1. Post-OpInfo
Althougheveryonerecoversatadifferentrate,you'll needaboutsix toeightweeksof healingbefore
youcan go back to yournormal routine.If youhave undergone BeatingHeartBypassSurgeryand/or
endoscopicveinharvestingduringyourbypasssurgery, youmayfindyourrecoverytobe quicker.
Duringthat time,keepintouchwithyourdoctor andfollow hisorher instructions.The followingpost
op instructionare providedforyourreview.
• General PostOperative Instructions
•Valve SurgeryPostOperative Instructions
• Gettingthe FamilyInvolved
•Sex afterSurgery
General Post-OperativeInstructions
Many questionsarise astowhat youshoulddoor shouldnotdoafterdischarge.The followingare
answerstothe mostcommonconcernsand questions.
•While the sternum(breastbone) ishealing,avoidliftinggreaterthan10 pounds,orpushing/pulling
activitieswithyourarms. The breastbone takesabout6-8 weekstoheal generally.
•Showersare permittedbuttubbathsare discouragedfor4-6 weeksoruntil yourincisionsare healed.
Avoidextremelyhotwaterwhichmaycause youto feel dizzyorweak.Youmaygentlywash(don'trub)
your incisionwithsoap.Donotuse creamsor lotionsonincisionsuntil theyare healed.
•Avoiddrivingacar for4-6 weeksaftersurgery.Yourreactiontime will be delayeddue toweakness,
fatigue,and/ormedication.Youdonotwant to riskhittingthe steeringwheel andre-injuringthe
sternum.Whenridingina car for longdistances,stopevery1-2hoursto stretch yourlegs.Thiswill
improve circulationinyourlegsandhelppreventswelling.
•Do not cross yourlegswhile lyinginbedorsitting.Thisputspressure onthe veinsunderthe kneesand
slowsbloodflow.If yourlegsorfeetswell,youshouldputthemona chair or stool while sitting.
•Sleepthe numberof hoursthat younormallysleptbeforeyoursurgery.Donotstay up verylate one
nightand try to "catch-up"the next.However,if youdoplantostay up late,take a nap beforehand.
•Avoid isometrics: strainingtomove yourbowels,pushing/pullingheavyobjects,orworkingwithyour
arms overhead.These activitiesdisproportionatelyelevate bloodpressure andputan addedstrainona
healingheart.
•It is importanttospace and pace youractivitiesto minimize fatigue.If youfeel tired,STOP,andrestfor
a while.Don'tpushyourself tofinishatask.

2. •A rest periodshouldbe takenatleastonce a day fora few weeksand,initially,preferablytwice,
morningandafternoon.Nappingisnotnecessary,butrestingis.Be sure todressdailyinstreetclothes.
You are onyour wayto recovery!
•Stair climbingisnotdiscouraged.Avoidpullingyourself upwithahandrail,andgo slowly.
•Use your elasticstockingsduringthe dayandremove thematnight.You shouldwearthe stockingsfor
at least2 weeksafterdischarge ormore if youranklesare still swollen.The stockingsaidbloodflowand
helpreduce swellinginthe legs.Itiseasiesttoputthe stockingsonbefore yougetoutof bedinthe
morningforthe day, howevermostpeopleputthemonaftera morningshower.Theyshouldfitsnugly.
•Your may notice a swellingorlumpat the top of your chestincisionwhichcouldtake severalmonthsto
disappear.
•Most patientsexperience incisionaldiscomfort inthe sternum.Thisdiscomfortwill decrease intime,
but mayreoccur whenthere isas an adverse change inthe weatherorwhenyouoverextendyourself.
Do not hesitate touse painrelievingmedicationasyouneedit.
•It is importanttodistinguishincisional discomfortfromchestpain(angina) youmayhave experienced
priorto surgery.Contact yourphysicianif youare experiencingchestpain.
•If yourchest or legincisionsdonotappeartobe healing(i.e.,redness,drainage,swelling,or
tenderness ispresent),notifyyourphysician.
•Take yourtemperature everymorningforone weekafterdischarge.Notifyyourphysicianif your
temperature staysabove 100 degreesFfor more thana day.
•Checkyour weighteverymorningforthe firsttwoweeks.If younotice asuddenweightgain,notify
your physician.
•Whenyou are upset,yourheartworksharder.It isbestto anticipate andavoidsituations,people,or
topicsof conversationthatmake youtense orangry.
•Rememberthatyourdiet,medications,andexercise are prescribedspecificallyforyou.Donot expect
your friendorneighborwhohasa heartconditiontohave the same prescriptions.
•Keepa recordof yourmedicationsandmedical historywithyouwhentraveling. (ReturntoTop)
Valve SurgeryPost-OpCare
Tell anydoctor or dentistwhotreatsyouthat youhave had your valve repairedorreplaced.Theymay
prescribe antibioticsbefore procedures,especiallydental work,topreventaninfectionfromsettlingin
your heart.
It islikelythatyouwill be takingCoumadin,ananticoagulant,commonlycalleda"bloodthinner."
Coumadincausesbloodtotake a longertime toform a clot.

