/clinical/,/clinical/pted/,/clinical/pted/hffy/,/clinical/pted/hffy/cardiology/,

/clinical/pted/hffy/cardiology/7248.hffy

201705123

page

100

UWHC,UWMF,

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

Homeward Bound (7248)

Homeward Bound (7248) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery

7248



Homeward Bound

What can I expect when I am discharged
from the hospital?
You can expect to stay in the hospital 4-5
days. Before you leave, you will learn how
to care for yourself at home. A friend or
family member should be present the day of
discharge to hear instructions with you. You
will receive prescriptions for medicines.
Your medicines may change after surgery.
You may take some different ones. The
doses of some may change. Please note the
names, doses, and times of your medicines.
Do not take the medicines you were taking
before surgery without checking with your
surgical team. Please bring your insurance
card if you plan to fill your prescriptions at
the UW Hospital Pharmacy.

You need a responsible person to drive you
home and stay with you for one week. It
may be helpful to have someone stay with
you for the first week or two after you go
home. Some patients may want or need to
stay at a place for more rehab or skilled
nursing facility after discharge from the
hospital. Your cardiac surgery team will
work with you to assess your needs. Your
case manager will help arrange for special
needs like Home Health, a nursing home
stay, or Meals on Wheels.

Most patients have follow-up visits with
their surgeons at 1 week and 4 weeks after
surgery. You will also have scheduled clinic
visits with your primary care doctor and
cardiologist in the first few weeks after
surgery.



How do I care for my incisions?
While you are in the hospital, your incisions
are covered to avoid irritation from the
telemetry leads or heart monitor. After
discharge, a dressing is only needed if
drainage is present. Small amounts of a
thin, light red fluid may drain from the chest
tube sites. This is normal. Cover the chest
tube sites with dry gauze and change daily
until the drainage stops.
At first, the incisions may be red and
swollen. The redness and swelling decrease
as they heal. Signs that an incision has
become infected include increasing redness,
warmth, soreness, thick yellow drainage,
and fever. If the drainage appears infected
(may be thick yellow with a bad smell),
please call your surgeon’s office right away.
Also call the office if you have any drainage
from your chest or leg incision (if you have
one). Drainage from these sites is not
common. Please call the surgeon’s office if
you have any of these signs.

Keep incisions clean and dry. Do not put
ointments, powders, or lotions on them.
Shower daily with your back to the stream.
Use a mild, fragrance-free soap. When
washing, avoid rubbing your incision. Pat
the incision dry. Do not take hot showers or
baths.

Tub baths, hot tubs, and swimming pools are
not allowed for 30 days or until your
incisions are fully healed. Any staples or
sutures will be removed at your first follow-
up visit.



2

What do I check every day?
 Weigh yourself daily.
 Measure your blood pressure and
heart rate daily if you have a blood
pressure cuff.
 Write your weight, blood pressure,
and heart rate (pulse) daily in your
Weight and Vital Signs Record.
Bring this to your first follow-up
visit.

Your therapy team including occupational
therapy, physical therapy and exercise
physiologist will help you provide additional
information and parameters.

All patients retain water after heart surgery.
You will be on a fluid restriction and low
salt diet for a few weeks after surgery to
help your body get rid of the extra water.
You will likely be on a water pill (diuretic)
when you go home as well to get rid of the
extra water. This helps your breathing. You
may have more changes to your diet (low fat
or low cholesterol) based on your heart
condition.

How active should I be?
As you heal you will slowly feel stronger
and more independent. This may take
weeks to months. Be patient. Give yourself
time. Each day find a balance between
increasing your activity, and getting enough
rest and sleep. Deep breathing helps your
lungs recover. Use your incentive
spirometer at home for 3 weeks to help your
lungs heal. Walking is a good safe way to
exercise after heart surgery. Be as active as
you feel you can be. Please see below for
activity restrictions after heart surgery. Call
your surgeon’s office if you have questions
or concerns about your recovery.

Pain medicine may cause you to become
drowsy, dizzy, or lightheaded. Do not drive,
use machines, or drink alcohol while taking
pain pills.

Do I have any activity restrictions after
heart surgery?
All patients have restrictions after heart
surgery. Your breastbone (sternum) is a
broken bone that cannot have a cast on it. It
takes about 12 weeks for a broken bone to
heal.
 You will have an 8 pound weight
restriction for the first 6 weeks. In
other words, you should not lift more
than 8 pounds during the first 6
weeks after surgery. This is about
the weight of a gallon of milk.
Starting the 7th week after surgery,
the amount of weight you may lift is
increased from 8 pounds to 20
pounds for 6 more weeks.
 Do not flex or extend your shoulders
over 90 degrees.
 Do not push or pull with your arms
when moving in bed and getting out
of bed.
 Avoid reaching too far across your
body.
 Do not hold your breath during
activity.
 Brace your chest when coughing or
sneezing for the first 2 weeks and as
needed.
 No over the shoulder activity.
 If you feel any pulling or stretching
in your chest, stop what you are
doing. Do not repeat the motion that
caused this feeling.
 Report any clicking or popping
noises around your breastbone to
your surgeon right away.
 Do not lay on either side for 12
weeks after surgery.

Avoid twisting motions and heavy lifting
until 12 weeks from surgery. This includes
but is not limited to these activities:
 Snow shoveling
 Lawn mowing
 Golf
 Tennis
 Hunting

3

 Fishing
 Running (walking is safe and
encouraged)
 Bike riding
 Motorcycle riding
 Contact sports (soccer, football)
 Weight lifting
 Bowling
 Vacuuming
 Sweeping
 Laundry
 Shopping
 Cleaning

Family may want to consider adjusting
things at home to help in the recovery.
Move commonly used items in
kitchen/bathroom/closet to a counter height
easy to reach.

