Florida Advanced Cardiothoracic Surgery

state of the art surgical therapies for heart failure

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It's normal to wonder what your life will be like after surgery.  How will things change?  Will you be able to do what you enjoyed before your operation?  Here you will find answers to commonly asked questions about:

• post-operative care & incision care

• activity

• diet

• medications.

Please remember we are happy to answer any questions which aren't covered here.  We're here to help you through this stressful time. 

Although each individual responds to surgery differently, some generalizations about post-operative care can be made:  

• It is normal to experience a decrease in appetite. Many patients also notice a diminished or absent sense of taste.  These symptoms should subside a few weeks after your operation. 

• Some swelling is also normal, especially if there is an incision in your leg.  Elevating your leg frequently improves this.  You may also want to wear elastic TED hose.

• You may have difficulty sleeping. Staying active during the day time, and taking a pain pill before bed sometimes helps.

• Constipation is very common after surgery. It may be related to strong pain medications, but it's important not to stop taking them if you still need them.  Rather, you may try a laxative of your choice and adding more fruits, fiber and juice to your diet.

• Muscle pain or tightness in your shoulders and upper back (between your shoulder blades) will also get better with time. This discomfort is related to the spreading of your wound, which allowed exposure to your heart or lungs.

• Lumps at the top of your incision will disappear with time.  More discussion on incision care follows below.

Remember - it takes 4 to 6 weeks to start feeling better.

After discharge, most surgeons agree it is safe to wash your incisions with mild soap and warm water on a daily basis. Avoid vigorous scrubbing. Seven days after discharge, you can remove any tapes that remain on your skin.  Keep in mind incisions may sunburn easily, so be sure to protect your incisions from overexposure to sunlight during the first year after surgery. The scar will darken if exposed to sun.

Remember to check your incisions every day, and notify your doctor if you notice increased tenderness of the incision line, increased redness or swelling around the edges of the incision line, any drainage from the incision line, or experience a persistent fever.

If you have wounds on your leg, follow these guidelines:

1. Care for your leg incision as described above.

2. Avoid crossing your legs, as this impairs circulation.

3. Avoid sitting in one position or standing for prolonged periods of time.

4. Elevate your leg on a stool or coffee table when sitting.

5. Check your leg daily for swelling. The swelling should decrease when you elevate your leg, but might recur when you stand. If you continue to have leg swelling or it becomes worse, notify your doctor.

6.  Wear your elastic stockings while you are up for at least two weeks after discharge. The stockings help decrease swelling. Remove your stockings at bedtime, and wash them with mild soap and water on a daily basis.

Following your operation, you will feel like you have no energy at all.  It's important to push yourself to be active. Some patients benefit from Cardiac Rehabilitation - a program which provides medically supervised exercise.  Other patients gradually increase their level of activity by themselves.  It's important that however you gain more confidence in your ability to do things, you stop any activity immediately if you feel short of breath, faint or dizzy, notice irregular heart beats, or you have chest pain. Rest until the symptoms subside. If they do not subside within 20 minutes, go to the closest emergency room or call 911.

Below are common guidelines for everyday living after you return home from the hospital. 

• Although you should avoid extremely hot water, you can take showers. Avoid soaking in baths for approximate 2 to 4 weeks after your operation.

• Wear comfortable, loose fitting clothes that do not put undue pressure on your incisions.

• Rest is important for yor recovery, so is exercise. It is important to have a good balance between the both of them. A good idea is to rest between activities and to take short naps as necessary. Rest at least 30 minutes after meals before exercising.

• Any form of aerobic exercise, like walking, is excellent for your postoperative recovery. It increases circulation throughout the body and to the heart muscle. It is important to increase your activity gradually. Walk at your own pace. Stop and rest if you get tired. Remember, cardiac rehabilitation is always an option. Don't compare yourself to others who had surgery, because each person progresses at a different rate after heart surgery.

• It is preferable that you don't climb stairs in the first few weeks; not that you can't climb, but you will become tired easily. If you use stairs, take a slow pace. Stop and rest if you tire. Always use the assistance of the handrail, but don't pull yourself up with your arms. This will put stress on your sternum (breastbone) wound. 

• You can resume sexual activity when you feel comfortable. For many people this is about 2 to 4 weeks after discharge. If you have questions, do not hesitate to ask your doctor or nurse. 

• We don't recommend you drive for approximately 4 to 6 weeks, especially if you are planning to drive by yourself. Early after surgery, your reflexes may be limited or slow, and this can impair your reaction time. Irregular heart rhythm is also very common up to 6 weeks following surgery; we don't want you to become dizzy and get into a car accident. When traveling, be sure to stop frequently and get out of the car for a little walk, to decrease the risk of blood stagnation and clots forming in leg veins.

• Avoid lifting, pushing, or pulling anything heavier than 10 pounds for at least 6 weeks after surgery.

• Check with your surgeon before returning to work.  Most patients will begin to feel like returning to light duty 6 to 12 weeks after surgery.

Your doctor will probably recommend that you follow a low fat, no added salt diet after discharge. This may reduce your risk of a heart attack in the future, as well as  your risk for requiring angioplasty or surgery again. You should try to have less than 30% of your calories from fat. Try to control your weight and eat less saturated fat and cholesterol. Avoid adding salt in cooking or at the table. Begin making changes to your diet when your appetite returns to normal.

We recommend you weigh yourself daily, at the same time each morning, after you urinate and before you eat breakfast.  Use the same scale everyday, and keep a record of each day's weight. Notify your doctor if you gain two pounds or more overnight.

It is very important to take your medication exactly the way your doctor prescribes.  Keep a current list in your wallet or purse, detailing the medicines, dosages, and  time of day each medication is to be taken.  Do not take other medicines without telling your doctor, and call your heart surgeon if you have any questions regarding  your prescribed medicine. It is important to understand that medicines can cause side effects.

You shouldn't hesitate to go to the nearest emergency room or call 911 if you experience any of the following side effects, or if you are not feeling well in general after your discharge.           

            - Excessive nausea, diarrhea, constipation or stomach pain     

            - Vomiting

            - Dizziness or lightheadedness when standing

            - Confusion

            - Tingling in hands and feet

            - Extremely slow or fast pulse

            - Skin rash

            - Unusual bruising or bleeding.