Open heart surgery is a serious procedure that will change the course of your life for several months beginning on the day your doctor decides it is the best course of action.
Although open-heart surgery sounds scary, and it is, the mortality rate is lower than you think. Still, it may take up to six weeks post-surgery for you to start feeling like you are in recovery and even longer to feel like yourself again. Still, for many people, the outlook is good, and the procedure provides a solution that improves your health for many years.
Because you could be down and out for four to six weeks, preparation for open heart surgery is vital. You’ll need to prepare physically and mentally, and you will also need to prepare your family and friends to help them understand what to expect and to provide you with the help you’ll need.
You will get plenty of advice from your medical teams to help you prepare for open heart surgery. It’s important to read that literature carefully and discuss questions and concerns with your healthcare provider. But some organizational things may not come up in the literature.
We put together a guide of the practical, non-medical things to keep in mind before open heart surgery.
How Much Help Will You Need? Consider It Carefully
As you prepare for open heart surgery, you may think about your health and physically preparing for the surgery itself. But the biggest challenge often lies in the four to six weeks after your surgery, and you want to start thinking for those challenges in the months before your surgery.
Depending on your health and your recovery, you could spend four to six weeks recovering from your surgery. You will likely need a lot of help during this time, and if you have a partner or spouse, they may also need extra help caring for you.
In the months and weeks leading up to your surgery, contemplate how much help you might need. Talk to family and friends in advance about your needs to find people available and willing to help.
You’ll want to designate specific roles to people to avoid chaos. For example, you might choose one person to coordinate your post-operative visits and meals. It’s also important to define your expectations. In the first days, you’ll want only a few visitors per day because you will be both weak and prone to infection.
You also want to find a backup caretaker for when your primary helper is unavailable. Professional help is often a good idea, and if you receive Medicare or Medicaid, your plan may cover those services. It’s difficult to know how you and your body will respond to surgery, and you may find simple things to be too strenuous. Having an extra set of hands is invaluable for many people.
Mentally Preparing For Your Surgery
For many, the most protracted process involves mentally preparing for your surgery. An open-heart procedure is often the culmination of months or years of health issues, and the procedure comes with risks. When it arrives, it’s as often as mentally challenging as it is physically exhausting.
Those who undergo this type of procedure to spend time relaxing before the surgery. Get a massage, follow a meditation program, and get plenty of sleep.
But you should also be prepared for the frustration that might also follow you on your journey. Hospital bills and insurance coverage issues will almost certainly come up. These issues take time, energy, and a considerable amount of mental fortitude to bring to a conclusion.
Former patients also say to prepare for both disappointment and sweet surprises. Some of the people who promise the world before your surgery might let you down during recovery. At the same time, other people might surprise you and provide incredible support in the weeks and months after your surgery.
You should also consider the inevitability of cabin fever. You can’t drive for weeks after your surgery, and many people find it isolating. Additionally, you’ll likely see yourself exhausted for several weeks so anything more than a short walk might take too much effort. You may spend a significant amount of time at home for four to six weeks after your surgery, and it can take a toll.
Finally, consider building some strength in your chest if your doctor says it is okay. Classes like pilates will help you add muscle and potentially even recover faster or with less pain after your surgery. Light exercise might also help you improve your mental wellbeing before surgery, which is a bonus.
Only engage in exercise recommend by your doctor, and be mindful of activity that challenges you physically.
Preparation for these eventualities also helps you mentally prepare for them. However, it’s still important to acknowledge some of the challenges that lie ahead.
What To Do Before Open Heart Surgery
As you prepare for open heart surgery, you will work with members of multiple teams including your general physician, a cardiology team, a surgery team, and nursing staff. All these people play a unique and essential role, but it’s important to remember that you are also a member of the team.
Open heart surgery requires your active participation before and after the surgery. If you have questions and concerns, it’s important to raise them with the relevant member of your team.
Before your surgery, your care provider will furnish you with written materials to help you get ready. Read them carefully and ask questions you may have before days before you begin completing the pre-surgery checklist provided.
In the weeks before your surgery, you have four items on your to-do list.
First, make an appointment to visit your dentist. You will need clearance from your dentist for surgery. Dental problems cause delays.
Second, set up plans for returning home after surgery. You will want someone to collect you from the hospital as well as someone to help you as you return home. You will likely need help for the first few days and weeks after your surgery, particularly with large tasks like cooking and driving. You will not be able to drive for two to three weeks after your surgery.
Third, nominate your family spokesperson. The hospital will want to know who to speak to and consult before, during, and after your surgery. Your spokesperson will talk with the members of your healthcare team and then pass on the information to other members of your family.
Make sure your family spokesperson is comfortable with the nomination as they will be the only family member the team will speak to.
If you are a candidate for open heart surgery and you have diabetes, consider visiting a podiatrist before your surgery.
