ADVICE ON POST AVR/BYPASS SURGERY - British Heart Fou...

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ADVICE ON POST AVR/BYPASS SURGERY

Maidenhead1 profile image
16 Replies

Hi all, I’m back to ask for more advice please.

My husband was discharged from hosp last night after one week, with very little advice.

1) could anyone please tell me is there anything I can buy, to make getting in& out of bed easier,& sleeping?

2) he was told to keep moving. Could you advice how much, say in a few days, could he go outside?

We left hosp last night with a bag of meds, told they would send for him 2 weeks for another echo& his surgeon in six weeks& that was it.

I believe they should have given him another few days in hosp, he is very fragile.

Sorry to ask these basic questions, but this is quite a weight on my shoulders,& I’m trying to find the energy to cope.

Thank you to anyone who reads this & can advise.

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Maidenhead1
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16 Replies
Chappychap profile image
Chappychap

Hospitals normally issue discharged patients with a pamphlet, they all tend to be pretty similar. Here's one from the Oxford Radcliffe Hospital,

ouh.nhs.uk/patient-guide/le...

This is the version issued by Liverpool Hospital,

lhch.nhs.uk/media/1099/card...

And here are the NHS guidelines for recovering after open heart surgery.

nhs.uk/conditions/coronary-...

What they all emphasise is the importance of getting your lungs back into shape with daily walks and breathing exercises. I've been there myself so I can vouch that this advice is the last thing most patients want to hear! You're exhausted from fractured sleep and in discomfort bordering on pain.

However, our lungs took a terrible battering during the operation. They collapsed when the chest cavity was pierced, and remained collapsed during the five hours or more of the operation (our breathing was handled via an artificial heart/lung machine). Fixing the many remaining pockets of micro collapse is a long and difficult job. But it's absolutely essential for a full and speedy recovery. Furthermore failure to get the lungs back in action can open the patient up to all sorts of secondary infections. So dig deep, grit your teeth, and make sure these daily walks and breathing exercises are completed.

As well as the above information here are some NHS guidelines on the essential breathing exercises that need to be performed multiple times each day. Be prepared, these "huffing" exercises can be quite painful, it may help to gently hug a pillow to your chest when conducting them.

kentcht.nhs.uk/cardiac-reha...

acprc.org.uk/Data/Publicati...

This post may sound a bit bleak, that's not my intention. My bypass surgery was amazingly effective. The recovery period is tough, but after about eight weeks or so I started to feel incredibly fit and strong, literally twenty years younger. And even now, after five years, that sense of energy and vitality has never gone away. But that positive outcome is largely contingent on the patient doing the hard work during those first grim weeks following discharge.

Good luck!

Maidenhead1 profile image
Maidenhead1 in reply to Chappychap

thank you so much, for your invaluable info. I’ve printed off the pamphlet from the Oxford/Liverpool hosp, and will take on board the daily walks& breathing exercises. xx

MichaelJH profile image
MichaelJHHeart Star

Chappychap has given you some very good advice. I cannot stress enough the importance of the breathing exercises. When I went to rehab many had not done so and some even struggled with the warm up let alone the exercises. He also MUST NOT push up from a chair for 6 - 12 weeks as it could result in an unstable sternum. I have only met one person with this, and he was nine months post surgery and struggling. I found a bed backrest very useful as lying flat was uncomfortable. I gradual.ly reduced the height over the weeks. It was also about the eight week mark I felt I was making real progress, three montghs when I started carrying light shopping bags, six months when everything felt fully normal again and about a year when I forgot about it for exrended periods.

amazon.co.uk/NRS-Healthcare...

Maidenhead1 profile image
Maidenhead1 in reply to MichaelJH

thank you Michael, did you find the backrest beneficial? I have no problem sending for one.

Great to see you have made a full recovery!

MichaelJH profile image
MichaelJHHeart Star in reply to Maidenhead1

I found the backrest very beneficial but unfortunately lost it in one of many moves since!

Chickenlou profile image
Chickenlou

Hi Maidenhead1

My fiancé had a triple bypass 3 years ago, so I’m happy to answer any questions you may have 😊

1. My fiancé slept in a recliner chair for a long time after his surgery, there was no way he was getting in and out of our bed (as low to the ground) and he was much more comfortable in the chair. (Appreciate that’ll be of no help if you don’t have a recliner chair!)

2. My fiancé was doing “laps” of the hospital before he was discharged, we kept going with this at home, very gradually building up the distance. He moved about as much as sensible and it seemed to help his lungs. I think he went outside on day 3 or 4 at home (we live in an upstairs flat, so he had the stairs to content with too.)

My fiancé was discharged on day 6 (and he had complications requiring an extra night in intensive care) and I was really scared for the first couple of days he was home, but he was fine. I remember the first night “sleeping” on the sofa next to him and basically just staring at him all night!

I made a chart with all his meds and the times of day he needed to take them, then crossed them off as he’d had them - this really helped.

We used rolled up towels for him to hold against his sternum when coughing, moving etc. I know some people recommended a small pillow, but I found towels much more practical, as they could be exchanged for a clean one when it fell on the floor/got food dropped on it etc.

