Frequently Asked Questions
Many questions arise as to what you should do or should not do after discharge. The following are answers to the most common concerns and questions.
While the sternum (breastbone) is healing, avoid lifting greater than 10 pounds, or pushing/pulling activities with your arms.
Showers are permitted but tub baths are discouraged for 4-6 weeks or until your incisions are healed. Avoid extremely hot water which may cause you to feel dizzy or weak. You may gently wash (don’t rub) your incision with soap. Do not use creams or lotions on incisions until they are healed.
Avoid driving a car for 4-6 weeks after surgery. Your reaction time will be delayed due to weakness, fatigue, and/or medication. You do not want to risk hitting the steering wheel and reinjuring the sternum. When riding in a car for long distances, stop every 1-2 hours to stretch your legs. This will improve circulation in your legs and help prevent swelling.
Do not cross your legs while lying in bed or sitting. This puts pressure on the veins under the knees and slows blood flow. If your legs or feet swell, you should put them on a chair or stool while sitting.
Avoid isometrics: straining to move your bowels, pushing/pulling heavy objects, or working with your arms overhead. These activities disproportionately elevate blood pressure and put an added strain on a healing heart.
It is important to space and pace your activities to minimize fatigue. If your feel tired, STOP, and rest for a while. Don’t push yourself to finish a task.
A rest period should be taken at least once a day for a few weeks and, initially, preferably twice, morning and afternoon. Napping is not necessary, but resting is. Be sure to dress daily in street clothes. You are on your way to recovery!
Stair climbing is not discouraged. Avoid pulling yourself up with a handrail, and go slowly.
Use your elastic stockings during the day and remove them at night. You should wear the stockings for at least 2 weeks after discharge or more if your ankles are still swollen. The stockings aid blood flow and help reduce swelling in the legs. It is easiest to put the stockings on before you get out of bed in the morning for the day, however most people put them on after a morning shower. They should fit snugly.
Your may notice a swelling or lump at the top of your chest incision which could take several months to disappear.
Most patients experience incisional discomfort in the sternum. This discomfort will decrease in time, but may reoccur when there is as adverse change in the weather or when you overextend yourself. Do not hesitate to use pain relieving medication as you need it.
It is important to distinguish incisional discomfort from chest pain (angina) you may have experienced prior to surgery. Contact your physician if you are experiencing chest pain.
If your chest or leg incisions do not appear to be healing (i.e., redness, drainage, swelling, or tenderness is present), notify your physician.
Take your temperature every morning for one week after discharge. Notify your physician if your temperature stays above 101 degrees F for more than a day.
Check your weight every morning for the first two weeks. If you notice a sudden weight gain, notify your physician.
When you are upset, your heart works harder. It is best to anticipate and avoid situations, people, or topics of conversation that make you tense or angry.
Remember that your diet, medications, and exercise are prescribed specifically for you. Do not expect your friend or neighbor who has a heart condition to have the same prescriptions.
Reasons to Call Your Surgeon’s Office
If you experience any of the following symptoms, report them to your surgeon’s office:
- Temperature above 101 degrees F on more than one occasion or chills for 24 hours.
- Excessive oozing, redness, swelling or tenderness at your incision sites.
- Increased fatigue or shortness of breath.
- Abnormal pain or other symptoms not relieved by your medications.
If You Had Valve Surgery…
Tell any doctor or dentist who treats you that you have had your valve repaired or replaced. They may prescribe antibiotics before procedures, especially dental work, to prevent an infection from settling in your heart.
It is possible that you may be taking Coumadin, an anticoagulant, commonly called a “blood thinner.” Coumadin causes blood to take a longer time to form a clot.
There are several points you should know about Coumadin:
You will need regular blood tests (prothrombin time) to regulate the dosage of Coumadin. Your physician will arrange these test for you.
Look for signs of bleeding while you are taking Coumadin. Notify your physician if you have:
- any abnormal bleeding
- red or black bowel movements
- pink or red urine
- severe headaches, abdominal or lower back pain
- faintness or dizziness
- red or “coffee ground like” vomitus
- excessive bruising
- excessive nose bleeds
- yellow or jaundice skin
- any symptoms that concern you
Take your Coumadin at the same time every day. NEVER make up for a missed dose by taking double the dose.
Don’t take aspirin, any medication containing aspirin or any “over-the-counter” medications without first checking with your physician as this can cause bleeding while taking Coumadin.
Excessive alcohol intake may also cause bleeding while taking Coumadin. Check with your physician about drinking alcohol.
Returning to Work
Returning to work is individualized based upon the nature of employment, desk job versus manual labor, the severity of your disease as well as your activity tolerance. Toward the end of your convalescence your physician will be better able to evaluate your progress and set a specific date for returning to work. In general, it is necessary to be out of work for 4-8 weeks after surgery.