When one should resort to Driving, stair climbing and normal sexual activity after Bypass surgery?

cartier95 Says:
January 10th, 2010 at 8:02 am

After Surgery

After your surgery you will be taken to the surgical intensive care unit on the ground floor next to the operating room. A nurse will be with you at all times. You will stay in the intensive care unit for about 24 hours. You will have some tubes and machines connected to you to help your recovery. They include:

A tube in your mouth to help your breathing for the first little while. It is connected to a respirator. It is usually removed a few hours after your surgery and replaced with an oxygen mask. The oxygen mask will be replaced with nasal oxygen.
Intravenous into the vein for fluids for approximately 24 hours.
E.C.G. patches on the outside of your chest to read the heart beat.
A tube to your bladder to drain your urine. This is in place for about 48 hours.
This sounds like a lot of equipment, but it is necessary and it is not long before it is all removed.

After the breathing tube has been removed you have to do deep breathing and coughing exercises. The physiotherapist and nurse will help you and support your chest while you do the exercises. You must do the exercises every two to three hours for about three to four days in order to prevent pneumonia.

The morning after surgery you will usually be sitting up on the edge of the bed and begin taking fluids like juice, milk or water. Your family can visit you in the intensive care unit for short periods of time.

Unit 6000

Once you leave the intensive care unit you will be transferred to unit 6000 on the 6 th floor of the hospital. Your care will continue, but you will become more independent. You may have oxygen and an IV for medications, but you will require less intensive care.

Approximately two days after your surgery you will be sitting up in a chair and going for short walks. Your activity will gradually increase. Within four to five days after surgery you will be able to walk the length of the hall, two to three times a day.

For the first week after surgery it is normal to have less of an appetite. You will be going home approximately five to six days after surgery.

Before Going Home

You will receive a medication prescription from your doctor on your day of discharge.
A pharmacist or nurse will review your medications with you and give you an information sheet about your medications.
A dietitian will teach you about a low cholesterol diet and give you an information booklet to take home with you.
You will receive videotape about your recovery at home that covers care of incisions, activity and diet.
The Tri-Hospital Cardiac Rehab Program Nurse Educator will visit you to discuss future activities and lifestyle modifications. Education and exercise classes at the Saskatoon Field House are available after you go home. You can take an active role to prevent further coronary artery disease.
An appointment card will be given to you to see your surgeon/cardiologist six weeks after you are discharged from the hospital.
Guidelines to Follow After Cardiac Surgery

General Guidelines for the First Six to Eight Weeks

Your strength and energy will gradually return if you gradually increase your activity and exercise and follow a well-balanced diet. Remember to stop and rest when you get tired.

Avoid extreme hot or cold temperatures and windy weather
Avoid exercise that requires extreme exertion or encourages breath holding such as pushing or pulling heavy objects (shoveling snow, lawn mowing, vacuuming) and exercise bikes with tension
Avoid constipation
Avoid lifting or carrying packages over 20 pounds (groceries, laundry, furniture)
Avoid exercising for one hour after a heavy meal
Use a regular exercise routine. Select an exercise program that is suitable for you and choose activities you enjoy.

Specific Guidelines for the First Week at Home

Stair climbing as tolerated
Rise at your usual time in the morning, dress and be up most of the day
Carry on the same activity level reached in the hospital and rest when tired
Walk 10 to 15 minutes, two to three times a day
Specific Guidelines for the Second Week at Home

Assist in light duties around the house – dusting, dishes, folding laundry
Increase exercise/walking to 20 minutes one or two times a day
Outdoor walking is good, unless it is very windy or cold. If available, walk in a shopping mall.
It is appropriate to resume sexual activity when you feel ready. A good guideline to use is when you are able to climb two flights of stairs without stopping.
Specific Guidelines for the Third Through the Sixth Week at Home

Increase your walking and/or exercise time to 30 minutes one or two times a day
Driving a car may be resumed after about four weeks, unless otherwise advised
Continue resting after meals
Consult Your Physician About the Following

Resumption of work, part-time or full-time
Participating in sports, social activities like golfing, bowling, curling, etc.
An exercise program for body conditioning, if you are not already participating in one
Diet

It is very important to follow a well-balanced diet. Refer to the diet instructions you were given before you were discharged from the hospital. You may have alcohol in moderation (one to two drinks per week), unless you are taking medications that require you to refrain from drinking alcohol. Discuss your diet with your physician. Your appetite may take a while to come back to what it was before your surgery.

