The first phase of recovery after heart surgery can last from 4 to 8 weeks. When the patient leaves the hospital, the doctor strongly recommends following the instructions for postoperative rehabilitation. If they are performed, the physical and emotional condition sick.
The support of loved ones plays an important role. After the operation, the patient is in no hurry, needs outside help and is emotionally unstable. The understanding and patience of loved ones will create a comfortable environment for the patient.
It is necessary to monitor the condition of the seams; they must be clean and dry.
Contact your doctor if you have any signs of infection, including:
- More drainage or seepage than usual
- The edges are moving apart
- Redness around the cut
- Heat
- You should also consult a doctor if you feel cracking or other significant chest discomfort when moving.
Pain relief
Your doctor will likely prescribe pain relievers before leaving the hospital.
Some discomfort around the incision and in your muscles—including itching, tightness, and numbness along the incision—is normal. But it shouldn't hurt as much as it did before the surgery.
Diet
Choice healthy food helps the healing process.
Rehabilitation after heart surgeryrequires focusing on a healthy diet. This will help the body heal, reduce the risk of complications and enable the patient to recover faster. Many studies have shown that a diet rich in fruits, vegetables, nuts and seeds can reduce the risk of heart disease.
Appetite may decrease noticeably, and food may lose its usual taste. The patient may also experience a strange metallic taste in the mouth. This is usually caused by surgery or related to medications. For full recovery may take 3 months. It is recommended to eat small portions frequently.
A healthy diet provides the body with plenty nutrients- such as vitamins, minerals, antioxidants and dietary fiber.
The diet should include:
- Meat and/or meat alternatives such as eggs, tofu, legumes and nuts;
- Fish – 2 dishes from oil fish per week, such as salmon, mackerel or sardines will help you get plenty of healthy omega-3 fats;
- Wholemeal bread or crackers, brown rice, wholemeal pasta, quinoa, barley, rye, couscous;
- Dairy products - preferably low fat;
- Healthy fats – small amounts of healthy fats and oils from nuts, seeds, avocados and fatty fish;
- Water – Avoid sugary soft drinks and alcohol.
The goal is to consume 2 meals of fruit, 5 meals of vegetables, and 4 or more meals of whole grains - depending on your energy needs.
More tips to help you eat well:
- Reduce salt intake - use as little salt as possible when cooking as this will help reduce blood pressure and helps prevent fluid retention;
- Avoid sugary foods - they are often eaten as a substitute for healthy foods and can contribute to weight gain.
If your appetite does not return within a few weeks, you should tell your doctor.
Emotional condition
Usually after heart surgery the patient is sad or in a depressed state, but these feelings should go away after the first few weeks.
To improve your mood:
- Walk daily;
- Devote time to hobbies and social activities;
- Talk openly about your feelings to loved ones;
- Sleep well.
Sex after surgery
In the first two weeks after heart surgery, most people undergo high risk heart problems during sex as a result of increased heart rate and blood pressure. However, this risk becomes significantly less by six weeks after surgery.
During recovery after heart surgeryYou may experience occasional chest pain, abnormal heart rhythms (arrhythmias), or heart failure, which increase your risk of heart problems during sex. People in these risk groups need additional assessment/or treatment before attempting sex.
The doctor will assess the patient's condition and advise when it is safe to resume intimate relationships.
Sexual problems
The patient may experience decreased sexual activity and desire. Various factors can contribute, including side effects medications, depression and fears about triggering another heart attack or death. You shouldn't worry about decreased sexual interest after full recovery body, the previous sex life will return.
Physical exercise
Since it takes 6-8 weeks to sternum healed after heart surgery, you need to slowly return to your normal activities.
When can you resume daily activities:
- Driving. Do not drive for 4-6 weeks unless advised by your doctor as concentration, reflex time and vision are often affected within 6 weeks.
- Sex. Sex requires about the same amount of energy as walking up two flights of stairs, as a rule, the patient is ready to return to this from about the 3rd week (loss of interest in sexual activity for a while is normal, however, the patient should return to normal life in 3 months).
- Job. The patient can return to work as soon as concentration, confidence and physical ability allow. Usually returning to an office job (or any other without physical and psychological stress) perhaps in 3 months, for work involving hard work - in six months.
- Housework. You should start with the things that the patient likes to do most and which are easy for him: cooking, caring for flowers, cleaning, scrubbing, washing. Heavier work is not recommended.
Rest and sleep
Postoperative period after heart surgerymay be accompanied by sleep problems, but after 3 months the sleep pattern should return.
If pain bothers you, you will need to take medications about half an hour before bedtime. You also need to arrange a comfortable bed, perhaps listening to relaxing music before bed will help the patient.
Call your doctor if your sleep begins to affect your mood or behavior.
Taking medications
Most patients after surgery need drug therapy. The medication must be taken strictly according to the regimen prescribed by the doctor; unauthorized termination of treatment is unacceptable. If you miss a dose, do not increase the dose next time. To eliminate omissions, you can create a schedule and mark each action on it. It wouldn't hurt to know side effects, indications for use and other features of each drug.
