Resuming Normal Activities
Once you return home after heart surgery, getting back to a normal routine will take time because your body systems have slowed as result of surgery, medications and less activity. Healing time will take at least two to three months.
You can expect to have good and bad days during this time and you may feel tired, irritable, anxious, depressed or simply not quite yourself for a few weeks. Don't be worried if you express your moods and feelings more than before. A lot of psychological energy is used in coping with the fears and demands after surgery. Talking with your family and friends can help with the normal emotional ups and downs after surgery.
Resuming Physical Activities
A slow increase in your activity will help promote healing and rebuild your body tone and strength. It is important to follow the guidelines provided by the nurse practitioner, staff nurses and/or cardiac rehabilitation nurses.
You will also have restrictions on your activities until after your return visit to your surgeon. Those restrictions may include:
- Do not drive a car until cleared by your doctor. Your reaction time will be slowed and you must avoid danger of re-injuring the breastbone while it is healing. You may ride in a car with your seatbelt on.
- Do not lift, carry, push or pull items weighing more than five to ten pounds, such as a heavy shopping bag, suitcase or small child. You should avoid strenuous exercise, such as swimming, jogging, biking, bowling, tennis and golf for three months after surgery.
- Do not do heavy house and yard work such as running a vacuum, mopping or scrubbing floors, mowing the lawn, raking, digging or chopping wood. These chores will strain your chest and upper arms and will affect proper healing of the breastbone.
- Do not return to work until having a discussion with your doctor at your follow-up visit.
Care of Your Incisions
As you heal, your incision will look better and the soreness will go away. Changes in the weather, too much or too little activity and sleeping in one position too long may cause increased soreness. You may also feel numbness or itching or see redness or swelling, which will also stop with time. To care for your incisions, we suggest:
- Wash gently with mild soap during your daily shower. Dry carefully with a towel. Pat it dry; Do not rub the incision.
- If you have small pieces of white tape over your incision, you must remove them after you have been home for seven days. If the strips come off on their own, you may leave them off.
- If your incisions are puffy, have areas of redness, are oozing, or begin to open slightly, call your surgeon.
- Women should wear a bra. A good support bra will reduce the tension placed on the incision. If the bra bothers you, you may put a small piece of gauze under the bra for added comfort.
- For discomfort or soreness, you may use a heating pad. Apply it four or five times per day on the low setting for about 20 minutes each time. If needed, take pain medication prescribed by your doctor.
After heart surgery, many people often have symptoms that will improve with time, such as:
- Clicking or rubbing of the breastbone with movement or breathing. After you have completely healed (about three months) this often stops.
- Swelling or knot-like lump at the top of your chest incision. This often goes away in six to eight weeks.
- Aches between your shoulder blades, over the ribs, in the back of the neck, chest or leg incision. This may last for many weeks and lessen with time.
- Tingling or numbness in your elbow or fingers. This may be due to the way your arm was placed during surgery.
- Slight swelling in your legs, which lasts four months or more. Keeping your legs up above heart level when sitting and sleeping will help this problem.
- Weakness and hoarseness in your voice may be present because of the breathing tube that was in place during and after surgery. This improves in a couple of weeks, although it may last longer.
- Constipation is a common problem and can be controlled with a mild laxative or diet changes. Increasing your daily routine, eating more fresh fruits, vegetables and other high fiber foods often helps.
- You may have a difficult time sleeping while you are in the hospital and also at home. Some common reasons are lack of exercise, a decrease in your daily routines, anxiety about surgery or being at home, family matters, depression and pain or discomfort near your incision. Try to decide what may be causing your sleeping problem and talk to your doctor about ways to resolve this.
- Numbness and soreness on the side of your chest where the internal mammary artery is located.
You may not have much of an appetite after your surgery, but it will increase as you recover. A balanced diet helps your body heal and lessens fatigue. Each day, eat a wide range of fruits, vegetables, whole grains, breads, meats and dairy products. Eat less foods with a high content of fat, cholesterol, sugar and salt. If a special diet has been ordered, your nurse and dietician will teach you these changes.
Smoking is harmful to your lungs, heart and new grafts. Smoking raises your heart rate and blood pressure, narrows blood vessels, and causes spasms of the heart vessels. Research has shown that new grafts clot much more often in smokers than in nonsmokers. If you smoke it is now more important than ever that you stop. Ask family members who smoke to quit with you. If you need more guidance, your cardiac rehab nurse can provide you with information that can help you quit smoking.
Coffee, tea and sodas have a high caffeine content that can be harmful to your heart. Reduce your intake of these liquids to one or two servings a day or switch to the decaffeinated versions. If you sometimes enjoy an alcoholic drink, you may do so after surgery. Your alcohol intake should not exceed two or three onces per day during your recovery. You should not drink alcohol if you are taking pain pills, sleeping pills or tranquilizers. Ask your doctor or nurse if alcohol will react with any of the pills you are taking.
Most patients need medications while they are healing. Before you are discharged from the hospital, your doctor will prescribe medications for you to take home. Do not take any of the medications you were using before surgery unless you are told to do so by your doctor. Do not increase, decrease or stop the amount of your medications without your doctor's advice. Once your prescriptions are written, one of your nurses will discuss each medication with you and give you a schedule. Keep your schedule on the refrigerator or another visible place and bring it with you when you visit your doctor.
Reasons to Call Your Doctor
If you feel any of these symptoms, report them to your doctor or nurse:
- Palpitations or a heart rate greater than 120 beats per minute when you are at rest, or a change from a regular to an irregular pulse.
- Increased fatigue or shortness of breath at rest.
- Temperature greater than 101 degrees more than one time, or chills for 24 hours.
- Excessive redness, swelling, soreness or drainage from any wound site.
- Swelling in your ankles and hands with a weight gain of two or more pounds in one day or five pounds in one week.
- Abnormal pain or other symptoms that do not go away with your medication.
- Pain in the calf of your leg.
If your follow up appointment is not made for you before you go home, do it once you get home. A report of your operation and your progress will be sent to your family doctor. You should also schedule a visit with your cardiologist and family doctor after you are home.