Home After Heart Surgery: The Journey Back to Normal
There's no place like home. But for a patient who has just had open-heart surgery, going home may bring feelings of fear or uncertainty and questions such as "How will I manage?" or "How will I know if I'm healing well?"
While concern is natural when you or a loved one heads home after heart surgery, knowledge and preparation are the keys to successful post-hospital recovery.
At Beth Israel Deaconess Medical Center (BIDMC), patients receive extensive education from doctors, physician assistants, nurses and physical therapists about what to expect when they are discharged from the hospital. To ease the transition, each patient attends a cardiac surgical discharge education class and receives personal attention along with written post-op instructions.
Common Recovery Pitfalls
"It's normal to feel anxious about leaving the hospital since our cardiac patients have a comfort level with constant monitoring here," said Joan A. Drevins, Education and Research Program Coordinator at BIDMC. "The class teaches them what to expect during the healing process and what they can and cannot do once they arrive home."
Drevins offers suggestions to help patients avoid common pitfalls on the road to recovery.
- Set the right pace: Sometimes patients feel almost too good when they get home and do too much too fast. Drevins advises them to be active but emphasizes the importance of following restrictions for certain activities like lifting heavy objects. "It's important to listen to the body and to stop and rest when tired," she explained. "This prevents patients from overdoing it one day and spending the next feeling exhausted."
- Get up and walk: Other patients are afraid to get moving again, but it's important. "Walking gives patients the biggest bang for their buck," said Drevins. "It helps the heart and circulation, encourages a healthy appetite and improves digestion. It also improves mood and gives patients a reason to get up, get dressed and feel productive."
- Ask for help when needed: Some patients recovering from heart surgery find it hard to rely on others for help, but pride is a risky quality during recovery. Asking for help with certain tasks can alleviate the hazards of doing too much.
Home Delivery for Mail Carrier Kevin Mulligan
Kevin Mulligan, who had open heart surgery at BIDMC early last year, attended Drevins' discharge class. He feels that this preparation made all the difference in his recovery.
"When I left the hospital five days after surgery, I felt comfortable and confident with going home," he said. I felt like everyone who worked with me really cared."
As a mail carrier for the U.S. Postal Service, Mulligan has walked three to four miles most days for years. So he was worried when he began to have a hard time breathing several days in row.
"Some folks might have ignored the symptoms, but I got it checked right away," he said.
Doctors soon determined that Mulligan was experiencing angina from atherosclerosis and that he needed triple coronary artery bypass graft surgery (CABG). This surgery uses arteries or veins from other areas in the body, bypassing narrowed coronary arteries to improve blood flow, relieve pain and possibly prevent a heart attack.
Kamal R. Khabbaz, MD, the CardioVascular Institute's Chief of Cardiac Surgery, performed the surgery, and Mulligan began the process of recovery.
"With the help of nurses, I was up and walking 48 hours after surgery," he said.
Collaboration with the Cardiac Team
As Mulligan prepared for his return home, all members of the cardiac team were involved.
"Each patient discharge is a team effort that is based on the individual needs of each patient," said Khabbaz. "The surgical team, nurses, a physical therapist and a nutritionist work with the patient and family to determine the best approach. We consider factors such as age, physical condition prior to surgery, and whether the patient lives alone."
BIDMC schedules a visiting nurse for an at-home visit to check vital signs and the incision if patients are homebound. Once they have left the hospital, patients are encouraged to begin an outpatient cardiac rehabilitation program, which runs two to three times a week for about three months. This allows the patient to exercise while being monitored and to receive health, diet and exercise advice from nurses, physical therapists and nutritionists.
"Most patients recovering from cardiac surgery remain in the hospital for four to five days and many can return to office-type work in one or two months," said Khabbaz. "Those with more physical jobs may need a longer recovery period."
For Mulligan, who's back on the job delivering mail in snow or rain or heat, the recovery period included three months in the outpatient cardiac rehab program. The results were all that he hoped for.
"The surgical team told me that in five months I'd be feeling like nothing ever happened," he said. "They were right - I'm as good as new!"
Above content provided by the CardioVascular Institute at Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2014