Frequently asked questions
Before surgery
We advise that you do not bring children into the ICU without first discussing with the surgical team. The ICU can be a scary place for children, and they may not understand why their loved one is looking unwell or is unconscious, despite recovering routinely and normally from their operation. As most patients stay in ICU for only 12-24 hours, we recommend children visit once you are back up on the ward.
Recovering from heart surgery generally takes most people anywhere from four weeks to three months. Plan to be off work for between four and twelve weeks, depending on the type of work you do. Look into any sickness benefits that maybe available to provide you with support during your recovery. Although your surgeon will be able to give you some guidance, your cardiologist and GP may be able to best advise you on when you will be ready to return to work. For further guidance, please see our page 'When can I resume my usual activities?' which may help you in better predicting the time you will require before being able to return to work.
To give you the best possible care and prepare you properly for your surgery, it is important your surgeon has a clear understanding of your current medications, your past medical history, any fears or concerns you might have and any other information that might influence your surgery. Be open and honest with your surgeon regarding everything to do with your health as this all helps towards ensuring you receive the best possible care before, during, and after your heart surgery. You may like to ask your GP for a medical history summary to give to your surgeon. This summary includes any past illnesses, operations, and current medications you are on. This will help ensure you do not forget anything important. Bring any recent x-rays or reports you may have received. Also, write down any questions you might have before you visit your surgeon, and if possible, it may be worthwhile to have someone accompany you to your visit to help you remember all the information that is provided at your consult.
See Information for Patients for more information.
In the past, cardiac surgery patients remained in bed for several days after their operation to promote rest and healing. However, research has shown there is benefit in getting up out of bed and moving around as soon as possible after your operation. These advantages include improved lung function, reduced risk of blood clots, prevention of pneumonia, decreased length of stay and less loss of muscle tone. Even with the tubes and drains still in your body - often while still in intensive care - you will be encouraged to get out of bed with the help of nursing staff and a physiotherapist.This may be difficult at first, but you will have plenty of help and be safe and supported every step of the way.
Movement after surgery may start the evening of your operation, including bending and straightening your legs almost as soon as you are awake,dangling your legs over the bedside,gently sitting out of bed in a chair, or even a small walk, if you are able. On the first day after your surgery, if possible, you will transfer from the bed to the chair two to three times and gently walk in the room and hallway. On the second day onwards, the physiotherapist and nursing staff will continue to increase your mobility to help you get back to moving as much as possible as soon as you can after surgery.
Your stay in hospital will depend on your operation, however as a guide, most heart surgery patients stay between five and seven days in hospital after surgery.
Depending on the operation, the average heart surgery takes three to four hours in the operating room. Your loved ones should know that in order to give you the best care possible, your doctors and nurses can need up to an one hour before your surgery and approximately an hour after surgery to make you comfortable and settled into your room. Your loved ones will be permitted to visit you roughly four to six hours from the time you are first taken from the ward for surgery.
Call your family doctor or cardiologist if your heart symptoms change or worsen at any time while you are waiting for your surgery and let us know at Adelaide Cardiothoracic on 08 8375 5950 (during business hours) or email us at contact@adelaidecardiothoracic.com.au.
However, if you have significant symptoms which are not relieved by rest or your medication, call an ambulance, ask someone to take you to the nearest Emergency Department, or call 000.
You will need to stop blood thinning medications (except for Aspirin) prior to your surgery as blood thinning medications can cause increased risk of bleeding. It is important your doctor knows exactly what medications you are taking, including all over the counter supplements and medicines, as their are diabetic medications, and supplements such as fish oil or vitamin K that may also need to be stopped prior to your surgery. Your doctor will advise you exactly when you need to stop and when. If you have any questions leading up to your operation, call us at Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au.
The breathing tube can be taken out as soon as you are able to meet requirements for breathing on your own and all your other vital signs are stable.
Recovery can be a challenge for the open heart surgery patient and his/her family. There may be days of high energy then days of fatigue, feelings of accomplishment and exuberance and then days of feeling blue, unexpected bouts of sadness and crying, or even getting angry, all of which are very normal as part of the physical and emotional healing process that takes place after cardiac surgery. It can take some months for this to stabilise and even up to a year before you truly feel like yourself again.
We recommend you have a family member or friend stay with you each night for up to one week after you get home from the hospital. Arrange for help at home for daily activities such as cleaning, groceries, laundry, and gardening for six to eight weeks. Nursing and home care services are NOT routinely supplied, but are available if necessary. You should be able to care for yourself by the time you are ready to go home.
Most patients who are recovering from heart surgery initially do so in the intensive care unit (ICU) for approximately 12 to 24 hours (sometimes longer depending on your health status). When surgery is complete, the surgeon will speak to your loved ones, and they will be told in which ICU bed you are recovering. After ICU, you will go to the ward where you will stay until you are ready to be discharged.
We recommend that female patients should wear a soft elastic bra (no under wire, usually a size larger around is more comfortable) 24 hours a day for the first six weeks following surgery. This will prevent the weight of the breast from pulling on the incision and sternum, thereby decreasing scarring and placing less weight on the sternum.
Yes, just ask your surgeon to provide a sick certificate for your friend or relative.
It is very common for patients to be emotional after surgery. You’ve been busy preparing for the surgery and now it is all over, you don't feel good and the result is not there yet. Many patients ask, "What have I done?!" Add in that the natural stress hormones produced by your body drop out at about three to five days after surgery, and you have a perfect formula for feeling depressed and teary (stress hormones are steroids and can elevate mood). Actually this is a normal response to surgical stress.
Following your surgery you will see your surgeon about two weeks after your operation, and if all is well, you will be referred back to your Cardiologist to follow-up on your recovery. It is important that you have a follow-up appointment with your Cardiologist approximately four to eight weeks after your surgery. If you do not receive notification of a Cardiology appointment, please call Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au and we will follow-up on a Cardiologist appointment for you. You should also visit your local GP within approximately a week from surgery to ensure you are recovering well and you have all the medications you require.
It is quite common to have difficulty sleeping at night for some time after cardiac surgery. You may find it difficult to fall asleep, or you may find that you wake up at 2:00 or 3:00am and cannot fall back to sleep. This will improve. Sometimes, if you are uncomfortable, taking a pain pill before bed can help, or propping pillows behind your back if you are normally a side sleeper to allow you to get back to a sleep position you are used to. Others sometimes find they sleep better in a recliner or lay-back chair for a time. Keeping active during the day helps you to be tired at night, which will help you sleep better.
Please notify us by calling Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au if:
you have any signs that may suggest an infection (e.g., fever or high temperature, cough, cold or flu symptoms, burning or pain on urination, or redness around cuts or scratches on your skin).
you need to defer surgery due to a change in your personal circumstances
Before you come to hospital, you can complete anAdvanced Care Directive, either online or by having a kit posted to you by phoning: 1300 366 424. The Advance Care Directive empowers you to make clear legal arrangements for your future health care, end of life, preferred living arrangements and other personal matters. It replaces the existing Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction with a single, Advance Care Directive Form. Once you have completed this form, ensure a copy is provided to your GP, your cardiologist and your surgeon.
