Recovery After Heart Surgery

Heart Surgery: Caring for Yourself After Your Leave the Hospital

 

General Care Guidelines

The following are general guidelines on how to care for yourself after leaving the hospital. If you have questions or concerns, ask your health care team.

Taking Care of Your Incisions

You will have several incisions after your surgery. Incisions are the cuts that your doctor makes in order to do your surgery.

You should take a shower at least one time every day. Rinse your incisions with mild soap (Ivory, Safeguard, Dial) and warm water. Gently pat the incisions dry.

  • DO NOT rub or scrub your incisions.
  • DO NOT take tub baths or swim until your surgeon says you may do so.
  • DO NOT use any creams, lotions or powders on your incisions.

You should check your incisions every day. You will likely have some itching, tightness, or numbness around the incisions. Call your surgeon immediately if you have swelling, redness or warmth around the incisions, white or yellowish fluid draining from the incisions or a fever of 100.4oF or higher. These are all signs of infection.

The main incision from your heart surgery should not have any fluid draining from it. You will also have several smaller incisions from tubes and drains that were placed in your chest during your surgery. These chest tube incision sites may have clear pink or yellow fluid that drains for a few days. Keep any chest tube incision sites that are draining covered with dry gauze pads. Remove the gauze before you take a shower. Apply a new, dry gauze pad after you shower.

It is normal to have pain at the incision site for a short time after you leave the hospital. You may also have aches and pains in your back, neck and shoulders as you recover and become more active. You will be sent home with a prescription for pain medicine. You should take the medicine if you need to. It can make you feel better and help with your recovery.

Women may find that wearing a comfortable, athletic bra that is not too tight can add support and help you to feel better as well. You may be more comfortable if you wear this bra during the day and at night.

Your  Medications

You will be sent home with prescriptions for medications. Your healthcare team will tell you how to take these medicines and explain the possible side effects. Make sure you fill these prescriptions immediately. It is important that you start taking them right away. As you recover, your cardiologist or cardiac surgeon may stop some medicines or may change the dose.

IMPORTANT: Bring a list of all of your medicines to every doctor's appointment.

Daily Activities

When you first get home, you will not be able to do all of your regular activities. It is important for you to give your body time to heal. You will slowly be able to return to your regular daily activities.

Walking is excellent exercise. It is important to walk slowly and pace yourself. You should start walking the day after you get home from the hospital. Make sure you dress properly for the weather, especially if it is cold or raining. Shopping malls can be a good place to walk. For the first week, walk three or four times a day for five minutes at a time. Add five minutes each week. This means you would walk 10 minutes at a time in week two, 15 minutes at a time in week three, and so on. Along with walking, you should continue to use your incentive spirometer at home to help clear your lungs.

When you get home from the hospital you will not be able to do certain activities. This is for a short time in order to give your body a chance to heal. Speak to your surgeon about when you can return to these activities.

  1. Driving: DO NOT drive a car until your cardiac surgeon says you may do so. This will likely be 2 to 4 weeks after surgery. You may ride in a car but you may not drive. Remember to always wear your seat belt.
  2. Lifting: It takes 2 to 4 weeks for your incisions to heal. DO NOT lift, pull or push anything heavier than 5-10 pounds for 2 weeks or more after leaving the hospital. This includes grocery bags and small children. DO NOT shovel snow, swim, play tennis, golf or other sports without permission from your doctor.
  3. Sexual activity: You may participate in sexual activity as soon as you feel ready. Sexuality is more than just sexual intercourse. It involes emotions, feelings, and intimacy. Honest communication about concerns and fears is the best way for you and your partner to feel comfortable. Be careful not to put too much pressure on your chest during sexual activity. Talk to your doctor if you plan on becoming pregnant.
  4. Returning to Work: Most cardiac patients do return to work some time after surgery. The amount of time depends on the type of surgery you had, how quickly you heal and the type of work you do. You will need clearance from your surgeon or cardiologist (heart doctor) in order to go back to work. Remember, it will take time for you to be able return to all of your regular activities so you may find it helpful to go back to work part-time at first.

Your  Diet 

You will need to eat a low salt, low cholesterol diet to keep your heart healthy. If you are already on a special diet (diabetic, renal) you will need to continue this diet as well. You may not have much of an appetite when you go home. It is important, however, for you to eat. Your body needs nourishment for you to heal. You may talk to a nutritionist or your cardiologist (heart doctor) about a diet that will work best for you. Please see the handout on diet and nutrition for more information about what foods you should and should not eat.

Check your weight every morning and keep a record of your weight. Make sure you use the same scale and are wearing the same type of clothing every time. Keeping track of your weight during the first few weeks at home is very important. It is even more important if you have had problems with edema (swelling) after surgery or if you are taking diuretics (water pills). Bring the record of your weight with you when you go to your follow-up appointments with your surgeon and cardiologist (heart doctor). Call your cardiologist immediately if you gain or lose more than 5 pounds in 3 days or less.

Smoking

DO NOT SMOKE!  If you smoke...STOP!  Smoking increases your risk for developing atherosclerosis (hardening of the arteries). It may be helpful to attend a program that offers group support and teaches tools and methods to help you quit. Ask your doctor about using a nicotine patch, gum or medications. A list of resources and support groups to help you stop smoking can be found in the Resource Section at the end of this packet.

Your  Emotions after Cardiac Surgery

It is common to feel depressed, angry, and emotional after heart surgery. There are both physical and psychological reasons for this. Anger and depression affect everyone differently. You may lose your appetite, become apathetic (lose the energy or desire to do too much) or cry. All of these symptoms should go away within a short period of time. The amount of time will be different for each person.

The recovery period can be emotionally and physically difficult for you, your family and your loved ones. It may be scary and lonely to think about your illness, your surgery and returning home. You will likely have good and bad days. In many cases a staff psychiatrist will talk to you to help with your emotional recovery.

Special Instructions

Patients who have had heart valve, aneurysm repair or congenital defect repair surgery will need antibiotics BEFORE certain medical tests and procedures. Antibiotics are needed for all procedures involving the GI (gastrointestinal tract: stomach, intestines), the GU (genitourinary tract: bladder, kidneys, reproductive organs) or dental procedures. The antibiotics will prevent bacteria from entering the body through the bloodstream which may cause an infection in the inner lining of the heart (endocarditis).

It is important that you tell ALL doctors and dentists who treat you that you had heart surgery. If they have any questions they should contact your cardiac surgeon. You cannot have any elective, non-emergency procedures (including dental cleanings) for 6 months after your heart surgery. If a doctor recommends a procedure please call your cardiac surgeon before scheduling. If you develop a fever or sore throat contact your cardiologist (heart doctor) or primary care doctor immediately.

If you are on a blood thinning medication including warfarin (Coumadin®) you will need to be monitored closely and go for regular blood tests to make sure you are taking the correct amount of medicine. If this is a new medicine for you, you will need to contact your primary care doctor for instructions on how to take warfarin (Coumadin®) and where and when to go for the special blood test called the INR. Many different medicines, foods and alcohol can affect your INR blood level. Please see the handout you will receive in the hospital about warfarin (Coumadin®) therapy.

Follow up Visits with your Doctor:

You will need to see your cardiac surgeon 2 to 3 weeks after you leave the hospital. You must call the surgeon's office as soon as possible to make this appointment. Schedule an appointment with your primary care doctor or the doctor who referred you to your surgeon within 2 weeks after you get home from the hospital as well.