Guide to Heart Patient

  Recovery after Discharge

1. St(i) After discharge from the hospital, the patient is advised to stay in Delhi or nearby place for a period of one week, so that the patient may approach the hospital, if needed. The patient can go to his/her hometown after the first follow-up visit.
2. Bathing : You can have bath one week after your operation. Avoid extremely hot or extremely cold water. Any ordinary soap can be used. Gently clean your operation site with soap and water but not rub it. Do not apply the soap cake directly on the incision. First apply the soap on the palm and then with your palm gently apply it on the incision. After bath, pat dry the operation site with a clean and soft towel.
3. Activity :Patients are encouraged to perform light activities from the beginning. Patients should perform all their personal activities without any help. Patients should participate in light house-hold activities from very beginning and as time passes, level of activity can be increased. One should work without getting tired and feeling short of breath and should rest in between. However, patients are advised not to lift weight (more than 4kg) for about 2 months during which time the bones in the incision are healing. Usually patient can return to normal life after a period of 6 to 8 weeks. There are few special aspects of your activities:

(i) STOPANY ACTIVITY IMMEDIATELY IF YOU FEEL SHORT OF BREATH, NOTICE IRREGULAR HEART BEATS, FEEL FAINT OR DIZZY, OR YOU HAVE CHEST PAIN. REST UNTIL THE SYMPTOMS SUBSIDE.
(ii)REST : You require 8 to 10 hours sleep, including the day time naps. Take rest between your activities and exercise. Rest for 30 minutes after your meals. DO NOT REMAIN IN THE BED ALL THE TIME. A proper balance of rest and exercise is essential for your recovery.
(iii) WALKING : This is one of the best form of exercise as it increases blood circulation throughout the body and also to the heart muscles. Gradually increase your walking speed and duration. Walk at your own pace. Stop and rest if you get tired. In poor weather, you can walk indoors. Do not take a walk immediately after meals.
(iv) CLIMBING STAIRS :Unless advised differently by your doctor, you can climb stairs. Climb slowly. Stop and rest if you become tired or short of breath. When using the handrail, do not pull yourself up with your arms, use your legs.
(v) DRIVING / TRAVELLING : You can travel as a passenger in a car or train at any time. However, long journeys should be avoided for first two weeks. Avoid driving, outdoor bicycling, motorcycles / scooter riding for 6 weeks after surgery.
(vi) SEX :You can resume sexual relations after 4 to 6 weeks when you are comfortable with your other activities. The level of exertion during intercourses is similar to walking approximately half a mile at a brisk pace or climbing two flight of stairs. When you can perform these activities without becoming fatigued or short of breath, sexual activity can be resumed.
(vii) LIFTING/PUSHING/PULLING : You should not put too much strain on your breastbone while it is healing. Avoid lifting, pushing or pulling anything heavier than 4kg for 6 weeks after surgery. This includes carrying children, groceries, suitcases and pushing or pulling any other heavy object.
(viii)WORK : Check your surgeon before returning to work, but most patients are fit to return to work after 6 weeks of operation, provided the work does not involve strenuous physical activity.
(ix)It is perfectly normal to have some swelling of the foot if a vein graft has been taken from the leg. Do not allow your legs to hang while sitting in a sofa or a chair. Keep your legs at level on a stool. While sleeping, raise your legs with help of one or two pillows. Wear your elastic stockings while standing or walking.

4. Care of operation site
One week after operation wash the operation site daily with mild soap and luke-warm water. Avoid vigorous scrubbing. Pat dry the operation site with a soft, clean towel. Do not apply any lotion, cream, oil or powder on your incision, unless prescribed by your cardiac surgeon.

5. Smoking / chewing of tobacco or pan masala
SAY NO TO SMOKING AND ALL FORMS OF TOBACCO : Smoking can further damage your already compromised lungs and can also increase the chances of getting your grafts blocked.

6.Visitors

Limit you visitors for the first couple of weeks. Visitors may transmit some communicable disease unknowingly. Also, too many visitors may disturb your rest and relaxation.

7. Diet

Eat well balanced meal. Avoid fatty, fried foods and foods high in salt and cholesterol. Take high protein diet, fresh-fruit and vegetables. Discuss about your diet with the dietitian at the time of discharge.

8.Danger signals

If any of the following symptoms / signs develop, come to the hospital and meet the doctor:

i. Reddened and swollen wound, warm to touch.

ii. Any type of discharge from the wound.

iii. Fever with chills.

iv. Fever with temperature more than 1000F two times in 24 hours.

v. Increasing ankle swelling.

vi. Excessive vomiting.

vii. Heart rate more than 150 beats / minute.

viii. Shortness of breath NOT relieved by rest.

ix. Sudden numbness or weakness in arms or legs.

x. Fainting spells

FOLLOW UP

Even when recovery is complete and you have resumed your work, regular follow-up visits to your cardiologist / cardiac surgeon are essential. This is essential to keep a check on various risk factors, including diabetes, hypertension, obesity and high lipid levels in blood.

What can you do to reduce the progression of coronary artery disease:

See prevention and slowing the progression of atherosclerosis and coronary artery disease.