The Advance Care Directive allows you to:
- write down your wishes, preferences and instructions for your future health care, end of life, living arrangements, personal matters
- and/or appoint one or more Substitute Decision-Makers to make these decisions on your behalf if you are unable to do so in the future.
Your Advance Care Directive only takes effect (can only be used) if you are unable to make your own decisions, whether temporarily or permanently.
After surgery, you may hear popping and clicking sounds in your chest. These sounds are caused by cartilage between your ribs. As the sternum settles and heals it can continue to make little sounds, and usually takes six to twelve weeks to settle completely, however sometimes it can take longer. As long as there is not significant pain or a grating feeling in your chest you should be fine, however if concerned, bring it up with your local doctor when you next visit.
Not smoking after heart surgery reduces risk of heart attack, stroke and death.
Researchers analysed data from the
trial, which followed 1,800 patients undergoing either Bypass Grafting or Percutaneous Coronary Intervention (such as stenting) for the treatment of coronary artery disease for five years. The study regularly provided information on smoking status in addition to other important health factors.
At the start of the study, one in five patients was a smoker. However, 60% of smokers quit after their heart procedure. After comparing outcomes among these groups of patients, researchers found that continuing to smoke did greatly increase risk of complications. Patients that continued smoking had nearly twice the risk of heart attack, stroke and death compared to those who didn’t smoke. Although nonsmokers had the lowest risk of complications following surgery overall, current smokers had significantly higher risk of death compared to those who quit smoking following their heart procedure.
Therefore smoking is always harmful to health and increases risk of health complications. Doing so can significantly reduce risk of heart attack, stroke and even death.
Quitting smoking is one of the most effective ways to improve health, even in patients already diagnosed with heart disease. There are many factors we can’t control—like age and family history—that increase risk for heart attack and stroke. Smoking, however, is something we can actively change and remains one of the most highly recognised risk factors for heart disease. There’s no question that kicking the habit, even after undergoing heart surgery, can go a long way in reducing risk of complications.
If you are a country or interstate patient, you will need to have accommodation close to the hospital available to you from the time of discharge. You will need to stay in Adelaide until ten days after surgery, OR until the next Wednesday or Friday cardiac surgery follow-up clinic, before being able to return home. This is to minimise the chances of complications occurring after you have left Adelaide and may be some distance from help. You will need to pay for your own accommodation while staying in Adelaide as accommodation is not provided by the hospital. If you do not have friends or family you can stay with, or no accommodation available to you, you can review or download the attached book, Practical Information for Country People Visiting FMC.
For country South Australian patients, you may be eligible for a subsidy towards your travel and accommodation through the Patient Assistance Transport Scheme (PATS) if you are a permanent resident of South Australia and live more than 100 kilometres from the hospital. Please ask your local doctor, call your local PATS office, or check online at www.countryhealthsa.sa.gov.au/pats for further information.
For Northern Territory patients, you may be eligible for financial assistance from PATS if you have to travel more than 200 kilometres one way to an approved specialist medical service, are eligible for Medicare and are an Australian citizen or permanent resident and have been living in the Northern Territory for six months or more. Please ask your local doctor, call your local PATS office, or check online at: www.nt.gov.au/wellbeing/health-subsidies-support-and-home-visits/patient-assistance-travel-scheme for further information.
For other State patients, request the PATS information for your state from your general practitioner, or see the bottom of page Preparing for my surgery.
In regard to depression and anxiety post-cardiac surgery, it can be a difficult time for many patients. There have been many papers written and it is still an area of a lot of debate as to exactly why there is such prevalence for post-cardiac surgery depression or anxiousness – some believe it could be related to the anaesthetic, and/or heart-lung machine, while others blame the residual aftermath of one of the most stressful times of your life (post-surgery stress). Whatever the reason, working through your depression is very important to help towards good recovery and reduced complications. Planning before surgery to have things to keep yourself entertained at rest can make a big difference, as well as getting back into some sort of routine as soon as possible after you return home, such as getting up and dressed, putting on make-up or going out for visits with friends. Just getting outside for a change of scene, and getting some sunshine can change your mood. If however you are struggling and feel listless or very down for more than two weeks at a time, it is worth discussing with your local doctor. There are wonderful support systems available to you, so do not be afraid to seek them out to help towards your recovery. You can contact Beyond Blue through their website: https://www.beyondblue.org.au/the-facts/depression or by calling them on 1300 22 4636.
You will need to avoid driving, outdoor bicycling, or motorcycle riding for four to six weeks after surgery. This time period is recommended to allow your breastbone to heal and because your reaction time may be delayed due to weakness, fatigue, and/or medication. You also do not want to risk hitting the steering wheel and reinjuring the sternum. When riding in a car, you can keep a cushion between you and the seat belt especially for long distances, and it is recommended you stop and take a rest every one to two hours to stretch your legs. This will improve circulation in your legs and help prevent swelling. Please also note that if you drive prior to this four to six week period, and you have an accident, you may not be covered by insurance. You do not need a formal clearance from your doctor to begin driving again.
PLEASE NOTE: If you are a commercial driver, you will need to wait twelve weeks and will require written permission from your cardiologist before being able to drive again. You may require an exercise stress test before being allowed to recommence driving.
Unfortunately, yes. In the event of an emergency or unforeseen circumstances, or if another patient requires surgery more urgently, your surgery may need to be postponed or cancelled. Should your surgery be postponed, every effort will be made to reschedule your surgery as soon as possible.
It is common to experience muscle pain or tightness in your shoulders and upper back between your shoulder blades – it is believed this is due to the position you needed to be in during your surgery. This will get better with time. Your pain medicine will also help relieve this discomfort. If an artery in your chest, called the mammary artery, was used during your surgery, you may experience numbness or tingling to the left of your chest incision. This is also expected and should improve with time.
Yes, but usually only two to three times daily. You will probably be tired and weak during the first few weeks after surgery. However, we recommend that you walk at home three to four times a day for about five minutes at a time. Then, increase activity according to the written instructions provided at discharge.
It takes most people about two to three months to recover physically after the operation. For the first three to six months many people feel very tired, especially at the end of the day. This tiredness and lack of energy gradually improves over the next 12 to 18 months. As a guideline: it takes approximately one month for the vessels to heal, two months for the muscles, six weeks to three months for the bone to mend, three months for blood counts to return to normal and up to 12 to18 months for inflammation to settle down and your full strength to return.
Try not to have any elective dental procedure for at least three months following your valve surgery. Dental and other surgical procedures can release bacteria into your blood, causing infection and possible damage to your heart and valve. To prevent bacteria from causing infection to your valve, always take an antibiotic before any dental work, surgical procedure, or placement of a tube or catheter inside your body. Also your dentist will probably want to temporarily stop your blood-thinning medication which is not recommended in the first three months.
