What Should Be Considered After Heart Surgery?
After reading this article where I explain what to do after heart surgery, you too will have complete and accurate information on this subject. All this information is the product of my 25 years of experience in the field of “Heart Surgery”. All the suggestions I have written below have been applied by my patients over the years and updated with their feedback. The purpose of this information is to make you feel safe after surgery, to prevent possible negative situations and to prevent you from making mistakes due to the wrong information you will hear from others.
Have You Had Heart Surgery?
If this article caught your attention and you continue reading, I guess you or a loved one has had heart surgery. First of all, I want to convey my “Get Well Soon” wishes to you. Please keep this in mind: A person who has had heart surgery is no different from a person who has not. They always ask me: “Doctor, have I become half a person now? Will I no longer be able to do what I used to do?” Definitely “No!”. You had this surgery to recover and you have “recovered.” You will only pay attention to certain things for the first 2 or 2 months after the surgery, that’s all. After that, you will do the same things that people your age do. In short, you will only put a 2-month “comma” in your life.
Things to Do at Home After Heart Surgery
Lying Position
Unless otherwise stated, there is no harm in turning to the right/left while lying down. In the past, we used to tell our patients to lie on their backs for 2 months. However, our experience over the years has shown that this is not necessary for every patient. We tell our overweight patients and those with thin/fragile bones that they have to lie on their backs for 2 months, just like before. But the good news is that 90% of our patients do not need this. Although we allow turning to the right and left, you should still be more careful while lying down and avoid sudden movements and unbalanced (asymmetrical) movements.
Nutrition and Fluid Consumption
In the days following the surgery, you will need calories to heal quickly. Therefore, do not follow any diet for 1 month. You can eat whatever you want, as long as it is low in salt. If you are diabetic, your diet should be suitable for that. However, you should know that it is absolutely necessary for your blood fats to be low in the long term after the surgery. This can only be achieved with a healthy diet throughout your life. Therefore, stay away from animal fats (butter, tallow) and fatty cheeses.
Unless your doctor tells you otherwise, you should continue to drink 2 liters of water at home, as we recommend in the hospital. This will help your kidneys work better and help the medications you use to be eliminated from your body.
Assistive Devices
If you were given a plastic breathing exercise device in the hospital that has balls inside and that inhales through the tube and these balls are inflated one by one, you should continue to use it at home for at least 2-3 weeks. Working with this device will ensure that your lungs are fully functional.
If you were told to wear compression stockings when you were discharged, continue to wear them for 2 months. You should take off your stockings, which prevent clots (embolisms) from reaching your lungs from your leg and reduce edema, when you go to bed and wear them when you walk around. It is normal for your leg with the vein removed to be a little more swollen than your other leg. It will return to normal within months. If you also experience swelling in your leg without the vein removed, this may be a sign of heart or kidney failure. In such a case, call our team immediately.
In the past, every patient who had heart surgery was put on a chest corset. Except for a very small number of patients with fragile bones, we no longer need this. If you were given a corset when you were discharged, you should continue to use it for 1 month. You can take it off at night when you go to bed. Do not forget that the chest corset has the feature of preventing your bones from moving.
Taking a Bath
You can take your normal bath from the day you are discharged. There is no harm in getting soapy water on your wound. The thin crusts around your wounds will soften and fall off on their own. Do not apply products such as loofahs or scrubs to these areas. In the early days, it will be easier for you to take a shower while sitting. After getting out of the bath, first dry your surgical area and then your entire body with a clean towel. If there is any discharge from your wounds, postpone taking a bath until it stops and inform your doctor. Wiping your body will be enough for this period.
Wound Care and Dressing
If your doctor recommends that you dress a discharged area at home, do so only with sterile gauze and Batticon solution that you can obtain from pharmacies. Avoid touching the wound with your hands during the dressing. Dressing twice a day, morning and evening, will be sufficient. If you observe an increase in the amount of discharge, call your doctor immediately.
