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

Family Timeline to Surgery and Recovery (7247)

Family Timeline to Surgery and Recovery (7247) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery

7247



Family 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.

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.
 If needed, meet with the Anesthesia Screening Clinic nurse.

5-14 Days before surgery – Vitamins, Herbs, Diet Supplements, and Medicines
taking
(See section in binder called “Medications and Herbs Which Affect Bleeding”)
 Your loved one should follow the surgeon’s instructions on stopping over the counter
and prescription medicines before their surgery.
 Your loved one stops taking all vitamins, herbs, and diet supplements for 10-14 days
before and up to 7 days after surgery.
 The 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 or aspirin-containing
products for 7 days before and 7 days after surgery. This includes ibuprofen, Advil®,
Motrin®, Nuprin®, Orudis®, and Aleve®.
 Your loved one stops taking Coumadin® 5 days before surgery. The doctor will notify
your loved one when to restart this medicine.
 It is all right for your loved one to use Tylenol® (acetaminophen).


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3 Days before surgery
 Your loved one stops drinking alcohol 3 days before surgery. When mixed with
anesthesia, it can have serious effects on a body.

Day before surgery

 Someone from First Day Surgery (FDS) calls the day before (or the Friday before if
surgery is on Monday) with instructions for your loved one. If they do not call by 1
p.m., please call 608-265-8857.
 If your loved one has a cold, fever, or illness the day before surgery, please call the
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, your loved one eats a light supper – small amounts of low fat
foods. They will stop eating solid food and drinking milk or juices with pulp at 7:00
pm. After 7:00 pm, your loved one drinks only clear liquids (apple juice, white soda,
tea, broth, Jell-O®, weak coffee, water) until midnight. After midnight, your loved one
does not eat or drink anything. This includes water, ice chips, gum, candy, and
chewing tobacco. This is important to prevent getting stomach contents into the lungs
during surgery.
 The evening before and the morning of surgery, your loved one needs to shower
with an antibacterial soap called Hibiclens®. The Hibiclens soap will be given during
the clinic visit. Please read HFFY 7938 Getting your Skin Ready for Surgery with
Hibiclens.
 Your loved one removes all make-up and fingernail polish. This includes clear nail
polish.
 Your loved one tries to have a restful night before surgery.
 The morning of surgery, your loved one brushes his teeth and rinses, but does not
swallow.
 Your loved one takes any morning medicines that have been instructed to take with a
small sip of water. Please do not have your loved one take potassium or vitamins since
they could cause an upset stomach. If your loved one has diabetes, please follow the
special instructions about insulin or oral medicines that have been given.
 Your loved one leaves all jewelry, rings, large sums of money, and credit cards at home.
 Your loved one should bring any inhalers or CPAP equipment, glasses, eye drops,
hearing aids, dentures, prostheses, or other special equipment that will be needed during
recovery. These items are labeled and in a case, if appropriate.
 Your loved one may 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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 Your loved one may bring a calling card or a cell phone if needed to make long distance
calls. You may bring in a laptop. All of the rooms have wireless internet access. Please
leave belongings in the trunk of the car on check in day. Once the room is ready, you
may take your belongings to the room.

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 loved one’s surgery starts later in the day. Please see the
section in your loved one’s binder called “Your Heart Surgery and Hospital Stay” for
details.
 Meet with surgeon before surgery for questions.
 A person from Anesthesia takes your loved one to the operating room (OR). You are
guided to the waiting area on the second floor in the C5 section (C5/2, just past the D
Elevator lobby on the 2nd floor). You should check in at the desk. You are given a pager
so that you can be contacted regarding your loved one’s surgery. Another option is to
leave a phone number for them to contact you.
 Your loved one’s surgery starts. You are updated by the OR staff during the surgery.
 Your loved one’s surgery is finished. You are guided to the Cardiothoracic Surgery Unit
on B4/5. Your surgeon updates you there.
 Your loved one arrives on the unit on B4/5 to recover. You may visit your loved one
after they are settled in the room and had some time to recover (this may be 1-2 hours).
Children may visit. However, this may be scary for some children. We ask that parents
use their judgment to decide what is best for their children.
 Your loved one will be waking up from anesthesia when you first enter the room. There
will be a breathing tube in his/her mouth to help them breathe. Your loved one will not
be able to talk while this tube is in place. It will be removed when your loved one is able
to breathe well on their own. When it is removed, your loved one, may talk and begin
taking ice chips and liquids.
 Your loved one will have several lines attached to them. Please see the section in the
binder called “Common Tubes and Lines” for details.
 You will hear noises such as the beep of the monitor and the bubbles from the chest
tubes. These are normal.
 Your loved one may have wrist restraints on when they first wakes up. This is to protect
them from hurting themselves while waking up from anesthesia.
 Your loved one may sit on the side of the bed the evening of surgery.