Personal Hygiene

Shower or sponge bath and avoid extremes in water temperature. It you have a leg incision, showering for a few weeks is safer and easier than getting out of a tub. Keep your incisions clean with mild unscented soap. If there is any increase in redness, swelling or tenderness notify your family doctor.

Smoking

Smoking is extremely dangerous to your heart and lungs. It should NEVER be resumed. To resume smoking increases the chances of your heart disease progressing. Nicotine causes your heart rate and blood pressure to rise, increasing the workload on your heart and stress on your lungs.

Many questions arise as to what you should do or should not do after discharge. The following are answers to the most common concerns and questions.

While the sternum (breastbone) is healing, avoid lifting greater than 10 pounds, or pushing/pulling activities with your arms. The breastbone takes about 6-8 weeks to heal generally.
Showers are permitted but tub baths are discouraged for 4-6 weeks or until your incisions are healed. Avoid extremely hot water which may cause you to feel dizzy or weak. You may gently wash (don’t rub) your incision with soap. Do not use creams or lotions on incisions until they are healed.
Avoid driving a car for 4-6 weeks after surgery. Your reaction time will be delayed due to weakness, fatigue, and/or medication. You do not want to risk hitting the steering wheel and re-injuring the sternum. When riding in a car for long distances, stop every 1-2 hours to stretch your legs. This will improve circulation in your legs and help prevent swelling.
Do not cross your legs while lying in bed or sitting. This puts pressure on the veins under the knees and slows blood flow. If your legs or feet swell, you should put them on a chair or stool while sitting.
Sleep the number of hours that you normally slept before your surgery. Do not stay up very late one night and try to "catch-up" the next. However, if you do plan to stay up late, take a nap beforehand.
Avoid isometrics : straining to move your bowels, pushing/pulling heavy objects, or working with your arms overhead. These activities disproportionately elevate blood pressure and put an added strain on a healing heart.
It is important to space and pace your activities to minimize fatigue. If you feel tired, STOP, and rest for a while. Don’t push yourself to finish a task.
A rest period should be taken at least once a day for a few weeks and, initially, preferably twice, morning and afternoon. Napping is not necessary, but resting is. Be sure to dress daily in street clothes. You are on your way to recovery!
Stair climbing is not discouraged. Avoid pulling yourself up with a handrail, and go slowly.
Use your elastic stockings during the day and remove them at night. You should wear the stockings for at least 2 weeks after discharge or more if your ankles are still swollen. The stockings aid blood flow and help reduce swelling in the legs. It is easiest to put the stockings on before you get out of bed in the morning for the day, however most people put them on after a morning shower. They should fit snugly.
Your may notice a swelling or lump at the top of your chest incision which could take several months to disappear.
Most patients experience incisional discomfort in the sternum. This discomfort will decrease in time, but may reoccur when there is as an adverse change in the weather or when you overextend yourself. Do not hesitate to use pain relieving medication as you need it.
It is important to distinguish incisional discomfort from chest pain (angina) you may have experienced prior to surgery. Contact your physician if you are experiencing chest pain.
If your chest or leg incisions do not appear to be healing (i.e., redness, drainage, swelling, or tenderness is present), notify your physician.
Take your temperature every morning for one week after discharge. Notify your physician if your temperature stays above 100 degrees F for more than a day.
Check your weight every morning for the first two weeks. If you notice a sudden weight gain, notify your physician.
When you are upset, your heart works harder. It is best to anticipate and avoid situations, people, or topics of conversation that make you tense or angry.
Remember that your diet, medications, and exercise are prescribed specifically for you. Do not expect your friend or neighbor who has a heart condition to have the same prescriptions.
Keep a record of your medications and medical history with you when traveling. (Return to Top)
Valve Surgery Post-Op Care

Tell any doctor or dentist who treats you that you have had your valve repaired or replaced. They may prescribe antibiotics before procedures, especially dental work, to prevent an infection from settling in your heart.