It is not allowed to take other medications not prescribed by a doctor without his consent. It is recommended that you carry a list of medications with you in your wallet at all times. This will come in handy if the patient goes to a new doctor, gets injured in an accident, or loses consciousness outside the home.
When to see a doctor
The good news is that complications from heart surgery are not common. If you experience any of the following symptoms, you should consult a doctor because this may indicate a heart problem:
- Persistent chest pain that is not related to stitches (angina is rare but possible);
- Arrhythmia;
- Heat;
- Chills;
- Rapid weight change (more than 2 kg in 24 hours);
- dizziness or fainting;
- Excessive fatigue or weakness;
- Severe shortness of breath or shortness of breath that gets worse;
- Nausea and vomiting;
- Weight loss or change in appetite;
- Sore throat.
Aftercare has great importance because people who have had heart surgery have a significantly increased risk of heart complications, including recurrent chest pain, heart attack, heart failure and increased risk of death. The risk of these problems is significantly reduced by carefully following your doctor's recommendations. Over time, your treatment plan may change as your heart health improves.
What awaits you after heart surgery? What loads are permissible and when? How will the return to normal life take place? What should you pay attention to in the hospital and at home? When can I return to full health? sex life, when will you be able to wash your car yourself? What and when can you eat and drink? What medications should I take?
All answers are in this article.
After heart surgery, you may feel like you've been given another chance—a new lease on life. You may think that you will be able to make the most of your “new life” and make the most of the results of the operation. If you have had coronary artery bypass surgery, it is important to consider lifestyle changes, such as losing 5 kilograms or starting regular exercise. physical exercise. This should be taken seriously and you should talk to your doctor about your risk factors. There are books about health and cardiovascular diseases, they should be guides to your new life. The days ahead will not always be easy. But you must move forward steadily towards recuperation and recovery.
In the hospital
In the inpatient department, your activity will increase every day. In addition to sitting on a chair, walking around the ward and in the hall will be added. Deep breathing to clear the lungs and exercises for the arms and legs should continue.
Your doctor may recommend wearing elastic stockings or bandages. They help blood return from the legs to the heart, thereby reducing swelling of the legs and feet. If the femoral vein was used for coronary artery bypass grafting, slight swelling of the legs during the recovery period is quite normal phenomenon. Raising your leg, especially when you are sitting, helps lymphatic and venous blood flow and reduces swelling. When lying down, you should take off your elastic stockings 2-3 times for 20-30 minutes.
If you get tired easily, taking frequent breaks from activity is part of recovery. Feel free to remind your family and friends to keep visits short.
Muscle pain and brief pain or itching in the wound area may occur. Laughter or blowing your nose can cause short-term but noticeable discomfort. Rest assured - your sternum is sewn very securely. Pressing a pillow to your chest can help reduce this discomfort; use it when you cough. Don't hesitate to ask for painkillers when you need them.
You may sweat at night, even though your temperature will be normal. These night sweats are normal for up to two weeks after surgery.
Possible pericarditis - inflammation of the pericardial sac. You may feel pain in your chest, shoulders, or neck. Typically, your doctor will prescribe you aspirin or indomethacin for treatment.
Some patients experience abnormal heart rhythms. If this happens, you will have to take medication for a while until the rhythm is restored.
In patients after surgery open heart Mood swings are common. You may be in a joyful mood immediately after surgery, but become sad and irritable during the recovery period. A sad mood and outbursts of irritability cause anxiety in patients and loved ones. If emotions become a problem for you, talk to your nurse or doctor about it. It has been established that mood swings are a normal reaction, even if they continue for several weeks after discharge. Sometimes patients complain of changes in mental activity - it is harder for them to concentrate, their memory weakens, and their attention is distracted. Don't worry - these are temporary changes and should disappear within a couple of weeks.
At home. What to expect?
You are usually discharged from the hospital on the 10-12th day after surgery. If you live more than an hour's drive from the hospital, take breaks every hour while traveling and get out of the car to stretch your legs. Prolonged sitting impairs blood circulation.
Although your recovery in the hospital was probably fairly rapid, your recovery at home will be slower. It usually takes 2-3 months to fully return to normal activity. The first few weeks at home can be challenging for your family too. Your loved ones are not used to the fact that you are “sick”; they have become impatient, and your mood may fluctuate. Everyone needs to try to make this period go as smoothly as possible. It will be much easier to cope with the situation if you and your family can openly, without reproaches or showdowns, talk about all your needs, and join forces to overcome critical moments.
Meetings with a doctor
It is necessary that you be observed by your regular attending physician (general practitioner or cardiologist). Perhaps the surgeon will also want to meet with you after discharge after one or two weeks. Your doctor will prescribe a diet and medications and determine the permissible loads. If you have any questions regarding the healing of post-surgical wounds, please contact your surgeon. Before you leave, find out where to go if you have any possible situations. See your doctor immediately after discharge.
Diet
Because you may initially experience loss of appetite, good nutrition has important While your wounds are healing, you may be discharged home on an ad libitum diet. After 1-2 months, you will most likely be advised to eat a diet low in fat, cholesterol, sugar or salt. If you are overweight, calories will be limited. A good diet for most heart diseases limits cholesterol, animal fats and foods high in sugar. It is advisable to eat foods high in carbohydrates (vegetables, fruits, sprouted grains), fiber and healthy vegetable oil.