We advise that you do not bring children into the ICU without first discussing with the surgical team. The ICU can be a scary place for children, and they may not understand why their loved one is looking unwell or is unconscious, despite recovering routinely and normally from their operation. As most patients stay in ICU for only 12-24 hours, we recommend children visit once you are back up on the ward.
Recovering from heart surgery generally takes most people anywhere from four weeks to three months. Plan to be off work for between four and twelve weeks, depending on the type of work you do. Look into any sickness benefits that maybe available to provide you with support during your recovery. Although your surgeon will be able to give you some guidance, your cardiologist and GP may be able to best advise you on when you will be ready to return to work. For further guidance, please see our page 'When can I resume my usual activities?' which may help you in better predicting the time you will require before being able to return to work.
To give you the best possible care and prepare you properly for your surgery, it is important your surgeon has a clear understanding of your current medications, your past medical history, any fears or concerns you might have and any other information that might influence your surgery. Be open and honest with your surgeon regarding everything to do with your health as this all helps towards ensuring you receive the best possible care before, during, and after your heart surgery. You may like to ask your GP for a medical history summary to give to your surgeon. This summary includes any past illnesses, operations, and current medications you are on. This will help ensure you do not forget anything important. Bring any recent x-rays or reports you may have received. Also, write down any questions you might have before you visit your surgeon, and if possible, it may be worthwhile to have someone accompany you to your visit to help you remember all the information that is provided at your consult.
See Information for Patients for more information.
In the past, cardiac surgery patients remained in bed for several days after their operation to promote rest and healing. However, research has shown there is benefit in getting up out of bed and moving around as soon as possible after your operation. These advantages include improved lung function, reduced risk of blood clots, prevention of pneumonia, decreased length of stay and less loss of muscle tone. Even with the tubes and drains still in your body - often while still in intensive care - you will be encouraged to get out of bed with the help of nursing staff and a physiotherapist.This may be difficult at first, but you will have plenty of help and be safe and supported every step of the way.
Movement after surgery may start the evening of your operation, including bending and straightening your legs almost as soon as you are awake,dangling your legs over the bedside,gently sitting out of bed in a chair, or even a small walk, if you are able. On the first day after your surgery, if possible, you will transfer from the bed to the chair two to three times and gently walk in the room and hallway. On the second day onwards, the physiotherapist and nursing staff will continue to increase your mobility to help you get back to moving as much as possible as soon as you can after surgery.
Your stay in hospital will depend on your operation, however as a guide, most heart surgery patients stay between five and seven days in hospital after surgery.
Depending on the operation, the average heart surgery takes three to four hours in the operating room. Your loved ones should know that in order to give you the best care possible, your doctors and nurses can need up to an one hour before your surgery and approximately an hour after surgery to make you comfortable and settled into your room. Your loved ones will be permitted to visit you roughly four to six hours from the time you are first taken from the ward for surgery.
Call your family doctor or cardiologist if your heart symptoms change or worsen at any time while you are waiting for your surgery and let us know at Adelaide Cardiothoracic on 08 8375 5950 (during business hours) or email us at contact@adelaidecardiothoracic.com.au.
However, if you have significant symptoms which are not relieved by rest or your medication, call an ambulance, ask someone to take you to the nearest Emergency Department, or call 000.
You will need to stop blood thinning medications (except for Aspirin) prior to your surgery as blood thinning medications can cause increased risk of bleeding. It is important your doctor knows exactly what medications you are taking, including all over the counter supplements and medicines, as their are diabetic medications, and supplements such as fish oil or vitamin K that may also need to be stopped prior to your surgery. Your doctor will advise you exactly when you need to stop and when. If you have any questions leading up to your operation, call us at Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au.
The breathing tube can be taken out as soon as you are able to meet requirements for breathing on your own and all your other vital signs are stable.
Recovery can be a challenge for the open heart surgery patient and his/her family. There may be days of high energy then days of fatigue, feelings of accomplishment and exuberance and then days of feeling blue, unexpected bouts of sadness and crying, or even getting angry, all of which are very normal as part of the physical and emotional healing process that takes place after cardiac surgery. It can take some months for this to stabilise and even up to a year before you truly feel like yourself again.
We recommend you have a family member or friend stay with you each night for up to one week after you get home from the hospital. Arrange for help at home for daily activities such as cleaning, groceries, laundry, and gardening for six to eight weeks. Nursing and home care services are NOT routinely supplied, but are available if necessary. You should be able to care for yourself by the time you are ready to go home.
Most patients who are recovering from heart surgery initially do so in the intensive care unit (ICU) for approximately 12 to 24 hours (sometimes longer depending on your health status). When surgery is complete, the surgeon will speak to your loved ones, and they will be told in which ICU bed you are recovering. After ICU, you will go to the ward where you will stay until you are ready to be discharged.
We recommend that female patients should wear a soft elastic bra (no under wire, usually a size larger around is more comfortable) 24 hours a day for the first six weeks following surgery. This will prevent the weight of the breast from pulling on the incision and sternum, thereby decreasing scarring and placing less weight on the sternum.
Yes, just ask your surgeon to provide a sick certificate for your friend or relative.
It is very common for patients to be emotional after surgery. You’ve been busy preparing for the surgery and now it is all over, you don't feel good and the result is not there yet. Many patients ask, "What have I done?!" Add in that the natural stress hormones produced by your body drop out at about three to five days after surgery, and you have a perfect formula for feeling depressed and teary (stress hormones are steroids and can elevate mood). Actually this is a normal response to surgical stress.
Following your surgery you will see your surgeon about two weeks after your operation, and if all is well, you will be referred back to your Cardiologist to follow-up on your recovery. It is important that you have a follow-up appointment with your Cardiologist approximately four to eight weeks after your surgery. If you do not receive notification of a Cardiology appointment, please call Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au and we will follow-up on a Cardiologist appointment for you. You should also visit your local GP within approximately a week from surgery to ensure you are recovering well and you have all the medications you require.
It is quite common to have difficulty sleeping at night for some time after cardiac surgery. You may find it difficult to fall asleep, or you may find that you wake up at 2:00 or 3:00am and cannot fall back to sleep. This will improve. Sometimes, if you are uncomfortable, taking a pain pill before bed can help, or propping pillows behind your back if you are normally a side sleeper to allow you to get back to a sleep position you are used to. Others sometimes find they sleep better in a recliner or lay-back chair for a time. Keeping active during the day helps you to be tired at night, which will help you sleep better.
Please notify us by calling Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au if:
you have any signs that may suggest an infection (e.g., fever or high temperature, cough, cold or flu symptoms, burning or pain on urination, or redness around cuts or scratches on your skin).
you need to defer surgery due to a change in your personal circumstances
Before you come to hospital, you can complete anAdvanced Care Directive, either online or by having a kit posted to you by phoning: 1300 366 424. The Advance Care Directive empowers you to make clear legal arrangements for your future health care, end of life, preferred living arrangements and other personal matters. It replaces the existing Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction with a single, Advance Care Directive Form. Once you have completed this form, ensure a copy is provided to your GP, your cardiologist and your surgeon.
