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
Making healthy food choices 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. Full recovery may take 3 months. It is recommended to eat small portions frequently.
A healthy diet provides the body with many 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 buttery fish meals per week, such as salmon, mackerel or sardines, will help you get plenty of healthy omega-3 fatty acids;
- 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 lower blood pressure and help 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 may contribute, including medication side effects, depression, and concerns about triggering another heart attack or death. You should not worry about decreased sexual interest; after the body is fully restored, your previous sex life will return.
Physical exercise
Since it takes 6-8 weeks for the breast bone to heal after heart surgery, you should 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 require drug therapy after surgery. 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 any of the the following symptoms, you need to 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.
Cardiac surgery is a branch of medicine devoted to the surgical treatment of the heart. For pathologies of cardio-vascular system such intervention is a last resort. Doctors try to restore the patient’s health without surgery, but in some cases only cardiac surgery can save the patient. Today, this field of cardiology uses the latest advances in science to return the patient to health and a full life.
Indications for operations
Invasive cardiac interventions are complex and risky work; it requires skill and experience, and the patient – preparation and implementation of recommendations. Because such operations involve risks, they are performed only when absolutely necessary. In most cases, they try to rehabilitate the patient with the help of medications and medical procedures. But in cases where such methods do not help, heart surgery is needed. The surgery is performed in a hospital setting and in complete sterility, the patient being operated on is under anesthesia and under the control of the surgical team.
Such interventions are needed for congenital or acquired heart defects. The first include pathologies in the anatomy of the organ: defects of the valves, ventricles, impaired blood circulation. Most often they are discovered during pregnancy. Heart defects are also diagnosed in newborns; often such pathologies need to be eliminated urgently in order to save the baby’s life. The leader among acquired diseases is ischemic disease, in this case, surgery is considered the most effective treatment method. Also in the heart area there are: impaired blood circulation, stenosis or valve insufficiency, heart attack, pericardial pathologies and others.
Heart surgery is prescribed in situations where conservative treatment does not help the patient, the disease progresses rapidly and threatens life, in pathologies that require urgent and immediate correction, and in advanced forms of the disease, late application to the doctor.
The decision to prescribe an operation is made by a council of doctors or. The patient must be examined to determine accurate diagnosis and type of surgery. They identify chronic diseases, stages of the disease, assess risks, in this case they talk about elective surgery. If needed emergency help, for example, when a blood clot breaks off or an aneurysm dissects, minimal diagnostics are performed. Anyway surgically the function of the heart is restored, its parts are rehabilitated, blood flow and rhythm are normalized. In severe situations, the organ or its parts can no longer be corrected, then prosthetics or transplantation are prescribed.
Classification of heart operations
There can be dozens of different diseases in the area of the heart muscle, these are: failure, narrowing of the lumens, ruptures of blood vessels, stretching of the ventricles or atria, purulent formations in the pericardium and much more. To solve each problem, surgery has several types of operations. They are distinguished by urgency, effectiveness and method of influencing the heart.
The general classification divides them into operations:
- Buried - used to treat arteries, large vessels, aorta. During such interventions, the chest of the person being operated on is not opened, and the heart itself is also not touched by the surgeon. That’s why they are called “closed” - the heart muscle remains intact. Instead of a strip opening, the doctor makes a small incision in the chest, most often between the ribs. Closed types include: bypass surgery, balloon angioplasty, stenting of blood vessels. All these manipulations are designed to restore blood circulation, sometimes they are prescribed to prepare for future open surgery.
- Open – carried out after opening the sternum and sawing the bones. During such manipulations, the heart itself can also be opened to get to the problem area. Typically, the heart and lungs must be stopped for such operations. To do this, they connect the artificial blood circulation machine - AIK, it compensates for the work of the “disabled” organs. This allows the surgeon to carry out the work carefully, and the procedure under AI control takes longer, which is necessary when eliminating complex pathologies. During open operations, the AIC may not be connected, but only the desired zone of the heart can be stopped, for example, during coronary artery bypass grafting. Opening the chest is necessary to replace valves, prosthetics, and eliminate tumors.
- X-ray surgery - similar to a closed type of operation. The essence of this method is that the doctor moves a thin catheter through the blood vessels and gets to the heart. The chest is not opened; the catheter is placed in the thigh or shoulder. A contrast agent is supplied through the catheter, which stains the vessels. The catheter is advanced under X-ray control, and the video image is transmitted to the monitor. Using this method, the lumen in the vessels is restored: at the end of the catheter there is a so-called balloon and a stent. At the site of narrowing, this balloon is inflated with a stent, restoring normal patency of the vessel.