It is likely that you will be taking Coumadin, an anticoagulant, commonly called a "blood thinner." Coumadin causes blood to take a longer time to form a clot.

There are several points you should know about Coumadin:

You will need regular blood tests (prothrombin time) to regulate the dosage of Coumadin. Your physician will arrange these test for you.
Look for signs of bleeding while you are taking Coumadin. Notify your physician if you have:
any abnormal bleeding
red or black bowel movements
pink or red urine
severe headaches, abdominal or lower back pain
faintness or dizziness
red or "coffee ground like" vomitus
excessive bruising
excessive nose bleeds
yellow or jaundice skin
any symptoms that concern you

Take your Coumadin at the same time every day. NEVER make up for a missed dose by taking double the dose.
Don’t take aspirin, any medication containing aspirin or any "over-the-counter" medications without first checking with your physician as this can cause bleeding while taking Coumadin.
Excessive alcohol intake may also cause bleeding while taking Coumadin. Check with your physician about drinking alcohol.
It is a good idea to carry a wallet identification card indicating that you are taking Coumadin.
Recovering from Open Heart Surgery is a Family Affair

Open heart surgery is an event that affects the patient, spouse, children, and significant others. It is similar to the ripple effect in a pond when a stone is dropped. Many waves occur before the pond eventually calms. In addition to the physical recovery that the patient undergoes, there is an emotional aspect of adjustment that the patient, as well as family, experience.

Facing the possibility of changing one’s lifestyle can be quite overwhelming. Some alterations take place immediately, such as diet changes and smoking cessation. Other changes may be more gradual, such as building up to and maintaining an exercise program, or incorporating long term stress management. Of importance to all those involved is realizing that the patient does have control in initiating the changes and in maintaining healthy new habits. This is the patient’s responsibility. Spouses, children, and significant others often struggle with the impossible task of making sure the patient never deviates off course and stays on the "straight and narrow’. Remember, others can assist and encourage, but only the patient can do!

Many lifestyle changes that occur as a result of having open heart surgery have a direct impact on the entire household. When a patient is forced to make changes for health reasons, very often all minds start to think along the same lines. This is especially true for others who might possibly be predisposed to coronary artery disease. Therefore, if the recovering patient has stopped smoking, family members who smoke are now motivated to quit. And when meals now need to be prepared in a heart-healthy fashion, chances are those who dine together will also be making these changes out of practicality for the cook resulting from a renewed awareness of the benefits to the heart.

Recovering from open heart surgery creates temporary role changes and responsibility shifts among family members. When the recovering patient returns home, he/she will have temporary physical limitations and dependencies which the family members compensate. The husband will need to shop and carry packages for his recovering wife who can neither drive herself to the store nor lift heavy packages. The son or daughter will have to mow the lawn and take out the garbage for their recovering father, who now has to limit exertion while he rebuilds his strength.

Just as the family needs to coordinate efforts in assisting the patient during his limitation phase, so should they enable him to increase his independence and regain his level of self reliance. This proves to be a very delicate balance and can be a cause of friction. Staying informed of the doctors recommendations on how the patient should progress can minimize the stress of this transitional period for both the patient and family.

Recovery will be a challenge for the open heart surgery patient and his/her family. There will be days of high energy and of fatigue, accomplishments, moments of temptation, feelings of exuberance and even days of feeling blue or angry, all of which are a part of the physical and emotional healing process that takes place.