The Advance Care Directive allows you to:
- write down your wishes, preferences and instructions for your future health care, end of life, living arrangements, personal matters
- and/or appoint one or more Substitute Decision-Makers to make these decisions on your behalf if you are unable to do so in the future.
Your Advance Care Directive only takes effect (can only be used) if you are unable to make your own decisions, whether temporarily or permanently.
After surgery, you may hear popping and clicking sounds in your chest. These sounds are caused by cartilage between your ribs. As the sternum settles and heals it can continue to make little sounds, and usually takes six to twelve weeks to settle completely, however sometimes it can take longer. As long as there is not significant pain or a grating feeling in your chest you should be fine, however if concerned, bring it up with your local doctor when you next visit.
Not smoking after heart surgery reduces risk of heart attack, stroke and death.
Researchers analysed data from the
trial, which followed 1,800 patients undergoing either Bypass Grafting or Percutaneous Coronary Intervention (such as stenting) for the treatment of coronary artery disease for five years. The study regularly provided information on smoking status in addition to other important health factors.
At the start of the study, one in five patients was a smoker. However, 60% of smokers quit after their heart procedure. After comparing outcomes among these groups of patients, researchers found that continuing to smoke did greatly increase risk of complications. Patients that continued smoking had nearly twice the risk of heart attack, stroke and death compared to those who didn’t smoke. Although nonsmokers had the lowest risk of complications following surgery overall, current smokers had significantly higher risk of death compared to those who quit smoking following their heart procedure.
Therefore smoking is always harmful to health and increases risk of health complications. Doing so can significantly reduce risk of heart attack, stroke and even death.
Quitting smoking is one of the most effective ways to improve health, even in patients already diagnosed with heart disease. There are many factors we can’t control—like age and family history—that increase risk for heart attack and stroke. Smoking, however, is something we can actively change and remains one of the most highly recognised risk factors for heart disease. There’s no question that kicking the habit, even after undergoing heart surgery, can go a long way in reducing risk of complications.
If you are a country or interstate patient, you will need to have accommodation close to the hospital available to you from the time of discharge. You will need to stay in Adelaide until ten days after surgery, OR until the next Wednesday or Friday cardiac surgery follow-up clinic, before being able to return home. This is to minimise the chances of complications occurring after you have left Adelaide and may be some distance from help. You will need to pay for your own accommodation while staying in Adelaide as accommodation is not provided by the hospital. If you do not have friends or family you can stay with, or no accommodation available to you, you can review or download the attached book, Practical Information for Country People Visiting FMC.
For country South Australian patients, you may be eligible for a subsidy towards your travel and accommodation through the Patient Assistance Transport Scheme (PATS) if you are a permanent resident of South Australia and live more than 100 kilometres from the hospital. Please ask your local doctor, call your local PATS office, or check online at www.countryhealthsa.sa.gov.au/pats for further information.
For Northern Territory patients, you may be eligible for financial assistance from PATS if you have to travel more than 200 kilometres one way to an approved specialist medical service, are eligible for Medicare and are an Australian citizen or permanent resident and have been living in the Northern Territory for six months or more. Please ask your local doctor, call your local PATS office, or check online at: www.nt.gov.au/wellbeing/health-subsidies-support-and-home-visits/patient-assistance-travel-scheme for further information.
For other State patients, request the PATS information for your state from your general practitioner, or see the bottom of page Preparing for my surgery.
In regard to depression and anxiety post-cardiac surgery, it can be a difficult time for many patients. There have been many papers written and it is still an area of a lot of debate as to exactly why there is such prevalence for post-cardiac surgery depression or anxiousness – some believe it could be related to the anaesthetic, and/or heart-lung machine, while others blame the residual aftermath of one of the most stressful times of your life (post-surgery stress). Whatever the reason, working through your depression is very important to help towards good recovery and reduced complications. Planning before surgery to have things to keep yourself entertained at rest can make a big difference, as well as getting back into some sort of routine as soon as possible after you return home, such as getting up and dressed, putting on make-up or going out for visits with friends. Just getting outside for a change of scene, and getting some sunshine can change your mood. If however you are struggling and feel listless or very down for more than two weeks at a time, it is worth discussing with your local doctor. There are wonderful support systems available to you, so do not be afraid to seek them out to help towards your recovery. You can contact Beyond Blue through their website: https://www.beyondblue.org.au/the-facts/depression or by calling them on 1300 22 4636.
You will need to avoid driving, outdoor bicycling, or motorcycle riding for four to six weeks after surgery. This time period is recommended to allow your breastbone to heal and because your reaction time may be delayed due to weakness, fatigue, and/or medication. You also do not want to risk hitting the steering wheel and reinjuring the sternum. When riding in a car, you can keep a cushion between you and the seat belt especially for long distances, and it is recommended you stop and take a rest every one to two hours to stretch your legs. This will improve circulation in your legs and help prevent swelling. Please also note that if you drive prior to this four to six week period, and you have an accident, you may not be covered by insurance. You do not need a formal clearance from your doctor to begin driving again.
PLEASE NOTE: If you are a commercial driver, you will need to wait twelve weeks and will require written permission from your cardiologist before being able to drive again. You may require an exercise stress test before being allowed to recommence driving.
Unfortunately, yes. In the event of an emergency or unforeseen circumstances, or if another patient requires surgery more urgently, your surgery may need to be postponed or cancelled. Should your surgery be postponed, every effort will be made to reschedule your surgery as soon as possible.
It is common to experience muscle pain or tightness in your shoulders and upper back between your shoulder blades – it is believed this is due to the position you needed to be in during your surgery. This will get better with time. Your pain medicine will also help relieve this discomfort. If an artery in your chest, called the mammary artery, was used during your surgery, you may experience numbness or tingling to the left of your chest incision. This is also expected and should improve with time.
Yes, but usually only two to three times daily. You will probably be tired and weak during the first few weeks after surgery. However, we recommend that you walk at home three to four times a day for about five minutes at a time. Then, increase activity according to the written instructions provided at discharge.
It takes most people about two to three months to recover physically after the operation. For the first three to six months many people feel very tired, especially at the end of the day. This tiredness and lack of energy gradually improves over the next 12 to 18 months. As a guideline: it takes approximately one month for the vessels to heal, two months for the muscles, six weeks to three months for the bone to mend, three months for blood counts to return to normal and up to 12 to18 months for inflammation to settle down and your full strength to return.
Try not to have any elective dental procedure for at least three months following your valve surgery. Dental and other surgical procedures can release bacteria into your blood, causing infection and possible damage to your heart and valve. To prevent bacteria from causing infection to your valve, always take an antibiotic before any dental work, surgical procedure, or placement of a tube or catheter inside your body. Also your dentist will probably want to temporarily stop your blood-thinning medication which is not recommended in the first three months.
Preparing for surgery
Meeting my surgeon...
After Surgery
We advise that you do not bring children into the ICU without first discussing with the surgical team. The ICU can be a scary place for children, and they may not understand why their loved one is looking unwell or is unconscious, despite recovering routinely and normally from their operation. As most patients stay in ICU for only 12-24 hours, we recommend children visit once you are back up on the ward.
