These guidelines should be carefully followed by the cardiac patient as well as by the family and friends who wish to help the patient return safely to his/her optimal level of health and physical activity.
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. Alternate your activities throughout the day with rest periods in between. It takes at least as much time to return to your regular activity level as the amount of time you were inactive. Before returning to full time work, resuming major household tasks, participating in recreational activities or driving, check with your physician.
Activities to avoid
These activities require more work from the heart muscle and may impair the healing process of the sternal incision:
- No Pulling
- No Pushing
- No Lifting
- No Breath-holding
- No opening stuck jar lids
Limit upper body and arm activity. Any activity which requires more than 5 to 10 pounds of effort is not recommended for six weeks or until you see your cardiac surgeon. An example of this would be lifting anything heavier than a gallon of milk.
Begin slowly. Pace yourself, walking three to four steps (both feet on each step), followed by a pause before continuing additional steps. Take stairs one at a time. After a week or two, you may eliminate the pauses and climb stairs normally, alternating steps in the usual pattern.
How soon you resume sexual activity after leaving the hospital depends on your progress and how you feel when returning home. A general recommendation is to wait several weeks following hospital discharge. You may wish to talk with your physician regarding your specific situation. Some basic guidelines include:
- Discuss with your partner any fears or anxieties you might have regarding sex.
- Use a non-strenuous position without putting pressure on the arms.
- The room should be a comfortable temperature.
- No sex if tired or after a heavy meal.
Good bowel habits may be maintained by a well-balanced diet, by drinking fluids and by engaging in light physical activity such as walking. When constipation occurs, avoid straining and use a mild laxative such as Milk of Magnesia, or stool softener. If constipation continues, check with your physician.
Angina is a serious warning sign. It is a message from your heart telling you it is not getting enough blood and oxygen. Angina can feel different to various people. Common symptoms include: chest, throat, jaw or arm discomfort, described as pain, tightness, pressure, heaviness, squeezing or burning. If angina occurs, stop your activity, sit down and relax.
If the discomfort does not subside within 5 to 10 minutes, seek immediate medical assistance. Any angina occurring before your six-week surgical checkup should be reported to your Johnson City Medical Center Hospital Cardiac Surgeon.
Sadness is normal during the post-discharge recovery period. Feeling "blue," being "down in the dumps" or having "cabin fever" are all a normal part of the recovery period. Just as your sleep cycle returns to normal, so too will your moods. Depression will include: not returning to normally enjoyable activities, continued fatigue or lethargy, even with continuing medical improvement, and a feeling of not being lovable, worthy or competent. Again, depression is not unusual; tell your doctor if you have any of these feelings.
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 okay.
You may take a warm shower. Wash your incision gently with soap and water; pat dry (don't rub). Do not use lotions, creams or powders.
Care for incision
- When staples or stitches are left in place, the Cardiac Surgeon's office staff will remove them in a few days. You will be given a date to return to their office for removal of stitches or staples.
- Wash incision daily with soap and water, which helps to remove scabbing.
- Do not wear constrictive clothing around the area of the incision. Women, however, need to wear comfortable bras.
- If the incision does not appear to be healing (redness, drainage, swelling or tenderness), inform your cardiac surgeon. Occasionally, drainage from the leg incisions may occur. If this is thin, clear or pink, this is normal. If drainage is yellow or green, call your cardiac surgeon.
- Use hydrogen peroxide on areas of incision that are draining if recommended by your surgeon.
- Do NOT apply hydrogen peroxide on areas of incision that is not draining as it may slow the healing process.
- Your incisions may look bruised or feel itchy, numb or sore.
Bathe regularly and do not use creams or lotions on incisions until they are well-healed. Do not wear restrictive clothing around the areas of incision. Women may, however, wear bras. If incisions do not appear to be healing (i.e., redness, drainage, swelling or tenderness are present), inform your Johnson City Medical Center Hospital Cardiac Surgeon.
Take your temperature every morning for one week after discharge. Notify your cardiac surgeon if your temperature stays above 100 degrees Fahrenheit for more than a day. If you feel ill from a cold or the flu, check with your cardiac surgeon.
Check your weight every day for the first two weeks. This should be done first thing in the morning. If you notice a sudden weight gain of 3-5 lbs, notify your cardiac surgeon.
You may resume driving at your cardiac surgeon's discretion - usually in four to six weeks. Avoid sitting for long periods of time. When sitting, do not cross your legs. When riding in a car, limit trips to one to two hours. If longer trips are necessary, stop and take a five to 10 minute stretch-and-walk break every one to two hours. Wear your seat belt.
- Bring all medications bottles with you for your first follow-up appointment with your cardiac surgeon.
- Do not restart any medications taken before the surgery, without checking first with your Cardiac Surgeon.
- Do not take any over-the-counter medications without checking with your Cardiac Surgeon.
- Tylenol can be taken as needed but not with other pain medications.
- Prescriptions for pain will be written when preparing for discharge from the hospital.
- Chest discomfort (angina)
- Sudden onset of chest pain not relieved by rest or prescribed medications. The pain of the incision should subside gradually.
- Redness, swelling or drainage from incisions.
- Excessive movement or clicking sounds from the breastbone.
- Leg pain and/or unusual swelling of legs or ankles.
- Body temperatures above 100 degrees Fahrenheit.
- Shortness of breath not relieved by rest.
- Coughing up blood.
- Dizziness, confusion or fainting.
An office appointment for follow-up with your Cardiac Surgeon will be necessary. This appointment is usually scheduled for 2 weeks after discharge from the hospital.
|If you experience any symptoms such as chest pain, dizziness, profuse sweating, extreme shortness of breath or a very rapid pulse, contact your physician as soon as possible. DO NOT continue to exercise if symptoms occur.
- Wait one to two hours after a meal to begin exercising.
- DO NOT SMOKE. Smoking increases your heartrate and blood pressure. Smoking decreases the supply of oxygen to your heart.
- Exercise daily, or at least four times per week. Remember to progress gradually. The exercise should be comfortable for you.
- Avoid exercise when you are ill or have a fever.
- Use the "Talk Test". If you are breathing so hard that you have difficulty talking ... SLOW DOWN!