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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Cardiology, Cardiovascular Surgery

Patient Timeline to Surgery and Recovery (7246)

Patient Timeline to Surgery and Recovery (7246) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery

7246


Patient Timeline to Surgery and Recovery

First visit: Meet with Surgeon

 Complete history and physical exam.
 Review medical records and test results.
 Discuss treatment options.
 Plan for surgery, if needed.
 Do other tests before surgery, if needed.
 Share review of findings with referring doctor.

Second visit: Pre-op Work-up

 Have blood drawn in the lab and a chest x-ray done.
 Meet with a nurse practitioner or physician’s assistant to discuss surgery.
o Update history and physical.
o Review medicines and discuss plan for taking them.
o Discuss what to expect during surgery.
o Sign consent for surgery.
 Meet with Learning Center nurse.
 Meet with Anesthesia Screening Clinic nurse.
 If you are an inpatient, you may meet a physical therapist or occupational therapist.
They will meet with you to discuss sternal precautions and possible post discharge
equipment.

5-14Days before surgery – Vitamins, Herbs, Diet Supplements, and Medicines
stop taking
(See section in binder called “Medications and Herbs Which Affect Bleeding”)
 You should follow the surgeon’s instructions on stopping over the counter and
prescription medicines before their surgery.
 Stop taking all vitamins, herbs, and diet supplements for 10-14 days before and up to 7
days after surgery.
 Your surgeon’s office will determine when to stop taking all anti-platelet drugs (aspirin
and Plavix®).
 Stop taking non-steroidal anti-inflammatory drugs, and aspirin-containing products for
7 days before and 7 days after your surgery. This includes ibuprofen, Advil®,
Motrin®, Nuprin®, Orudis®, and Aleve®.

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 Stop taking Coumadin® 5 days before your surgery. Do not restart this drug until told
to do so by your doctor.
 It is all right to use Tylenol® (acetaminophen).

3 Days before surgery
 Stop drinking alcohol 3 days before surgery. When mixed with anesthesia, it can have
serious effects on your body.

Day before surgery

 Someone from First Day Surgery (FDS) calls the day before (or the Friday before if
your surgery is on Monday) with instructions. If they do not call by 1 p.m., please call
608-265-8857.
 If you have a cold, fever, or illness the day before surgery, please call your surgeon’s
office between 8:00 and 4:30 pm, Monday through Friday. After hours and on
weekends, please call the hospital operator (608) 262-0486 and ask to speak with the
cardiac surgery physician assistant on call.

Night before and morning of surgery before hospital arrival
 The night before surgery, eat a light supper – small amounts of low fat foods. Stop
eating solid food and drinking milk or juices with pulp at 7:00 pm. After 7:00 pm,
drink only clear liquids (apple juice, white soda, tea, broth, Jell-O®, weak coffee,
water) until midnight. After midnight, do not eat or drink anything. This includes
water, ice chips, gum, candy, and chewing tobacco. This is important to prevent getting
stomach contents into your lungs during surgery.
 The evening before and the morning of surgery, you need to shower with an
antibacterial soap called Hibiclens®. You will get this soap during your clinic visit.
Scrub gently from your neck to your toes for 2-3 minutes. Avoid scrubbing too hard.
You should not break the skin. Rinse off, do not apply any lotions or powder to the
skin. Avoid getting Hibiclens® in your eyes or genitals.
 Please remove all make-up and fingernail polish. This includes clear nail polish.
 Try your best to have a restful night before surgery.
 The morning of surgery, brush your teeth and rinse, but please do not swallow.
 Take your morning medicines that you’ve been told to take with a small sip of water.
Do not take potassium or vitamins since they may make you sick on an empty stomach.
If you have diabetes, please follow the special instructions about your insulin or oral
medicines that you’ve been given.
 Please leave all jewelry, rings, large sums of money, and credit cards at home.
 Bring any inhalers or CPAP equipment, your glasses, eye drops, hearing aids, dentures,
prostheses, or other special equipment that you will need during recovery. Be sure
these items are labeled and in a case, if appropriate.
 Feel free to bring pajamas, a robe, non-skid slippers, and other personal items. All
rooms are private and TVs are provided at no charge.

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 Bring a calling card or your cell phone if you wish to make long distance calls. You
may bring in your laptop. All of the rooms have wireless internet access. Please leave
your belongings in the trunk of your car the day you check in. Once your room is
ready, your family can bring your things to you.

