Gaining 2 to 3 pounds (1 to 1½ kilos) in one day might be due to extra body fluid. If you notice this sudden weight gain over 2 to 3 days, please call your family doctor. If you notice swelling of your ankles, you should also call your doctor. 8 9

6 Incision Care Gently wash your incision with soap and water. You may have a shower when you get home unless you have drainage from your incision. When you shower, do not let the water spray right on your incision. Do not take a tub bath. Soaking your incision might damage the healing skin. You might have Steristrips (small bandaid-like tapes) over your incision. Steristrips can get wet. Pat them dry after your shower. All Steristrips can be taken off 7 to 10 days after you get home. Your incision might be itchy. Itchiness is a normal part of healing. Do not scratch, rub, or use lotions or powder on your incision until the skin is completely healed. Protect your incision from the sun. This will prevent your scar from permanently turning brown. You might notice some clear yellow or slightly bloody drainage from your incision or from where your chest tubes were. This should stop in the first 2 weeks you are home. Please Call Your Family Doctor If You Notice Thick yellow-green drainage from any incision or chest tube site. A red, tender area in your incision that is warm to touch. New swelling or a sharp pain in your incision. Fever. Emotions and Feelings After surgery you might feel blue or low in spirits. This can happen in hospital or after going home. This is common and might last a few days or sometimes a few weeks. Family members might also feel a range of emotions. Talking out your feelings may help you and your family deal with them. If you continue to feel blue or are worried by how you are feeling, talk with your family doctor. After major surgery, you might have bad dreams or changes in your sleep habits. You might have trouble concentrating and remembering. This usually gets better by the end of the recovery period. After Valve Surgery People who have had surgery on their heart valves might be more prone to infections of the valves. It is very important to guard against this. All people who have had valve surgery should take antibiotic medications before surgery or major dental work. Be sure to tell any doctor or dentist who cares for you in the future that you have had heart valve surgery. They might ask you to take an antibiotic. Antibiotics should also be taken as soon as you notice any infection in your body

7 After Bypass Surgery After your heart surgery is a good time to modify risk factors for heart disease. Guidelines for Modifying Risk Factors Do not smoke. Avoid smoke-filled areas Control your weight Follow your diet Exercise regularly Take medications for high blood pressure or high cholesterol levels if your doctor advises you to do so Take medications to decrease platelet stickiness and keep your grafts open If you have any questions about risk factors for heart disease or how to change them, please ask your doctor, nurse, or cardiac rehabilitation program. Community Resources Pacific Open Heart Association The Pacific Open Heart Association is made up of people from British Columbia and the Yukon who have had heart surgery. Members are willing to help others who are having heart surgery. If you wish, leave a message at and a member will return your call. Their logo is their motto: To Lend a Helping Hand. British Columbia and Yukon Heart and Stroke Foundation The B.C. and Yukon Heart and Stroke Foundation provides information for people with heart disease and their families. Their phone number is or Supervised Community Cardiac Rehabilitation/ Exercise Programs Supervised exercise programs help improve fitness level. A referral will be sent to your local community program if available. Typically you will be able to start a program in 1 to 2 months after surgery. Talk to your doctor or nurse if you have any other questions about these programs. HealthLink BC Call from anywhere in British Columbia to speak with a nurse any time of the day or night. On weekdays, you can speak to a dietitian about nutrition and healthy eating. At night pharmacists are available to answer your medication questions

8 Questions to Ask Hospital Staff After reading this booklet, you might have some questions. Feel free to write them down here to ask your doctor or nurse. 14

9 The members of the Heart Surgery Team at Vancouver Hospital wish you a good recovery. Updated by: Cardiac Surgical Patient Education Committee (April 2015) Illustrations by: Vicky Earle - The Media Group, UBC For more copies, go online at or and quote Catalogue No. FD.123.G561 Vancouver Coastal Health, April 2015 The information in this document is intended solely for the person to whom it was given by the health care team.

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