Anemia
Anemia (anemia) is a common condition after any surgical intervention. It can be eliminated, at least partially, by eating foods rich in iron, such as spinach, raisins or lean red meat (the latter in moderation). Your doctor may recommend taking iron tablets. This medicine can sometimes irritate your stomach, so it's best to take it with food. Please note that this may discolor the stool. dark color and cause constipation. Eat more fresh vegetables and fruits and you will avoid constipation. But if constipation becomes persistent, ask your doctor to help with medications.
Wound and muscle pain
Discomfort due to pain in the postoperative wound and muscles may persist for some time. Sometimes pain-relieving ointments help if you massage the muscles with them. The ointment should not be applied to healing wounds. If you feel clicking movements of the sternum, notify your surgeon. Itching in the area of a healing wound is caused by hair regrowth. If your doctor allows it, a moisturizing lotion will help in this situation.
Contact your doctor if you notice following symptoms infections:
- temperature above 38°C (or less, but lasting more than a week),
- wetting or discharge of fluid from postoperative wounds, persistent or new appearance of swelling, redness in the area of the postoperative wound.
Shower
If the wounds heal, no open places and getting wet, you can decide to shower 1-2 weeks after surgery. Use plain warm soapy water to clean the wounds. Avoid bubble baths, very hot water and very cold water. When you wash for the first time, it is advisable to sit on a chair while showering. Gently touching (not wiping, but blotting), dry postoperative wounds soft towel. For a couple of weeks, try to have someone nearby when you bathe or shower.
General guidelines for home practice
Gradually increase your activity every day, week and month. Listen to what your body is saying; rest if you are tired or have shortness of breath or feel chest pain. Discuss the instructions with your doctor and consider any comments or changes made.
- If prescribed, continue to wear elastic stockings, but remove them at night.
- Schedule rest periods throughout the day and get a good night's sleep.
- If you are having trouble sleeping, it may be due to your inability to get comfortable in bed. Taking a painkiller pill at night will help you rest.
- Continue training your arms.
- Shower if the wounds are healing normally and there are no weeping or open areas on the wound. Avoid very cold and very hot water.
First week at home
- Walk on level ground 2-3 times a day. Start with the same time and distance as in last days in the hospital. Increase your distance and time, even if you have to stop for a short rest a couple of times. You can do 150-300 meters.
- Take these walks at the most convenient time of day (this also depends on the weather), but always before meals.
- Choose a quiet, non-tiring activity: draw, read, play cards or do crossword puzzles. Active mental activity is beneficial for you. Try walking up and down the stairs, but don't do it frequently.
- Travel with someone for a short distance in a car.
Second week at home
- Lift and carry light objects (less than 5 kg) for short distances. Distribute the weight evenly on both hands.
- Gradually return to sexual activity.
- Do light housework such as dusting, setting the table, washing dishes, or helping with cooking while sitting.
- Increase your walking to 600-700 meters.
Third week at home
- Do household chores and yard work, but avoid strain and long periods of bending or working with your arms raised.
- Start walking longer distances - up to 800-900 meters.
- Accompany others on short shopping trips by car.
Fourth week at home
- Gradually increase your walks to 1 km per day.
- Lift items up to 7 kg. Load both hands equally.
- If your doctor allows, start driving for short distances yourself.
- Do daily activities such as sweeping, briefly vacuuming, washing the car, cooking.
Fifth - eighth week at home
At the end of the sixth week, the sternum should have healed. Continue to continually increase your activity. Your doctor will order a stress test approximately six to eight weeks after surgery. This test will establish adaptation to stress and will serve as a basis for determining the extent of the increase in activity. If there are no contraindications and your doctor agrees, you can:
- Continue to increase your walking distance and speed.
- Lift things up to 10 kg. Load both hands equally.
- Play tennis, swim. Tackle the lawn, weed, and shovel in the garden.
- Move furniture (light objects), drive a car over longer distances.
- Return to work (part-time) if it does not involve heavy physical labor.
- At the end of the second month, you will probably be able to do everything you did before the operation.
If you were working before surgery but have not returned yet, now is the time to do so. Of course, it all depends on your physical condition and type of work. If the work is sedentary, you can return to it faster than heavy physical work. A second stress test may be performed three months after surgery.
Sex after surgery
Patients often wonder how the surgery will affect sexual relations and are reassured to learn that most people gradually return to their previous sexual activity. It is recommended to start small - hugs, kisses, touches. Transition to a full-fledged sex life only when you stop being afraid of physical discomfort.
Sexual intercourse is possible 2-3 weeks after surgery, when you are able to walk 300 meters at an average speed or climb one floor of stairs without chest pain, shortness of breath or weakness. The heart rate and energy expenditure during these activities are comparable to the energy expenditure during sexual intercourse. Certain positions (such as on your side) may be more comfortable at first (until the wounds and sternum are completely healed). It is important to rest well and be in a comfortable position. For sexual activity, it is recommended to avoid the following situations:
- Being overly tired or excited;
- Have sex after drinking more than 50-100 grams of strong alcoholic drink;
- Overload with food during the last 2 hours before the act;
- Stop if chest pain occurs. Some shortness of breath is normal during sexual intercourse.