The recovery is a long process and I cannot stress enough that you need to look after yourself too. Try to rest as much as possible and take a little time for yourself everyday (even if you stay in the house with him, try to relax in another room with a cup of tea, or have a relaxing bath) - whatever you can to recharge yourself a little.

If you have any questions please ask, as I am happy to try and help. xx

Maidenhead1 profile image
Maidenhead1 in reply to Chickenlou

I can identify with you so much. Afraid we don’t have a recliner, but thought the backrest was a good idea.

The meds aren’t a problem, as I had a HA 7 months ago’ I’m used to sorting my own out. I think thus is why his OHS is effecting me so much, as u fortunately I don’t have the energy I had, but these are very early days, so with the advice I’ve had, let’s hope things improve!

Dogloverxthree profile image
Dogloverxthree

I wish I had known about this site before I had my triple bypass. I only saw physio once when thy walked me down the corridor and up a small set of steps never given any breathing instruction or leaflet, told not to use arms to get up and down and had a rolled up towel to hold if I coughed, perhaps this is why I now have chronic pain 10 years later! So follow al this good advice you are offered on this site, hope his recovery is progressing well

Cat04 profile image
Cat04

I am 4.5 weeks post AVR/OHS. I started with 4 pillows plus a V pillow to sleep quite upright but am now down to just 2 plus V to stop me rolling over. Don't use arms to push up, shuffle his bottom up the bed.Keep doing the breathing exercises supported by the rolled up towel especially if he needs to cough.

Little walks around the house to start with progressing to outside when he feels confident enough. Wear a scarf over his mouth to stop cold air irritating his lungs.

Start with just 5 mins per day and build up when he feels able. If he gets very breathless do less.

Keep taking the pain killers regularly even if he thinks he's ok and not feeling too bad - the pain keeps coming back in neck, shoulders, back & chest so keep on top of it all.

Join Facebook group

UK Aortic and Heart Defects Pre Surgery Post Surgery

A small group with extremely helpful & supportive members who have all been through or waiting for surgery.

Best wishes and please PM me if I can help more.

francesw47 profile image
francesw47

Hi

The things I found most helpful after AVR:

1. A cheap spirometer purchased from Amazon. It cost about £6. I still use it! I huffed and puffed away using that - up to 10 times a day - made a huge difference. As others have said, the collapse of the lungs during surgery can cause real problems further down the road and its essential to get breathing properly as quickly as possible. Uncomfortable, but necessary. I had a nebulizer 3x daily whilst in hospital - also a great help.

2. A V shaped pillow. Again, purchased from the same online retailer. I put pillows behind it, and stuffed the V with a cushion - all helped to keep it stable. Really helped in the first couple of weeks at home.

3. A cushion that I could hold to my sternum - useful for car journeys and when coughing or laughing!

Apart from the above, the road to recovery appeared slow initially and was a matter of will at times - but a daily (or twice daily) walk for increasing distances (literally to the next lamp post on bad days) to build up stamina and recover strength. It was June when I had both surgeries so the weather was warm and walking became a real pleasure. A nap daily for a while and really wholesome tasty food. The rate of recovery was slow to begin with but the pace of recovery increased rapidly and the difference to my health was obvious after a few weeks.

And above all else - a good cardiac rehab programme. Were you given the contact details of the local cardiac nurses? Worth giving them a call - and when you are ready, go with your partner to the rehab programme.

Let us know how you both get on.

Cat04 profile image
Cat04 in reply to francesw47

Not every region gives cardiac rehab for OHS AVR. There is nothing available to me unless I pay privately. I was advised to walk, walk, walk.

francesw47 profile image
francesw47 in reply to Cat04

Gosh that is awful. And quite shocking. AVR is open heart surgery as well, you need all the support you can get. Walking was my joy I have to say....and its free! Glad you are recovering ok.

Maidenhead1 profile image
Maidenhead1 in reply to francesw47

thankyou very much for your reply, I think it’s a spirometer he has home with him, I’ve ordered the V shaped pillow, so making progress, and all the advice from you& the group has been a godsend. Onwards and upwards 👍

CyclingTime profile image
CyclingTime

In bed I had to sleep cuddling a pillow to my chest pretty much for the first 6 weeks. Getting out of bed is very much a gentle roll whilst clutching the pillow to my chest with both arms crossed holding it, no sharp jerks or movements.

I started walking outside almost immediately, it was this time last year. Wrapped up very warm, my first walks were only 50yds out and 50 yds back and I quickly built up from there as I felt better. I would do two walks one on the morning and one afternoon, my wife came with me for the first two weeks.

After that as I was more mobile I used a phone app called Strava, you can configure that so when you go for a walk it sends a text message to your wife's phone. They then have a link which they can open and follow your walk to check on progress, then if you stop or feel you can't go further you can call for a lift and they know exactly where you are.

Hopefully some help there

Maidenhead1 profile image
Maidenhead1 in reply to CyclingTime

fabulous idea with the Strava app, and all the rest of your info. Many thanks

Rhinos67 profile image
Rhinos67

I'm post surgery now, but got loads of advice and support, then and still now from UK Aortic and Heart Defects Pre and Post surgery Facebook group 😊

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