Categories: Cardiology

Precautions to be taken after a heart operation

Many heart ailments are not cured by medical treatments alone. There are many heart diseases, either present at birth or contracted with age, infective or degenerative, require surgical correction, with or without the help of a heart-lung machine. You may undergo coronary artery bypass grafting, valve replacement, combined procedure, closure of holes in heart, abnormal persistent great vessel communication, or correction of blue babies with heart surgery. This may be done by cutting your breast bone or making an opening it in between the ribs.

Most people need to spend 3 to 10 days in the hospital, partly inward and partly in ICU. By the time you are fit to be discharged, you will be able to walk and will be educated in the basic exercises for your early recovery.
It takes at least 4 to 6 weeks to recover. During the period, the patient may complain of weakness, tiredness, pain in the incision site, itching sensation, and restricted mobility of arms. There may be a loss of sleep as well. The patient may also complain of constipation. Mentally, the patient may suffer from depression or have mood swings. The patient may be required to take lots of medication and may have a loss to taste for food.

At the time of discharge, you will be given your discharge papers, stating your disease, the treatment received, medication, food habits to be followed, and necessary exercises. You can take assistance during the initial few days, while walking or climbing stairs. Walking is the best form of exercise. It should be graduated and stopped or restricted if you have difficulty in respiration. Avoid lifting heavy weights, or any exercise that strains your chest muscles, and or if it causes pain. Avoid driving during the initial 6 weeks after the operation, as twisting movements are needed to turn the steering wheel. Long-distance travel should be avoided, one should restrict sexual activity during the initial recovery phase. Gradually, sexual activity can be resumed. Avoid using any sex-enhancing medications.

The wound should be gently washed with mild soap and water only lukewarm water should be used for bathing. Long showers should be avoided. Do not use creams, oils, and perfumes on the body. Apply the dressing, as done by the doctor and nurse. One should inform your doctor if you have a fever, swelling, redness, and/or some sort of discharge or pain in the incision site. Sometimes, in the initial one to two weeks, you will be able to hear a `click` sound coming from the chest bone. It usually disappears. If persistent rocking of the chest is experienced, then discuss the matter with your doctor.
Nutrition is important in the recovery period. During the initial two weeks, eat as per your choice since many food items may be unpalatable. For a diabetic patient, a diabetic diet has to follow. Avoid lots of table salt as it can cause excessive accumulation of water in the body and even cause hypertension. Many times, fluid intake restriction is advised to prevent overburdening of the heart. Eat lots of vegetables, fruits, whole grains, bread, lean meat, fish, and low – fat dairy products. Processed foods should be avoided. They contain a high amount of salt and preservatives.

In general, high-saturated fats, salt, and sodium should be taken in limited quantities. After the valve replacement, do not take supplemental calcium without approval from your doctor. Patients taking anticoagulation drugs like warfarin and acitrom should avoid food containing lots of vitamin k liver, broccoli, brussel sprouts, green onion leaves, green leavy vegetables such as spinach, coriander, cabbage, mustard green, parsley, kale, turnip greens, margarine, and soyabean oil. The patients need to do regular prothrombin check-ups as advised by the doctor.

You should consult a doctor if you have any doubts regarding medications or experience any of the problems mentioned below.
• Pain, swelling, redness, itching, and discharge from the incision site
• Fever, headache, dizziness or weakness
• Absence or change in valve click sound in case of mechanical valve replacement
• Blood in urine or stool
• Heavy bleeding during periods or other heavy vaginal bleeding (in women)
• Severe bruising, prolonged nasal bleed, blood in cough, vomiting
• Any change in the rate of your pulse beat, it less than 60 or more than 100
• Difficulty in breathing
• If you become pregnant or want to conceive

During the recovery phase, medication, as advised, should be continued along with regular exercises and lung physiotherapy. The patient should maintain a healthy diet and enjoy a proper amount of sleep per day. Patients should stop smoking or chewing tobacco in any form, control diabetes, and hypertension and reduce obesity if overweight. After 6 weeks of convalescence, patients can join their regular work with care, after a check-up with your doctor. For children, try to avoid competitive sports after discharge unless the doctor allows it. Family members should support the patient, boost their morale and help in early recovery.

Dr. Perwaiz Alam, Senior Consultant Cardiac Surgery – Adult, Brahmananda Narayana Multispeciality Hospital, Jamshedpur

Narayana Health

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