Recovering at Home

Within 3 to 5 days, most patients are eager to leave the hospital despite some apprehension about giving up the security of an expert medical team. It is important to be patient with the pace of recovery, even after discharge from the hospital.

Remember, fatigue is normal after a major operation like heart surgery. You shouldn't be surprised to find that one day you feel strong, while the next day you feel tired and weak. Don't get discouraged; your recuperation period will allow the body to heal, replenish its blood content, and increase its strength and endurance.

CUMC has both in-patient and out-patient cardiac rehabilitation programs. In addition, we can refer patients to a variety of home health care agencies if necessary for post-discharge home care and cardiac rehabilitation. Please speak with your physician and social worker about these options.

Showering and Incision Care

You may shower if your surgeon has approved this prior to discharge. Your incisions may itch or feel sore, tight or numb for a few weeks. Some bruising around the incisions is also normal.

  • Use warm (not hot) water.
  • You may wash your incisions gently with soap and water, but do not scrub them.
  • Pat your incisions dry.
  • Do not take baths or use powders or lotions near the incisions.

You may have white pieces of tape on your chest. These are called "steri strips". They will gradually fall off. If they have not fallen off in 7 days, gently wash your chest with soap and water and gently peel them off. You may have some bleeding if the strips pulled off any scabs.

If you find it more comfortable, a thin layer of gauze may be placed over the incision(s). Women may wish to place cotton or soft material between the bra and chest wall.

Incision Care

  • Your skin is sealed within 24-48 hours after surgery.
  • You may itch or feel sore, tight or numb for a few weeks. Some bruising around the incision is also normal.
  • Avoid sun exposure for the first year
  • Chest tube drainage — Within the first week after surgery, fluid may leak out from your chest tube sites. You may cover the sites with sterile bandages. Call your surgeon's office if have to change the bandages more than once/day.

Signs of Possible Infection

  • Non-uniform redness that spreads
  • Increased swelling/tenderness along incision line
  • Oozing
  • Pain
  • Bad odor
  • Grinding/clicking sensation
  • Persistent high fever (over 101 degrees)

Weighing Yourself

Weigh yourself daily. Rapid weight gain can be a sign that your heart is not pumping efficiently. If you gain more than 2–3 pounds in one day or more than 3–5 pounds in one week, call your cardiologist.

Temperature

  • If you feel warm or chilled, take your temperature 3 times a day (morning, afternoon and evening).
  • Call your cardiologist if your temperature exceeds 101 degrees.

Diet/Nutrition

You may notice that after surgery you have lost your appetite for food or just feel too tired to eat. This is very common, but you need nourishment to enable your body to heal and get stronger.

  • Eat a balanced diet and drink adequate fluids to encourage a return to your normal bowel pattern. Do not take laxatives daily unless specifically instructed by your doctor. You may try prune juice or other natural methods.
  • If your physician recommends a diet based on your individual needs, you will receive written information to help you follow the plan at home.
  • Eat a variety of foods. You may want to eat many small meals throughout the day instead of three larger meals.
  • Avoid too much fat, saturated fat and cholesterol.
  • Eat foods with adequate starch and fiber.
  • Avoid too much sodium/salt.
  • Avoid too much sugar.
  • Maintain ideal weight (consult your physician).

Dr. Emile Bacha – Do I need a special diet after heart surgery?

Medications

  • Take all medications prescribed by your doctor as directed.
  • Do not change the dosage of your medication without your doctor's approval.
  • If you are on iron pills, please note that they may cause constipation and black stools.

Pain Relief

If your doctor did not prescribe a pain medication prior to discharge, Extra Strength Tylenol™ is an effective painkiller for pain around your incisions or on your chest. If Tylenol™ does not control the pain or the pain becomes more severe or happens more often, call your surgeon or your cardiologist.

Walking Program

  • As you recover from heart surgery, walking represents the best form of exercise for you. You should consult with your doctor before taking up more vigorous forms of activity such as swimming or biking.

    When you begin a walking routine, pick a time that is convenient and stick to it. Walk on level ground, in a rhythmic and even pace, letting your arms swing at your sides. Wear comfortable walking shoes and dress appropriately for the weather.

    Avoid exercise for up to 1-1/2 hours after eating, and don't walk outdoors when the temperature or weather makes you uncomfortable. When the weather is severe, walk indoors at a shopping mall or at a health club with an indoor track or treadmill.

  • If you begin to feel very tired, short of breath or dizzy, rest immediately and reduce the distance you walk the next day. If you experience chest pain, nausea or vomiting, headache or pain in your jaws, teeth, arms or ears, or any symptom similar to your previous angina, contact your doctor immediately and do not resume walking unless your physician approves.
  • Most patients should be capable of walking at least 1-1.5 miles/day at one month after surgery.
  • Studies have shown that people who exercise at least 30 minutes per day, 5 days a week remain healthier and experience fewer problems. They may also live longer.

