Instructions for operated patients

Each patient reacts differently to a surgery. Thus, the recovery is different after each surgery, whether it is an aortocoronary bypass of narrowed or blocked arteries (CABG-BYPASS) or repair/replacement of a narrow valve. In spite of these differences, some things can be generalized.

After a heart surgery, and sometimes even before the procedure, patients and their families often ask questions about a later recovery. The answers to the most common questions are as follows.

Remember: If your doctor’s instructions are in any way different from the ones listed below, always follow the instructions of your doctor.

IT IS ABSOLUTELY NORMAL:

• To have a reduced appetite. It takes a few weeks for the appetite to be returned. Many patients noted that their taste was reduced or almost disappeared. It will be back. Some patients even complain of nausea after smelling food 1-2 weeks after surgery.
• To have swelling of legs, especially if you have a cut on the leg. This leg will have a tendency to swell for some time. Raising your legs will help. Wear elastic stockings if prescribed.
• To have trouble sleeping at night. It may happen that you have difficulty falling asleep or waking up at 2:00 or 3:00 in the night and you can not fall asleep again. This will improve. Sometimes it helps to take a painkiller before bedtime.
• To have a constipation. You can use a laxative of your choice. Add more fruit, fruit juices and fibrous vegetables to your diet.
• To have mood swings and feel depressed. You can have good and bad days. Do not get discouraged. The situation will be corrected.
• To have a thickening at the top of the cut above the thoracic bone. It will eventually disappear.
• To notice occasional “snapping” or other sensation in the chest in the first days after surgery. It should be happening more and more rare and disappear during the first few weeks. In case of worsening, call your surgeon.
• To feel muscle pain or tension in the shoulders and upper back between shoulder blades. This will improve over time. Painkillers will ease this discomfort.
• Remember that it takes 4 to 6 weeks to start feeling better.
• Take all medicines prescribed by your doctor.
• You may feel stiffness in the area to the left of the wound if an internal chest artery (LIMA, chest artery) has been used during the surgery. That is normal.

WOUND CARE

While in the hospital, follow the doctor’s instructions. After releasing the wound can be washed with a mild soap and warm water daily.

Avoid strong rubbing of cutting location.

Keep in mind that cuts can easily burn in the sun. Protect cuts from excessive exposure to the sun during the first year after surgery. The scar will pigment more (become darker) if exposed to the sun. Do not put any lotions, creams, oils and powders on the cuts, unless the cardiac surgeon says otherwise.

Check the wound every day.

Tell your doctor if you notice any of the following:

• Increased sensitivity of the cut
• Increased redness or swelling around the edges of the cut
• Any kind of leak from the wound
• Increased long-lasting temperature

LEG WOUND CARE

If a vein from a leg is used in aortocoronary bypassing, follow these instructions:

• Nourish the wound on the leg as described above.
• Avoid crossing legs because it is not good for circulation.
• Avoid sitting in one position or standing for a long time.
• Raise your legs on a chair when you are sitting. You can also lie on the couch and lift your legs on the couch back.
• Check if your leg is swollen every day. The swelling should be reduced when you lift your legs, but it can return when you stand. If your leg still swells or your condition worsens, tell your doctor.
• If you are prescribed elastic socks or elastic bandages, wear them for at least two weeks after release when you are on your feet. Socks reduce swelling, especially if you have a cut on the leg. Remove elastic socks before bedtime.

FOREARM WOUND CARE

If an artery from left or right forearm is used in myocardial revascularisation, treat a wound as mentioned above. In some patients, occasional feelings of frisson or quiver may occur in the area of ​​the thumb or palm. These problems are not troublesome and are transient.

MEDICINES

Before releasing home, you will receive a release letter with a list of medicines you need to take and medicines for the first few days. Take medicines exactly as prescribed.

Always carry with you a list of medicines you are currently taking, the dose and time you need to take them. Do not take other medicines without a doctor’s knowledge.

You will receive further information on medicines from a nurse or a doctor before release.

Side effects

It’s important to understand that medicines can cause side effects. If you have any of the following side effects of medicines, you should contact your doctor:

• Excessive nausea, diarrhea, constipation or stomach pain
• Vomiting
• Dizziness at standing
• Confusion
• Quiver in fists and feet
• Extremely slow or fast pulse
• Skin rash

ACTIVITIES

Stop immediately with any activity if you feel breathless, notice irregular heartbeats, feel weakness or dizziness, or have chest pains.

Take a break until the symptoms disappear.

If they do not disappear within 20 minutes, inform your doctor.

Showering

You can take a shower after wires of a temporary heart electrostimulator have been removed. Avoid soaking in a bath until the wounds have healed. Avoid hot water.

Resting

Recovery needs balanced rest and exercises. Plan a break between activities and, if necessary, a little sleep. Resting also includes a quiet seating for 20-30 minutes. Relax at least 30 minutes after eating, and before exercise.

Visits

Limit visits during the first few weeks. If you are tired, apologize and lie down. Your visitors will understand.

Walking

This is one of the best ways to exercise because it improves circulation of the whole body and heart muscle. It’s important to gradually increase your activity. Walk at a speed that suits you. Stop and relax if you feel tired. Each person is recovering at a different pace after heart surgery. Do not try too many things at once. In the cold weather, wear a scarf or mask around the mouth and nose.

Stairs

You can freely go up stairs, unless your doctor tells you differently. Take them with small steps. Stop and relax if you feel tired. If you use a grip, do not pull yourself up using hands. Use your feet.

Driving

As a passenger in a car, you can drive at any time. Avoid driving a car, bicycle or motor 6 weeks after surgery. This period of time is recommended in order for the chest bone to heal. When traveling, exit every 2 hours from the car and walk for a few minutes.

Lifting

You should not strain chest bone too much while healing. Avoid lifting, pushing or pulling anything heavier than 5 kilograms for 6 weeks after surgery. This includes carrying children, groceries, luggage, mowing, sucking and moving furniture. Do not hold your breath during activity, especially when you lift something.

Daily weighing:

Weigh yourself each morning at the same time after urination, but before breakfast. Use the same scales every day.

Keep a record of daily weight.

Notify your doctor in case of gain 1 kg or more overnight.

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When do you continue with usual activities?

1-6 weeks:

• Easier home jobs: dust removal, table setting, dishwashing, stacking clothes.
• Light gardening: planting plants, cropping flowers
• Handicraft, cooking, climbing stairs, shopping, restaurants, car passenger, walking

After 6 weeks:

• Return to work part-time (if the job does not require lifting of weight and if the return is approved by a surgeon)
• Heavy home work: vacuum cleaning, sweeping, laundry, ironing
• Harder gardening: mowing grass, grabbing leaves
• Official or recreational trip, fishing, light aerobics (no weights), dog walking, car driving

After 3 months:

• All previous activities (but also greater permissible intensity)
• Heavy home work: floor scrubbing, window washing
• Hard gardening: removing snow, digging
• Football, tennis, bowling, hunting, jogging, cycling, weightlifting, riding a motorcycle, push-ups