After Your Heart Surgery: What to Expect

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In the Intensive Care Unit (ICU)

After your surgery, you will be brought to the ICU for monitoring. When you start to wake up, you may feel yourself coughing or have a choking feeling; this feeling will pass. The nurses will be on hand to help you relax.

While you are still intubated (on the respirator), we will have you sit up in the bed. You may hear machines pumping and beeping. These alarms and monitors help the nurses and doctors know how awake you are. The tube attached to the respirator will be removed when you are coming out of sedation. This can occur anywhere from 6-24 hours following surgery. The doctors and nurses will ask you to squeeze their hands and lift your head off the pillow. This tells us that you can now handle breathing on your own.

Restraints are often used for safety reasons. You can imagine that a first response upon waking would be to pull at the tube in your throat. Restraints prevent this from occurring. While recovery time varies from person to person, most patients are able to breathe on their own the first day after surgery. Once the tube comes out, you will probably be thirsty. You can ask the nurse to wet your lips. You will not be allowed to drink right away, but you will over time. The breathing tube may also cause a sore throat or a loss of voice. These symptoms are only temporary.

Your diet will include clear fluids when your nurse and doctor feel you are ready. Other foods will be added as your tolerance increases. By the next day after surgery, many patients are eating solid food.

You will receive chest physical therapy to prevent lung complications and help you clear your lungs. This therapy consists of your nurse or physical therapist performing percussion, or clapping, on your back, followed by deep breathing and coughing.

It is important to frequently use the incentive spirometer (and continue to use at home). This device measures your progress in taking deep breaths. You will continue to use the incentive spirometer throughout your hospital stay.

Following surgery, your body needs more sustenance than usual, so it is important to try to eat a healthy diet and ensure your protein and calorie intake is as high as possible, as recommended by your dietician and doctor.

Step-down Unit

Once you are cleared (approximately 12-48 hours after surgery), you will be transferred from the Intensive Care Unit (ICU) to the Step-down Unit, where you will be monitored as you recover. You may soon be moved to a semi-private room on 5HN. Private rooms are available for a fee and are subject to availability. Please note that private rooms are not covered by insurance.

Individual patients experience varying degrees of pain and soreness after heart surgery. Most pain is managed with oral medications, such as Tylenol, Gabapentin, or opioids like Oxycodone.

When you do your required exercises, you can reduce the pain caused by breathing and coughing by holding a pillow provided by the ICU staff firmly against your chest over the incision. This serves as a splint or brace to reduce movement and pain associated with these activities.

As you feel stronger, you will be encouraged to stand up and move around. You will also continue deep breathing and coughing exercises to clear your lungs. While they may be uncomfortable, these exercises are essential to prevent complications arising from the build-up of secretions in your lungs.

You will gradually progress from moving about your room with assistance to walking in the halls of 5 Hudson North unaided. Your doctor may recommend that you begin working with a physical therapist who will teach you a program of stretching and progressive walking.

Eating

Good nutrition is essential for healing. While your physician and registered dietitian will plan a diet tailored to your special needs, it's up to you to follow these recommendations conscientiously. Don't worry if you are unable to eat everything you are served; just try to eat something at every meal. Let your nurse know if you experience nausea; your health care team may be able to offer some assistance in relieving your discomfort.

Shifts in Weight

Please be aware that there are often significant weight shifts around the time of surgery. You may gain fluid weight before and during the operation and lose it afterward.

Education

There are numerous opportunities for education during and after your stay that we encourage you and your family to take advantage of:

Closed Circuit Television to learn about various heart-related topics.
Education seminars on discharge planning on 5 Hudson North.
Heart of Hearts Support and Education Group (post-discharge.)

More Heart Surgery Guides

For more information, call us at (212) 305-2633 or use our appointment request form.