Recovering from heart surgery generally takes most people anywhere from four weeks to three months. Plan to be off work for between four and twelve weeks, depending on the type of work you do. Look into any sickness benefits that maybe available to provide you with support during your recovery. Although your surgeon will be able to give you some guidance, your cardiologist and GP may be able to best advise you on when you will be ready to return to work. For further guidance, please see our page 'When can I resume my usual activities?' which may help you in better predicting the time you will require before being able to return to work.
To give you the best possible care and prepare you properly for your surgery, it is important your surgeon has a clear understanding of your current medications, your past medical history, any fears or concerns you might have and any other information that might influence your surgery. Be open and honest with your surgeon regarding everything to do with your health as this all helps towards ensuring you receive the best possible care before, during, and after your heart surgery. You may like to ask your GP for a medical history summary to give to your surgeon. This summary includes any past illnesses, operations, and current medications you are on. This will help ensure you do not forget anything important. Bring any recent x-rays or reports you may have received. Also, write down any questions you might have before you visit your surgeon, and if possible, it may be worthwhile to have someone accompany you to your visit to help you remember all the information that is provided at your consult.
See Information for Patients for more information.
In the past, cardiac surgery patients remained in bed for several days after their operation to promote rest and healing. However, research has shown there is benefit in getting up out of bed and moving around as soon as possible after your operation. These advantages include improved lung function, reduced risk of blood clots, prevention of pneumonia, decreased length of stay and less loss of muscle tone. Even with the tubes and drains still in your body - often while still in intensive care - you will be encouraged to get out of bed with the help of nursing staff and a physiotherapist.This may be difficult at first, but you will have plenty of help and be safe and supported every step of the way.
Movement after surgery may start the evening of your operation, including bending and straightening your legs almost as soon as you are awake,dangling your legs over the bedside,gently sitting out of bed in a chair, or even a small walk, if you are able. On the first day after your surgery, if possible, you will transfer from the bed to the chair two to three times and gently walk in the room and hallway. On the second day onwards, the physiotherapist and nursing staff will continue to increase your mobility to help you get back to moving as much as possible as soon as you can after surgery.
Your stay in hospital will depend on your operation, however as a guide, most heart surgery patients stay between five and seven days in hospital after surgery.
Depending on the operation, the average heart surgery takes three to four hours in the operating room. Your loved ones should know that in order to give you the best care possible, your doctors and nurses can need up to an one hour before your surgery and approximately an hour after surgery to make you comfortable and settled into your room. Your loved ones will be permitted to visit you roughly four to six hours from the time you are first taken from the ward for surgery.
Call your family doctor or cardiologist if your heart symptoms change or worsen at any time while you are waiting for your surgery and let us know at Adelaide Cardiothoracic on 08 8375 5950 (during business hours) or email us at contact@adelaidecardiothoracic.com.au.
However, if you have significant symptoms which are not relieved by rest or your medication, call an ambulance, ask someone to take you to the nearest Emergency Department, or call 000.
You will need to stop blood thinning medications (except for Aspirin) prior to your surgery as blood thinning medications can cause increased risk of bleeding. It is important your doctor knows exactly what medications you are taking, including all over the counter supplements and medicines, as their are diabetic medications, and supplements such as fish oil or vitamin K that may also need to be stopped prior to your surgery. Your doctor will advise you exactly when you need to stop and when. If you have any questions leading up to your operation, call us at Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au.
The breathing tube can be taken out as soon as you are able to meet requirements for breathing on your own and all your other vital signs are stable.
Recovery can be a challenge for the open heart surgery patient and his/her family. There may be days of high energy then days of fatigue, feelings of accomplishment and exuberance and then days of feeling blue, unexpected bouts of sadness and crying, or even getting angry, all of which are very normal as part of the physical and emotional healing process that takes place after cardiac surgery. It can take some months for this to stabilise and even up to a year before you truly feel like yourself again.
We recommend you have a family member or friend stay with you each night for up to one week after you get home from the hospital. Arrange for help at home for daily activities such as cleaning, groceries, laundry, and gardening for six to eight weeks. Nursing and home care services are NOT routinely supplied, but are available if necessary. You should be able to care for yourself by the time you are ready to go home.
Most patients who are recovering from heart surgery initially do so in the intensive care unit (ICU) for approximately 12 to 24 hours (sometimes longer depending on your health status). When surgery is complete, the surgeon will speak to your loved ones, and they will be told in which ICU bed you are recovering. After ICU, you will go to the ward where you will stay until you are ready to be discharged.
We recommend that female patients should wear a soft elastic bra (no under wire, usually a size larger around is more comfortable) 24 hours a day for the first six weeks following surgery. This will prevent the weight of the breast from pulling on the incision and sternum, thereby decreasing scarring and placing less weight on the sternum.
Yes, just ask your surgeon to provide a sick certificate for your friend or relative.
It is very common for patients to be emotional after surgery. You’ve been busy preparing for the surgery and now it is all over, you don't feel good and the result is not there yet. Many patients ask, "What have I done?!" Add in that the natural stress hormones produced by your body drop out at about three to five days after surgery, and you have a perfect formula for feeling depressed and teary (stress hormones are steroids and can elevate mood). Actually this is a normal response to surgical stress.
Following your surgery you will see your surgeon about two weeks after your operation, and if all is well, you will be referred back to your Cardiologist to follow-up on your recovery. It is important that you have a follow-up appointment with your Cardiologist approximately four to eight weeks after your surgery. If you do not receive notification of a Cardiology appointment, please call Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au and we will follow-up on a Cardiologist appointment for you. You should also visit your local GP within approximately a week from surgery to ensure you are recovering well and you have all the medications you require.
It is quite common to have difficulty sleeping at night for some time after cardiac surgery. You may find it difficult to fall asleep, or you may find that you wake up at 2:00 or 3:00am and cannot fall back to sleep. This will improve. Sometimes, if you are uncomfortable, taking a pain pill before bed can help, or propping pillows behind your back if you are normally a side sleeper to allow you to get back to a sleep position you are used to. Others sometimes find they sleep better in a recliner or lay-back chair for a time. Keeping active during the day helps you to be tired at night, which will help you sleep better.
Please notify us by calling Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au if:
you have any signs that may suggest an infection (e.g., fever or high temperature, cough, cold or flu symptoms, burning or pain on urination, or redness around cuts or scratches on your skin).
you need to defer surgery due to a change in your personal circumstances
Before you come to hospital, you can complete anAdvanced Care Directive, either online or by having a kit posted to you by phoning: 1300 366 424. The Advance Care Directive empowers you to make clear legal arrangements for your future health care, end of life, preferred living arrangements and other personal matters. It replaces the existing Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction with a single, Advance Care Directive Form. Once you have completed this form, ensure a copy is provided to your GP, your cardiologist and your surgeon.
The Advance Care Directive allows you to:
- write down your wishes, preferences and instructions for your future health care, end of life, living arrangements, personal matters
- and/or appoint one or more Substitute Decision-Makers to make these decisions on your behalf if you are unable to do so in the future.