Tips for your continued successful recovery:
Encourage each other to express and discuss your feelings. Open communication can minimize misunderstandings.
Seek support by talking with others who have experienced similar circumstances. Sharing common concern can be reassuring.
Reach out for help. Having to focus on changing several habits can be overwhelming. Behavior modification groups (i.e. Smoke Enders) provide structure as well as the mutual support helpful for success.
Become knowledgeable about your condition.
Be inquisitive, attend lectures, and explore literature. Being informed can reduce anxiety.
Begin and maintain an exercise program for your physical and mental well being. Exercising with others can create added motivation.
If you are feeling emotionally overwhelmed, seek professional advise. A trained counselor can help you to cope more adequately with your concerns. Consult your hospital social worker or physician for this service.

Remember, recovery takes time. All of those involved will adjust according to their ability to assimilate the lifestyle and role changes which inevitably take place. Sharing your feelings and discussing ongoing issues can make for a smoother transition for all. (Return to Top)

Sex After Surgery

There is a great deal of pleasurable sexual activity that is not sexual intercourse. Being near someone, holding, fondling, caressing, are all activities that enhance closeness and pleasure. Since these activities require very little energy, you may engage in these anytime after discharge from the hospital. Many couples find that this expression of love allows them to return slowly to a full sex life with confidence.

Sexual intercourse requires slightly more energy, therefore a waiting time of 1-3 weeks is generally recommended. Another consideration will be position. As the sternum has been cut, a modification may be necessary in order to prevent injury to the sternum or incisional pain. Exercise will strengthen the heart and overall physical condition. So as you engage in the home walking program and witness firsthand increased endurance and confidence, you will know when you are ready. The energy expenditure for intercourse is the equivalent of walking briskly or climb two flights of stairs. The heart rate rarely rises above 120 beats/minute and blood pressure elevations are similarly mild and transient.

The person recovering after open heart surgery may be more conscious of his or her heartbeat, breathing, and muscle tension. This awareness is normal and is no cause for alarm.

Fear of performance and general depression are two psychological factors that can greatly reduce sexual interest and capacity. These are considered normal during convalescence and in most cases disappear within 3 months. If depression continues after 3-6 months, professional counseling should be considered.

Various medications may affect sexual drive and/or function. If this occurs, consult your physician. Often a change in medication or dosage can remedy the problem. Never stop taking any prescribed medication without your physic7ian’s approval.

Ways to prepare for the resumption of sexual activity:

The first step is to exercise as mentioned above.
The second step is to be tolerant of each others emotions. For a brief time following open heart surgery, emotions are delicately balanced and subject to rapid mood swings. Try to keep day to day events in perspective and remember that a good sense of humor is a good ally.
The third step is to try to adjust mutual sexual expectations. Emotional response as well as physical responses sometimes make the resumption of sexual relations fearful and that is normal. Therefore don’t expect too much at first.
Some general guidelines:

Be relaxed and rested before intercourse. Avoid sex if you are fatigued or upset.
Choose a position that does not restrict breathing or require prolonged muscular support.
Maintain a comfortable room temperature and familiar surroundings and partner.
Speak with your physician if you are experiencing any chest pain, angina, shortness of breath, rapid heart rate, or extreme fatigue in relation to sexual activity.
Wait at least 1 hour after a meal or alcoholic beverages before having sexual activity.
Open communication is important between partners.

7 Responses to “When one should resort to Driving, stair climbing and normal sexual activity after Bypass surgery?”

cartier95 Says:
January 10th, 2010 at 8:02 am
After Surgery

After your surgery you will be taken to the surgical intensive care unit on the ground floor next to the operating room. A nurse will be with you at all times. You will stay in the intensive care unit for about 24 hours. You will have some tubes and machines connected to you to help your recovery. They include:

A tube in your mouth to help your breathing for the first little while. It is connected to a respirator. It is usually removed a few hours after your surgery and replaced with an oxygen mask. The oxygen mask will be replaced with nasal oxygen.
Intravenous into the vein for fluids for approximately 24 hours.
E.C.G. patches on the outside of your chest to read the heart beat.
A tube to your bladder to drain your urine. This is in place for about 48 hours.
This sounds like a lot of equipment, but it is necessary and it is not long before it is all removed.

