HeartCheck How Healthy Your Heart Is?

Before Surgery

Tell your doctor what medications you're taking, especially aspirin or an anticoagulant ("blood thinner"). Your doctor will tell you if you should stop taking them. Also bring a complete list of your current medications. (Including over-the-counter drugs, vitamins and herbal supplements), allergies, your medical records and health insurance information.

If you smoke, stop to improve your blood flow and breathing.

The Night Before Surgery

The night before your surgery, you can eat a normal meal, but do not eat, drink or chew anything after the time your doctor specified usually midnight. This includes gum, mints, water, etc.

Bathe or take a shower, wash from your neck down with the anti-bacterial soap provided.

To help prevent infection, any hair in an incision area may be shaved.

The Morning of Surgery

Proceed with your routine morning care. If you bathe or take a shower, wash from your neck down with the anti-bacterial soap provided.

When brushing your teeth, avoid swallowing any water.

Women should not wear any makeup.

You should leave jewellery, watches, money and other valuables at home or with the person who accompanies you.

Give personal belongings to your family because you will not return to the same room immediately after your surgery.

Your unit nurse and patient assistant will verify your identity before surgery by checking the identification bracelet on your wrist. You will then be transported to the operating theatre.

After Surgery

Waking Up in the ICU

Immediately after your surgery, you will be taken to the intensive care unit (ICU) to recover. The ICU is a busy place; you can expect bright lights and a great deal of activity during the day. Many of the sounds you will hear are made by monitors and different types of equipment.

It's normal to feel cold and to shiver for a short while after you arrive in the ICU. Your nurse will give you blankets to keep you warm. It's also normal to wake up feeling thirsty, because of the medications you received before or during the surgery, or because you had nothing to eat or drink before your operation. Your fluid intake will be limited.

Your medications will be given through intravenous (IV) tubes at very controlled rates using pumps. To help you breathe, an endotracheal tube (breathing tube) was inserted while you were asleep during surgery. This tube is connected to a ventilator that assists your breathing and you will not be able to talk or swallow. When you are fully awake and breathing on your own, the breathing tube will be removed, and you will be able to talk.

Pain Control

Although all patients are concerned about the pain they will experience, pain after surgery is not as severe as most patients anticipate. To control your pain, you will be given medication that is injected, given orally or by suppository. While doses are calculated to keep you as comfortable as possible, if the medications affect your breathing and/or blood pressure, your physician may decrease the amount of pain medication given to you.

Coughing and Deep Breathing

As you recover in the ICU, the nurses will monitor your blood pressure, pulse rate and breathing. The endotracheal tube (breathing tube) will continue to help you breathe. To prevent postoperative pneumonia, the nurses and respiratory therapists will periodically remove any secretions that may have settled in your lungs. As soon as your breathing tube is removed, you should begin using your incentive spirometer, followed by coughing exercises. You should continue these exercises every hour when you are awake even after you have been transferred to the ward.

Movement and Changes in Position

While lying in bed, moving and changing position will help improve blood flow in your legs and remove secretions in your lungs. You can move your feet, wiggle your toes and point your toes up toward your head and then down toward the foot of the bed. Your nurse will help you change positions by turning you from one side to another.

Shifting to Ward

Your surgeon, and anaesthesiologist will determine the best time for you to be transferred from the ICU to the WARD. Most patients are transferred within 2 days. If you remain in the ICU for more than a day, your surgeon or a member of your surgery team will explain the specific reasons for the delay. The extra time spent in ICU is often for precautionary reasons and does not indicate any problem.

Discharge from hospital

When you are discharged from the hospital, you will receive instructions about your home care from your doctor. These will include your rehabilitation program, any medications you may require, your return appointment time and any other information you may need. Convalescence at home usually takes four to six weeks depending on your condition before surgery. Minor aches and pains are normal in the first few weeks following surgery.

Going Home by Plane

When you are making flight reservations, let the airline know that you are recovering from surgery. If you had heart surgery, the sternal wires placed during surgery may set off the airport alarms. Ask for a wheelchair to take you to and from the plane. Once in the plane, stand up in the aisle and stretch your legs for a few minutes every hour to get your circula­tion going. If possible, also walk up and down the aisle.

Going Home by Car

When riding in a car, remember to stop every hour and walk 5 to 10 minutes to get your circulation going. You should wear your seatbelt, placing a small towel in between the seatbelt and your incision. If your car trip is long, it is better to take a break and stay overnight in a hotel, then resume the next morning.