Your Advance Care Directive only takes effect (can only be used) if you are unable to make your own decisions, whether temporarily or permanently.
After surgery, you may hear popping and clicking sounds in your chest. These sounds are caused by cartilage between your ribs. As the sternum settles and heals it can continue to make little sounds, and usually takes six to twelve weeks to settle completely, however sometimes it can take longer. As long as there is not significant pain or a grating feeling in your chest you should be fine, however if concerned, bring it up with your local doctor when you next visit.
Not smoking after heart surgery reduces risk of heart attack, stroke and death.
Researchers analysed data from the
trial, which followed 1,800 patients undergoing either Bypass Grafting or Percutaneous Coronary Intervention (such as stenting) for the treatment of coronary artery disease for five years. The study regularly provided information on smoking status in addition to other important health factors.
At the start of the study, one in five patients was a smoker. However, 60% of smokers quit after their heart procedure. After comparing outcomes among these groups of patients, researchers found that continuing to smoke did greatly increase risk of complications. Patients that continued smoking had nearly twice the risk of heart attack, stroke and death compared to those who didn’t smoke. Although nonsmokers had the lowest risk of complications following surgery overall, current smokers had significantly higher risk of death compared to those who quit smoking following their heart procedure.
Therefore smoking is always harmful to health and increases risk of health complications. Doing so can significantly reduce risk of heart attack, stroke and even death.
Quitting smoking is one of the most effective ways to improve health, even in patients already diagnosed with heart disease. There are many factors we can’t control—like age and family history—that increase risk for heart attack and stroke. Smoking, however, is something we can actively change and remains one of the most highly recognised risk factors for heart disease. There’s no question that kicking the habit, even after undergoing heart surgery, can go a long way in reducing risk of complications.
If you are a country or interstate patient, you will need to have accommodation close to the hospital available to you from the time of discharge. You will need to stay in Adelaide until ten days after surgery, OR until the next Wednesday or Friday cardiac surgery follow-up clinic, before being able to return home. This is to minimise the chances of complications occurring after you have left Adelaide and may be some distance from help. You will need to pay for your own accommodation while staying in Adelaide as accommodation is not provided by the hospital. If you do not have friends or family you can stay with, or no accommodation available to you, you can review or download the attached book, Practical Information for Country People Visiting FMC.
For country South Australian patients, you may be eligible for a subsidy towards your travel and accommodation through the Patient Assistance Transport Scheme (PATS) if you are a permanent resident of South Australia and live more than 100 kilometres from the hospital. Please ask your local doctor, call your local PATS office, or check online at www.countryhealthsa.sa.gov.au/pats for further information.
For Northern Territory patients, you may be eligible for financial assistance from PATS if you have to travel more than 200 kilometres one way to an approved specialist medical service, are eligible for Medicare and are an Australian citizen or permanent resident and have been living in the Northern Territory for six months or more. Please ask your local doctor, call your local PATS office, or check online at: www.nt.gov.au/wellbeing/health-subsidies-support-and-home-visits/patient-assistance-travel-scheme for further information.
For other State patients, request the PATS information for your state from your general practitioner, or see the bottom of page Preparing for my surgery.
In regard to depression and anxiety post-cardiac surgery, it can be a difficult time for many patients. There have been many papers written and it is still an area of a lot of debate as to exactly why there is such prevalence for post-cardiac surgery depression or anxiousness – some believe it could be related to the anaesthetic, and/or heart-lung machine, while others blame the residual aftermath of one of the most stressful times of your life (post-surgery stress). Whatever the reason, working through your depression is very important to help towards good recovery and reduced complications. Planning before surgery to have things to keep yourself entertained at rest can make a big difference, as well as getting back into some sort of routine as soon as possible after you return home, such as getting up and dressed, putting on make-up or going out for visits with friends. Just getting outside for a change of scene, and getting some sunshine can change your mood. If however you are struggling and feel listless or very down for more than two weeks at a time, it is worth discussing with your local doctor. There are wonderful support systems available to you, so do not be afraid to seek them out to help towards your recovery. You can contact Beyond Blue through their website: https://www.beyondblue.org.au/the-facts/depression or by calling them on 1300 22 4636.
You will need to avoid driving, outdoor bicycling, or motorcycle riding for four to six weeks after surgery. This time period is recommended to allow your breastbone to heal and because your reaction time may be delayed due to weakness, fatigue, and/or medication. You also do not want to risk hitting the steering wheel and reinjuring the sternum. When riding in a car, you can keep a cushion between you and the seat belt especially for long distances, and it is recommended you stop and take a rest every one to two hours to stretch your legs. This will improve circulation in your legs and help prevent swelling. Please also note that if you drive prior to this four to six week period, and you have an accident, you may not be covered by insurance. You do not need a formal clearance from your doctor to begin driving again.
PLEASE NOTE: If you are a commercial driver, you will need to wait twelve weeks and will require written permission from your cardiologist before being able to drive again. You may require an exercise stress test before being allowed to recommence driving.
Unfortunately, yes. In the event of an emergency or unforeseen circumstances, or if another patient requires surgery more urgently, your surgery may need to be postponed or cancelled. Should your surgery be postponed, every effort will be made to reschedule your surgery as soon as possible.
It is common to experience muscle pain or tightness in your shoulders and upper back between your shoulder blades – it is believed this is due to the position you needed to be in during your surgery. This will get better with time. Your pain medicine will also help relieve this discomfort. If an artery in your chest, called the mammary artery, was used during your surgery, you may experience numbness or tingling to the left of your chest incision. This is also expected and should improve with time.
Yes, but usually only two to three times daily. You will probably be tired and weak during the first few weeks after surgery. However, we recommend that you walk at home three to four times a day for about five minutes at a time. Then, increase activity according to the written instructions provided at discharge.
It takes most people about two to three months to recover physically after the operation. For the first three to six months many people feel very tired, especially at the end of the day. This tiredness and lack of energy gradually improves over the next 12 to 18 months. As a guideline: it takes approximately one month for the vessels to heal, two months for the muscles, six weeks to three months for the bone to mend, three months for blood counts to return to normal and up to 12 to18 months for inflammation to settle down and your full strength to return.
Try not to have any elective dental procedure for at least three months following your valve surgery. Dental and other surgical procedures can release bacteria into your blood, causing infection and possible damage to your heart and valve. To prevent bacteria from causing infection to your valve, always take an antibiotic before any dental work, surgical procedure, or placement of a tube or catheter inside your body. Also your dentist will probably want to temporarily stop your blood-thinning medication which is not recommended in the first three months.
While in hospital...
We advise that you do not bring children into the ICU without first discussing with the surgical team. The ICU can be a scary place for children, and they may not understand why their loved one is looking unwell or is unconscious, despite recovering routinely and normally from their operation. As most patients stay in ICU for only 12-24 hours, we recommend children visit once you are back up on the ward.