After the breathing tube has been removed you have to do deep breathing and coughing exercises. The physiotherapist and nurse will help you and support your chest while you do the exercises. You must do the exercises every two to three hours for about three to four days in order to prevent pneumonia.

The morning after surgery you will usually be sitting up on the edge of the bed and begin taking fluids like juice, milk or water. Your family can visit you in the intensive care unit for short periods of time.

Unit 6000

Once you leave the intensive care unit you will be transferred to unit 6000 on the 6 th floor of the hospital. Your care will continue, but you will become more independent. You may have oxygen and an IV for medications, but you will require less intensive care.

Approximately two days after your surgery you will be sitting up in a chair and going for short walks. Your activity will gradually increase. Within four to five days after surgery you will be able to walk the length of the hall, two to three times a day.

For the first week after surgery it is normal to have less of an appetite. You will be going home approximately five to six days after surgery.

Before Going Home

You will receive a medication prescription from your doctor on your day of discharge.
A pharmacist or nurse will review your medications with you and give you an information sheet about your medications.
A dietitian will teach you about a low cholesterol diet and give you an information booklet to take home with you.
You will receive videotape about your recovery at home that covers care of incisions, activity and diet.
The Tri-Hospital Cardiac Rehab Program Nurse Educator will visit you to discuss future activities and lifestyle modifications. Education and exercise classes at the Saskatoon Field House are available after you go home. You can take an active role to prevent further coronary artery disease.
An appointment card will be given to you to see your surgeon/cardiologist six weeks after you are discharged from the hospital.
Guidelines to Follow After Cardiac Surgery

General Guidelines for the First Six to Eight Weeks

Your strength and energy will gradually return if you gradually increase your activity and exercise and follow a well-balanced diet. Remember to stop and rest when you get tired.

Avoid extreme hot or cold temperatures and windy weather
Avoid exercise that requires extreme exertion or encourages breath holding such as pushing or pulling heavy objects (shoveling snow, lawn mowing, vacuuming) and exercise bikes with tension
Avoid constipation
Avoid lifting or carrying packages over 20 pounds (groceries, laundry, furniture)
Avoid exercising for one hour after a heavy meal
Use a regular exercise routine. Select an exercise program that is suitable for you and choose activities you enjoy.

Specific Guidelines for the First Week at Home

Stair climbing as tolerated
Rise at your usual time in the morning, dress and be up most of the day
Carry on the same activity level reached in the hospital and rest when tired
Walk 10 to 15 minutes, two to three times a day
Specific Guidelines for the Second Week at Home

Assist in light duties around the house – dusting, dishes, folding laundry
Increase exercise/walking to 20 minutes one or two times a day
Outdoor walking is good, unless it is very windy or cold. If available, walk in a shopping mall.
It is appropriate to resume sexual activity when you feel ready. A good guideline to use is when you are able to climb two flights of stairs without stopping.
Specific Guidelines for the Third Through the Sixth Week at Home

Increase your walking and/or exercise time to 30 minutes one or two times a day
Driving a car may be resumed after about four weeks, unless otherwise advised
Continue resting after meals
Consult Your Physician About the Following

Resumption of work, part-time or full-time
Participating in sports, social activities like golfing, bowling, curling, etc.
An exercise program for body conditioning, if you are not already participating in one
Diet

It is very important to follow a well-balanced diet. Refer to the diet instructions you were given before you were discharged from the hospital. You may have alcohol in moderation (one to two drinks per week), unless you are taking medications that require you to refrain from drinking alcohol. Discuss your diet with your physician. Your appetite may take a while to come back to what it was before your surgery.

Personal Hygiene

Shower or sponge bath and avoid extremes in water temperature. It you have a leg incision, showering for a few weeks is safer and easier than getting out of a tub. Keep your incisions clean with mild unscented soap. If there is any increase in redness, swelling or tenderness notify your family doctor.

