In-hospital vs at-home post-AVR support?

[Nic25]

Hi everyone. I'm currently in that limbo stage of waiting for a date for AVR and so am trying to work out some of the practical logistics. My wife is, naturally, planning to take time off after my op to help with my recovery but, as her employer isn't being exactly generous with paid leave (just one week), I wanted to ask if anyone has any views on the value of her taking time off while I am in hospital vs time off once home?

She had originally assumed she'd probably be with me at the hospital for the whole time I was in and will, I am sure, want to be on site when I go under and immediately pre-op and then on discharge, but how valuable otherwise is it to have someone around in hospital when (I assume) you should otherwise be in good hands?

She obviously wants to maximise her paid leave, although she is expecting she will probably also need to take some unpaid leave. So I was wondering what anyone else's experiences have been, although I appreciate everyone will differ? Getting up and down to the hospital is doable (even if a bit of a trek by train) and so eeking out her paid leave by commuting up and down a bit could feasibly be doable, just about. I also do have various siblings who are likely to be keen to visit and fuss about.

Also, I'm going to be in St Thomas' in London - so does anyone have any views on or experience of what the family accommodation there is like? Anything we need to know? We have three teenage/20s daughters - two who will be coming down from uni and then, I imagine, returning - so we may be quite a crowd for at least a few days.

Many thanks in advance! Nic

[Alison1960]

Hi Nic

On day of op if you are first in you will go at about 7:45am with a very jolly porter. Family can come to doors if tgeatre with you but that’s when I crumbled. After op same youarr in overnight ICU - my husband came for 20 minutes but I don’t remember him being there. After that u go to HDU where visiting is 2pm -7:30pm which is far too long. An hour is plent incase you want anything like fresh fruit or juice from the M&S downstairs. You will be really tired and as soon as you are up to it the physio gets you walking.

When you move to the ward after a few days it’s more sociable. Pay tv only do take an i-pad/audio books etc. Maybe binoculars to watch the Houses of Parliament and river boats. (Amazing views which I never want to see again!)

Plan your journey home well as we were caught in traffic and it took 2.5 hours to get home so warn the ward staff to have meds ready.

Once you’re home is when you will really need your wife. You will be exhausted and need TLC. I needed help to shower for a few days and was given loads of healthy food. Sleep patterns get affected and I still have a bit of brain-fog so am even dopier than I was. I’ve been home 6 days and feel SO much better. My op had a little complication with electrics so I was in hospital 10 nights instead of 5-7 as we’d planned. Be aware you won’t know exactly but most people were out 5-7 nights.

Anything else you want to know then message me. Which surgeonhave you got? They are all great there anyway. Xxxx

[Nic25 in reply to Alison1960]

Thank you Alison. That's great advice as ever. Will do! Hope you're feeling more on the mend. My surgeon is Mr Salih. Sure he's great but I wouldn't half getting in his diary at this point! Nic x

[marypw]

My husband had a triple bypass last year. I would definitely recommend that your wife is at home with you for the first week. You will be exhausted and not able to lift anything. Even carrying a mug of tea will be too much!

It's good to have someone with you when you start going for short walks as well.

Best wishes!

[Nic25 in reply to marypw]

Thank you Marypw. That's really helpful. Appreciated. Nic

[Shar28]

My husband had an AVR in January, in Coventry. He had a post-op problem with AF and didn’t react well to the opiates they gave him so I spent quite a lot of time in hospital with him. He was discharged sooner that they would perhaps have liked (he pleaded with them to let him go) and I stayed at home with him for 2 weeks after discharge. I took 4 days paid leave, 1 week unpaid leave and 1 week holiday. I’m not trying to alarm you with the thought of problems, the care he received was very good, but we’re all different with differing needs that aren’t always obvious, no matter how much we wish to plan ahead. I think the most worrying time for me was when I wasn’t there on the wards with him, because I knew he wasn’t having a straight-forward recovery, but my time at home with him afterwards was invaluable. He needed help showering, dressing, carrying things up and downstairs etc. And I found it easier to cope than I would have done if I’d had to go back into work. I know some partners have taken paid sick leave rather than unpaid leave. A chap in at the same time as my husband didn’t have any visitors as his wife doesn’t drive and they have young children and he was happy with that because he got lots of rest. I guess what I’m saying is there aren’t any hard and fast rules, you need to play it by ear to a certain extent and do what feels right for you and your family at the time. All the best. X

[Nic25 in reply to Shar28]

Thank you Shar28. A lot of food for thought there! That's really helpful. Yes as you say we're all different, it's impossible to know what's going to happen, how you'll be and feel. But I guess I'll find out! Lots to digest here so much appreciated. Thank you Nic x

[JayceeW]

Hi Nic25. Having had a AVR and a double bypass, I can confirm that you will be well looked after in hospital. For someone specifically to be there pre-op and immediately after is really not necessary, but help is really necessary when you first return home. Hope all goes well. Keep smiling!

