What to Expect Before and After Surgery

After Surgery

The length of your surgery
You and your family should expect that you will be in surgery for several hours. The operation itself doesn’t take that long, but extra time is needed for surgical preparation and completion.

Waking from anesthesia
When you start to awake, you may hear sounds in the ICU, such as beeps and alarms from the equipment around you. You will probably hear people talking. A nurse may ask you questions or tell you that your surgery is over.

Pain
Pain medications will be ordered and should be taken when needed. They help you rest and move around more easily.

Don’t wait too long to ask for pain medication if you need it. It works best that way.

Family visits
Your family is welcome to visit after surgery and help you recover during your hospital stay.

You need time to rest in order to regain your strength. During these visits, your family members may feel free to touch you, hold your hand and even kiss you.

When your family leaves the hospital, they should tell you and your nurse where they can be reached and when they plan to return.

As you regain strength, your family can begin helping you with some of your daily activities, such as walking and bathing. This helps them become accustomed to assisting you in your recovery. It also helps everyone to feel more comfortable with the care you will receive when you return home.

Your recovery
At first, you’ll be allowed to have only ice chips or sips of liquid. Your diet will then be advanced as tolerated. In most cases, you may be allowed to eat solid foods as soon as the next day. It’s important to try to eat the food you are given, because it will help the healing process.

Your nurse and a respiratory therapist will have you begin deep breathing and coughing exercises. The reason for his is to clear and re-expand your lungs.

At first, a nurse may have to assist you in turning from side to side in your bed, but soon you will be able to do this yourself. You will also receive daily physical therapy, when needed, and be able to get more active in other ways, such as sitting in a bedside chair and going to the restroom. Most surgery patients can do this the first day after surgery.

Your incisions will bother you less as you become able to move around. If they remain sore or continue to bother you, try to relax, change positions a lot, or elevate your legs if they are sore. Also, do not hesitate to ask your nurse for pain medication as needed.

If you’re diabetic
This information is for those of you with the diagnosis of diabetes. We want to assist you with your care. After surgery, it is especially important to monitor and control your blood sugars closely. We will be asking you to check your blood sugars more often than some of you have in the past.

We will supply a log for you to record your blood sugar numbers, and the nurse will be providing you with further information. Some adjustments to your medications may be necessary, and those changes will be reviewed with you.

Activities during recovery
Following are descriptions of what you can expect as you attempt various activities during your recovery in the hospital.

Leaving your bed
One of the first things you will do is go from lying in your bed to sitting on the side of it. After that, you will move from the bed to sitting in a chair, then walking about your room, and finally, walking in the hallway. You will need assistance at first, and should accept it so that you don’t risk injury. As your strength returns, you’ll be able to move about alone.

Some steps to remember that will help you get out of bed easier include:

Start by raising the head of your bed
Roll over on your side to reach the edge of your bed
Swing your legs over the side of the bed, and use your elbow to raise you upper body. If you need to, use the side rails to help, but not to support your total body weight
Take a couple of minutes to just sit on the side of your bed. Make sure you don’t feel dizzy or lightheaded before you try standing up

Relaxing
After surgery, it’s normal for patients to feel a little anxious or frightened. Learning how to relax can help you feel calm and return to normal activities faster. Why? Because relaxing both your mind and your body will help you get out of bed and walk more easily and comfortably. Relaxing also helps relieve pain and promotes better, more restful sleep. All of this adds up to a quicker recovery.

A simple relaxation exercise you can practice is called “controlled breathing.” To do this, try to focus only on your breathing. Doing this can help you avoid more stressful thoughts. You may want to practice this before your surgery. Once you have learned how to do it, you can use controlled breathing to help you anywhere, anytime. Here is how to do it:

Find a quiet place where you won’t be disturbed
Get into a comfortable position
Close your eyes and visualize a place that, to you, is safe and secure
Breathe slowly and easily. Inhale through your nose to a count of four. Hold for several seconds, then exhale through your mouth to a count of six
As you breathe out, let your muscles relax and your mind and body release the stresses of the day

Respiratory exercises
As we mentioned earlier, you will begin breathing and coughing exercises soon after your surgery, which will help clear mucus from your lungs.

This mucus collects in lungs during any major surgery, and if you don’t get it out, it can cause pneumonia and other health problems you don’t want.

The deep breathing exercises open up tiny air sacs in your lungs. Coughing helps bring up the mucus. The better you do these exercises, the more quickly you will recover. They won’t harm your incision, but it may hurt when you do them. If so, ask your nurse for pain medication.