Driving

  • To protect your breastbone from injury, do not drive until your doctor gives his approval (approximately 3-5 weeks after surgery).
  • Wear shoulder and seat belts when traveling in a car.

Exercise Bikes

Check with your cardiologist or surgeon before using an exercise bike.

Lifting

When you first arrive home from the hospital, you may find even the smallest items hard to lift without straining your chest. Here are several practical suggestions to make lifting easier:

  • Avoid heavy lifting, such as full suitcases, wet laundry or full grocery bags.
  • For small objects on a table or countertop, first pull them close to you and lift with both hands.
  • Use the weight of your whole body to open heavy doors or to push shopping carts and vacuum cleaners. These activities should be avoided when you first arrive home.
  • Use a step stool to reach high places, don't stretch and strain.
  • Bend at the knees–not from the waist–when lifting from the ground.

Depression

Depression may affect you in many ways throughout your recovery:

  • Appetite. You may eat too much or too little.
  • Sleep. You may oversleep or not be able to sleep.
  • Emotions. You may find yourself crying for no reason.

Recognize that you may feel angry or depressed. Try to talk openly about your feelings with your loved ones. It will also help to identify and stick to a regular daily routine. This will help you build your strength and help you recover faster. For example:

  • Try to get 6 to 8 hours of sleep a night. Go to bed at the same time each night.
  • Wake up and shower each morning at approximately the same time.
  • Weigh yourself daily.
  • Take your temperature (if you feel hot or have the chills).
  • Get dressed in regular daytime clothes. This will make you feel more like being active.
  • Eat breakfast.
  • Take your medication.
  • Plan your day to help you from getting too tired.
  • Follow the walking plan provided by your physical therapist.

Sexual Activity

Thousands of heart patients have learned that having heart disease, a heart attack, a stroke, or undergoing surgery does not mean an end to a satisfying sex life. After the first phase of recovery is complete, patients find that the same forms of lovemaking that were pleasing before are still rewarding.

Many myths surround sex after heart disease. The most common one is that resuming sex often brings on a heart attack, stroke or sudden death. This simply isn't true. There's no reason why a heart patient can't resume usual sexual activity as soon as they feel ready to do so. Talk with your doctor if you have any concerns.

Fear about performance and general depression are two psychological factors that can greatly reduce sexual interest and capacity. After recovery, heart patients may feel depressed. This depression is normal, and in 85 percent of the cases it disappears within three months. However, it tends to exaggerate whatever previous sexual problems were present between partners.

  • Feel free to resume sexual activity once you've checked with your doctor.
  • Until your sternum has healed to its full strength (approximately 6 weeks), it is suggested that the patient is located in the bottom position or a side by side position is utilized.
  • Choose a time when you are rested, relaxed and free from the stressful feelings brought on by the day's schedules and responsibilities.
  • Wait one to three hours after eating a full meal so that digestion can take place.
  • Select a familiar, peaceful setting that is free from interruptions.

Other Activities

As you feel stronger, you can go out and do more. At first, keep activities to about an hour.

Activities to try:
  • Crafts, painting, knitting
  • Cards or table games
  • Walks with friends
  • Shopping, movies or sports event
Activities to avoid:
  • Swimming
  • Driving
  • Golfing
  • Strenuous activities

Remember to Move Carefully!

  • Rapid change of position (sitting to standing or vice versa) may be accompanied by dizziness if done to quickly.
  • Rest whenever you get tired.
  • Rest between activities. If you need to rest for more than one hour after an activity, you may be pushing yourself too hard. Do a little less the next day.
  • Avoid placing undue strain on your chest region by sitting in one position for long periods of time.
  • When sitting or standing, use your leg muscles—do not use your arms to lower or raise yourself from your chair.
  • Do not cross your legs—it interferes with blood flow.
  • Pace yourself.

When to Call Your Doctor

If you experience any of the following symptoms, it is essential for you to let your doctor know:

  • Chills, or fever above 101 degrees.
  • Fainting or a severe headache.
  • Drainage from an incision.
  • Loss of consciousness.
  • Pain not relieved by pain medication.
  • Blood in urine or stool.
  • Fluttering in the chest or a rapid heart rate (palpitations).
  • Shortness of breath that does not go away with rest.
  • Nausea, vomiting or diarrhea.
  • Increased swelling, redness or bruising in or around the incisions.
  • Marked swelling of legs, ankles and/or feet.