Heart Surgery FAQ

Wound Care

1. How do I take care of my incisions?
2. What are the signs of infection?
3. Do I need to change the dressing?

You will be told how to care for your incision(s) before you leave the hospital. It is important to:

• Keep your incision(s) clean and dry.
• Use only soap and water to cleanse the area.
• Do not apply ointments, oils, salves or dressings to your incision unless specifically told to do so.
• Eat a healthy diet to help healing.

Call your doctor if signs of infection appear:

• Increased drainage or oozing from incision.
• Redness or warmth around the incision
• Increased opening of the incision line
• Increased body temperature (greater than 101 degrees Fahrenheit or 38 degrees Celsius)

After discharge, typically we like the wound to be left open, however, bandages can be applied to protect the wound from abrasions or mechanical injury. Should there be any problems with the wound, please contact our clinic.

Pain Relief

1. How much pain should I expect after the surgery?
2. What type of pain management is used while in the hospital?
3. What will I take for pain after discharge to home?
4. When do I need to call my doctor?

Open heart operations are performed by a bone splitting operation through the breastbone. This bone is firmly sealed at the end of surgery, and there is surprisingly little pain or chest wall discomfort following the operation. What discomfort there is rapidly recedes as time from surgery passes.

However some muscle or incision discomfort, itching, tightness and/or numbness along your incision are normal after surgery. You should not have pain in your chest similar to what you had before surgery. You will be given a prescription for a pain medication before you leave the hospital.

If you had bypass surgery, you may have more pain in your legs than around your chest incision if saphenous vein grafts were used. Walking, daily activities, and time will help to lessen leg discomfort and stiffness.

We are very cognizant that pain control is very important for the patient's well being. Medications are provided to control the level of pain. The typical patient, however, requires only Paracetamol and occasional Paracetamol with Codeine for control of pain.

All patients are provided with a prescription for Paracetamol with Codeine; however, the majority is well controlled with Paracetamol alone.

Call your doctor if your sternum feels like it moves, or it pops or cracks with movement.

Swelling of Legs

1. Why do I have swelling of the legs?
2. How can I do to lessen the swelling?
3. When do I need to call my doctor?

You may return home with some swelling in your legs and feet, especially if you had vein grafts taken from your legs. If you notice swelling:

Place your feet up higher than your heart level when resting. One way to do this is to lie on your bed or couch and put several pillows under your legs. Or, you may lie on the floor and place your feet on the couch. Try this three times a day for one hour to relieve swelling. (Note- recliners do not adequately elevate your feet).

• Do not cross your legs
• Walk daily even if your legs are swollen
• Hospital support hose may be suggested

Call your doctor if swelling in your leg(s) become worse or painful and/or associated with increased fatigue and/or shortness of breath.

Medications

What medicine should I take after surgery?

You may need medications after surgery. Your doctor will tell you if you need these medications until you recover from heart surgery or lifelong. Make sure you understand the names of your medications, what they are for, and what times to take them. Only take the medications that are prescribed when you are discharged from the hospital. If you want to take medications you were previously on for other conditions, discuss this with your doctor first.

Anti-Embloic Stocking

How long should I wear my stocking?

Anti-embolic stocking needs to be worn for about a month. This will help to reduce chances of deep vein thrombosis and leg swelling. You can remove the stocking after retiring to bed at night.

Driving

When can I drive again?

Typically our patients are given permission to begin driving at one month following the date of surgery.

Activity

1. Am I allowed to lift heavy things after surgery?
2. Can I go up steps?
3. What about exercise? When can I play golf again?

After an open heart operation, we are concerned with healing of the breastbone. We, therefore, limit the patient to 5 lbs. for the first month and increasing the weight lifting limit by 5 lbs. for each subsequent month.

You can go up steps Yes, however, at an appropriate pace.