What To Do Two Days Before Your Surgery
Because you will spend the day before open heart surgery at the hospital itself, you’ll use the last few days before hospital to prepare for your stay in the hospital and the weeks ahead.
Packing For The Hospital
Start the process by packing for your hospital stay. If your doctor gave you a checklist to follow, we encourage you to start there first. Your doctor’s list will be unique to your hospital.
In addition to your doctor’s checklist, be sure to pack things like:
Be sure not to bring valuable items with you to the hospital. Leave jewelry, large amounts of cash, and expensive electronic devices at home. If you bring your mobile phone or tablet, ask your family representative or another family member to look after it for you.
Although you should avoid bringing large amounts of cash or credit cards you won’t use, many patients find petty cash helpful for buying small items like newspapers or additional comfort items. It is often useful to leave this cash with your family member, too, and ask for it back after surgery.
If there is no other alternative, you may ask the hospital to store personal items in the safe until you receive your discharge.
What To Do One Day Before Your Surgery
Most open-heart surgery patients receive instructions to check in to the hospital the day before their surgery. By now, your bags are full, and your home should be ready for your arrival in a few days.
The instructions provided for the day before your surgery are vital to the success of your operation.
Your doctor will provide you with fasting instructions and potentially other pre-operation directions. Follow these carefully and inform your care provider if an issue arises.
You should also receive a designated anti-bacterial soap from your team. Shower with the soap the night before your surgery. It helps lower the amount of bacteria on your person, which could lower your risk of infection.
If you are in the hospital and struggle to sleep, tell your care provider. In some cases, they will provide medication to help you relax or sleep. A good night’s rest is vital for waking up refreshed and calm and ready for surgery.
What Happens The Day Of Your Open-Heart Surgery
In many cases, you will wake up in the hospital on the day of your procedure. If so, your team will walk you through the routine to prepare for surgery.
Your medication regimen may change on the day of your surgery. If there are prescriptions you are not allowed to take, your team will let you know. Be sure only to take them with enough water to help you swallow to avoid breaking the fasting regimen.
Throughout the day, you will need to provide a list of your medications and your prescription instructions. Your nursing team will also take your temperature and check your vitals for a baseline and to rule out any last-minute infections.
What To Do After Your Open Heart Surgery
After your surgery concludes, you arrive in the ICU. Initially, you will use a catheter and may use a nose and throat tube to keep your stomach empty. For the first few hours, you will get your medications and all other fluids through a catheter.
Your family may visit you in the ICU after getting clearance from the care team. Your designated organizer should help manage these visits and keep them limited to a few people a day.
What you do after your surgery often depends on how well you prepared for your recovery before entering the hospital. Ideally, you will have set up:
Remember to keep in communication with your doctor and health team. Attend your appointments and let them know how you feel. Only you know how your body feels, so let people know when you can.
Are You Ready For Open Heart Surgery?
Open heart surgery is a huge deal, and it will dominate months of your life no matter how much you prepare. Committing to putting in the work before and after the surgery will help you feel more confident when you arrive at the hospital for your surgery and when you go home.
Remember that the most important instructions come from your doctors and medical team. They are also your best resource because they know both your health history and the risks of the procedure. Communicating with your doctors and your family and friends will be the most critical part of preparing for and recovering from your surgery.
Finally, preparation requires both mental and physical tasks. You may find that your surgery is as emotionally exhausting as it is physically exhausting. Give yourself the time and space to recover and acknowledge when you need more help.
Are you getting ready for open heart surgery? What’s the greatest challenge? Share your thoughts in the comments below.
No matter what type of surgery you need, the process is nerve-wracking. You experience anxiety from merely waiting for the day of your operation and especially when it's as serious of a surgery as open heart. However, knowing how to prepare and what to expect reduce your stress, at least slightly.
About An Open Heart Surgery
Open heart surgery describes any surgery that requires a surgeon to make an incision in part of the chest cavity to access the heart muscle. The name is a bit misleading since, nowadays, the surgeon usually makes a small incision, rather than entirely cutting your chest open, to perform a procedure on either the heart or heart valves.
The National Heart, Lung, and Blood Institute declares coronary artery grafting as the most common variety of open heart surgery performed on adults. The surgeon connects, or grafts, a clogged artery to another healthy vessel, bypassing the area where the blockage is. Ultimately, this allows blood to flow more optimally through your heart.
It’s possible if you have one or more heart valves with damage that you may need to undergo open heart surgery to repair or replace the valve. You could also have this type of procedure if you have heart abnormalities or damage to your heart. Surgeons use this form to implant medical devices like pacemakers or replace a damaged heart with a donor one.
What To Expect During Open Heart Surgery
Expect a seven- to 10-day hospital stay. The recovery time depends on how well you heal and your current level of health prior to having the operation.
