Admission

Please check in with our Patient Business Office one day before your surgery, unless otherwise instructed by your physician, and bring along one of the following:

Our Admission office will be able to assist you in choosing a room that is suited to your need and comfort.

If you have any questions, please contact our Patient Business Office Manager at ext. 1206.

Please leave your valuables at home.

Visiting hours:

What to Pack for the Hospital

The hospital will provide you with an admission kit of basic toiletries, water jar and a cup. If you like, you could bring your own.

Leave all valuables at home (including jewelry, wedding bands, watch, etc).

Please remind your family and friends not to send flowers to you till after you have transferred out of ICU.

Have 6 blood donors come to the laboratory if you havent done so.

Day Before Surgery

You will be asked to scrub your body and hair with a special soap twice a day.

Day of Surgery

Before you leave your room, you will be asked to remove your glasses or contact lenses, dentures, hearing aids and all jewelry and give it to your family. You will be given medications to let you rest comfortably about an hour before the operation.

An attendant will escort you to surgery on a rolling bed. You will probably be awake enough to move between the beds, but you may not remember doing so. The anesthesiologist will give you anesthesia agents that bring deep sleep, freedom from pain and absence of memory during the operation.

Heart surgeries usually take 4-6 hours. The length of the operation depends on how complex it is. Since each operation is different, how long your operation will take is hard to predict exactly. During your operation, your family and friends may stay in the waiting room.

After surgery is over, you will be admitted to Intensive Care Unit (ICU). A nurse will be present at all times to provide the care you need. Anesthetics wear off at different rates. Some people awaken and become conscious in an hour or two but most take much longer. Your family members may visit briefly within to 1 hour after your operation. Visitation in ICU is limited in order to let you rest.

Children under 12 years of age are not allowed in ICU.

What to Expect After Surgery

Phase I Recovery (ICU Stay)

Test

You may expect to have ECGs, blood tests and chest x-rays.

Nursing Routines and Treatments

Immediately after surgery, you will receive care by a team of specially trained nurses and respiratory therapists in ICU.

ICU is a busy place. You can expect bright lights, strange noises, and a great deal of activities. You will be surrounded by monitors, and equipment that help in your recovery.

The nurse and therapists will be checking on you often to assess your vital signs, breathing, IV fluids, and drainage tubes.

When you awaken from surgery, you will have a breathing tube in your mouth and will not be able to talk until it is removed. Your nurse will suck mucus from your lungs and mouth through this tube. It will be unpleasant and will cause a choking or coughing feeling. You will feel some pressure in your throat while the tube is in place. It is important for you to relax.

During surgery a drainage tube was placed into your stomach either through your nose or your mouth to prevent nausea. In addition, a tube was place in your bladder to drain your urine.

Chest drainage tubes placed in your chest near the bottom of your incision drains the blood and fluid that collects in the chest after heart surgery. It is often taken out 1-2 days after surgery when drainage stops.

Bladder catheter is inserted during surgery too to collect urine and show how your kidneys are working. While its in, you may feel like you have to urinate. It will be taken out after a couple of days. And when it is taken out, you may feel some burning when you first urinate, but the sensation will eventually go away.

Activity

The first activity after your operation is simply moving about in bed. Then, you may begin sitting on the side of the bed or in a chair as soon as you are able to, and you can begin walking within a day or two. Deep breathing, coughing and leg exercises will be taught by the physiotherapist to prevent complications.

Pain Management

Pain relief is an important part of your recovery. Everyone has some pain after surgery, especially with activities such as coughing, deep breathing and walking. For each person the level of pain will be different.

Your nurses will be asking you about your pain. They may ask you to measure your pain on a scale of 0 to 10, 0 being no pain and 10 being the worst pain, and may ask you to describe your pain. Pain medication may be given to you orally, and perhaps rectally. The pain medicine will be adjusted to your individual needs.

There are also non-drug pain relief methods available. These methods can be effective for mild to moderate pain. The most common non-drug relief methods are relaxation, distraction, and imagery. You may need instruction from your doctor or nurse about these methods.

Diet

You may wake up feeling thirsty. This is to be expected. It may be due to drugs received during surgery, or because you had nothing to eat or drink for a long time before your surgery.