Taking a Shower or Bath

You may shower using warm, rather than hot water shower with your back facing the water spray. It is OK to let warm water run down over your incisions; Consider using a shower stool if you feel weak or unsteady. Wash your incision gently every day with warm water and mild soap then pat dry with a soft towel.

Do not apply lotion, powder, or ointments until the scab has fallen off (around 4 weeks).

Do not take a tub bath, soak in a Jacuzzi or go in a pool for approximately four weeks.

Do not put the soap directly onto the incision and do not rub the incisions. Pat your incisions dry, making sure not to rub them.


Your chest incision extends through layers of skin, muscle and bone. Your skin may be healed by the time of discharge, your breastbone should take six to eight weeks, and your scar should fade in approximately six months to one year. Tingling, itching, and numbness are normal sensations associated with surgical wounds and will eventually disappear. During the first six months after surgery, protect your incisions from the sun by wearing a shirt or sun block. For women, wearing a soft bra to support your breasts will minimize incisional discomfort. It is also normal to have muscle or incision discomfort in your chest if you are doing an activity.

You should not have the same pain that you had before surgery; if you do, let your doctor know. Also, if your sternum (breastbone) feels like it moves, pops or cracks when you move around, call your doctor.

Night Sweats

Patients often complain of night sweats for the first few weeks. Should you experience this, check your temperature to make sure that you do not have a fever. If your temperature is 101 degrees Fahrenheit or greater, call your doctor. If you do not have a fever, there is very little that can be done, but you should make yourself as comfortable as possible while waiting for the night sweats to go away. Night sweats usually disappear in a few weeks.

Disturbed Sleep

Following surgery, some patients experience nightmares or insomnia. This will also disappear with time. To help you sleep better, try shortening your naps during the day and/or increasing your afternoon activities so that you will feel tired in the evenings. It is perfectly safe to sleep on your back, side or stomach.

Poor Appetite and Nausea

Many patients lose weight in the postoperative period. They complain of lack of appetite and mild nausea. Certain medications such as pain pills may cause nausea. Try eating small frequent amounts of food, and take medications on a full stomach unless otherwise directed. If you continue to experience nausea or lack of appetite, call your doctor.


Constipation is due to inactivity, limited fluid intake and lack of dietary fiber and is aggravated by medications such as pain pills and iron. Eating plenty of fiber and using your prescribed stool softener as instructed can usually relieve constipation. If this does not work, call your doctor.


Fatigue is probably the number one patient complaint following heart surgery. Fatigue results from an extended lack of sleep while in the hospital, energy used by your body to heal its wounds, and energy used to fight off pain. To combat fatigue, space your activities to allow for rest periods. Take plenty of naps, do mild physical activity regularly, eat well, and use your pain medication as needed.

Resuming Activities

Physical Activities

You may do light household chores, such as shopping, cooking, light gardening, dusting, and washing dishes when you feel up to it. You may do light, quick activities where your arms are above your shoulders, such as brushing your hair. But do not do any activities where your arms are above shoulder level for a long time, such as washing a window or dusting a high shelf. Do not do any activity that causes pain or pulling across your chest. Do not lift, push or pull objects heavier than 5 pounds until your doctor says it is okay to do so.

Climbing Stairs

Unless restricted by your doctor, it's okay for you to climb stairs after 2 weeks. You may feel off-balanced after surgery, so be careful and hold the handrail when walking up and down stairs. If you need to, stop and rest and you use the stairs only when necessary.

Driving a Car

You should not drive for 4 weeks from the date of your surgery or while you are still taking pain pills. During this time your reaction time may be dulled, and if an incision was made on your sternum, your breastbone will still be healing. Make sure to wear your seat belt but cushion your incision with a soft towel or pillow.

Returning to Work

Returning to work depends upon the type of work you do and your energy level. It usually takes 4-6 weeks before most patients feel they have returned to their full energy level. The decision to return to work should be made jointly between you and your surgeon. You may want to consider taking it lightly at first.


You may resume sexual activity after your surgery. In the first few weeks after surgery, however, you may find that pain along your incision may limit your activity to a certain extent. Just remember that during the first 8 weeks after surgery, any activity or position that causes pain or pulling across your chest must be avoided.


Proper exercise will help your healing and recovery, as well as increase your stamina, maintain your ideal weight by burning calories, and lower stress in your everyday life.