The safest are minimally invasive methods, that is, x-ray surgery and closed type operations. With such work there is the least risk of complications, the patient recovers faster after them, but they cannot always help the patient. Complex operations can be avoided with periodic examinations. The earlier the problem is identified, the easier it is for the doctor to solve it.
Depending on the patient’s condition, there are:
- Planned surgery. It is carried out after a detailed examination, within a specified time frame. Planned intervention is prescribed when the pathology does not pose any particular danger, but it cannot be postponed.
- Emergency are operations that need to be done in the next few days. During this time, the patient is prepared and all the necessary studies are carried out. The date is set immediately after receiving the necessary data.
- Emergency. If the patient is already in serious condition, the situation can worsen at any moment - surgery is scheduled immediately. Before it, only the most important examinations and preparations are carried out.
In addition, surgical assistance can be radical or auxiliary. The first implies complete elimination of the problem, the second - elimination of only part of the disease, improving the patient’s well-being. For example, if a patient has a pathology of the mitral valve and stenosis of a vessel, the vessel is first restored (auxiliary), and after a while valve plastic surgery is prescribed (radical).
How the operations are done
The course and duration of the operation depends on the pathology being treated, the patient’s condition, and the presence of concomitant diseases. The procedure may take half an hour or may take 8 hours or more. Most often, such interventions last 3 hours, take place under general anesthesia and control of an artificial cardiologist. First, the patient is prescribed a chest ultrasound, urine and blood tests, an ECG, and consultation with specialists. After receiving all the data, the degree and location of the pathology is determined, and it is decided whether there will be an operation.
As part of the preparation, a diet low in fatty, spicy and fried foods is also prescribed. 6-8 hours before the procedure, it is recommended to refuse food and drink less. In the operating room, the doctor assesses the patient’s well-being and puts the patient into medical sleep. For minimally invasive interventions, local anesthesia is sufficient, for example during X-ray surgery. When the anesthesia or anesthesia takes effect, the main actions begin.
Heart valve surgery
The heart muscle has four valves, all of which serve as a passage for blood from one chamber to another. The most commonly operated valves are the mitral and tricuspid valves, which connect the ventricles to the atria. Stenosis of the passages occurs when the valves are insufficiently widened, and blood flows poorly from one section to another. Valve insufficiency is a poor closure of the valves of the passage, and there is an outflow of blood back.
The plastic surgery is performed openly or closed; during the operation, special rings or sutures are applied manually along the diameter of the valve, which restore normal lumen and narrowing of the passage. Manipulations last on average 3 hours; for open types, an AIK is connected. After the procedure, the patient remains under the supervision of doctors for at least a week. The result is normal blood circulation and functioning of the heart valves. In severe cases, the original valves are replaced with artificial or biological implants.
Elimination of heart defects
In most cases, defects are congenital, the reason for this may be hereditary pathologies, bad habits parents, infections and fever during pregnancy. At the same time, children may have different anatomical abnormalities in the heart area; often such anomalies are poorly compatible with life. The urgency and type of surgery depend on the child’s condition, but they are often prescribed as early as possible. For children, heart surgery is performed only under general anesthesia and under the supervision of medical equipment.
At older ages, heart defects develop due to atrial septal defects. This happens with mechanical damage to the chest, infectious diseases, due to concomitant heart disease. To eliminate this problem, open surgery is also needed, often with artificial cardiac arrest.
During the manipulations, the surgeon can “patch” the septum using a patch, or sutured the defective part.
Bypass surgery
Coronary artery disease (IHD) is a very common pathology, affecting mainly the generation over 50 years of age. Appears due to impaired blood flow in the coronary artery, which leads to oxygen starvation myocardium. There is a chronic form, in which the patient has constant attacks of angina, and an acute form, which is myocardial infarction. They try to eliminate chronic ones conservatively or using minimally invasive techniques. Acute requires urgent intervention.
To prevent complications or alleviate the disease, use:
- coronary artery bypass grafting;
- balloon angioplasty;
- transmyocardial laser revascularization;
- coronary artery stenting.
All these methods are aimed at restoring normal blood flow. As a result, enough oxygen is supplied to the myocardium with blood, the risk of heart attack is reduced, and angina is eliminated.
If it is necessary to restore normal patency, angioplasty or stenting is sufficient, in which the catheter is moved through the vessels to the heart. Before such an intervention, coronary angiography is performed to accurately determine the blocked area. Sometimes blood flow is restored bypassing the affected area, while a bio-shunt (often a section of the patient’s own vein from the arm or leg) is sutured to the artery.