Recovering from heart surgery generally takes most people anywhere from four weeks to three months. Plan to be off work for between four and twelve weeks, depending on the type of work you do. Look into any sickness benefits that maybe available to provide you with support during your recovery. Although your surgeon will be able to give you some guidance, your cardiologist and GP may be able to best advise you on when you will be ready to return to work. For further guidance, please see our page 'When can I resume my usual activities?' which may help you in better predicting the time you will require before being able to return to work.
To give you the best possible care and prepare you properly for your surgery, it is important your surgeon has a clear understanding of your current medications, your past medical history, any fears or concerns you might have and any other information that might influence your surgery. Be open and honest with your surgeon regarding everything to do with your health as this all helps towards ensuring you receive the best possible care before, during, and after your heart surgery. You may like to ask your GP for a medical history summary to give to your surgeon. This summary includes any past illnesses, operations, and current medications you are on. This will help ensure you do not forget anything important. Bring any recent x-rays or reports you may have received. Also, write down any questions you might have before you visit your surgeon, and if possible, it may be worthwhile to have someone accompany you to your visit to help you remember all the information that is provided at your consult.
See Information for Patients for more information.
In the past, cardiac surgery patients remained in bed for several days after their operation to promote rest and healing. However, research has shown there is benefit in getting up out of bed and moving around as soon as possible after your operation. These advantages include improved lung function, reduced risk of blood clots, prevention of pneumonia, decreased length of stay and less loss of muscle tone. Even with the tubes and drains still in your body - often while still in intensive care - you will be encouraged to get out of bed with the help of nursing staff and a physiotherapist.This may be difficult at first, but you will have plenty of help and be safe and supported every step of the way.
Movement after surgery may start the evening of your operation, including bending and straightening your legs almost as soon as you are awake,dangling your legs over the bedside,gently sitting out of bed in a chair, or even a small walk, if you are able. On the first day after your surgery, if possible, you will transfer from the bed to the chair two to three times and gently walk in the room and hallway. On the second day onwards, the physiotherapist and nursing staff will continue to increase your mobility to help you get back to moving as much as possible as soon as you can after surgery.
Your stay in hospital will depend on your operation, however as a guide, most heart surgery patients stay between five and seven days in hospital after surgery.
Depending on the operation, the average heart surgery takes three to four hours in the operating room. Your loved ones should know that in order to give you the best care possible, your doctors and nurses can need up to an one hour before your surgery and approximately an hour after surgery to make you comfortable and settled into your room. Your loved ones will be permitted to visit you roughly four to six hours from the time you are first taken from the ward for surgery.
Call your family doctor or cardiologist if your heart symptoms change or worsen at any time while you are waiting for your surgery and let us know at Adelaide Cardiothoracic on 08 8375 5950 (during business hours) or email us at contact@adelaidecardiothoracic.com.au.
However, if you have significant symptoms which are not relieved by rest or your medication, call an ambulance, ask someone to take you to the nearest Emergency Department, or call 000.
You will need to stop blood thinning medications (except for Aspirin) prior to your surgery as blood thinning medications can cause increased risk of bleeding. It is important your doctor knows exactly what medications you are taking, including all over the counter supplements and medicines, as their are diabetic medications, and supplements such as fish oil or vitamin K that may also need to be stopped prior to your surgery. Your doctor will advise you exactly when you need to stop and when. If you have any questions leading up to your operation, call us at Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au.
The breathing tube can be taken out as soon as you are able to meet requirements for breathing on your own and all your other vital signs are stable.
Recovery can be a challenge for the open heart surgery patient and his/her family. There may be days of high energy then days of fatigue, feelings of accomplishment and exuberance and then days of feeling blue, unexpected bouts of sadness and crying, or even getting angry, all of which are very normal as part of the physical and emotional healing process that takes place after cardiac surgery. It can take some months for this to stabilise and even up to a year before you truly feel like yourself again.
We recommend you have a family member or friend stay with you each night for up to one week after you get home from the hospital. Arrange for help at home for daily activities such as cleaning, groceries, laundry, and gardening for six to eight weeks. Nursing and home care services are NOT routinely supplied, but are available if necessary. You should be able to care for yourself by the time you are ready to go home.
Most patients who are recovering from heart surgery initially do so in the intensive care unit (ICU) for approximately 12 to 24 hours (sometimes longer depending on your health status). When surgery is complete, the surgeon will speak to your loved ones, and they will be told in which ICU bed you are recovering. After ICU, you will go to the ward where you will stay until you are ready to be discharged.
We recommend that female patients should wear a soft elastic bra (no under wire, usually a size larger around is more comfortable) 24 hours a day for the first six weeks following surgery. This will prevent the weight of the breast from pulling on the incision and sternum, thereby decreasing scarring and placing less weight on the sternum.
Yes, just ask your surgeon to provide a sick certificate for your friend or relative.
It is very common for patients to be emotional after surgery. You’ve been busy preparing for the surgery and now it is all over, you don't feel good and the result is not there yet. Many patients ask, "What have I done?!" Add in that the natural stress hormones produced by your body drop out at about three to five days after surgery, and you have a perfect formula for feeling depressed and teary (stress hormones are steroids and can elevate mood). Actually this is a normal response to surgical stress.
Following your surgery you will see your surgeon about two weeks after your operation, and if all is well, you will be referred back to your Cardiologist to follow-up on your recovery. It is important that you have a follow-up appointment with your Cardiologist approximately four to eight weeks after your surgery. If you do not receive notification of a Cardiology appointment, please call Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au and we will follow-up on a Cardiologist appointment for you. You should also visit your local GP within approximately a week from surgery to ensure you are recovering well and you have all the medications you require.
It is quite common to have difficulty sleeping at night for some time after cardiac surgery. You may find it difficult to fall asleep, or you may find that you wake up at 2:00 or 3:00am and cannot fall back to sleep. This will improve. Sometimes, if you are uncomfortable, taking a pain pill before bed can help, or propping pillows behind your back if you are normally a side sleeper to allow you to get back to a sleep position you are used to. Others sometimes find they sleep better in a recliner or lay-back chair for a time. Keeping active during the day helps you to be tired at night, which will help you sleep better.
Please notify us by calling Adelaide Cardiothoracic on 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au if:
you have any signs that may suggest an infection (e.g., fever or high temperature, cough, cold or flu symptoms, burning or pain on urination, or redness around cuts or scratches on your skin).
you need to defer surgery due to a change in your personal circumstances
Before you come to hospital, you can complete anAdvanced Care Directive, either online or by having a kit posted to you by phoning: 1300 366 424. The Advance Care Directive empowers you to make clear legal arrangements for your future health care, end of life, preferred living arrangements and other personal matters. It replaces the existing Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction with a single, Advance Care Directive Form. Once you have completed this form, ensure a copy is provided to your GP, your cardiologist and your surgeon.
The Advance Care Directive allows you to:
- write down your wishes, preferences and instructions for your future health care, end of life, living arrangements, personal matters
- and/or appoint one or more Substitute Decision-Makers to make these decisions on your behalf if you are unable to do so in the future.