Taking medications
Many patients after surgery need drug treatment. Take medications only as prescribed by your doctor and never stop taking them without consulting your doctor. If you forget to take a pill today, don't take two at once tomorrow. It is worth keeping a medication schedule and marking each dose on it. You should know the following about each of the prescribed medications: name of the drug, purpose of action, dose, when and how to take it, possible side effects.
Keep each medicine in its container and out of the reach of children. Do not share medications with other people because they may be harmful to them. It is recommended that you carry a list of your medications with you in your wallet at all times. This will come in handy if you go to a new doctor, get injured in an accident, or pass out outside your home.
Medicines to prevent blood clots (blood clots)
Antiplatelet agents
These bad cholesterol-lowering pills can reduce triglycerides and increase good cholesterol. Should be taken after dinner.
- Eat fruits and vegetables more often. Try to always have them at hand (in the car, at your desk).
- Eat lettuce, tomatoes, cucumbers and other vegetables with every meal.
- Try adding one new vegetable or fruit each week.
- For breakfast, eat porridge with bran (for example, oatmeal) or dry breakfast (muesli, cereal).
- At least twice a week, eat sea fish for lunch.
- Use vegetable oil, preferably olive.
- Instead of ice cream, eat frozen kefir yogurt or juice.
- For salads, use diet dressings and diet mayonnaise.
- Instead of salt, use garlic, herbal or vegetable spices.
- Watch your weight. If yours is high, try to reduce it, but no more than 500-700 grams per week.
- More movement!
- Monitor your cholesterol levels.
- Only positive emotions!
Cardiovascular diseases, unfortunately, occupy one of the first places in mortality in our country. But cardiology does not stand still, but is constantly improving. New treatment methods are constantly emerging in this area and the latest technologies are being introduced. Naturally, people suffering from severe heart disease are interested in all the innovations in cardiology, and therefore different ways surgical interventions.
When is cardiac surgery used?
Absolutely not any disturbance in cardiac activity entails surgical intervention. There are very clear criteria on which the attending physician relies when recommending this or that cardiac operation. Such indications may be:
- Significant and rapidly progressive deterioration of the patient's condition associated with chronic heart failure.
- Acute conditions, life threatening sick.
- Extremely low efficiency of simple drug treatment with obvious dynamics towards a deterioration in general condition.
- The presence of advanced cardiac pathologies that developed against the background late treatment to a doctor and lack of adequate treatment.
- both congenital and acquired.
- Ischemic pathologies leading to the development of heart attack.
Types of heart surgery
Today, there are many different surgical procedures on the human heart. All these operations can be divided according to several basic principles.
- Urgency.
- Technique.
Operations varying in urgency
Any surgical intervention will fall into one of the following groups:
- Emergency operations. The surgeon performs such heart operations if there is real threat patient's life. This could be sudden thrombosis, myocardial infarction, incipient aortic dissection, or cardiac injury. In all these situations, the patient is sent to the operating table immediately after diagnosis, usually even without further tests and examinations.
- Urgent. In this situation there is no such urgency, clarifying examinations can be carried out, but the operation cannot be postponed either, as a critical situation may develop in the near future.
- Planned. After long-term observation by the attending cardiologist, the patient is referred to the hospital. Here he undergoes all the necessary examinations and preparation procedures before surgery. The heart surgeon clearly sets the time for the operation. If problems arise, such as a cold, it can be postponed to another day or even a month. There is no threat to life in such a situation.
Differences in technique
In this group, all operations can be divided into:
- With an opening of the chest. This classic method, which is used in the most severe cases. The surgeon makes an incision from the neck to the navel and opens chest fully. This gives the doctor direct access to the heart. This manipulation is performed under general anesthesia and the patient is transferred to the artificial circulation system. As a result of the fact that the surgeon works with a “dry” heart, he can eliminate even the most severe pathologies with minimal risk of complications. TO this method resort when there are problems with coronary artery, aorta and others main vessels, with strong atrial fibrillation and for other problems.
- Without opening the chest. This type of surgery belongs to the so-called minimally invasive techniques. There is absolutely no need for open access to the heart. These techniques are much less traumatic for the patient, but they are not suitable in all cases.
- X-ray surgical technique. This method in medicine is relatively new, but it has already proven itself very well. The main advantage is that after these manipulations the patient recovers very quickly and complications occur extremely rarely. The essence of this technique is that a device similar to a balloon is inserted into the patient using a catheter to dilate the vessel and eliminate its defect. This entire procedure is carried out using a monitor and the progress of the probe can be clearly controlled.
Difference in the amount of assistance provided
All surgical procedures in people with heart problems can be divided both by the volume and direction of the problems being eliminated.
- The correction is palliative. Such surgical intervention can be classified as auxiliary techniques. All manipulations will be aimed at bringing blood flow back to normal. This may be the final goal or preparation of the vessel for further surgical procedures. These procedures are not aimed at eliminating the existing pathology, but only eliminating its consequences and preparing the patient for full treatment.