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Day after surgery (Post-op Day #1)

 The cardiac team sees your loved one daily to check on their 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
the door to discuss your loved one’s progress. Then they will come into the room to
update you and your loved one. Please see the section in his binder called “Your Health
Care Team” for a list of the people caring for your loved one.
 Tubes and lines start to be removed based on how well your loved one is doing. Their
diet is advanced from liquids to soft foods.
 Your loved one starts getting out of bed to sit in a chair. The goal is to get out of bed and
sit in the chair at least 3 times per day. A good time to sit in a chair is when eating.
 Your loved one starts walking in the halls. The goal is to walk in the halls at least 4 times
per day.
 Your loved one is taught how to cough and deep breathe using an incentive spirometer
(breathing tool). This helps to prevent pneumonia. They should do this 10 times each
hour while awake.
 Staff from other services meet with your loved one based on their needs, such as physical
therapy (PT), occupational therapy (OT), and case management.

Post-op Day #2 until discharge

 The cardiac team rounds on your loved one every day.
 All tubes and lines are removed except an IV and the telemetry patches. There are some
exceptions to this.
 Your loved one continues building strength by walking, sitting in a chair, and helping
with daily cares.
 Your loved one continues their breathing exercises.
 A member of the cardiac team discusses discharge with you and your loved one. Please
see the section in your loved one’s binder called “Homeward Bound” for details.
 A member of the cardiac rehab team meets with your loved one on post-op day 3-4.

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

 You and your loved one meet with other members of the health care team, such as staff
from pharmacy, nursing, case management, and cardiac rehab.
 Your loved one picks up their medicines at the pharmacy of choice before arriving home.
 Your loved one limits lifting to no more than 8 pounds for the first 6 weeks. Your loved
one should not drive for 4 weeks. These restrictions help the breastbone heal. Other
follow-up care such as having blood drawn in the lab is arranged as needed.


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Recovery after the hospital

 Every patient is unique in how they recover and feels after heart surgery. However, there
are some common experiences shared by many post-heart surgery patients. Please see
the section in your loved one’s binder called “Homeward Bound” for details.
 Your loved one weighs themselves daily.
 Your loved one cannot lay on either side for 12 weeks after surgery.
 Your loved one measures their blood pressure and heart rate daily. Please record these
numbers and bring them to the follow-up visits.
 Your loved one increases their daily activity slowly, while keeping the weight lifting
limits in mind.
 Your loved one rests and recovers and takes part in other activities as they feel ready.

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

 Have blood drawn in lab and chest x-ray or other tests done as needed.
 Meet with nurse practitioner or physician’s assistant to discuss progress since discharge.
Your loved one may not see the surgeon at this visit.
 If you are recovering well, this may be the only visit needed.


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

Cardiac rehab will start 2-4 weeks from discharge.

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

 Have blood drawn in the lab and a chest x-ray or other tests done as needed.
 Meet with a nurse practitioner or physician’s assistant first, then your surgeon.

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

6 weeks after surgery: The amount of weight your loved one may lift is increased from 8
pounds to 20 pounds for 6 more weeks.

12 weeks after surgery: Your loved one may resume their normal daily routine, without
restriction.



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#7247