Recovery after interventions
After surgery, the patient remains in the hospital for another 1-3 weeks, during which time doctors will evaluate his condition. The patient is discharged after verification and approval by the cardiologist.
First month after surgical procedures called the early postoperative period, at this time it is very important to follow all the doctor’s recommendations: diet, calm and measured lifestyle. Nicotine, alcohol, junk food and physical exercise prohibited regardless of the type of intervention.
The doctor's recommendations must also contain a warning about dangers and complications. Upon discharge, the doctor will set a date for the next appointment, but you need to seek help unscheduled if the following symptoms occur:
- sudden fever;
- redness and swelling at the incision site;
- discharge from the wound;
- constant chest pain;
- frequent dizziness;
- nausea, bloating and stool disorders;
- difficulty breathing.
During routine examinations, the cardiologist will listen to your heartbeat, measure your blood pressure, and listen to your complaints. To check the effectiveness of the operation, ultrasound is prescribed, CT scan, X-ray studies. Such visits are scheduled once a month for six months, then the doctor will see you once every 6 months.
Often except surgical care prescribe medications. For example, when replacing valves with artificial implants, the patient takes anticoagulants for life.
In the postoperative period, it is important not to self-medicate, since the interaction permanent medications and other medications can give negative results. Even regular painkillers need to be discussed with. To keep fit and restore health faster, it is recommended to spend more time in the fresh air and walk.
Life after heart surgery will gradually return to normal, full recovery forecast throughout the year.
Cardiac surgery offers a variety of methods for cardiac rehabilitation. Such operations are designed to restore physical and moral strength to the patient. There is no need to be afraid or avoid such procedures; on the contrary, the sooner they are carried out, the greater the chances of success.
Diseases of the cardiovascular system are rightly called one of the most current problems modernity. Around the world, up to 20 million people die from them every year. These diseases cause fear because they creep up unnoticed. Few people will go to an appointment with a cardiologist until signs of malaise clearly manifest themselves. Cardiac surgery, which comes to the rescue when conservative treatment becomes ineffective, saves the lives of thousands of patients every year. These operations are becoming more and more complex and high-tech, doctors are starting to treat cases that until relatively recently were considered hopeless. Despite the increase in the severity of cardiac surgery patients over the past 15-20 years, mortality in cardiac surgery has decreased significantly, and today is about 1-2% in uncomplicated cases. According to publications in medical journals in 1965, the mortality rate was about 15%. However, the incidence of complications still remains high. Modern medicine has learned to treat well many complications that until recently were fatal. But we have not yet learned how to prevent their appearance. The frequency of their occurrence still remains at a very high level. Finding ways to prevent postoperative complications in cardiac surgery is the foundation on which patient safety should be based before, during and after surgery.
An important problem in the prevention of postoperative complications, including the prevention of infection in the surgical area, is low level knowledge of our patients.
The main causes of postoperative complications and/or readmission of patients undergoing reconstructive cardiac surgery are often due to behavioral factors:
· Violation of drug therapy.
· Incorrect wearing of postoperative bandages.
· Violation of the physical activity regime.
· Lack of self-control.
· Non-compliance with diet.
Taking into account the relevance of this problem, a study was conducted in the cardiac surgery departments of the Samara Cardiac Dispensary to determine the level of awareness of cardiac surgery patients about the prevention of postoperative complications. The order to conduct the study was approved by the Ethics Committee of the State Budgetary Healthcare Institution
"Samara Regional Clinical Cardiological Dispensary" and the Board of the Samara Regional public organization nurses.
The object of the study was a group of men and women 50-65 years old, numbering 125 people, who were treated in the 4th and 11th cardiac surgery departments of the Samara Regional Clinical Cardiological Dispensary in the period from 01.08.2015 to 30.09.2015 who underwent open heart surgery (coronary artery bypass grafting , aortic, mitral valve replacement and others).
The effectiveness of the activities was assessed through conversations and questionnaires conducted with patients before and after the training.
The results of the initial survey revealed:
ü 26% of respondents know that violation of drug therapy and physical activity regimen are risk factors for postoperative complications,
ü 35% of patients are aware that smoking and alcohol are risk factors for CHF,
ü to the question: “Do you know about the principles of nutrition in the postoperative period?” - 18% answered “yes”,
ü 11% are aware of the main symptoms of complications in the early postoperative period,
ü “Do you know about self-care in the early postoperative period?” - only 10% answered positively,
ü 100% of respondents are afraid of the upcoming operation and the future,
ü 80% of cardiac surgery patients do not have healthy sleep.
The results of the survey show that patients' awareness of the prevention of postoperative complications is low. Patients' quality of life is sharply reduced. Only 15 out of 125 people knew about the use of elements of self-help and self-care before training.