- Radical intervention. With such manipulations, the surgeon sets himself the goal of completely eliminating the developed pathology if possible.
Most frequently performed heart surgeries
People with problems of the cardiovascular system are often interested in what types of heart surgeries there are and how long they last. Let's look at some of them.
Radiofrequency ablation
Quite a large number of people have problems with a violation in the direction of its increase - tachycardia. IN difficult situations Today, cardiac surgeons offer radiofrequency ablation or “cauterization of the heart.” This is a minimally invasive procedure that does not require an open heart. It is performed using x-ray surgery. The pathological area of the heart is exposed to radiofrequency signals, which damage it, and therefore eliminate the additional path along which the impulses pass. Normal pathways, at the same time, are completely preserved, and the heart rhythm gradually returns to normal.
Coronary artery bypass grafting
With age or due to other circumstances, arteries may develop atherosclerotic plaques, which narrow the lumen for blood flow. Thus, the flow of blood to the heart is greatly impaired, which inevitably leads to very disastrous results. In the event that the narrowing of the lumens reaches critical condition, surgery recommends coronary artery bypass surgery to the patient.
This type of operation involves creating a bypass path from the aorta to the artery using a shunt. The shunt will allow blood to bypass the narrowed area and normalize blood flow to the heart. Sometimes it is necessary to install not one, but several shunts at once. The operation is quite traumatic, like any other, performed during the opening of the chest and lasts a long time, up to six hours. Coronary artery bypass surgery is usually performed on an open heart, but today it is gaining more and more popularity alternative methods– coronary angioplasty (insertion of an expanding balloon through a vein) and stenting.
Like the previous method, it is used to increase the lumen of the arteries. It is classified as a minimally invasive, endovascular technique.
The essence of the method is to insert an inflating balloon in a special metal frame into the artery into the pathology zone, using a special catheter. The balloon inflates and opens the stent - the vessel also expands to required sizes. Next, the surgeon removes the balloon; the metal structure remains, creating a strong frame for the artery. Throughout the procedure, the doctor monitors the progress of the stent on the X-ray monitor.
The operation is practically painless and does not require long and special rehabilitation.
Heart valve replacement
With congenital or acquired pathology of the heart valves, the patient is often indicated for their replacement. Regardless of what type of prosthesis will be installed, surgery most often takes place on an open heart. The patient is put to sleep under general anesthesia and transferred to a cardiopulmonary bypass system. Taking this into account, the recovery process will be long and fraught with a number of complications.
An exception to the procedure for heart valve replacement is the replacement of the aortic valve. This procedure can be performed using a gentle endovascular method. The surgeon inserts a biological prosthesis through the femoral vein and places it in the aorta.
Operations Ross and Glenn
Heart surgery is often performed on children diagnosed with congenital defects of the cardiac system. The most frequently performed operations are the Ross and Glenn techniques.
The essence of the Ross system is to replace aortic valve on the patient's own pulmonary valve. The biggest advantage of such a replacement is that there will be no risk of rejection, like with any other valve taken from a donor. In addition, the fibrous ring will grow with the child’s body and can last him a lifetime. But, unfortunately, an implant must be placed in place of the removed pulmonary valve. The important thing is that an implant in place of the pulmonary valve lasts much longer without replacement than a similar one in place of the aortic valve.
Glenn's technique was developed for the treatment of children with pathologies of the circulatory system. This is a technology that allows you to create an anastomosis to connect the right pulmonary artery and the superior vena cava, which normalizes the movement of blood flow through the systemic and pulmonary circulation.
Despite the fact that surgery significantly prolongs the patient's life and improves its quality, it is still mostly a last resort.
Any doctor will try to do everything possible to ensure that the treatment is conservative, but, unfortunately, sometimes this is completely impossible. It is important to understand that any surgical intervention on the heart is a very difficult procedure for the patient, and it will require high-quality rehabilitation, sometimes quite long.
Rehabilitation time
Rehabilitation after heart surgery is a very important stage in the treatment of patients.
The success of the operation can only be judged after completion, which can last quite a long time. This is most true for patients who have undergone open-heart surgery. Here it is extremely important to follow the doctors’ recommendations as closely as possible and have a positive attitude.
After surgery to open the chest, the patient is discharged home after about a week or two. The doctor gives clear instructions for further treatment at home - they are especially important to do.
Ride home
Already at this stage, it is important to take measures so that you do not have to return back to the hospital urgently. It is important to remember here that all movements should be as slow and smooth as possible. If the journey takes more than one hour, you need to periodically stop and get out of the car. This must be done to avoid stagnation of blood in the vessels.
Relationships with family
Both relatives and the patient need to understand that people who have suffered heavy operations under general anesthesia, they are extremely prone to irritability and mood swings. These problems will pass over time, you just need to treat each other with maximum understanding.
Taking medications
This is one of the most important points in life after heart surgery. It is important for the patient to always have everything with him necessary medications. It is especially important not to be excessively active and not to take medications that are not prescribed. In addition, you should not stop taking medications prescribed by your doctor.