Despite your thirst, you will not be allowed to drink anything immediately after surgery. You may probably begin to eat ice chips and drink sips of liquid to begin with. However, you will gradually progress from liquids to solids over time. Most of the time you will have your breakfast by the next morning. Try to eat the food that is served even if you dont feel like it. A well-balanced diet speeds healing.

Phase II Recovery (Back to the Wards)

When you no longer need constant care, you will be moved from the ICU to a regular unit. At this point, you are on the road to recovery and are encouraged to take an active part in your care.

Tests

You may continue to expect to have blood tests. Other tests, such as x-rays may be ordered by your doctor.

Nursing Routines and Treatments

The nurses will be assessing your condition at least every 4 hours. Continue to do breathing and leg exercises every 2 hours while you are awake. You will be weighed every morning. All your fluid intake and urine output must be recorded. The nurses will also clean and change your incisional dressing on the 3rd day after the surgery. You should take a look at the wound. If you have any questions relating to the care of wound, ask your nurse at this time.

Pain Management

You are encouraged to take your pain medication. Pain medicines given rectally are given for the first two days. As you improve, you will be changed to pain pills every 4 to 6 hours upon request. If you are comfortable, you breathe better and move easier.

Diet

Nutrition is a vital part in helping your body to heal after surgery. This is not the time to begin a diet. Your appetite will probably be poor for a few days. This is normal. Even so, it is important to drink enough liquid and eat enough food to nourish your body and provide nutrients for proper healing.

Activity

Your activities will go from sitting on the side of the bed, to sitting in a chair, to walking in your room, to walking in the hall. Each day, you should walk longer distances and more often. Make sure to take rest periods between activities. At first you will need help. As you get stronger you can move about on your own.

Other Aspects of Recovery

Walking

Take several short walks between times of rest. This keeps you from getting too tired while you are building your strength. Posture should be good. Dont slump even if you are sore. Walking straight gives you better balance.

Sitting in a Chair

It will feel better to sit in a chair with a firm back than to sit on the side of the bed for a long time. Pillow under your arms will also make you feel better since they keep your shoulders from drooping.

Do Not Cross Your Legs While Sitting

This puts pressure on the veins under the knees and slow blood flow. If your legs or feet swell, you should put them on a chair or stool that is as high as the one in which you are sitting.

Elastic Stockings

Elastic stockings help circulate blood and reduce swelling in the legs when you are less active. They should fit snugly and not roll down or leave marks on your legs. It should not be too loose or too tight. Wear good-fitting slippers with non-skid soles when you are out of bed and are wearing these stockings. They are slippery if you do not wear shoes with them.

Bathing

Sponge baths are given right away. Youll probably be allowed to on the 3rd after the surgery if your wound is dry and not oozing. The nurse or your family should be close by during your first shower after the operation since you may be weak.

Healing of the Incision

Your chest incision will remain exposed once the initial surgical bandage has been taken off. Your leg wounds will be covered with a layer of gauze when you put on the elastic stockings. Your incisions are closed with stitches under the skin that your body absorbs. These wounds require about six weeks to heal completely. Its better to avoid lifting heavy objects during this period. The color of the wound will gradually change from purple to red to pink, returning to normal after several months.

Activity and Exercise Tips

Getting Out of Bed

Getting out of bed is easier if you do the following:

Breathing and Coughing Exercises

Breathing and coughing exercises are the best way to help clear your lungs of mucus and reduce the chance of breathing problems. Deep breathing opens up the tiny air sacs in the lungs. Coughing helps bring up the mucus.

These actions may cause some discomfort but wont harm your incision. You may do these exercises in a bed or chair.

If in bed, raise the head of the bed until you are sitting. Bend your knees to relax your stomach muscles. Hold a pillow or folded blanket firmly against your incision. Stay like this for the exercises.

If in a chair, sit with your back supported and feet on the floor. Hold a pillow or blanket ifrmly against your incision. Then do this:

Breathing and Upper Limbs Exercises

In conjunction with breathing exercises, you could exercise your upper limbs by:

Or, you may use the breathing device as instructed by the respiratory therapist or physiotherapist.

Leg Exercises

Tightening and relaxing your leg muscles squeezes the veins in your legs. This helps blood flow and makes your leg muscles stronger. There are many ways to do this. For example: You can do leg and foot exercises several times a day, 10 to 20 repetitions at a time (or as your doctor recommends). You wont need to do them after you are walking and more active.