Your Advance Care Directive only takes effect (can only be used) if you are unable to make your own decisions, whether temporarily or permanently.
After surgery, you may hear popping and clicking sounds in your chest. These sounds are caused by cartilage between your ribs. As the sternum settles and heals it can continue to make little sounds, and usually takes six to twelve weeks to settle completely, however sometimes it can take longer. As long as there is not significant pain or a grating feeling in your chest you should be fine, however if concerned, bring it up with your local doctor when you next visit.
Not smoking after heart surgery reduces risk of heart attack, stroke and death.
Researchers analysed data from the
trial, which followed 1,800 patients undergoing either Bypass Grafting or Percutaneous Coronary Intervention (such as stenting) for the treatment of coronary artery disease for five years. The study regularly provided information on smoking status in addition to other important health factors.
At the start of the study, one in five patients was a smoker. However, 60% of smokers quit after their heart procedure. After comparing outcomes among these groups of patients, researchers found that continuing to smoke did greatly increase risk of complications. Patients that continued smoking had nearly twice the risk of heart attack, stroke and death compared to those who didn’t smoke. Although nonsmokers had the lowest risk of complications following surgery overall, current smokers had significantly higher risk of death compared to those who quit smoking following their heart procedure.
Therefore smoking is always harmful to health and increases risk of health complications. Doing so can significantly reduce risk of heart attack, stroke and even death.
Quitting smoking is one of the most effective ways to improve health, even in patients already diagnosed with heart disease. There are many factors we can’t control—like age and family history—that increase risk for heart attack and stroke. Smoking, however, is something we can actively change and remains one of the most highly recognised risk factors for heart disease. There’s no question that kicking the habit, even after undergoing heart surgery, can go a long way in reducing risk of complications.
If you are a country or interstate patient, you will need to have accommodation close to the hospital available to you from the time of discharge. You will need to stay in Adelaide until ten days after surgery, OR until the next Wednesday or Friday cardiac surgery follow-up clinic, before being able to return home. This is to minimise the chances of complications occurring after you have left Adelaide and may be some distance from help. You will need to pay for your own accommodation while staying in Adelaide as accommodation is not provided by the hospital. If you do not have friends or family you can stay with, or no accommodation available to you, you can review or download the attached book, Practical Information for Country People Visiting FMC.
For country South Australian patients, you may be eligible for a subsidy towards your travel and accommodation through the Patient Assistance Transport Scheme (PATS) if you are a permanent resident of South Australia and live more than 100 kilometres from the hospital. Please ask your local doctor, call your local PATS office, or check online at www.countryhealthsa.sa.gov.au/pats for further information.
For Northern Territory patients, you may be eligible for financial assistance from PATS if you have to travel more than 200 kilometres one way to an approved specialist medical service, are eligible for Medicare and are an Australian citizen or permanent resident and have been living in the Northern Territory for six months or more. Please ask your local doctor, call your local PATS office, or check online at: www.nt.gov.au/wellbeing/health-subsidies-support-and-home-visits/patient-assistance-travel-scheme for further information.
For other State patients, request the PATS information for your state from your general practitioner, or see the bottom of page Preparing for my surgery.
In regard to depression and anxiety post-cardiac surgery, it can be a difficult time for many patients. There have been many papers written and it is still an area of a lot of debate as to exactly why there is such prevalence for post-cardiac surgery depression or anxiousness – some believe it could be related to the anaesthetic, and/or heart-lung machine, while others blame the residual aftermath of one of the most stressful times of your life (post-surgery stress). Whatever the reason, working through your depression is very important to help towards good recovery and reduced complications. Planning before surgery to have things to keep yourself entertained at rest can make a big difference, as well as getting back into some sort of routine as soon as possible after you return home, such as getting up and dressed, putting on make-up or going out for visits with friends. Just getting outside for a change of scene, and getting some sunshine can change your mood. If however you are struggling and feel listless or very down for more than two weeks at a time, it is worth discussing with your local doctor. There are wonderful support systems available to you, so do not be afraid to seek them out to help towards your recovery. You can contact Beyond Blue through their website: https://www.beyondblue.org.au/the-facts/depression or by calling them on 1300 22 4636.
You will need to avoid driving, outdoor bicycling, or motorcycle riding for four to six weeks after surgery. This time period is recommended to allow your breastbone to heal and because your reaction time may be delayed due to weakness, fatigue, and/or medication. You also do not want to risk hitting the steering wheel and reinjuring the sternum. When riding in a car, you can keep a cushion between you and the seat belt especially for long distances, and it is recommended you stop and take a rest every one to two hours to stretch your legs. This will improve circulation in your legs and help prevent swelling. Please also note that if you drive prior to this four to six week period, and you have an accident, you may not be covered by insurance. You do not need a formal clearance from your doctor to begin driving again.
PLEASE NOTE: If you are a commercial driver, you will need to wait twelve weeks and will require written permission from your cardiologist before being able to drive again. You may require an exercise stress test before being allowed to recommence driving.
Unfortunately, yes. In the event of an emergency or unforeseen circumstances, or if another patient requires surgery more urgently, your surgery may need to be postponed or cancelled. Should your surgery be postponed, every effort will be made to reschedule your surgery as soon as possible.
It is common to experience muscle pain or tightness in your shoulders and upper back between your shoulder blades – it is believed this is due to the position you needed to be in during your surgery. This will get better with time. Your pain medicine will also help relieve this discomfort. If an artery in your chest, called the mammary artery, was used during your surgery, you may experience numbness or tingling to the left of your chest incision. This is also expected and should improve with time.
Yes, but usually only two to three times daily. You will probably be tired and weak during the first few weeks after surgery. However, we recommend that you walk at home three to four times a day for about five minutes at a time. Then, increase activity according to the written instructions provided at discharge.
It takes most people about two to three months to recover physically after the operation. For the first three to six months many people feel very tired, especially at the end of the day. This tiredness and lack of energy gradually improves over the next 12 to 18 months. As a guideline: it takes approximately one month for the vessels to heal, two months for the muscles, six weeks to three months for the bone to mend, three months for blood counts to return to normal and up to 12 to18 months for inflammation to settle down and your full strength to return.
Try not to have any elective dental procedure for at least three months following your valve surgery. Dental and other surgical procedures can release bacteria into your blood, causing infection and possible damage to your heart and valve. To prevent bacteria from causing infection to your valve, always take an antibiotic before any dental work, surgical procedure, or placement of a tube or catheter inside your body. Also your dentist will probably want to temporarily stop your blood-thinning medication which is not recommended in the first three months.
Recovering once home...
If you have any further questions, please do not hesitate to send us a message, phone us at Adelaide Cardiothoracic on (+61) 08 8375 5950 or email us at contact@adelaidecardiothoracic.com.au.
More of your questions regarding Heart Surgery may be answered in our booklet: Your Surgery and Beyond, Cardiac Surgery.
More of your questions regarding Lung Surgery may be answered in our booklet:
Your Surgery and Beyond, Thoracic Surgery.
