Open Heart Surgery: What to Expect in the Hospital

Part 2 of 3  (See all 3 parts of this article here)

By Mike DuBose with Dr. Surb Guram, MD and Blake DuBose

 

Open heart surgery is a major procedure, and it can be very taxing on your body and mind. From a mental aspect, one of the worst parts is the uncertainty: What will happen? How will I feel after? Will I be in severe pain? It’s natural to have such questions when you are about to undergo a multi-hour surgery that will affect one of the most important organs in your body!

One thing that can help you relax when considering open heart surgery is to learn as much about it as possible. When you know what you can expect, you won’t have to worry about as many unpleasant surprises—for example, when I learned that painkillers make me very nauseated! It’s hard to predict exactly how you will react to open heart surgery because everyone’s body is different, but here are some experiences that I had on the day of my own surgery, along with some recommendations that may be helpful.

The Morning of Your Surgery

Ask a trusted family member or friend to drive you to the hospital on the day of your surgery. One person is typically all that will be allowed to accompany you, so there is no use in bringing more (the rest can come later when the surgery is over). Don’t bring any valuables with you—you will not need them in your hospital room, and you do not want to lose them! The person accompanying you should have your license and a credit card in case co-pays are required, but you will probably have paid prior to this time.

You will have to arrive at the hospital at some ungodly hour on the morning of your operation, depending on whether you are the first patient scheduled for the day or not (I prefer to be second in line for surgery to ensure that the surgical team is “warmed up.”). Once you arrive at the hospital, you might have to check in with the admissions office again, but may be able to avoid it if you asked to be cleared for surgery in advance. You will then proceed to the pre-op area.

During the pre-operation period, they will begin an IV and prepare you for surgery. Often, you just sit in bed and wait until the surgical team is ready, which can take a while. Be sure to ask for extra covers during the pre-op, as it will be very cold in the operating room. If you are diabetic, like I am, ask the surgeon or your doctor before surgery if you can measure your sugar levels with your own machine and regulate insulin. Most hospitals will require you to use their insulin for safety reasons, but I personally found that they did not do a good job. While you normally want your sugar readings between 70-120, most surgical staffs will prefer that they run around 200 to prevent lows during surgery.

From the pre-op, you will be rolled into the operating room, which will look like something from Star Wars. Tell the anesthesiologist (who will be one of the first to see you) that you would like anti-nausea medications during surgery. I joked with my surgical team, saying, “I hope everyone is in a good mood today!”

Your surgery and post-recovery will likely take 3-5 hours. I suggest that family members wait near the hospital but not in the family waiting area, which will just add to their anxiety and worry. They should bring reading materials, earphones, and iPods or smartphones to listen to music while they wait. They could even visit nearby shops and businesses, grab a bite to eat, or do anything else that helps distract them and put them at ease (by the way, the food in the Cleveland Clinic’s restaurants was excellent, but patient food was not!). The Cleveland Clinic gave my family a beeper to alert them when the procedure was almost over. Most places will contact your family roughly 30 minutes before the surgery is complete to alert them that they should come meet with the surgeon.

The Immediate Aftermath: The Intensive Care Unit (ICU)

After surgery, you will be transferred to a cardiac intensive care unit. You will probably be unconscious for a while, and visitation will be limited. Your family should be prepared to see you hooked up to all types of scary wires, tubes, and equipment and not looking your best. Most likely, you will just want to sleep, and you will probably not want any visitors.

If I had to have my surgery over again, I would probably ask for few, if any, post-operative pain medications like morphine. Most pain medications cause nausea and serious constipation. If you are in extreme pain, you should take painkillers; however, if you are nauseated like I was, avoid them—they will make it worse. (Expect medical staff to push them, however!) It is up to you, but if you do accept pain meds, try to take as few as possible and stop them soon after the surgery.

The level of care in the ICU is usually excellent because of the few patients there and the small staff-to-patient ratio. You will be monitored there for a while to ensure that your condition is stable before you are sent to a regular room on the cardiac ward.

The Cardiac Ward

After spending about a day in the ICU (this may vary depending on your unique situation), you will be transferred to the cardiac ward. Unlike in the ICU, the nurses and staff of the cardiac ward will be tending to a lot of patients, so don’t expect an immediate response if you call for assistance. A few suggestions for making your stay more pleasant include:

• Forget about bringing a bunch of clothes. A loose-fitting sweat suit will work perfectly. The nurses have seen just about everything and will not be offended if you are dressed casually or in a hospital gown!
• Hospitals can be noisy. Take an iPod or smartphone and small noise-cancelling earphones that cover your ears to listen to your favorite music. Most hospitals don’t have electrical outlets near the bed to recharge your electronic devices, so bring a charger with a very long cord (retail stores like Target sell 10-foot ones that are compatible with iPhones and iPods).
• Do not expect to sleep well during your hospitalization. When you’re not being kept up by disturbing sounds during the night, doctors and nurses will be coming in to check your vitals and/or take blood. Then, they get you up at the break of dawn! It is necessary, but can be annoying. However, try to sleep as much as you can—your body uses that time to repair and recover.
• Learn how to work all the bed equipment (how to raise and lower your upper body, how to call a nurse, etc.) so that you can be comfortable.
• If you are nauseated, tell the nurse and doctor and ask for medicine. If one type of medication does not work, ask to try others until the nausea subsides.
• Keep a small cooler with a few drinks on your bedside table and ask staff to fill it occasionally. Bring some crackers with you as well, since you will probably not have much of an appetite for other foods. Real ginger ale and soda crackers make a good combination, especially if your stomach is upset.
• Expect bad hospital food (but if you are hungry and ask nicely, nurses might authorize a one-time cheeseburger)!
• Ask for a daily sponge bath (don’t assume that you will get one without asking!). With so many wires hooked up to you, it will be impossible to take a shower until the day of your release—four or five days later! You can also request a bedpan and bottled water so you can brush your teeth in bed.
• Request that hospital staff turn your body on a daily basis (even if you don’t want to move) so you don’t develop bedsores, which could get infected and complicate your treatment.
• Expect to have blood drawn many times! I left the hospital with black-and-blue arms.
• To prevent blood clots, you will need to wear support hose, both at the hospital and at home. The nurses will probably have to wrestle with them, since they are very hard to put on. I learned that the easiest way to put them on at home is to roll them up your feet and legs.
• As soon as you are well enough, walk around the hospital as often as you can to get your lungs going. This rebuilds red blood cell levels, helping to prevent anemia.