After an open heart operation we encourage exercise, especially the  lower body exercises are superior. We, therefore, encourage walking, use of a treadmill at low speed and an exercise bicycle. We do not allow returning to weight lifting or heavy straining with the upper body. With regard to playing golf, we limit the patients in the following way: For the first month following surgery no golf whatsoever, or if they are feeling well they may practice putting. During the second and third months we progressively allow the patient to increase the distance from the hole, allowing pitching and chipping during the second month, and approach shots in the third month. After three months if the patient is doing well he may play a full round of golf.

Diet

1. What should be my diet after surgery?
2. Can I drink alcohol?

We encourage a general healthy diet without restrictions following surgery; however, diabetics will need to stay within diabetic calorie limits.

We suggest no alcohol in the first few weeks following an operation, and this can be discussed with your surgeon at your follow up visit.

Work

When can I return to work?

During the first month following open heart surgery we do not allow patients to participate in their work. After the first month, depending upon the type of work and the amount of physical activity needed, the patient may or may not be allowed to work. This will be at the discretion of the surgeon and the patient's cardiologist.

Emotions

Is it unusual to feel sad or blue after surgery?

It is common after surgery to feel sad or blue. These feelings should go away after the first few weeks. If they do not, call your doctor.

To help relieve the emotional blues:

• Get dressed every day
• Walk daily
• Resume hobbies and social activities you enjoy
• Share your feelings with others

Visit with others. Limit your visits to 15 minutes at first. Then increase them depending on how you feel

• Get a good night’s sleep

Join a support group or cardiac rehabilitation program

Sex

When can I resume sexual activity after surgery?

Many patients and their partners feel nervous about resuming sexual activity after heart surgery. The amount of energy it requires to perform intercourse with a spouse or regular partner is similar to climbing about one or two flights of stairs or walking about one half mile (0.8 km) at a brisk pace. If you cannot perform these activities without becoming tired or short of breath, please allow additional recovery time before resuming sexual activity. For the first six to eight weeks, use positions which limit pressure or weight on the breastbone or tension on the arms and chest.

• Keep in mind that a sexual relationship has both physical and emotional aspects
• Talk openly with your partner
• Allow a gradual return of sexual activity
• Have sex when you are rested and physically comfortable
• Create realistic performance expectations - it may take time to return to an active sex life
• Be caring honest and loving with each other

Soon you and your partner will return to a satisfying emotional and physical relationship. Anxiety on the part of either partner, as well as some medications, may interfere with sexual arousal or performance. So, discuss any difficulties with your doctor.

Mental Function

Is it normal to feel frustrated during the recovery period?

Some people become frustrated during recovery from heart surgery because they feel they are not as sharp mentally as they were before surgery. These cognitive changes are normal after heart surgery. The entire body, including the brain, was seriously stressed during surgery, especially if the surgery involved stopping the heart and circulating the blood through a heart-lung machine. With time, in most cases, normal cognitive functioning returns. Patience is needed to avoid the frustration that can accompany this side effect of surgery. You should not force yourself to work or perform mentally stressful tasks, such as balancing a checkbook in the first couple of weeks after surgery.

Cardiac Rehabilitation

Do I need to begin an exercise program?

For many people with coronary artery disease, a cardiac rehabilitation program provides an excellent opportunity to begin an exercise program, learn about your heart disease, and learn strategies to change your lifestyle to prevent further progression of your disease.

Travel

When can I start traveling in an airplane or train?

We suggest limited travel in the first few weeks after an open heart operation. We prefer, if possible, that the patient be seen in follow up by both their surgeon and their cardiologist prior to traveling long distances, but the majority of our patients can travel quite soon.

Miscellaneous

When can I take vitamins?

We encourage the use of a multivitamin, and the patient may return to any vitamin supplementations they were taking prior to surgery.

Will I need extra sleep after discharge?

It is common that sleep patterns are altered following an open heart operation. This alternation generally returns to normal as the days and weeks pass following surgery, but there is no need for extra sleep.