When you come in on the day of your procedure, a nurse preps you for the surgery. Anticipate the procedure taking at least three to six hours.
First, you get general anesthesia before the procedure. The anesthesia keeps you asleep during the entire process, so you’re unaware of what’s going on. You won’t feel any pain during any portion of the surgery either.
Once you’re under, the next portion consists of removing hair on your chest, which a nurse will do for you. This eliminates the risk of your body hair interfering with your procedure.
Then, the surgeon creates an incision in your chest. Although it was once standard to make an 8- to 10-inch slice in your chest, your surgeon may cut a much smaller area because of today’s advanced technology.
The incision runs through part or all of your breastbone, so the surgeon may access your heart. The surgeon might need to connect you to a heart-lung bypass machine, which pushes blood away from your heart, allowing the surgeon the ability to operate. However, advancements allow surgeons to operate without the need for this device in many cases.
The next part of the surgery consists of the surgeon bypassing or replacing the damaged vessel or valve. If you need an entirely new heart, this is when the surgical specialist removes your old heart and replaces it with a new one.
Finally, the surgeon closes your breastbone using a wire. The wire remains inside your body. Then, the surgeon uses stitches to close your original cut. If you’re older or had multiple surgeries in the past, the surgeon may opt to use sternal plating, a procedure that reunites your breastbone using small titanium plates.
You stay in the intensive care unit for at least one week following your surgery. It might take up to six weeks after your surgery for you to truly feel better. For some individuals, it takes up to six months to experience the full benefit of the surgery.
What To Know About After Open Heart Surgery
When you wake up from the general anesthesia, you’ll have two or three drainage tubes extending from your chest. These tubes help eliminate fluid from around your heart. At this stage, you might still have an IV in your arm to supply you with hydration. You also might have a catheter to eliminate urine.
Once you’re up from the anesthesia and are starting to get around a little bit, a member of the staff will cleanse your wound on a regular basis. You’ll learn how to perform this task before you leave the hospital, so you or someone else may do it for you at home.
Before you even leave the hospital, the doctor prescribes pain medication to promote a more comfortable recovery.
Risks For Open Heart Surgery
Part of preparing for open heart surgery is understanding the risks associated with the procedure. Often, knowing that a procedure is common and not much risk usually will ease your mind a bit.
First and foremost, the mortality rate for the surgery is extremely low. A study published back in 2013 showed the mortality rate when people were still in the hospital was 2.94.
Though these side effects aren’t common, you could experience any of the following:
Preparing For Your Open Heart Surgery
You have several steps to perform before you’re ready for surgery.
Talk To Your Surgeon
Initially, you want to consult with your surgeon. He or she provides you with information that can assist in easing your mind about having open heart surgery. You want to let the practitioner know if you’re taking any medications, vitamins, minerals, or herbal supplements.
You want to start discussing with your doctor what you need to do early to avoid missing out on the deadlines you have. For example, you’re going to need to have imaging of your heart and surrounding tissue performed before the surgery. You’ll also need to have bloodwork done to determine if you have any issues that could cause you problems.
More than likely, you’ll receive advice about how to prepare for your procedure. For instance, if you smoke, you’ll need to quit two weeks prior to having the surgery. Additionally, if you take blood thinners, you must stop them two weeks before the procedure, or you risk experiencing heavy bleeding during the surgery.
Make sure you let your doctor know about any drug or alcohol addiction you suffer from. If you quit immediately preceding the surgery, you risk having withdrawal symptoms during the surgery. This is especially the case if you suffer from alcohol or benzodiazepine addiction because either one could induce a seizure during your surgery.
Straighten Out Your Home Life
Before you go into surgery, make sure you prepare your life for the pause you’re going to have to take. For example, schedule someone to come into your home and take care of your furry friends and water your plants when you’re in the hospital.
Prepare all of your legal documents, so they’re in one easily accessible area. Although you don’t want to think something is going to happen, you do want to prepare for life no matter what is in the future.
Make sure you clean your house thoroughly, so you don’t have to return home to filth.
At this stage, you want to prepare your home for your recovery. You should have extra pillows and blankets in your bed for when you go back home. You might want to have a stash of books and recorded programming on your DVR in order to keep yourself busy.
Changing Lifestyle Habits
You should quit smoking and drinking alcohol at least two weeks prior to your surgery. Although it's best for your heart to discontinue or at least limit your intake after your surgery, you may resume smoking and drinking after you recover from open heart surgery.
You need to quit smoking and drinking before surgery because they can cause delays in your post-surgical recovery. Drinking can impair your immune system as well as your liver function. Alcohol coagulates your blood, increasing your risk for complications.
Surgery is stressful. Not to mention, you could develop pneumonia or other lung issues. Thus, you want to start deep breathing exercises prior to your surgery. If your care team doesn't give you one, ask if you may have an incentive spirometer (IS) to help you.
