Home Recovery and Discharge Planning: Overview
Planning for your discharge begins when you are admitted to the hospital. If you have any specific concerns about returning home, please inform your nurse. A case manager is assigned to assist you with any needs or concerns you may have such as home medical equipment or home health needs
Generally, a slow, progressive approach to resuming your previous activity level is best for your heart. You should eventually be able to perform many household tasks, participate in recreational activities and return to work. Normal activities can be resumed, usually after the six-week healing period. Don't expect an instant recovery and don't resume activities at your previous levels. Though visitors mean well, too much visiting can be exhausting and interfere with your recovery. Try to limit the number of visitors and the length of the visit. It takes at least as much time to return to your regular activity level as the amount of time you were inactive. Follow the specific discharge instructions you receive when you leave the hospital.
Avoid activity outdoors when temperatures are below 32 degrees fahrenheit. During the summer when it is hot and humid, walk early in the morning or late in the day if you are walking outside. Avoid extreme temperatures such as steam baths, saunas, spas and whirlpools until your doctor advises you that it is all right.
Common Feelings After Cardiac Surgery Include:
- Not having much of an appetite. It takes several weeks for your appetite to return. Many patients notice that their sense of taste is diminished or almost absent. It will return. Some patients even complain of nausea at the smell of food for a week or two after surgery.
- Having some lower leg swelling, especially if you have an incision in your leg. That leg will tend to swell more for some time. Elevating your legs will help. Wear your elastic TED hose if they were prescribed for you.
- Having a lump at the top of your incision. This will disappear with time.
- To notice an occasional "clicking noise" or sensation in your chest in the first days after surgery. This should occur less often with time and go away completely within the first couple of weeks. If it gets worse, call your surgeon.
- Experience muscle pain or tightness in your shoulders and upper back between your shoulder blades. This will get better with time. Your pain medicine will also help relieve this discomfort.
- If an artery in your chest, called the mammary artery, was used during your surgery, you may experience numbness to the left of your incision. This is normal.
- Having difficulty sleeping at night. You may find it difficult to fall asleep, or you may find that you wake up at 2 a.m. or 3 a.m. and cannot fall back to sleep. This will improve. Taking a pain pill before bed sometimes helps.
- Having problems with constipation. You may use a laxative of your choice. Add more fruits, fiber and juice in your diet.
- Having mood swings and feeling depressed. You may have good days and bad days. Do not become discouraged. This will get better.
- Remember it takes four to six weeks to start feeling better.
- Remember to take all your medicines as prescribed by your doctor.
Cardiac Surgery Discharge Instructions
- Take your temperature daily. If greater than 101 degrees Fahrenheit for more than a day, notify your surgeon.
- Weigh yourself daily in the morning. Write down and bring log to your follow-up appointment with your surgeon. Report to your doctor any weight gain over three pounds in two to three days.
- Do not lift anything more than five to 10 pounds for the first six to eight weeks unless the doctor gives you other instructions. This will allow proper healing of the breastbone which usually takes six weeks.
- Wash your incision with mild soap and water and pat it dry. Do not use powder or lotion on your incisions. Steri-strips/staples will be removed at your follow-up visit with the surgeon. Protect your incision from overexposure to sunlight during the first year after surgery.
- Do not bathe or shower in very hot water. This may cause dizziness or weakness. No hot tubs for eight weeks.
- Use anti-emboli (TED) stockings during the day and remove them at night. You should wear the stockings for two weeks after discharge the stockings aid blood flow and help reduce swelling in the legs.
- Monitor your incision for signs and symptoms of infection. Redness of the incisions is expected since this is part of the healing process. Some clear or light pink drainage from the leg incision is common. Report any drainage from chest incision.
- Remove your ex-chest tube dressing on the day after discharge.
- Don't drive while taking your pain medication. Driving may be permitted after four to six weeks or sooner if your doctor approves. When riding in a car for long distances, stop every one to two hours to stretch your legs. This will improve circulation in your legs and help prevent swelling.
- Follow a no added salt, low fat, low cholesterol diet or other specific diet that has been explained to you. Initially, eat what you like, but keep the amounts moderate. After two to four weeks, once you've recovered and have more energy, follow "heart-healthy" eating habits. This means eating foods rich in nutrients. Nutrient-rich foods contain vitamins, minerals, fiber and others, but are low in calories. Choose foods like vegetables, fruits, whole-grain products and fat-free or low-fat dairy products.
- Keep a list of your medicines you take including the doses and times you take them. Bring the list or your pill bottles with you when you see your physician.
- Take your medicine as directed. Call your physician if you feel you are experiencing any side effects. Do not stop any medication unless directed by your physician.
- Rest: Plan rest periods throughout the day. You need to pace yourself. A rest period should be taken at least once a day for several weeks. Try to get eight to 10 hours of sleep each night. Look at your progress one day at a time.
- 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 swell, you should put them on a chair or stool while sitting.
- Activities that should be avoided for the first four to six weeks are: vacuuming, moving furniture, weeding, raking, mowing, gardening and mopping. Some activities you can participate in are: setting and clearing the table, minor repairs around the house, dusting furniture, potting plants and shopping. Stair climbing is not discouraged – avoid pulling yourself up with a handrail and go slowly.