Drug Use
Be sure to use the medications prescribed in your prescription on time and regularly. If you have had valve surgery in particular, you should pay great attention to the use of your Coumadin medication (we also give this medication to patients with poor vascular structure or persistent heart palpitations). Do not forget that this medication is vital for you as it can cause bleeding (nose, stomach, etc.) and bruising when taken in excess, and can cause clotting around the valve and prevent the valve from working when taken in small amounts.
Daily Life and Activities
After being discharged, continue to walk as in the ward. You should avoid lying down all the time. When you feel like you can do it (about 3-4 weeks), you can start doing light housework and even do small gardening jobs. You should avoid heavy lifting for 2 months following your surgery.
We do not recommend that you go outside for the first week after you go home. We recommend that you go outside and walk regularly every day from the second week onwards.
Most patients complain of not being able to sleep at night during the first week after being discharged. This is normal and does not require the use of any medication. If you do not sleep during the day, your nighttime sleep will return to normal earlier.
We allow you to drive 8 weeks after surgery. If you drive before, you may experience pain in your arms and shoulders when moving the steering wheel. A sudden brake and the seat belt may damage your sternum. In addition, you may be dangerous in traffic because you will not be able to move as quickly as necessary yet.
It would be in your best interest to prevent visitors for another 2 weeks to protect yourself from flu and other infections that may come from outside. You should not tire yourself by meeting too many people.
The pain in your chest will go away in 3 months. If these pains reach a level that bothers you a lot, you can use a painkiller recommended by your doctor.
Cigarettes and Alcohol
Try to stay in a smoke-free environment. Advise those around you who smoke to quit as soon as possible. You should not even use the word cigarette in your future life.
You should avoid excessive alcohol consumption throughout your life. If you are taking sleeping pills, tranquilizers or any painkillers, the effects of the drugs may increase when combined with alcohol. Since alcohol will also interact seriously with Coumadin, it is recommended that valve patients using Coumadin be more careful about alcohol.
Sexual Life
Unless your doctor tells you otherwise, you can have sexual intercourse when you feel comfortable. Avoid positions that put pressure on your breastbone or arms until your breastbone has fully healed (2 months). You should not be upset if early attempts are unsuccessful or challenging.
When Should You Call Your Doctor?
Please call your doctor if you experience any of the following symptoms:
- Excessive sweating and fever over 38° C
- Shortness of breath and fainting at rest
- Infection or flu
- Irregular and rapid heartbeat
- Feeling sick with simple exertion
- Redness, swelling or discharge from wounds
If you are taking blood thinners, you should call your doctor if:
- Bruising or bleeding that you can’t explain
- Black stools, dark or bloody urine
- Severe or frequent headaches
What Should You Do During Long-Term Follow-ups?
Other check-ups after your first check-up will be done by your cardiologist. However, if you experience any problems with your wounds at any time, do not hesitate to contact your operating surgeon.
If you have had Coronary Artery Bypass Surgery (CABG):
- Have your blood lipids checked and have an echocardiogram every 6 months,
- Have an exercise test, echocardiogram, and chest X-ray every year,
- Your cardiologist may find it necessary to have a control angiography in the long term (like 5 years).
If you have had valve surgery:
- Have your prothrombin time (PTT, INR) checked every month so that your cardiologist can adjust your Coumadin dose and inform him/her of the results.
- Have an echocardiogram, ECG and chest X-ray done every year.
- If you are going to have a surgical procedure or dental treatment that involves bleeding, inform your doctor that you are using Coumadin.
- During such a procedure, you should use antibiotics to protect against valve infection (endocorditis prophylaxis). Have the relevant doctor consult with the cardiologist for Coumadin adjustment and antibiotics.
Don’t forget
These rules that you must follow after heart surgery are very important for you to live a healthy, long, quality and happy life with your loved ones.
Get well soon wishes…