You may want to practice these exercises before your surgery. This could help you to do them better once you are in the hospital. The best way to practice them at home will be to do them in a chair.

Sit with your back supported and with your feet on the floor. Hold a pillow or blanket firmly against your chest (in the hospital this will offer support to your incision).

Whether in a chair or a bed, the way to do the exercise is to:

Breathe in slowly through your nose for a count of two. You should feel your rib cage expand as your upper chest and shoulders relax.
Breathe out slowly through your mouth.
After several deep breaths, breathe in slowly through your nose. Open your mouth, stick out your tongue and cough hard 3 times as you breathe out.
Repeat the third step several times.

A respiratory therapist or your nurse will use a device called an incentive spirometer during your deep breathing exercises. This device gives you feedback regarding how well you are taking deep breaths. Slow, deep breaths are important for opening up your airways and expanding your lungs. Without them, the coughing part of the exercise will be less effective.

Leg exercises
Tightening and relaxing your leg muscles squeezes the veins in your legs to improve blood flow and help strengthen your leg muscles. There are a number of ways to do this. You can:

Press your feet against the foot of the bed
Turn your feet in a circular motion
Bend your feet and toes toward your head while keeping your legs straight
These leg and foot exercised can be done several times a day, for 10-20 repetitions at a time, or as your doctor recommends. If needed, a family member can help you. You probably won’t need to do these exercises once you start walking and get more active.

Walking
As you regain your strength, you may start to take several short walks in between times of rest. These walks will actually help you feel less tired. Your walking posture should be as straight as possible, even if you are sore. Good posture provides better balance, and helps you breathe better. Just be sure you are wearing well-fitting slippers with non-skid soles.

If your doctor has ordered support stockings, make sure you leave them on during your walks. They aid blood flow and help reduce swelling in your legs. Your support stockings should remain snug as you walk. If you notice them rolling down, or leaving marks on your legs when you remove them, let your nurse know. She or he may need to find you a better-fitting pair. Don’t walk in the stockings without slippers or shoes. The stockings are slippery and could cause you to fall.

Sitting in your chair
You may find it more comfortable to sit in a chair that has a firm back rather than sitting on the side of your bed – especially if you are sitting for a longer period of time. Placing a pillow under your arms will also improve your comfort level in the chair because it will prevent your shoulders from drooping.

When sitting in your chair, remember not to cross your legs. Crossing them places pressure on the veins under your knees, which slows blood flow. If your legs or feet swell, elevate them using another chair or stool which is higher than the one in which you are sitting.

Intimacy and your heart
After surgery, resuming sexual relations may cause you to feel some concern. As you begin to feel better, these thoughts are likely to pass. In order to help you work through your feelings, speak to your partner regarding your concerns. Your partner may share your concerns and together you can work through them. When you are ready to resume sexual relations, start slowly, relax and enjoy one another.

Sex after heart surgery
After major surgery, it is important to ask your doctor prior to resuming sex. Once you receive the OK, you can resume sexual relations without fear of injuring yourself. Healing after surgery most often takes 4 to 6 weeks.

STOP SMOKING
Refraining from smoking is the best thing you can do for your health.

As a result of your surgery, you were most likely forced to stop smoking. As difficult as this may be for you, it is very important that you continue not to smoke.

Smoking has several detrimental effects on your heart and lungs. It can increase you heart rate, narrow your blood vessels, raise your blood pressure, cause spasms of your coronary arteries and scar your lungs. Kicking the habit is one of the best things you can do for your heart and your health.

Here are some helpful tips to help you refrain from smoking:

Discard any and all cigarettes or ashes.
Clean out all ashtrays and put them away.
Ask friends and family members not to smoke around you.
Set a goal for yourself each day. Tell yourself, “today, I will not smoke.”
Remember, one cigarette is one too many. This will have an adverse affect on your progress.
Don’t think just one cigarette won’t matter, because it will!

Going home
You and your family will be asked to attend a homegoing discharge class. The group provides an opportunity for families and friends to acquire information, ask questions, and share experiences. A case manager, dietician and physical therapist are involved with this class to answer any questions you may have.

Before leaving the hospital, someone will outline a program of initial home recovery with you. Your first few weeks at home are a good time to enjoy naps, plan things to do a day at a time, and slowly rebuild your strength.

Once you are home, you’ll start to feel more like doing your normal activities. Just be careful not to rush things. Your body needs time to heal. It will let you know how much to do and how fast. So do what you can. But don’t forget to relax and enjoy your recovery.