Day of surgery

 Arrive at First Day Surgery (FDS). Arrival time for a first start surgery is 5:30 a.m.
You are told a different time if your surgery starts later in the day. Please see the
section in your binder called “Your Heart Surgery and Hospital Stay” for details.
 Meet with surgeon before surgery for questions.
 A person from Anesthesia takes you to the operating room (OR). Your family is
guided to the waiting area. This is on the second floor in the C5 section.
 Surgery starts. Your family is updated by the OR staff during your surgery.
 Surgery is finished. Your family is guided to the Cardiothoracic Surgery Unit on B4/5.
Your surgeon updates your family.
 You arrive on the unit on B4/5. Your family may visit after you are settled in your
room and have had some time to recover (this may be 1-2 hours).
 There is a breathing tube in your mouth. You are not able to speak while this is in
place. It is taken out as soon as you are awake enough to breathe well on your own.
When it is removed, you may talk and begin taking ice chips and liquids.
 You have several tubes and lines in after surgery. Please see the section in your binder
called “Common Tubes and Lines” for details.
 You hear noises such as the beep of the monitor and the bubbles from the chest tubes.
These are normal.
 You can bring ear plugs and let your family know you prefer to wear them.
 You may have wrist restraints when you first wake up. They limit movement of your
hands. This is to protect you from hurting yourself while you are waking up from
anesthesia.
 Your nurse may have you sit on the side of the bed the evening of surgery.

Day after surgery (Post-op Day #1)

 The cardiac team sees you daily to check on your progress. This is called rounding.
The time of day may vary. It could be early morning, late afternoon, or evening.
Several members of the cardiac team may be present. They first meet outside your
door to discuss your progress. Then they come into your room to update you and
answer your questions. Please see the section in your binder called “Your Health
Care Team” for a list of the people caring for you.
 Tubes and lines start to be removed based on how you are doing. Your diet is advanced
from clear liquids until bowel movement is achieved, then heart healthy diet.
 Physical therapy and occupational therapy may see you to start helping you get up and
move to the chair and walking.

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 You will learn about sternal precautions to prevent problems with your incision.
 You get out of bed to sit in a chair in the morning. Your goal is to get out of bed and sit
in a chair at least 3 times per day. A good time to sit in a chair is when eating.
 You start walking in the halls. Your goal is to walk in the halls at least 4 times per day.
 You cough and deep breathe using an incentive spirometer (breathing tool). This helps
to prevent pneumonia. You should do this 10 times each hour while you are awake.
 A case manager helps you with any discharge needs like rehab stay or home health.
 People from other services meet with you based on your needs.

Post-op Day #2 until discharge

 The cardiac team rounds on you every day.
 All tubes and lines are removed except an IV and the telemetry patches. There are
some exceptions to this.
 You continue building strength by walking, sitting in a chair, and taking part in your
daily care.
 You continue your breathing exercises.
 A member of the cardiac team discusses discharge with you. Please see the section in
your binder called “Homeward Bound” for details.

 A person from cardiac rehab meets with you on post-op day 3-4.

Discharge day (Post-op Day #4-5)

 A pharmacist reviews your medicines with you.
 Your nurse reviews your discharge instructions with you.
 Other members of the health care team such as a case manager, occupational therapist
or physical therapist may meet with you before you leave.
 You pick up your medicines at your pharmacy of choice before you get home.
 You limit your lifting and driving to help your breastbone heal. You should not lift
more than 8 pounds for 6 weeks. You should not drive for 4 weeks. You will be given
further instructions when you see the cardiac surgeon.
 You cannot sleep on your side for total of 12 weeks.
 Other follow-up care such as having blood drawn in the lab is arranged as needed.

Recovery after the hospital

 Every patient is unique in how he recovers and feels after heart surgery. However,
there are some common experiences shared by many post-heart surgery patients.
Please see the section in your binder called “Homeward Bound” for details.
 Weigh yourself daily.

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 Measure your blood pressure and heart rate daily. Please record these numbers and
bring them to your follow-up visits.
 Increase your daily activity slowly. Keep your weight lifting limits in mind.
 Rest and recover. Take part in other activities as you feel ready.
 Do not lay on either side for 12 weeks after surgery.

First follow-up visit (about 1 week from discharge)

 You may need to have blood drawn in the lab and a chest x-ray or other tests done
before your follow-up visit. This will be discussed with you before you leave the
hospital.
 You meet with a nurse practitioner or physician’s assistant to discuss progress since
discharge. You may not see your surgeon at this visit.

Follow-up with primary care provider in 2-4 weeks from discharge.

Cardiac rehab will start 2-4 weeks from discharge. Cardiac rehab is program
developed to help participants learn about heart healthy life, exercise and
methods to reduce stress. This program can last by number of visits your
insurance company may allow.

Final follow-up visit (about 4 weeks from discharge)

 You may need to have blood drawn in the lab and a chest x-ray or other tests done
before this follow-up visit. This will be discussed with you before this visit.
 You will meet with a nurse practitioner or physician’s assistant first, then your surgeon.
 If all is going well, you will not need to be seen in cardiac surgery clinic again.
 You may resume driving 4 weeks from surgery unless you are taking narcotic pain
medicine.

Follow-up with cardiologist in 4-6 weeks from discharge or as advised by your
surgeon.

6 weeks after surgery: The amount of weight you may lift is increased from 8 pounds to 20
pounds for 6 more weeks. You need to sleep on your back for 6 weeks more.

12 weeks after surgery: You may resume your normal daily routine.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7246