[Nic25 in reply to JayceeW]

Thank you JayceeW, that's all useful. Much appreciated. Nic

[Ruffio]

You really won't want people there all the time when you are recovering in hospital. You will be very tired, and surprised just how exhausting it is having visitors. An hour or two is plenty. Once you get home you may need help washing and dressing at first, and as you can't lift anything heavier than a cup full of water in a kettle, you will need some help. I would definitely take the time off for when you get home.

[Nic25 in reply to Ruffio]

Thank you Ruffio. Yes it sounds like the tiredness is going to be a real factor! That's great. Appreciated. Nic

[Gundoglady]

I had my op 6years ago at the Heart hospital in Marylebone, and I can tell you what my husband would say!

My husband would definitely recommend you have someone with you in the hospital, until you are fully conscious and aware of what is happening around you!

When I was moved from ICU to HCU the nurse that moved me forgot to hook up my external pacemaker! And the nursing staff just kept resetting the alarm on it rather than checking out what the problem was, it took my husband to question them for them to do anything about it.

My drains were left in to long, even though I was in pain from them and my consultant had asked for them to be removed!.I could list more errors, but, it would serve no purpose x

Imo I would have someone coming and going for the first couple of days in hospital, just to be an advocate for you, once you are fully awake that won't be an issue X

You will most definitely need someone at home for the first few days/week.

After that you should be fine, but it all depends on your recovery X

If you are having a mechanical heart valve fitted, you'll probably be on warfarin, my one piece of advice would be to make an appointment at your drs surgery to see the INR nurse, I found it difficult to get my first appointment. Have a chat before you go for surgery x

[Nic25 in reply to Gundoglady]

Thank you Gundoglady. I'm going for tissue, so hopefully warfarin shouldn't be an issue, but that's all really useful advice. Thank you. Appreciated. Nic

[sandybrown]

Hospitals do vary in their practice but under the NHS guidance it should be the same. Having said this after resetting an alarm once is OK but need to investigate it the second time.

When my aunty was in hospital after a heart attack there was an alarm to monitor her but the nurse station was not connected to the bed. While I was talking to my aunty she experience a problem and I had to shout to get a nurse to the bed!!.

Yes I agree it is better to have some one with you, I was in Singapore with my brother before and after a major procedure during the day this did help his recovery.

[Nic25 in reply to sandybrown]

Thank you Sandybrown, wow, that's good to know and be aware of! Lots to mull over here but thank you, much appreciated. Nic

[Midgeymoo17]

My Dad took all time off after I was discharged. In fact he was in theatre himself doing a paediatric spinal operating list while I was on the table. However, the nurses on my ward were quite allowing for the fact my dad was working full time after he explained that the kids he was working on had been waiting an average of 3.5 years for their procedures and he could not cancel the with 2 weeks notice. So he was allowed to visit around 7:30 each morning and 6pm each evening. This was honestly enough for me. First week home I needed more help but was still quite independent and with a bit of pre-prepping could have been left alone all day.

Unfortunately, it is unlikely your wife will be able to revise up that 1 week allowance. Carers discretionary paid leave is only protected for someone who is either caring for a child or with right of attorney. Any carers leave beyond that is at an employee discretion. Alternatively, the employer may allow your wife to take it out of her remaining holiday allowance or negotiate longer on half pay. Truthfully, I was asleep so much of the time my mum got one right relaxing two weeks.

[Nic25 in reply to Midgeymoo17]

Thank you Midgeymoo17, your dad sounds amazing! Yes my wife accepts the leave question is what it is, we'll just have to work round it. What she's thinking is to try and go into work for some of the time I'm physically in hospital so as to maximise the time she has off when I'm back home. Still haven't worked out the mechanics of this fully - we sort of need the date to know for eg where weekends will fall and so on - but this is all really helpful advice. Appreciated. And hope you're recovering well! Nic

[Midgeymoo17 in reply to Nic25]

The date problem is a real pain and exactly why my dad could not change the person doing the paediatric list. And thanks, I recovered well my procedure was in 2017. The time of most need was definitely my first week home.