3. There are several pointsyoushouldknow aboutCoumadin:
•You will need regularbloodtests(prothrombintime) toregulate the dosage of Coumadin.Your
physicianwill arrange these testforyou.
•Look for signsof bleedingwhileyouare takingCoumadin.Notifyyourphysicianif youhave:◦any
abnormal bleeding
◦red or black bowel movements
◦pinkor red urine
◦severe headaches,abdominalorlowerbackpain
◦faintnessordizziness
◦red or "coffee groundlike"vomitus
◦excessivebruising
◦excessivenose bleeds
◦yelloworjaundice skin
◦any symptomsthatconcernyou
•Take yourCoumadinat the same time everyday.NEVERmake up fora misseddose bytakingdouble
the dose.
•Don't take aspirin,anymedicationcontainingaspirinorany"over-the-counter"medicationswithout
firstcheckingwithyourphysicianasthiscan cause bleedingwhiletakingCoumadin.
•Excessive alcohol intakemayalsocause bleedingwhile takingCoumadin.Checkwithyourphysician
aboutdrinkingalcohol.
•It is a goodideato carry a walletidentificationcardindicatingthatyouare takingCoumadin. (Return
to Top)
RecoveringfromOpenHeartSurgeryisa FamilyAffair
Openheartsurgeryis an eventthataffectsthe patient,spouse,children,andsignificantothers.Itis
similartothe ripple effectinapondwhena stone isdropped.Manywavesoccur before the pond
eventuallycalms.Inadditiontothe physical recoverythatthe patientundergoes,there isanemotional
aspectof adjustmentthatthe patient,aswell asfamily,experience.

4. Facing the possibilityof changingone'slifestyle canbe quite overwhelming.Some alterationstake place
immediately,suchasdiet changesandsmokingcessation.Otherchangesmaybe more gradual,suchas
buildinguptoand maintaininganexercise program, orincorporatinglongtermstressmanagement.Of
importance toall those involvedisrealizingthatthe patientdoeshave control ininitiatingthe changes
and inmaintaininghealthynewhabits.Thisisthe patient'sresponsibility.Spouses,children,and
significantothersoftenstruggle withthe impossible taskof makingsure the patientneverdeviatesoff
course and stayson the "straightand narrow'.Remember,otherscanassistandencourage,butonlythe
patientcan do!
Many lifestyle changesthatoccuras a resultof havingopenheartsurgeryhave a directimpacton the
entire household.Whenapatientisforcedtomake changesforhealthreasons,veryoftenall minds
start to thinkalongthe same lines.Thisisespeciallytrue forotherswhomightpossiblybe predisposed
to coronary arterydisease.Therefore,if the recoveringpatienthasstoppedsmoking,familymembers
whosmoke are nowmotivatedtoquit.Andwhenmealsnow needtobe preparedinaheart-healthy
fashion,chancesare those whodine togetherwillalsobe makingthese changesoutof practicalityfor
the cook resultingfromarenewedawarenessof the benefitsto the heart.
Recoveringfromopenheartsurgerycreatestemporaryrole changesandresponsibilityshiftsamong
familymembers.Whenthe recoveringpatientreturnshome,he/she will have temporaryphysical
limitationsanddependencieswhichthe familymemberscompensate.The husbandwill needtoshop
and carry packagesfor hisrecoveringwife whocanneitherdrive herself tothe store norliftheavy
packages.The son or daughterwill have tomow the lawnand take outthe garbage for theirrecovering
father, whonowhas to limitexertionwhile he rebuildshisstrength.
Justas the familyneedstocoordinate effortsinassistingthe patientduringhislimitationphase,so
shouldtheyenable himtoincrease hisindependence andregainhislevelof self reliance.Thisprovesto
be a verydelicate balance andcanbe a cause of friction.Stayinginformedof the doctors
recommendationsonhowthe patientshouldprogresscanminimize the stressof thistransitional period
for boththe patientandfamily.
Recovery will be achallenge forthe openheartsurgerypatientandhis/herfamily.There willbe daysof
highenergyandof fatigue,accomplishments,momentsof temptation,feelingsof exuberance andeven
daysof feelingblue orangry,all of whichare a part of the physical andemotional healingprocessthat
takesplace.