During their hospital stay, patients were given classes on the following topics:
· risk factors for cardiovascular diseases;
· general information about open heart surgery;
risk factors for postoperative complications;
· symptoms of complications and principles of self-control;
· diet in early and late postoperative period;
principles of self-care:
· physical activity;
Practical classes were conducted where patients learned correct technique self-measurement of blood pressure, pulse counting, weighing, training in how to properly wear a bandage and the technique of applying an elastic bandage in the area of a postoperative wound on the leg.
All patients received educational materials on self-control and a “After Heart Surgery” leaflet. It contains information about frequently asked questions:
ü “How will the preparation for the operation proceed?”
ü “What will happen to me on the day of the operation?”
ü “How long will the operation last?” And the most current issues:
ü “What will the suture be like and will it get infected after the bandage is removed?”
ü “When and how to put on a bandage?”
ü “When should I start bandaging my leg with an elastic bandage and how long should I wear it?”
ü and other useful information.
After repeated questioning, the level of patients' knowledge about the prevention of postoperative complications increased significantly. 84% of patients acquired self-help skills and 100% learned elements of self-care. After completing the training course, patients began to understand that responsibility for the effectiveness of the prescribed treatment largely depends on themselves.
The introduction of nursing research into practice has made it possible to increase the status of nursing staff and responsibility for the work performed. Maintaining nursing documentation allows you to systematize information obtained during the examination of patients. With the daily registration of nursing records, nurses learn to better and more deeply understand patients, collecting information about their life history and illness. In the process of working in new conditions, nurses develop new qualities: compassion, empathy, the ability to put themselves in the patient’s place and see the world through his eyes. There is constant growth professional knowledge. Carrying out independent nursing care required nurses to study special medical literature on care. Nursing standards have been developed to allow for more effective implementation of nursing interventions. The quality of care has increased, which has ensured the prestige of working in the departments.
Bibliography
1. Glushchenko T.E. Features of clinical-functional and clinical-social indicators of adaptation of patients before and after coronary artery bypass surgery depending on the level of personal anxiety // Siberian Medical Journal. – 2007. – Volume 22, No. 4. – P. 82–86.
2. Ivanov S.V. Mental disorders associated with open-heart surgery // Psychiatry and psychopharmacotherapy named after. Gannushkina. – 2005. – No. 3. – P. 35–37.
3. Moiseeva T.F. Experience in managing nursing personnel in the Omsk regional clinical hospital: increasing the professional level of nursing staff. // Home nurse. - 2012 - No. 6. - P. 26-27.
4. Niebauer J. Cardiac rehabilitation. Practical guide. – M., 2012. – 328 p.
5. Sopina Z.E., Fomushkina I.A. Quality management of nursing care. CRM system for business. GEOTAR-Media, 2011. – 178 p.
Every year, the country carries out the most complex operations on blood vessels and the heart, the staff of cardiac surgeons is improved, and the latest equipment is purchased. As a result, there are more and more patients who have successfully undergone heart surgery. Whether such a person will return to normal life after surgery depends 50% on the success of the surgery, and 50% on proper rehabilitation after heart surgery. What rehabilitation measures are carried out after cardiac surgery? To answer this question more completely, it is necessary to have an idea of what types of heart surgeries there are.
1 Heart surgery
Surgery on the heart and blood vessels may be required in case of ineffectiveness of therapeutic treatment and progressive deterioration of the patient’s well-being, with congenital and acquired heart defects, and anomalies of the heart vessels. Significant damage to the coronary arteries by plaques of atherosclerosis, severe ischemic heart disease, heart attack, pathologies of the heart valve apparatus - all these diseases can become indications for surgical treatment.
The very first, most traumatic operations were performed on an open heart with an opening of the chest; during such operations, the patient is connected to a heart-lung machine, and the heart is turned off (stopped) for the duration of the operation. And today such operations do take place, but surgical interventions on the beating heart or closed ones, as well as minimally invasive surgical procedures, are becoming increasingly common.
Minimally invasive techniques allow surgical treatment without opening the chest, through several punctures, sometimes under local anesthesia. Coronary artery bypass grafting, coronary artery stenting, radiofrequency ablation, elimination of some valve defects, and pacemaker placement today can be performed minimally invasively endoscopic method without an incision in the sternum, on a beating heart. This allows you to reduce the number of complications after surgery, speed up rehabilitation period, increase the recovery rate.