Preparing to Be Discharged

You will probably stay at the hospital for 3-5 days after your surgery, depending on how well it went and how you are recovering. Even though you will want to get back to the comfort of your own home, don’t push doctors to release you early. Otherwise, you might experience complications and have to come back to the hospital!

In the days after your surgery, you will be taking many medicines to prevent strokes and other problems, and they will be gradually tapered off in the first month after the procedure. The day before your release, ask your doctors for prescriptions so you can have them filled at a nearby or hospital pharmacy. Call the pharmacy (or ask a friend or family member to call) to make sure that they have the medications in stock.

On the day before your release, obtain hard copies of all of your medical records and a CD of any imaging records (this will require a medical release form). Your local internist and cardiologist will need them, and it is like pulling teeth to get them from the hospital once you return home! Ask for a copy of your post-surgery blood test results before leaving the hospital as well.

Note: When reviewing your blood test results, keep a close watch on your hemoglobin readings for signs of anemia. According to the Mayo Clinic, symptoms of anemia are difficulty breathing, no energy, pale color, fatigue, dizziness, irregular heartbeat, cognitive problems, cold hands and feet, and headaches—all of which I had! My hemoglobin dropped below 8; normal levels are 12.5-17. If your reading is below that, you will suffer from anemia, which was the worst part of the whole experience, in my opinion! It took me about a month to recover from the anemia. If you are anemic, ask the doctor to start you on an iron supplement immediately, preferably before you leave the hospital. Beware: iron supplements can have side effects, including “gorilla breath;” take them at night with food. I chose to raise my hemoglobin levels through foods that are naturally high in iron versus taking medicine.

When you are finally ready to leave, ask that a trained nurse (preferably, a cardiac nurse practitioner) provide your discharge summary, not a regular nurse on the cardiac ward, who may just read the information to you. You need a trained professional to have a dialogue with you about what will happen when you leave the hospital. Pay close attention to what he or she says, take notes, and carefully read any materials that you are given. Be sure that another family member is present during the discharge to help you remember important points.

Leaving the Hospital

It is nearly impossible to know the exact date and time that you will be released since there are so many variables that can impact when you are ready to leave the hospital. If you traveled to obtain your surgery, airlines will usually work with you to change your flight itineraries with no penalties if you have to stay longer than expected. (However, be prepared to give them your doctor’s and hospital’s names and telephone numbers.)

If you came from out of town, I recommend staying at a nearby hotel for 1-2 days after surgery. That way, if you experience problems, you can return to the hospital that performed your procedure and have them addressed. Cleveland Clinic has a hotel attached, which was expensive, but I felt that the convenience outweighed the cost.

When it comes time to fly home, ask for wheelchair assistance when checking in and upon arrival at your local airport. Don’t pick up anything weighing more than 10 pounds, including suitcases! There’s no shame in letting family, friends, and airport staff help you carry your bags when your body is recovering from such major trauma.

The bottom line: Having open heart surgery can be a serious mental, physical, and emotional challenge. However, by going into the process calm, informed, and positive, you’ll have greater chances of successful long-term outcomes. Open heart surgery can sound scary, but keep reminding yourself that it will all be worth it when you’re living a longer, happier, healthier life!

Look for our next article on recovering from open heart once you reach home.

 (See all 3 parts of this article here)

About the Authors: Our corporate and personal purpose is to “create opportunities to improve lives” by sharing our knowledge, research, experiences, successes, and mistakes. You can e-mail us at [email protected].

Mike DuBose received his graduate degree from the University of South Carolina and is the author of The Art of Building a Great Business. He has been in business since 1981 and is the owner of Research Associates, The Evaluation Group, Columbia Conference Center, and DuBose Fitness Center. Visit his nonprofit website www.mikedubose.com for a free copy of his book and additional business, travel, and personal articles, as well as health articles written with Dr. Surb Guram, MD.

Blake DuBose graduated from Newberry College’s Schools of Business and Psychology and is president of DuBose Web Group (www.duboseweb.com).

Katie Beck serves as Director of Communications for the DuBose Family of Companies. She graduated from the USC School of Journalism and Honors College.

Dr. Surb Guram, MD is a board-certified internist and a graduate of the University of South Carolina School of Medicine. He is a partner with the SC Internal Medicine Associates in Irmo, SC and has practiced internal medicine in the Midlands for the past 30 years. See www.scinternalmedicine.com for more information on Dr. Guram and his practice.

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