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Changing Lifestyles, Changing Habits: The High-Tech Heart: Recovering from Surgery

separator Many people lead productive, healthy lives after heart surgery, but getting to that point takes patience and determination. It's a lot of hard work and commitment. It's important to have realistic expectations about this.

Many times, you hear about how well somebody you know has done after a heart operation, but you don't hear about what it took to get to that point. People don't like to complain, and when it's all over, they're probably not dwelling on the difficulties anymore. But if you know what happens each step of the way in your recovery, you'll be better prepared and less likely to be disappointed.

The entire recovery period can take three, maybe even four months for some people. It comprises about four stages:

Immediately After the Surgery

When you wake up, you're in the intensive care unit (ICU). There is likely to be a tube that goes from your mouth into your windpipe (an endotracheal tube), and you'll probably be attached to a mechanical ventilator, a machine that breathes for you.

You'll also probably have an IV or other type of tube in your arm, your wrist and under your collarbone or at the base of your neck. There will be tubes that drain fluid from your chest, and a catheter that empties your bladder.

The first few days after the surgery are probably the most difficult. The endotracheal tube makes it impossible to talk, but that's often removed within hours. The other tubes aren't painful, but they're uncomfortable. You'll be asked to sit up within hours after you're awake, and this can be painful because of the incision. You'll also need to cough and breathe deeply to prevent pneumonia, and this can be painful too.

Walking can be painful if you've had an incision in your leg, and you will be asked to walk soon after the surgery. Getting up and moving around can help prevent the formation of blood clots, which is one of the complications of bypass surgery.

In this period of your recovery, don't hesitate to ask for pain medication. You may also want something to help you sleep, because the ICU can be a noisy place. The constant monitoring, while necessary, can also make sleeping difficult.

For most people, all the tubes are out after two or three days. If they're able to walk a little, it's time for the next phase, which is usually a step-down unit specifically for cardiac patients or a regular hospital floor.

The Remainder of Your Hospital Stay

In the beginning of this next phase, you'll probably feel like you're being monitored about as much as you were in the ICU. Nurses and respiratory therapists will continue to ask you to do breathing and coughing exercises several times a day, and they'll be taking your pulse and blood pressure frequently.

It's common not to have much of an appetite at this point, and you may be given high-protein drinks until your appetite returns to normal. A dietitian will begin working with you now to talk about healthy eating habits. Before you leave the hospital, your dietitian may provide you with ideas for a month's worth of heart healthy meals.

Physical therapy is another important component of your hospital stay. It helps you recover strength and movement and it helps restore conditioning to your heart.

Common complications during this period include:

Pulmonary, or lung problems, which is why the breathing exercises are so important.

Emotional problems, especially depression. The surgery itself is enough to cause the depression. Heart surgery can cause feelings of anxiety, and that's understandable. The medications you begin taking after surgery can also have an effect on your mood, so it's no wonder that many patients suffer from depression after heart surgery. Be sure to tell your doctor if you are feeling depressed, because there are a lot of ways to manage this condition. And you're recovery may go more smoothly if you do treat the depression.

If you're progressing without complications, chances are you'll go home in 10 days to two weeks.

Recovering at Home

You'll have to take it easy for several weeks. You'll probably see your surgeon and a cardiologist a couple of times during this phase.

One thing many people find difficult is that they're not supposed to drive for at least six weeks after the surgery. Your breastbone is not completely healed yet, and steering a car can delay the healing process. Additionally, an accident could cause serious chest injury, because your breastbone wouldn't be able to provide the protection it normally does.

Also during this period, you may find standing for any period of time to be painful. Usually, patients are asked not to stand for longer than 30 minutes the first month after the operation. After that, it's possible to stand for as long as you like, provided it doesn't cause leg swelling.

A complication to watch out for at this time is infection of the incisions. Call your doctor right away if you:

  • Develop a fever
  • Notice any part of the incision becoming red, swollen or draining fluid

About six weeks after the surgery, many people are back to their regular activities. People often go back to work about three months after their operation, but this is something you should talk about with your doctor.

Recovery Over the Long Term

Now that you've recovered, you're ready for the most important aspect of life after heart surgery: adopting a healthy lifestyle and sticking with it. The surgery can fix existing problems, but if you don't eat, exercise and manage stress according to recommendations of your healthcare team, you may find yourself with the same problems that got you on the operating table in the first place.

Don't let all your hard work during recovery go to waste. The best way to avoid more surgery is to eat the right foods and keep yourself fit. Encourage your family and friends to help you in this process.

Source:
The American Heart Association; R. Cicala. The Heart Disease Source Book. Lowell House/Contemporary Publishing Group, Inc. Los Angeles, California90067, 1998.



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