Discharge advice

Recovering at home

Now that you are home, you need time to heal. Along with the healing process will come good days and bad days. Eating properly and taking your medication are important factors that will facilitate your recovery. It is also important to get enough rest and to begin to increase your physical activity.

A reminder to valve surgery patients

Your exercise programme does differ from that of bypass patients. Exercises are to be restricted and taken at a much slower pace.

Future surgical procedures

If you have to undergo surgery in the future, even minor surgery such as dental extractions, there is a small but significant risk of an infection of the valves. It is therefore necessary to inform your cardiologist of this beforehand, so that you can take antibiotics immediately as a preventative measure. Take your 'valve card' with you when you visit your doctor.

Diet

At first you may not have much of an appetite, but eating is necessary to increase your strength. While in hospital, you may have noticed that the foods served to you were not always heart-healthy. This is because initially the most important thing is that the food appeals to you so you will eat. Once you regain your appetite, eating a heart-healthy diet becomes more important.

Medication

It is important that you know the names of your various medications and when to take them.

Emotions

It is normal to be emotional after heart surgery, or any health crisis. Feelings of depression, anger and fear are quite common. Family members are likely to experience these feelings as well. This is a normal part of the healing process and will improve over time. It is important to talk about your feelings and discuss your heart surgery and recovery with others. It is also important to return to activities that you enjoy. Hobbies such as craftwork, playing cards or reading can be resumed almost immediately.

Incision care

It is important to pay attention to the care of your incisions. Some general guidelines for proper incision care are:

• Showers (ten minutes or less) are allowed if your incisions are dry and healing.
• Quick baths are OK, but too much moisture can cause premature dissolving of the stitches.
• Avoid extreme water temperatures.
• Gentle soap is permitted, but do not scrub yourself with a washcloth until your skin is healed completely.
• Lotions, ointments or dressings are not recommended.
• Slight itching, numbness or tightness around the incision area is normal.

Stitches

If you have regular stitches or staples they will be removed from your chest and leg ten to fourteen days after surgery.

When to notify your doctor

Notify your doctor if you experience the following signs of infection:

• increased drainage or opening of the incision
• increased redness or warmth around the incision
• a fever of more than 100°F or 37,5°C.

If you notice any swelling of your feet or ankles, try propping up your feet and do not cross your legs. Regular walking and wearing the support stockings for five to six weeks is recommended. Call your doctor if the swelling worsens.

Home activity

For the first six to eight weeks after surgery, you may feel tired or weak. During this time you can gradually resume your activities and develop an exercise programme. At first take daily walks and resume light household chores such as cleaning and fixing meals that you feel able to cope with. Space your activities, allowing time to rest if you get tired. Avoid lifting, pushing or pulling heavy objects until your doctor tells you that you may resume these activities. Car driving is usually permitted three to four weeks after surgery. Wearing a seatbelt will not in any way damage your incision.

Overexertion

If you cram too many activities into a day, your body will let you know right away, or it may take a day or so to catch up with you. Symptoms of overexertion include:

• Extreme fatigue
• Chest discomfort
• Excessive shortness of breath
• Light-headedness
• Rapid or irregular heart rate.

If you experience any of these symptoms, sit or lie down and rest. If these symptoms persist longer than twenty to thirty minutes, call your doctor.

Sexual activity

Resuming sexual activity is an important part of getting your life back to normal, but it can also cause fear and anxiety for you and your partner. The most common fear is that sex will be too strenuous and cause a heart attack. Generally, having sex with your partner is no more strenuous than briskly walking half a mile or climbing two flights of stairs. If performing these activities leads to angina, shortness of breath or fatigue, see your doctor before resuming sexual activity. You and your partner should be open and honest about your thoughts and feelings. It is also wise to avoid positions that put pressure on the breast bone, arms and chest, and wait at least half an hour after eating before engaging in any sexual activity.

Certain medications, in addition to anxiety, can interfere with sexual arousal and performance. Speak with your doctor or cardiac rehabilitation staff member if you have any questions or concerns.