Do not drive for the first 4 weeks to help
your breastbone heal well. When 12
weeks have passed since surgery, you may
resume your normal routine activities. Call
your surgeon’s office if you have questions.

There are many things you can do while you
are healing and getting stronger. Do as
much as you can based on how you feel and
your weight and arm restriction. Below are
some examples of light activities:
 Seeing friends
 Walking

Dental hygiene is important for overall
health. This includes:
ξ brushing teeth with fluoridated
toothpaste and a soft bristle brush for
2 minutes two times every day
ξ flossing daily
ξ visiting a dentist 2 times per year for
teeth cleaning and x-rays.

Are there any common experiences after
heart surgery?
Heart surgery is a stress on the body. It
takes time to recover. There are some
common experiences that many heart
surgery patients have after surgery. You
may have none, some, or all of these.

Many patients have shortness of breath.
This can be from extra water in your body,
anemia, or the stress from surgery. Having
shortness of breath with effort is common.
Call your surgeon’s office if it gets worse.

Another common experience after heart
surgery is decreased appetite or food tasting
different. Patients sometimes have a
metallic taste when they eat. There is no
known reason for this. It may be from
medicines used during the surgery such as
anesthesia or the body’s response to stress.
Eating small meals throughout the day may
help. Eat whatever you can, but keep in
mind your fluid restriction and low salt diet.
Protein is needed for healing. It is helpful to
eat high protein meals for a few weeks after
surgery. If your appetite decreases or your
sense of taste changes, you can expect it to
return to normal several weeks after surgery.

Patients often have sleeping problems. They
may have trouble falling asleep or staying
asleep. Patients sometimes have strange or
vivid dreams. There is no known reason for
any of these. Most patients find that their
sleeping problems go away in a few weeks.
A sleep aid may be helpful for a short time.
Please talk with your surgery team about
medicines, if you are having trouble
sleeping.

Changes in mood, such as depression or
feeling very emotional, are common for
people who have just had heart surgery.
This seems to be due to the stress of the
surgery. It is best to share your thoughts and
feelings with someone. Patients with strong
emotional support tend to recover more
quickly. If you are having problems coping
or need support, please talk with your doctor
or nurse. People most often feel better and
more like themselves within several weeks
after surgery.

4


Here are some ideas to help you heal and
feel more positive about yourself and your
recovery:
 Do things that you enjoy and are
within your limits.
 Take it day by day based on how you
feel.
 Get together with family and friends.
 Talk about your feelings.

When may I return to work?
Everyone recovers from heart surgery at
their own pace. When you can return to
work will depend on how you feel and the
kind of job you have. Many patients start to
feel ready to return to work between 4-6
weeks after surgery. You may find it
helpful to start back to work part time or on
a reduced schedule until you are fully
recovered. If your job requires heavy lifting
(greater than 20 pounds), you have two
choices. You do other work at your job that
does not require heavy lifting or you wait to
go back to work until you are able to do
heavy lifting. Most often weight restrictions
are lifted at 12 weeks after surgery. If you
need paperwork filed for your job, please
bring it with you for your surgeon to
complete.

When and whom to call for help?

Call 911 if you:
 Have chest pain that is different than
your incisional pain or seems like
angina.
 Have severe shortness of breath.
 Are fainting or feel like you are
going to faint.
 Have a fast irregular heart beat while
at rest for 10 minutes (feel your heart
racing).
 Are unconscious.

Call your surgeon’s office during the first
4 weeks after discharge if:
 You feel short of breath.
 Your legs or feet are swollen.
 Your heart rate (pulse) is less than 55
or greater than 120.
 Your weight goes up or down by 2
pounds during 1 day.
 Your weight goes up or down by 5
pounds during 1 week (7 days).
 You have any of these signs of
infection
○ Pus (may be thick yellow drainage
with a bad smell).
○ Warmth.
○ Pain or soreness.
○ Redness.
○ Temperature higher than 100.5 θ F

Are there special precautions for patients
who have had a heart valve replaced?
 Take antibiotics before any dental
work (cleaning), surgery, or major
tests. Your dentist or doctor can
order these for you. Always take
them before your visit.
 Watch for signs of infection. It is
possible to have an infection around
your heart valve (bacterial
endocarditis). If you notice any
signs of infection, call your local
doctor right away. Signs and
symptoms may include:
o Chills, then heavy sweating.
o Temperature greater than
101°F.
o Lack of hunger and weight
loss.
o Fatigue and weakness.
o Joint pain.






5

What are the contact phone numbers?
 The phone numbers for the surgeons’ offices during business hours (weekdays 8:00 am
to 4:30 pm):
o Dr. Takushi Kohmoto 608-262-3858
o Dr. Lucian Lozonschi 608-262-3858
o Dr. Nilto DeOliveira 608-263-6311
o Dr. Satoru Osaki 608-263-0439
o Dr. Paul Tang 608-263-6551

 After hours/weekends/holidays, call 608-262-0486. This will get you the paging
operator. Ask for the cardiac surgery resident or physician assistant on call. Leave
your name and phone number with an area code. The physician or physician’s assistant
will call you back.

 If you live out of the area, please call 1-800-323-8942 to reach the paging operator.

 For questions about appointments, please call the Cardiology Clinic at 608-263-1530
during business hours (weekdays 8:00 am to 4:30 pm).

















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#7248