Getting Ready for Discharge

Most patients are ready to be discharged by 4th or 5th day after the operation. The usual hospital stay after an operation is about one week (5-7 days), depending upon whether there are any other complications.

It is not unusual to feel apprehensive and uncertain about going home. It may be scary to leave the security of the hospital with its expert medical team and special equipment. Remember, though, that the doctor will not let you leave until he or she thinks you have recovered enough to safely continue your recovery at home.

Before you leave, there are some important steps to assist you in discharge from the hospital.

If you anticipate having special needs at home, share your concerns with the nurse or doctor. Ask questions now.

Keep in mind that you will not be able to drive for approximately 4-6 weeks after the surgery. Arrange for transportation for a morning discharge. Wear a comfortable outfit to go home.

To take home:

Moving Right Along

You will find that you may still be weak after you go home from the hospital. After you return home it will take about 4 to 6 weeks to recover from your heart surgery. This is not very long, if you think about it.

It will be a good time to:

You will start doing more of your usual activities and will feel stronger every day. You will know by how you feel how fast you can go and how much you can do. Enjoy this time of healing. It may be the best thing you can do for yourself and those who love you. Dont rush it!

Take this time to review the materials shared with you during your hospital stay. You will receive a telephone call from Adventist Heart Centre few days after you have gone home to see how you are doing.

Make sure your nurse has the telephone number where you can be reached after discharge. If you have any concerns during your recovery, please feel free to call Adventist and Vascular Centre at (04) 226-1133 Ext. 1290 or your doctor.

Some basic guidelines are listed below.

These guidelines are meant as a reinforcement or supplement to the information given to you by your doctor. If your doctor gives you guidelines that are not the same as these, you should follow your doctors directions.

Routine at Home

Exercises

Lifting

Avoid lifting or moving anything more than 5-10 lbs (2.2 kg 4.5 kg) for 4-6 weeks. Forceful movement or pressure can interfere with the healing of your breastbone.

Driving

Let others drive for the first 4 to 6 weeks after surgery. Motion from steering can worsen the chest pain from your healing breastbone. Also, your response time may be slow due to fatigue, weakness or medication.

Hygiene and Wound Care

Housework

Light housework and gardening only during the first few weeks. No vacuuming, mopping, trimming or other heavy arm exercises till at least six weeks later. Remember not to lift anything weighing more than 10 lbs (4.5 kg).

On the Job

Your doctor can advise you about the best plan for returning to work. If you have a desk job, you may be able to return in three to four weeks. If you have a more physical job, you may need to wait six to eight weeks.

Your Feelings

It is common to feel depressed or frustrated while recovering from major surgery. You may find it hard to concentrate or you may have trouble sleeping. Remind yourself that these things are only temporary. As you become rested and get your strength back, you will feel that you are doing better each day.

The Sensuous Heart

Medications

Take your medicines as prescribed. Make sure you understand how and when to take your medicine.

Your Health

Lower Your Risk

Cardiac Rehabilitation

The Cardiac Rehabilitation program at Adventist Heart Centre is a vital part of your recovery. While you are in the hospital, the doctor, nurse, dietitian, and physiotherapist may have talked to you and your family regarding your recovery and rehabilitation.

There is continuous cardiac rehabilitation available on an outpatient basis. Our team will be able to provide exercise and nutritional guidance. The professional staff is there to provide emotional support as you modify your lifestyle.

Mended Hearts Support Group is formed by Adventist Heart Centre to facilitate people who had experienced heart- mending procedures to share their experiences with others and give support to each other throughout their rehabilitation.

If you have questions about these services, we are here to help you.

Heart Healthy Diet

The Food Service & Dietetics Department play a vital role in the recovery of a patient by guiding them to maintain a healthy lifestyle through the provision of dietary management consultation by qualified Dietitians. If you would like to schedule an appointment to meet with our dietitian, please call ext. 1270.

Guidelines to a Heart Smart Diet

Reduce All Fats

Reduce High Fat Snacks and Dessert

Eat More Whole Grain Products

Eat More Vegetable and Fruit

Choose Low Fat Dairy Products

Choose Meat Alternatives

When to Call Your Doctor