Seam care
The patient should calmly accept the temporary feeling of discomfort in the suture area. At the beginning it may be painful sensations, feeling of tightness and itching. To relieve pain, your doctor may prescribe painkillers; to relieve other symptoms, you can use special ointments or gels, but only after consultation with a surgeon.
The seam should be dry, without excessive redness or swelling. This needs to be monitored closely. The seam area must be constantly treated with brilliant green, and the first water procedures allowed to be taken after about two weeks. Such patients are only allowed to shower, and to take baths and sharp changes temperatures are contraindicated. It is recommended to wash the seam only with ordinary soap and gently blot it with a towel.
In a situation where the patient’s temperature rises sharply to 38 degrees, severe swelling with redness at the suture site, fluid secretion is observed or is disturbing severe pain, you need to urgently consult a doctor.
It is important for a person who has undergone heart surgery to set a goal for maximum recovery. But the main thing here is not to rush, but to do everything gradually and very carefully.
In the first days after returning home, you need to try to do everything as smoothly and slowly as possible, gradually increasing the load. For example, in the first days you can try to walk from one hundred to five hundred meters, but if fatigue appears, you should rest. Then the distance must be gradually increased. It's best to walk on fresh air and on flat terrain. After a week of starting walks, you should try to climb 1-2 flights of stairs. At the same time, you can try to do simple work around the house.
After about two months, the cardiologist will test the healing of the sutures and give permission to increase physical activity. The patient may begin to swim or play tennis. He will be allowed to do light gardening work with light lifting. The cardiologist should conduct another test in three to four months. By this time all the main motor activity it is desirable for the patient to recover.
Diet
This aspect of rehabilitation also needs to be paid close attention.
The first time after surgery, the patient quite often has no appetite and at this time any restrictions are not very relevant. But over time, the person recovers and his desire to eat familiar foods is restored. Unfortunately, there are a number of strict restrictions that will now always have to be observed. You will have to greatly limit fatty, spicy, salty and sweet foods in your diet. Cardiologists advise what you can eat after heart surgery - vegetables, fruits, various cereals, fish and lean meat. It is extremely important for such people to monitor their weight, and therefore the calorie content of their food.
Bad habits
Patients who have undergone heart surgery are, of course, strictly prohibited from smoking and drinking narcotic drugs. Drinking alcohol on rehabilitation period also prohibited.
Life after surgery can become full and rich. After going through a period of rehabilitation, many patients return to life without pain, shortness of breath and, most importantly, fear.
How to conduct it correctly postoperative period, what to be prepared for and what to fear.
Heart surgery is a chance for successful continuation of normal full life. The realization of this chance largely depends on a properly conducted postoperative period. It will not be easy for the patient and his family at first, but if everything is done correctly, the result will exceed all expectations. Main principle- do not make sudden movements: all “pre-operative” activity will have to be restored calmly and slowly.
Emotions
Mood swings after cardiac surgery Almost everyone has an open heart. Joyful excitement after recovery from anesthesia is often replaced by depressive irritation. Memory weakens, concentration decreases, and absent-mindedness appears. Neither the patient nor his relatives need to worry about this. These symptoms usually go away within a month after surgery.
Home!
Usually you are discharged from the hospital 7-14 days after surgery. The patient must remember that even if everything was successful, it will take him from 2-3 months to a year to fully recover after the operation. You need to start taking care of yourself right outside the hospital. There are many cases where the patient had to be returned by ambulance within 3-6 hours after discharge. If the journey home takes more than an hour, you must stop and get out of the car. Otherwise possible serious problems with blood circulation of blood vessels.
At home, we must try to build relationships in such a way that the postoperative period is as smooth as possible for both the patient and his family members. Family members should treat the patient with understanding and make efforts for his recovery, but this does not mean that their entire life from this period should be subordinated only to him. neither the patient nor his relatives need it.
It is imperative that the patient is constantly monitored by the attending physician after discharge - a family doctor, internist or cardiologist.
What (not) is
Immediately after the operation, the appetite is most likely not very good, and healing of physical and mental wounds requires good nutrition. Therefore, it is possible that for 2-4 weeks doctors will not set food restrictions at all. However, within a month, serious dietary restrictions will begin - on fats, cholesterol, sugar, salt, and calories. It is advisable to eat food with a high amount of easily digestible carbohydrates (vegetables, fruits, sprouted grains) and fiber. To combat anemia, you will most likely have to eat foods high in iron: spinach, raisins, apples, and moderately lean red meat.
Diet for the rest of your life:
- Lots of vegetables and fruits
- Porridge, possibly with bran, or muesli and cereal for breakfast
- Sea fish as a main course at least 2 times a week
- Fermented yogurt or juice instead of ice cream
- Only dietary dressings, olive oil and mayonnaise for salads
- Herbal and vegetable spices instead of salt
- Reduce weight to normal, but not quickly. 1-2 kilograms lost per month is ideal
- Move!
- Check your sugar and cholesterol regularly
- Smile at life!
