Let's talk recouperating -- specifically walking

[Der Biermeister]

I know I've touched on this already, but today I want to get some indepth knowledge. I know I've mentioned that I am a walker and my FIRST realistic goals in the hospital and afterwards will be to walk, walk, walk.

Seems like most of you veterans have mentioned that they will have you up and walking a little bit as soon as the next day after the operation. And then -- I guess?? -- they encourage you to walk more and more during the rest of the hospital stay? ASSUMING EVERYTHING IS GOING NORMAL -- would it be unrealistic to think I'll be walking several hundred yards by my last day in the hospital?

If so, can I plan on walking everyday once I get home? Like maybe 1/4 mile the first day, and slowly increase?

I am assuming (once again) that this will be the best therapy for a healing heart, and will get me back into the swing of things quicker. Not sure it will do much for healing the sternum, but it also shouldn't hurt.

Thanks for the advice

 

[Rivet]

And then -- I guess?? -- they encourage you to walk more and more during the rest of the hospital stay? ASSUMING EVERYTHING IS GOING NORMAL -- would it be unrealistic to think I'll be walking several hundred yards by my last day in the hospital?

If so, can I plan on walking everyday once I get home? Like maybe 1/4 mile the first day, and slowly increase?

When in hospital, the nurses will make you walk 3-4 times a day. They're not real concerned about distance - just that you do it. By the last day, I was doing about 2 laps around the floor on each walk (probably less than 100 yards ... I'm not a good judge of distance). Also, do your breathing exercises and coughing (not fun, but neither is pneumonia).

When you get home, you should walk 3-4 times each day. It is better to take shorter, multiple walks than one long walk. I was not given any set program to follow - just to gradually increase distance.

I am at week 4 and walking 2-3 miles total each day. When I first got home, I would just walk to the corner and back. By then end of first week, I was walking around the block or two.

Your mileage may vary

 

[Der Biermeister]

Rivet
A "lap" around the floor -- I assume you mean the whole ward -- would easily be 100 yards or more in a normal hospital.

 

[MikeHeim]

You are correct in your assumption that activity is the best therapy for the healing heart. That said, I wouldn't expect to walk several hundred yards daily by time you leave the hospital (of course this depends on how long you're in the hospital). I have also seen posts where people talked about walking the next day after surgery, and I haven't understood them. The day after my surgery, I still had chest tubes, a catheder, and pacemaker wires attached to me, so there was no chance I was walking anywhere. They DID have me get out of bed and sit in a chair (next to the bed) for 30-45 minute periods. I didn't have any complications, so I don't know why my wires and tubes would have been in any longer than other peoples'. Perhaps it's just how different hospitals operate.

Anyways, I went walking the second day after my surgery. I probably walked about 100 feet before I had to turn around. I was wiped out for the rest of the day! The next day was better (probably 200 feet, twice), but that was also the day I was discharged. After I got home, I was able to slowly increase the distance. One word of advice: do not walk far from home for the first couple weeks unless you have someone to come pick you up if troubles arise. They will. You will find out that you can go from feeling good and energetic to completely out of gas in around ten seconds. Out of gas is completely different from getting tired. Out of gas means that your legs turn to jelly, and you are basically incapable of moving yourself forward in a productive manner. You don't want to be two miles from your house when this happens. It happened to me when I was six blocks from my house, and there was absolutely no way I could have made it home.

Anyways, I don't want to reveal all the secrets. It's much more fun to find out on your own!

 

[ClickerTicker]

I had the luxury (sort of) to be able to complete most of my walking rehab whilst in hospital - I was in for over 6 weeks for the endocarditis.
I think I started walking after about a week, for a hundred yards or so. Graduated to doing a loop of that hospital level, tugging a drip stand with my antibiotics around with me. By the end I was allowed out during the day and used to walk several miles. Did get some funny looks as I still had my central line in place with the lumens dangling from my neck and my hospital ID bracelet on.
I would certainly have preferred to rehab at home though - six weeks drives you crazy!

 

[Phyllis]

**** was walking the cardiac unit halls the second day even with a lot of the tubes still connected. By the time he left the hospital, he was walking two or three laps around the unit, 3 or 4 times a day. At home he walked around the house for the first week and then started walking outside. One mile to begin with and up to 3 miles by his 6 week surgeon appt. A lot depends on the condition you were in before hand and of course your recuperation after surgery. However, walking and moving about is important to your recovery. **** was a very determined guy- it was December and he was walking in 10 degree temperatures some days!

 

[Der Biermeister]

I can't be certain -- but I fully intend to keep "moving" just as soon as they get me up. Maybe baby steps for a day or two, but I CANNOT lay in bed, it drives me nuts. Plus it always ends up throwing my back out. So, at a minimum I will want to be put into a chair to sit during the day. And walking to and fro the restroom. I just spent over a week in the hospital due to losing half my blood from a colonoscopy - and it caused a mild MI. I was up almost immediately and tried to maintain some strength during the stay. Also, I fully understand the importance of warding off pneumonia by not being bedridden, and of course doing the spirometer exercises hourly.

Interesting that as much walking as I do -- 4 miles per day, every day -- those 10 days felt like it set me back a year! The first 3-4 days of walking (just last week) my calves felt really sore, like I hadn't walked in years.

Now -- having said all that, I also fully appreciated that I might be having a pipe dream here and that I could be knocked flat on my butt for a lot longer than I am hoping. But ...... no reason not to think positively, right?