Basically, you should be taking slow, deep breaths as much as possible starting a few weeks before your open heart surgery.
See Your Dentist
It seems odd saying you should seek out the assistance of a dentist before your heart surgery, but you want to make sure you don't have any oral health issues that could affect your heart. For instance, issues like an abscess or infection could lead to an infection in the lining of your heart – a condition known as endocarditis. You may want to discuss any oral health problems with your surgeon if you know you have them, so you and your dentist can work together to ensure the best possible outcome for your surgery.
Designate A Communicator
You'll want to designate a person to speak on your behalf to the rest of your family. You want this person to be responsible for communicating with health professionals and then relaying the information back to your loved ones. Be sure to let your surgical team know who this person is. You may want to make this person the same one who's your power of attorney (POA).
Preparing The Day Before
Make sure you pack a bag with comfortable clothes for at least one day after your procedure, more if you don’t have anyone who’s going to fetch items for you and deliver them.
Keep a list of all the medications you take and the dosages you take. You also want accurate insurance information on hand. You should make sure this information is accessible, so you can give it to whoever needs it.
Your doctor may request you wash using a special soap that cleanses your skin and removes bacteria to prevent an infection from occurring. Generally, you have to quit all liquids and solids before midnight the night before your surgery.
It’s best that you show up for the procedure in loose-fitting clothing. This will make you feel more comfortable and it easier to prep you.
Preparing After Your Surgery
Your aftercare is essential for how you heal. You may need to make certain lifestyle changes to promote a better recovery and outcome.
How To Take Care Of Your Incision
Although the nursing staff will take care of your wounds during your initial few days in the hospital, you'll eventually need to take care of your own incision. It isn't as hard as you think. Instead of scrubbing out your wound, just take daily showers and allow the soap and water from washing to flow over top of your wound.
Once you get out of the shower, you want to just pat your incision dry rather than scrubbing. If you scrub it, you could risk ripping your sutures.
Know The Signs Of Infection And Other Complications
You want to contact your surgeon immediately if you have any signs of infection. For instance, if you have a fever over 100.5 degrees Fahrenheit, it could indicate you have an infection.
You want to continuously monitor your incision for redness around it, which is especially important if you have valve replacement surgery. The swelling around your incision should decrease over time, not increase. Let your surgeon know immediately if the swelling gets
You shouldn't have drainage that's an odd color like green or yellow. Let your surgeon know immediately if you have any odor coming from your incision. Additionally, you want to let your doctor know if you experience difficulty urinating or pain while you urinate.
All of the aforementioned issues are signs of an infection, and you want to receive care for it as soon as possible to prevent any serious complications.
It's possible to have congestive heart failure after you undergo surgery. The signs of it include the following:
Precautions After Your Surgery
Your surgeon will let you know when you can start resuming your daily routine and when you can start exercising again. You'll need to start slow, so you must enter into a rehabilitation program appointed by your doctor.
Once you get out of the hospital, you'll want to keep walking as much as possible. You want to try to walk when it's cool outside as opposed to when it's hot and humid. Start off slowly and then gradually increase how far you can walk. Keep in mind, this is essential for preventing blood clots and also for strengthening your heart and keeping your body in shape. Even if you feel like you can do more strenuous exercise, don't.
You won't be able to lift anything heavier than five pounds for the first six to eight weeks after your procedure. This is about the weight of a gallon of milk. If you lift anything heavier, you risk hurting your sternum. Moreover, you don't want to push or pull anything for the same reason. You may even want to cross your arms while holding your elbows when you sneeze to prevent problems.
Recognizing Depression And Anxiety
It's quite common to experience depression or anxiety after you have open heart surgery. Doctors aren't sure why it happens though. The feelings of depression are typically only short-term, so they only last a few weeks after surgery. If they last any longer, it's important to talk to your physician because you may need an antidepressant.
Sometimes, you develop anxiety, often because of the pain you're experiencing. Unfortunately, anxiety can make your pain feel even worse. You may need to learn some tactics to combat your pain and anxiety besides just taking pain meds. For instance, it might help you to learn breathing techniques or find activities you can do to take your mind off of everything.
Changing Your Lifestyle To Promote Heart Health
Especially if you partook in unhealthy lifestyle habits that led to you needing surgery, it’s important for you to make a plan for what you’re going to change after the surgery. Maybe, you want to lose 15 or 20 pounds, so you’re a bit closer to your target weight, so you
don’t risk needing surgery again.
Changing your diet is essential too, no matter what type of surgery you had. You want to limit your sodium intake because excessive sodium can cause high blood pressure. Additionally, your surgeon will want you to limit your caffeine intake, especially when you first get out of the hospital.
Open heart surgery isn’t a pleasant experience, but knowing how to prepare gives you an advantage. You can have less to worry before the surgery and won’t have to go back home where nothing is ready for you.