Postoperative sutures
There will definitely be discomfort at the incision site after the operation and will only go away with time. When the stitches are overgrown, pain-relieving ointments and moisturizing lotions can be used to relieve discomfort. It is best if the patient consults his surgeon before using any ointments. If you are concerned about the cosmetic consequences of the operation, then it is advisable to see a plastic surgeon immediately after removing the stitches.
With normal healing postoperative sutures, 2 weeks after the operation you can take a shower (not a bath, especially not a jacuzzi!). But at the same time: no expensive shampoos and contrasting changes in water temperature. Wash with plain soap and get wet (do not wipe, but blot with a clean towel). It is best for the first “water procedures” after the operation to be accompanied by someone close to you: you never know what can happen….
You should call your surgeon immediately if you experience the following symptoms:
- temperature above 38°C
- severe swelling and redness of the sutures, discharge of fluid from them
- severe pain at the surgery site
Movement
From the first day after the hospital, you can try to calmly walk 100-500 meters on a flat surface. You need to stop - stop! You should go for a walk when it is convenient and when the weather permits. But not immediately after eating! By the end of the first month after the operation, you can slowly walk 1-2 kilometers.
At the end of the first week of staying at home, you can independently and slowly walk 1-2 flights up and down the stairs. Start wearing light items - up to 3-5 kilograms. If everything went ok with the stairs, you can gradually (!) start thinking O
Light won't hurt Homework: wiping dust, setting the table, washing dishes or helping household members prepare food.
After one and a half to two months, the sutures should heal completely, and then most likely cardiologists will conduct a functional stress test, based on the results of which it will be possible to judge the acceptable rate of increase in motor and psychological activity. Gradually, you can begin to lift and move heavier things, swim, play tennis, and do light (physically) work in the garden and/or office. A repeat test is usually performed 3-4 months after surgery.
Medicines
The most important thing here is complete absence independence. Medicines are always at hand and are taken only as prescribed by a doctor, and are not canceled without his prescription. Special attention- drugs to prevent blood clots, for example aspirin and medications to normalize blood pressure. Do not forget about drugs and dietary supplements that reduce the level bad cholesterol.
Before any significant surgical intervention, and not only on the heart, the patient is overcome by doubts and fears. This condition can be alleviated if you become familiar with the features of the operation in advance. Do not hesitate to ask the doctor and other persons involved in the operation anything that you do not understand.
Almost all open heart surgeries (coronary artery bypass surgery, heart valve replacement, correction birth defects heart, operations for cardiomyopathies, pericarditis) have much in common. Some surgeries (such as heart transplants) are unique and different from others.
The vast majority of surgeries are planned several days or weeks in advance, depending on the patient's condition, personal plans, and the surgeon's plans. The operation can be performed immediately if the patient's condition requires it. If surgery is planned in advance, you can stock up on your own blood in advance in case you need a transfusion during surgery.
A week or two before surgery
If you are planning heart surgery, you can discuss some preliminary preparation issues with your doctor.
- Aspirin or similar medications should be discontinued for ten days before surgery. These medications inhibit platelet function (ie, blood clot formation) and may cause excessive bleeding during surgery. If painkillers or anti-inflammatory medications are needed, acetaminophen (paracetamol, Tylenol, Panadol) is recommended, which does not cause bleeding.
- If the patient constantly takes so-called indirect anticoagulants, then you need to go to the hospital a few days before the planned operation. During this time, anticoagulants long acting will replace short-acting drugs that can be temporarily discontinued during surgery.
- All other medications can continue to be taken until arrival at the hospital, unless the doctor gives special reservations about this.
- If in the last week before the planned operation there are signs of infection (fever, cold, cough, runny nose), then you need to inform your doctor about it.
Preparing for surgery
The patient arrives at the hospital at noon or the evening before the operation, less often - in the morning on the day of the operation.
You need to take a blood test, x-ray, and ECG in advance.
Each hospital has its own method of familiarizing the patient with preparations for surgery. Typically, the surgical team (cardiac surgeon, anesthesiologist, cardiologist) meets with the patient and his family the evening before surgery or the morning of surgery to conduct a short examination and obtain information from the medical history. The patient may be shown a video about the operation and post-operative care for cardiac patients.
Relatives should find out where they can be during the operation and when they can expect to hear first about the progress of the operation. The patient and his relatives will be told about the means of special observation (monitoring) in the ward intensive care, where he will stay for the first few days after surgery.
The doctor will explain what medications you can take before surgery. Taking medications against angina pectoris is, as usual, allowed. After 24 hours on the eve of surgery, the patient should not eat or drink anything, because anesthesia is safer to do on an empty stomach.
Final preparations include shaving hairline on the body from neck to ankles (hair can absorb bacteria) and washing with a special cleaning soap.
Before surgery, sedatives are administered to relieve anxiety. In the preoperative room, a catheter is installed: small and flexible, it is inserted along the needle and left in the vein, and the needle is removed. Anesthetics and other medications are administered through this catheter. The patient is now completely ready for surgery.
Operation
For cardiac surgery they do general anesthesia: This means that the patient is asleep during the operation. Depending on the type of operation, the chest is opened either through the sternum or through the ribs.