Smoking

Smoking is extremely dangerous to your heart and lungs. It should NEVER be resumed. To resume smoking increases the chances of your heart disease progressing. Nicotine causes your heart rate and blood pressure to rise, increasing the workload on your heart and stress on your lungs.

Many questions arise as to what you should do or should not do after discharge. The following are answers to the most common concerns and questions.

While the sternum (breastbone) is healing, avoid lifting greater than 10 pounds, or pushing/pulling activities with your arms. The breastbone takes about 6-8 weeks to heal generally.
Showers are permitted but tub baths are discouraged for 4-6 weeks or until your incisions are healed. Avoid extremely hot water which may cause you to feel dizzy or weak. You may gently wash (don’t rub) your incision with soap. Do not use creams or lotions on incisions until they are healed.
Avoid driving a car for 4-6 weeks after surgery. Your reaction time will be delayed due to weakness, fatigue, and/or medication. You do not want to risk hitting the steering wheel and re-injuring the sternum. When riding in a car for long distances, stop every 1-2 hours to stretch your legs. This will improve circulation in your legs and help prevent swelling.
Do not cross your legs while lying in bed or sitting. This puts pressure on the veins under the knees and slows blood flow. If your legs or feet swell, you should put them on a chair or stool while sitting.
Sleep the number of hours that you normally slept before your surgery. Do not stay up very late one night and try to "catch-up" the next. However, if you do plan to stay up late, take a nap beforehand.
Avoid isometrics : straining to move your bowels, pushing/pulling heavy objects, or working with your arms overhead. These activities disproportionately elevate blood pressure and put an added strain on a healing heart.
It is important to space and pace your activities to minimize fatigue. If you feel tired, STOP, and rest for a while. Don’t push yourself to finish a task.
A rest period should be taken at least once a day for a few weeks and, initially, preferably twice, morning and afternoon. Napping is not necessary, but resting is. Be sure to dress daily in street clothes. You are on your way to recovery!
Stair climbing is not discouraged. Avoid pulling yourself up with a handrail, and go slowly.
Use your elastic stockings during the day and remove them at night. You should wear the stockings for at least 2 weeks after discharge or more if your ankles are still swollen. The stockings aid blood flow and help reduce swelling in the legs. It is easiest to put the stockings on before you get out of bed in the morning for the day, however most people put them on after a morning shower. They should fit snugly.
Your may notice a swelling or lump at the top of your chest incision which could take several months to disappear.
Most patients experience incisional discomfort in the sternum. This discomfort will decrease in time, but may reoccur when there is as an adverse change in the weather or when you overextend yourself. Do not hesitate to use pain relieving medication as you need it.
It is important to distinguish incisional discomfort from chest pain (angina) you may have experienced prior to surgery. Contact your physician if you are experiencing chest pain.
If your chest or leg incisions do not appear to be healing (i.e., redness, drainage, swelling, or tenderness is present), notify your physician.
Take your temperature every morning for one week after discharge. Notify your physician if your temperature stays above 100 degrees F for more than a day.
Check your weight every morning for the first two weeks. If you notice a sudden weight gain, notify your physician.
When you are upset, your heart works harder. It is best to anticipate and avoid situations, people, or topics of conversation that make you tense or angry.
Remember that your diet, medications, and exercise are prescribed specifically for you. Do not expect your friend or neighbor who has a heart condition to have the same prescriptions.
Keep a record of your medications and medical history with you when traveling. (Return to Top)
Valve Surgery Post-Op Care

Tell any doctor or dentist who treats you that you have had your valve repaired or replaced. They may prescribe antibiotics before procedures, especially dental work, to prevent an infection from settling in your heart.

It is likely that you will be taking Coumadin, an anticoagulant, commonly called a "blood thinner." Coumadin causes blood to take a longer time to form a clot.