2 Why is rehabilitation needed?
Many are confident that successful heart surgery is a guarantee of a return to full, healthy life. In fact, the postoperative and rehabilitation period is very important. The extent to which the patient carefully follows all the recommendations of the attending physician and responsibly approaches the implementation of the rehabilitation program depends on how much he can restore the lost health function and improve the level of quality of life.
For cardiac patients who have undergone surgical intervention on the heart, you can derive a simple equation: surgery + rehabilitation = improved quality of life. This equation works in the following data: high professionalism of cardiac surgeons, a well-designed rehabilitation plan, and the responsibility of the patient.
3 What does the rehabilitation plan include?
A rehabilitation plan after heart and vascular surgery is drawn up individually for each person by a rehabilitation physician, cardiologist, physiotherapist, and occupational therapist. When drawing up a rehabilitation program, doctors take into account:
- volume and type of operation performed. Open heart surgery requires more gentle and somewhat delayed rehabilitation measures than minimally invasive interventions, especially in the early postoperative period;
- age. Age is necessarily taken into account by rehabilitation specialists, since the older the patient, the less pronounced the restorative ability of the heart muscle and its energy intensity, the rehabilitation plan is drawn up taking this indicator into account;
- concomitant chronic diseases. Some activities and physical exercises during the recovery period may be contraindicated for people suffering from other chronic diseases in the stage of subcompensation;
- the presence or absence of postoperative complications.
Basic rehabilitation measures include physical rehabilitation(breathing, therapeutic exercises, feasible physical activity and exercises), as well as psychosocial rehabilitation (consultation with a psychotherapist, organization of a patient school where group classes, teaching patients a healthy lifestyle, proper nutrition, return to social activity).
4 Rehabilitation stages
When do rehabilitation activities begin? Most patients will probably answer: after a person is discharged from the hospital in feeling good. Not at all, the first stage of rehabilitation should begin in the hospital, literally at the patient’s bedside. What are the rehabilitation stages?
- Sanatorium-resort stage,
- Outpatient stage.
5
The goal of rehabilitation in the postoperative period and during hospital stay: elimination and prevention of postoperative complications, early verticalization of the patient and physical activity in an accessible volume, psychological adaptation to undergo surgery, selection medications. The sooner the activities begin, literally hospital bed- all the better. It is mandatory to carry out breathing exercises for a bedridden patient, massage, and preparation for physical therapy exercises in the form of turns in bed, weak contractions of muscle groups.
As the muscles strengthen, pain in the area of the postoperative wound decreases, and the patient’s well-being improves, the list of exercises expands and the load increases slightly. Physical exercises can be carried out first in the ward, and then on special simulators, always under the supervision of a physical therapy doctor with a daily analysis of the patient’s well-being, pulse and respiration rate, blood pressure, periodic ECG recording, or daily ECG monitoring.
If the patient has undergone a dissection of the sternum, for better fusion and speedy healing of the sutures, the patient is recommended to wear a postoperative bandage or corset for 2-3 months; such patients are recommended to sleep only on their back for the first month. According to indications, patients are prescribed physical therapy - UHF, electrical stimulation, ultrasound. The patient should be explained what care should be postoperative wound how to support yourself after discharge physical activity, fulfill breathing exercises how to eat right.
All activities at the hospital stage should pursue the following goal: the patient should leave the hospital as early as possible. But not in the interests of the hospital and medical staff, but because his good health allows him to do this.
6 Sanatorium-resort stage
Patients after heart surgery, upon the recommendation of the attending physician, can be sent for further rehabilitation to specialized sanatoriums cardiological profile. The sanatorium continues to restore both the physical and psychological condition of the patient. A patient admitted to the sanatorium first undergoes an examination. The doctor interviews him, collects anamnesis, clarifies complaints, gets acquainted with medical documentation patient, history of heart disease, prescribes additional examination if necessary.
Based on all the data received, doctors draw up an individual plan for managing the patient during his stay in the sanatorium. Rehabilitation activities include physical therapy, therapeutic nutrition, exercises therapeutic exercises, massage. At the sanatorium, diagnostic examinations and drug therapy can be adjusted if necessary. A few days before the end of the sanatorium-resort treatment, the patient undergoes a full examination again; upon discharge, the doctor gives personal recommendations, notes them in the discharge summary, because they may be necessary for the subsequent outpatient rehabilitation stage.
7 Outpatient stage
The longest in time and, perhaps, the most important for the patient. After all, it includes regular medical observation of the patient in the clinic, rational employment of patients, compliance healthy image life, proper nutrition. At this stage, doctors annually draw up an individual rehabilitation program (IRP) for each patient, which includes drug therapy, physical therapy, diet therapy, physiotherapy and other rehabilitation measures as indicated.