During the operation, the function of the lungs and heart is performed by the heart-lung machine. Thanks to this, the surgeon can safely work on a motionless heart.
In a state of anesthesia, breathing occurs through a breathing tube, which is otherwise called endotracheal. This tube helps with breathing while the patient is under anesthesia and also helps clear secretions from the lungs. The tube is inserted through the mouth or nose and is sometimes left in the airway for several hours or even days after surgery (depending on the patient's need for assisted breathing).
Relatives are informed when most of the operation is completed, i.e. when the heart-lung machine is turned off and the heart begins to work on its own. The patient is left in the operating room for observation for approximately 1-2 hours and then transferred to the intensive care unit. After this, the relatives will be informed about the progress of the operation and the person operated on.
Intensive care ward
During your stay in the intensive care ward, the ward staff uses various monitoring systems to monitor how the heart is working after surgery. To monitor pressure in the right side of the heart and in the pulmonary artery, a catheter is inserted through the veins of the neck into the right ventricle and atrium. This catheter is used to assess cardiac output(i.e. the amount of blood flowing through the heart in 1 minute).
Drainage tubes inserted into the chest during surgery drain excess blood or fluid from the tissues surrounding the heart into a separate container. Using a catheter inserted into bladder, remove urine and control its quantity.
A nasogastric tube is inserted into the stomach through the nose or mouth to remove gastric juice, and also so that the intestines can rest a little before working again. Nutrients necessary for life, as well as solutions and medications, are supplied through a catheter contained in the brachial vein. Doctors carefully monitor the amount of fluid administered and excreted during the patient’s stay in the intensive care unit.
Happens after heart surgery short-term disturbances heart rhythm, so the medical staff constantly monitors the electrocardiogram on the monitor. Factors that contribute to the occurrence of arrhythmias after cardiac surgery are trauma to the heart during surgery, the presence of a catheter to monitor pressure in the heart, changes in the level of potassium and sodium ions in the blood, stress (this is the body’s normal reaction to fear and anxiety). Some changes heart rate may require temporary drug treatment.
The endotracheal (breathing) tube remains in the throat until complete recovery spontaneous breathing and the ability to cough up mucus. Although the tube does not cause pain, it does cause some discomfort: for example, you cannot speak because the tube passes through the glottis.
However, you can use gestures to explain the need to the nurse. The endotracheal tube is removed when blood tests indicate that the blood is sufficiently oxygenated and the patient can cough on his own. After the tube is removed, an oxygen mask is put on. There may still be discomfort in the throat and hoarseness for some time.
During the recovery stage, you need to breathe deeply and actively cough. Some movements may cause discomfort, so medications are prescribed to reduce pain.
Staying in the intensive care unit cannot be called rest. The patient may get tired of the constant signals that the heart rate monitoring system gives (and it works around the clock), as well as frequent follow-up visits from medical staff. However, it is precisely this kind of intensive supervision, despite the attendant inconveniences, that helps to quickly regain strength and ultimately leave the hospital safely.
The length of stay in the intensive care unit depends on the complexity of the surgical procedure. When doctors decide that there is no longer a need for intensive monitoring, the patient will be transferred to the post-block ward, where monitoring will continue, but at a less intense level.
Postblock
Heart rate monitoring continues around the clock and in the post-unit. This is done for the timely detection of rhythm disturbances that require drug treatment. Blood tests are also done frequently. On the first day of stay in the post-unit, an oxygen mask is also put on, and then this is done only if necessary. The moisture supplied along with oxygen helps clear secretions from the lungs.
Coughing is necessary to clear the airways; there are several arguments in its favor. With a cough, pulmonary secretions come out - sputum, which may overlap Airways and prevent oxygen from entering the lungs. When secretions block the airways, conditions arise for the development of pneumonia. In addition, coughing requires a deep breath and this promotes better ventilation of those areas of the lungs that may have been compressed during surgery.
Nurses help you return to bed, cough and breathe deeply. To improve expectoration, nurses massage the chest with tapping.
In the post-block the patient gradually recovers physical activity(under the control of cardiac monitors). As you recover, you can spend more and more time out of bed, walking around the ward in supportive elastic stockings, which are recommended during this time to stimulate blood circulation in the legs.
Doctors continue to monitor the volume of fluid drunk and excreted. You must tell the nurse about the amount of liquid you drink or consume with food. During the entire hospital stay, it is necessary to count the amount of urine excreted to determine the balance between fluid consumed and excreted. The first few days after surgery, the body weight is slightly increased due to the solutions administered during the operation, and over time this excess weight disappears.
There may be a few days after surgery poor appetite. However, it is necessary to consume enough fluids and nutrients to improve the healing process.
During the recovery phase, some emotional outbursts are possible. There can be both good and bad days after surgery. Confusion may persist for two to three days (sometimes a little longer). The reasons for this are different - medications, insomnia, signals given by the equipment in the intensive care ward. However, all medical staff will come to help.
The length of stay in the post-block is not fixed. The surgeon decides when special monitoring is not required. Sometimes, even after monitoring has stopped, it may be necessary to continue rehabilitation treatment in the post-block or general hospital ward.