There are several points you should know about Coumadin:

You will need regular blood tests (prothrombin time) to regulate the dosage of Coumadin. Your physician will arrange these test for you.
Look for signs of bleeding while you are taking Coumadin. Notify your physician if you have:
any abnormal bleeding
red or black bowel movements
pink or red urine
severe headaches, abdominal or lower back pain
faintness or dizziness
red or "coffee ground like" vomitus
excessive bruising
excessive nose bleeds
yellow or jaundice skin
any symptoms that concern you

Take your Coumadin at the same time every day. NEVER make up for a missed dose by taking double the dose.
Don’t take aspirin, any medication containing aspirin or any "over-the-counter" medications without first checking with your physician as this can cause bleeding while taking Coumadin.
Excessive alcohol intake may also cause bleeding while taking Coumadin. Check with your physician about drinking alcohol.
It is a good idea to carry a wallet identification card indicating that you are taking Coumadin.
Recovering from Open Heart Surgery is a Family Affair

Open heart surgery is an event that affects the patient, spouse, children, and significant others. It is similar to the ripple effect in a pond when a stone is dropped. Many waves occur before the pond eventually calms. In addition to the physical recovery that the patient undergoes, there is an emotional aspect of adjustment that the patient, as well as family, experience.

Facing the possibility of changing one’s lifestyle can be quite overwhelming. Some alterations take place immediately, such as diet changes and smoking cessation. Other changes may be more gradual, such as building up to and maintaining an exercise program, or incorporating long term stress management. Of importance to all those involved is realizing that the patient does have control in initiating the changes and in maintaining healthy new habits. This is the patient’s responsibility. Spouses, children, and significant others often struggle with the impossible task of making sure the patient never deviates off course and stays on the "straight and narrow’. Remember, others can assist and encourage, but only the patient can do!

Many lifestyle changes that occur as a result of having open heart surgery have a direct impact on the entire household. When a patient is forced to make changes for health reasons, very often all minds start to think along the same lines. This is especially true for others who might possibly be predisposed to coronary artery disease. Therefore, if the recovering patient has stopped smoking, family members who smoke are now motivated to quit. And when meals now need to be prepared in a heart-healthy fashion, chances are those who dine together will also be making these changes out of practicality for the cook resulting from a renewed awareness of the benefits to the heart.

Recovering from open heart surgery creates temporary role changes and responsibility shifts among family members. When the recovering patient returns home, he/she will have temporary physical limitations and dependencies which the family members compensate. The husband will need to shop and carry packages for his recovering wife who can neither drive herself to the store nor lift heavy packages. The son or daughter will have to mow the lawn and take out the garbage for their recovering father, who now has to limit exertion while he rebuilds his strength.

Just as the family needs to coordinate efforts in assisting the patient during his limitation phase, so should they enable him to increase his independence and regain his level of self reliance. This proves to be a very delicate balance and can be a cause of friction. Staying informed of the doctors recommendations on how the patient should progress can minimize the stress of this transitional period for both the patient and family.

Recovery will be a challenge for the open heart surgery patient and his/her family. There will be days of high energy and of fatigue, accomplishments, moments of temptation, feelings of exuberance and even days of feeling blue or angry, all of which are a part of the physical and emotional healing process that takes place.

Tips for your continued successful recovery:
Encourage each other to express and discuss your feelings. Open communication can minimize misunderstandings.
Seek support by talking with others who have experienced similar circumstances. Sharing common concern can be reassuring.
Reach out for help. Having to focus on changing several habits can be overwhelming. Behavior modification groups (i.e. Smoke Enders) provide structure as well as the mutual support helpful for success.
Become knowledgeable about your condition.
Be inquisitive, attend lectures, and explore literature. Being informed can reduce anxiety.
Begin and maintain an exercise program for your physical and mental well being. Exercising with others can create added motivation.
If you are feeling emotionally overwhelmed, seek professional advise. A trained counselor can help you to cope more adequately with your concerns. Consult your hospital social worker or physician for this service.

