A survivor’s advice to patients – side effects of surgery at home

Debra Becker is a heart disease survivor. Her guest blog will share her story and her advice for others in four installments. This is Part 3. Read Part 1 here and Part 2 here.

Debra Becker

This past October I had unexpected open heart surgery to repair my mitral valve after several major cordae (chords) broke. Seemingly healthy with no known personal history of heart disease, I exercised regularly and maintained a healthy diet. Although everyone’s recovery is unique, there are numerous side effects you’ll likely experience after cardiac surgery.

This article focuses on patients’ first months home from the hospital.   Even if you entered the hospital in nearly peek physical shape, cardiac surgery drains you in ways you never imagined.

• After an extended hospital stay, your own bed has never felt so comfortable!
• Muscle weakness anywhere and possibly everywhere, due to extended inactivity and abnormal sleep cycles. Walking and light stretching, if allowed, will help. Ask your doctor to prescribe physical therapy if necessary.
• Although the swelling in your legs and feet should subside soon after leaving the hospital, your chest will probably be swollen for a couple of months post-surgery. Note: if your doctor prescribed diuretics before bed, you may wake up frequently throughout the night to urinate. If so, inform your doctor, who may move your evening dosage back to late afternoon or eliminate it completely.
• If your skin remains dehydrated and flaky, a regimen of gentle weekly exfoliation will help tremendously! Continue moisturizers and serums too. Do avoid your surgical scar sites until your surgeon gives approval.
• You may shower. Consider installing a shower chair for increased stability. Allow warm water to trickle down your incision, and pat dry; do not rub your incision. You will be asked not to take a bath, sit in a jacuzzi or swim for approximately a month.
• Constipation will be resolved with stool softeners and magnesium. If constipated, ask your doctor about switching from Ferrous Sulfate to Gentle Iron, which is more easily absorbed. Be sure your dosage of Gentle Iron contains an equal amount of elemental iron. For example, 325mg of Ferrous Sulfate contains 65mg of elemental iron per pill.
• Mood swings and depression are expected; cardiologists routinely prescribe anti-depressant medication following cardiac surgery. You are not alone!
• It takes about a month for the glue holding the skin covering your sternum together to dissolve. Most likely, the incision will have scabbed over before the glue comes off.
• Your sternum bone will heal in six to eight weeks. It is essential not to use your arms or your core while the bone is healing; they work in tandem with your sternum. Heed your surgeon’s advice!
• Sternotomy scar – expect your scar to be red in color for several months, eventually fading to a thin white line. Women, your bra may rub against your incision, causing a lump at the top and/or bottom. This will disappear over time. Most likely, you be able to begin treating this scar after the glue and scabbing fall off. To achieve faster healing, ask your dermatologist for recommendations.
• Drainage tube and pacing wire scars: Begin treatment with aquaphor and antibiotic ointments, with your doctor’s approval. About a month after surgery, you’ll most likely be allowed to use scar gel to reduce the appearance of these scars.
• IV and central line scars should heal quickly on their own. Scar gels and moisturizers may help.
• Reduced exercise: the first couple of months post-surgery, short walks and climbing stairs once or twice a day will comprise your at-home exercise program. A Cardiac Rehab Program may be prescribed and is an excellent means to help you establish a proper exercise program one step at a time and give you the knowledge and routine to maintain it.
• Severe loss of mental focus was totally unexpected, yet it is very likely and commonly does not resolve for at least a year.
• Inability to work – you won’t medically be allowed to work for a minimum of three months, often five or six. Your body and mind need this time to heal.
• A healthy, balanced diet is now more important than ever! Ask to see a dietician if you want professional guidance.
• Bi-annual dental exams and cleanings are crucial! Plaque from periodontal disease frequently escapes through your bloodstream to your coronary arteries, potentially leading to coronary blockage and a compromised heart.
• Antibiotics may be required before dental cleanings/work and surgery on any area that cannot be sterilized.
• Cholesterol levels will be routinely monitored. If your LDL or triglyceride numbers are elevated, or you have coronary artery blockage, more sophisticated tests, nutritional counseling, further surgery and/or statins may be required.
• Blockage of sinuses; for me, the essential oxygen therapy before, during and after surgery led to ongoing nasal congestion. A visit to an ear, nose and throat specialist found a papilloma blocking my left nasal passage and cauterized it with endoscopic nasal surgery, right in the office. I was able to breathe much better immediately after the lesion was removed!
• Stress should be non-existent; it will interfere with healing. If your environment subjects you to stress, ideally, eliminate the toxin.
• You may become very sensitive to extreme hot and extreme cold temperatures. I was surprised when I became physically sick shortly after being outside in frigid weather. If you live in a cold climate, consider requesting a handicap tag for your vehicle. My internist completed the paperwork and I picked up the tag at my town hall.

One more piece of advice: advocate for yourself! Your physician’s instructions will be based on education and also what has worked best for the majority of his or her patients.  If these directions are not working well for you, speak up and seek or even suggest  more optimal alternatives.

Thanks for reading my American Heart Association blog!

Debra