How much pain will I feel after surgery?
Generally, open heart surgery is not a particularly painful experience. One notable exception is the removal of the drainage tubes. It does feel a bit odd and sometimes can be a brief source of pain. It does feel uncomfortable when you cough or sneeze. To alleviate this pain, a cough buddy (a stuffed teddy bear) is provided. You wrap your arms around the bear and squeeze it when you cough. Pain medicine is provided with a patient controlled analgesia (PCA) pump. This should be used liberally during the first few days, as it is much easier to prevent pain than to take it away. After a few days, most patients just take Tylenol, although narcotics are available on request. A prescription for narcotics is provided upon discharge.
How long will it take me to recover?
Recovery time is variable. A rule of thumb is that if you come to the hospital healthy, you will recover faster than if you arrive sick. Patients with an aortic aneurysm are generally otherwise healthy and can withstand surgery without a significant recovery time. In all cases, patients should sleep prior to surgery and arrive rested. We can provide sleep aids to assist in this process.
There are methods to facilitate recovery. Perhaps the most important influence is a positive mental attitude. Patients who believe they will have a procedure and then will live an abundant, healthy life will generally have a rapid recovery. The second method, if you are a smoker, is to reduce your number of cigarettes to under five per day. Obviously the time before heart surgery is stressful. It is too optimistic to anticipate that you will quit prior to the operation. In truth, it is probably not a great decision to quit within two weeks of an operation as quitting leads to a temporary increase in mucous production, which increases the need to cough.
Most patients will remain in the hospital for 5-7 days. You will then go home and feel tired for a week or two. Afterwards you will feel relatively normal. It takes six weeks before the sternum is completely healed, soheavy lifting during that time is not permitted. During the recovery time, it is quite normal to be aware of your heartbeat. Your heart becomes temporarily attached to your breastbone, which then transmits sound through the bones of your ear. It is normal and can be alleviated by purchasing a sound diffuser.
When can my children visit?
Typically, you will want to recover for two days before your children come to visit. They are not permitted in the Intensive Care Unit, but they may come to visit you on the recovery floor. By this time your drainage tubes have been removed, you will be out of bed, and you will start to have energy for little visitors.
When will I leave the hospital?
Most patients are discharged from the hospital within four to seven days. The timing is dependent upon your energy level. Before discharge, you will need to climb a flight of stairs and walk 150 feet. We do not discharge you before you are ready to be home. Some patients will need to go to an acute rehabilitation facility close to home if they have not progressed enough in independent living. Our social workers have relationships with a variety of superb facilities throughout the tri-state area. The transition from NYP/Columbia to these centers is seamless, and the treating physicians at these facilities keep in contact with our group.
How will I feel when I get home?
You will feel tired, usually around midday. It is common to nap each day for a week or two after discharge. Your energy level will gradually improve. It is important to get outside as much as possible and walk. It is okay to tire yourself out. You cannot destroy the repair, so gradually push yourself to return to fitness. Your chest will be intermittently sore. Keep your cough buddy and continue to use it. Also, you will be provided with a breathing device. It is important to continue to use that as well.
When can I drive?
You can drive after three weeks, as long as you are feeling mentally stable, are not still fatigued, and are not taking narcotics. Start with small distances and gradually increase to normal driving. It is important to drive defensively as your breastbone is not fully healed for four-six weeks, so an accident can have a serious consequence.
When can I back to work?
Going back to work is an individual decision. The stress of surgery, the medications given, and the interruption of normal sleep patterns all require a bit of time to resolve. If your occupation requires important decision-making but not physical labor, three weeks off is usually enough. For those of you who need to do physical labor, six weeks off is necessary. If you are entitled to medical leave, it is generally advisable to take one month off from work.
When can I shower?
You can shower as soon as you get home. Blot your incision dry and avoid rubbing it. You will have several cloth strips across your wound. These will gradually fall off in the shower over time. If they still remain 10 days after discharge, just peel them off.
Will I need to resume my old medications or take any new ones?
You should schedule an appointment with your cardiologist immediately after discharge. Your doctor may change the medicines that you were given at discharge. Your care is provided by a team approach, with your surgeon and cardiologist working closely together. Bring all of the medicines that you were given at discharge to your cardiologist. Your doctor will have already been provided a copy of your discharge paperwork and a report of the operation.
When will I see my surgeon again?
You will see your surgeon four weeks after discharge. Your surgeon and nurse practitioner are available by phone any time after discharge, by calling the office 212.305.6380. If any issue arises prior to four weeks, you will be seen in the office as necessary.
When should I see my cardiologist?
You should be seen by your cardiologist within two weeks of discharge.
When should I call my surgeon?
You should call your surgeon with ANY questions or concerns that arise. The only silly question is the one that wasn't asked.
When can I resume sexual activity?
You can resume sexual activity after discharge within reason. You cannot support your weight with your arms, so limit sexual positions to those that do not require you to bear weight on your arms.