Remember, recovery takes time. All of those involved will adjust according to their ability to assimilate the lifestyle and role changes which inevitably take place. Sharing your feelings and discussing ongoing issues can make for a smoother transition for all. (Return to Top)

Sex After Surgery

There is a great deal of pleasurable sexual activity that is not sexual intercourse. Being near someone, holding, fondling, caressing, are all activities that enhance closeness and pleasure. Since these activities require very little energy, you may engage in these anytime after discharge from the hospital. Many couples find that this expression of love allows them to return slowly to a full sex life with confidence.

Sexual intercourse requires slightly more energy, therefore a waiting time of 1-3 weeks is generally recommended. Another consideration will be position. As the sternum has been cut, a modification may be necessary in order to prevent injury to the sternum or incisional pain. Exercise will strengthen the heart and overall physical condition. So as you engage in the home walking program and witness firsthand increased endurance and confidence, you will know when you are ready. The energy expenditure for intercourse is the equivalent of walking briskly or climb two flights of stairs. The heart rate rarely rises above 120 beats/minute and blood pressure elevations are similarly mild and transient.

The person recovering after open heart surgery may be more conscious of his or her heartbeat, breathing, and muscle tension. This awareness is normal and is no cause for alarm.

Fear of performance and general depression are two psychological factors that can greatly reduce sexual interest and capacity. These are considered normal during convalescence and in most cases disappear within 3 months. If depression continues after 3-6 months, professional counseling should be considered.

Various medications may affect sexual drive and/or function. If this occurs, consult your physician. Often a change in medication or dosage can remedy the problem. Never stop taking any prescribed medication without your physic7ian’s approval.

Ways to prepare for the resumption of sexual activity:

The first step is to exercise as mentioned above.
The second step is to be tolerant of each others emotions. For a brief time following open heart surgery, emotions are delicately balanced and subject to rapid mood swings. Try to keep day to day events in perspective and remember that a good sense of humor is a good ally.
The third step is to try to adjust mutual sexual expectations. Emotional response as well as physical responses sometimes make the resumption of sexual relations fearful and that is normal. Therefore don’t expect too much at first.
Some general guidelines:

Be relaxed and rested before intercourse. Avoid sex if you are fatigued or upset.
Choose a position that does not restrict breathing or require prolonged muscular support.
Maintain a comfortable room temperature and familiar surroundings and partner.
Speak with your physician if you are experiencing any chest pain, angina, shortness of breath, rapid heart rate, or extreme fatigue in relation to sexual activity.
Wait at least 1 hour after a meal or alcoholic beverages before having sexual activity.
Open communication is important between partners.
Dr Dee Says:
January 10th, 2010 at 8:02 am
3 weeks
♥♥ Peachy ♥♥ Says:
January 10th, 2010 at 8:02 am
When one’s doctor says they should, I would imagine. If he didn’t say, then I guess one would have to assume as soon as possible.
SAMI Says:
January 10th, 2010 at 8:02 am
Tread mill test decides it. If your exercise tolerance is normal you can begin them. As a rough indicator if you can climb 25 steps at 45 degrees gradient in less than 30 seconds without getting breathless you are fit.
foogill Says:
January 10th, 2010 at 8:02 am
When I had my vaesectomy I asked the doctor when I could resume normal sexual activity. He told me as soon as I wanted but they generally ask you to wait until You’ve left the theatre.
Cartier95’s reply was short, concise and to the point.
michael c Says:
January 10th, 2010 at 8:02 am
stair climbing can be resumed three to four weeks after surgery that is to say a reasonable 14to 20steps which can gradually be increased ,gentle sex with an understanding partner after two months ,driving a car after three months when your chest wall has healed
gangadharan_nair Says:
January 10th, 2010 at 8:02 am
The full benefits from the operation may not be determined until 3 – 6 months after surgery. Sexual activities may be resumed 4 weeks after surgery. All activities that do not cause fatigue are permitted, and the schedule for resuming normal activities is determined with the physician.

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