After your heart surgery, you will be taken directly to the Open Heart Unit (OHU). You do not go to a recovery room first.
As soon as your surgery is completed, I will meet with your family in the waiting room outside of the intensive care unit. It usually takes about 30-40 minutes to get you settled in the ICU. The nurses will want to make sure you are completely stable, post-operative labs drawn, and chest x-ray completely before your family can come in and see you.
For the first couple of hours you’re going to be fairly sleepy. Most patients will remain on the ventilator (breathing machine) until they are awake and strong. Our open heart nurses and respiratory therapists are amazing, among the most experienced in the country. As soon as you are awake and strong, the breathing tube will be removed.
As I discuss under types of incisions, you will probably be pleasantly surprised that you do not have a lot of discomfort even immediately after surgery. If you do need pain medications, the nurses will of course give you enough to make sure you are comfortable.
By the next morning, you’ll have most of your drains and catheters removed and you’ll be sitting up in a chair. The drains I am referring to include “chest tubes” which are placed at the time of surgery to make sure that we can monitor any potential bleeding. Most patients have their chest tubes removed on the first post-operative day.
You will also have a catheter in your bladder. Again most patients have the “Foley” catheter removed on the first or second day.
By the second day, you will most likely be transferred to the Transitional Open Heart Unit (TOHU).
For the remaining time in the hospital, you’ll be working on getting your strength back. We will have physical and occupational therapists working with you, walking the halls, and climbing stairs. Your heart will be monitored for any arrhythmias and depending on your type of surgery, blood thinners may be needed.
One of the interesting things we do at the time of surgery is to place small, temporary pacemaker wires on the surface of the heart in case your heart rhythm doesn’t come back properly after the surgery. Yes, some patients end up needed permanent pacemakers placed (but usually less than 5% of the time).
If your heart rhythm is fine, we remove the temporary pacemaker wires prior to your going home. Yes, just like your chest tubes and bladder drain, the temporary pacemaker wires are removed at the bedside. Our expert team of physician assistants are very experienced and make every effort to make sure you have very little discomfort. The tubes, drains, and wires all come out quickly and most patients don’t have significant pain (but are relieved when it’s all out!).
When you go home, you’ll be able to walk stairs, shower, bathe, and generally take care of yourself. Visiting nursing will be arranged. Sometimes patients will need to go to a rehabilitation center for a week or so prior to going home. This depends on how well you recover, your age, other health problems, and how much support you have at home.
After you are discharged, you will see me or one of my physician assistants in the office to check on your progress and of course, to check on your wounds. We will also make sure you have follow-up appointments with your primary care physician and your cardiologists.
When you are at home, if you have any questions or concerns, just call our office. If it is after hours, you can always get the physician assistant and/or surgeon on call. You don’t necessarily need to come to the emergency department. Call us first unless you feel that you have a life-threatening problem because many things that seem worrisome to you, may be fairly routine and not something to worry about. If you are concerned that there is a serious problem that needs immediate attention, make sure you go to the nearest emergency department. We can always have you transferred back to our campus once you are stabilized.
Overall, you will find the post-operative experience to be excellent. Everyone is very caring and you will find that there is a true team spirit.