 

[sfconstrct]

sfconstrct

sfconstrct

Der, it is differant for everyone. I am 50 and am in good shape, a gym rat. I was in the gym working out the day before my surgery. Not hard but working all the muscle groups. My thought was the stronger I went in the stronger I would come out. Today is my third week from surgery. I just finished walking almost 4 miles in about one hour give or take 5 or ten minutes. I was walking the next day at the hospital. The lungs are their biggest concern. My lungs were clear from the get go and I was strong going in. I don't feel I am pushing it I just walk at a medium pace and increase it each day. I walk at the beach in so. ca. almost went up a very large flight of stairs but decided to wait on that for a while, so instead just walked a bit farther before I turned around. I have been very lucky, I have had no complications, very little pain, it really wasn't that bad. (knock on wood). So bottom line go in as strong as you can and that will make the recovery easier. You will be walking as much as you can without obviously overdoing, listen to you body. Good walking and good luck. As for the tubes mine came out the next day I had a temp. pace wire in just in case they needed it which didn't bother me when I walked they took it out the day I got discharged. I was in on Thursday the 16th. out the 19th. Steve in so. ca.

 

[RandyL]

You will be able to when the nurses keep bugging you to walk

 

[tobagotwo]

Walking is all over the map. Some people have to make do with a few, tottering steps, and some of us are fortunate and go on (sort of) as if we hadn't had the operation.

I was walking the day after surgery. They hung or placed all of my "accessories" on a wheeled cart, and it went right along with me. I did stairs on day two, because the therapist was thrilled with my heart rate on day one (you are attached to that monitor, too, so you can't fool them about how you feel while walking). The therapist carried some of my tubey stuff and electronic paraphernalia up and down the stairs, too, just so she could see me do it. I carried the rest. I believe there was less of it. The Foley was gone, but the chest drain was still in.

Here is my advice about walking after surgery, for what it's worth. Put away the measuring stick. Put the pedometer back in the drawer. It's about movement, not fitness goals. You're not in training, you're in recovery. Training is later, if you like.

Try not to set goals, but instead, listen to your body. Monday and Tuesday, you'll move right along. Wednesday, it may feel like you're dragging an anchor. So, enjoy Monday and Tuesday, and don't push Wednesday. Thursday, you may feel great. Respond to your body, not "the 16th telephone pole, which is your goal for Wednesday."

Realize that when you first return from surgery, you have no second wind. When you're tired, you don't get to stumble all the way back exhausted. You just have to sit down. Or if you don't, you fall down. For a few weeks, when you're tired, you're finished - period.

So only use up half your energy on the way out. Or plan to wind up in a place where you can reasonably rest before you return. Be prepared to just sit down, if you need to, even on a curb. Don't be embarrassed. If anyone were to ask, you can tell them you just had OHS, and they will clam up so fast you'll hear the escaping air whistle as their jaws slam shut.

Go to the bathroom first. There are no roadside bathrooms in the suburbs.

Bring a cell phone, so you can call someone to come pick you up if you goof up on your energy level. Don't be too proud to use it.

You have all day. If you run out of energy, don't panic. After you rest, you'll get some back.

Walk to move, not to set a pace. If you walk a mile or saunter a mile, you've done your heart and body good. Again, this is not a fitness quest. We're going for "normal" here. Fitness later. If you can't figure out that you're not quite normal yet, you have a serious screw loose.

If you feel good, go for a longer distance, especially if there's a place to stop built in if you need it. Don't raise the distance bar and the speed bar at the same time. You'll lose.

I did a lot of walking, far sooner and far more distance than my cardiologist was comfortable knowing about (really, really sooner, really, really farther). But I didn't push myself. I went with what my body felt genuinely ready for, and no more. I didn't come home aching and proud that I had beaten my healing heart into a pulp by pushing it past its limits.

Naturally, distance and speed generally increased on their own as I went along - but some days weren't good walking days. I let go of them. I figured my body was working on healing something else at the time. I didn't just lay around, but I didn't walk to the next town and back, either.

Best wishes,

 

[Der Biermeister]

Bob - thanks for the reminders. I pretty much learned all of that back 5 years ago when I had my right knee replaced. You have to be prepared to totally crap out on a walk. I learned the cell phone thing then too, but thankfully never had to use it. One thing I did -- of course we are talking a different kind of operation - was I carried one arm crutch with me. I would be fine on the walk up to maybe the half-way point, but then the leg would suddenly give out me and I'd need the crutch to get home.

It really IS all about just taking it easy and building up slowly. Steve's recent reports have emphasized all that.

 

[jeffp]

A crutch would be the wrong thing to use in a patient with any strenum incision. The idea of the crutch is to use the arm and chest wall to support the weight rather than the leg. You don't want to put an expansion force on your strenum that soon, if 8-10 lbs is the usual limit, imagine what a pulling force of your body weight will do. Take it easy until you know what you can do. Two weeks out, I was able to totter to the mailbox, rest a few minutes, totter back and then take a 3 hour nap. Everyone's different, but stay within your physical limits, not what you would like them to be, its not a contest! Best of luck meister, I'll try to pop in on you next Friday.

 

[bobcatrel]

walking

walking

A lot has to do with your fitness level pre-surgery. I was a runner and biker so in fairly good shape. When I left the hospital, I was told to walk 5 min. 3times a day for the first week. Second week 10 min. 3 times a day. Doesn't sound like much but you will be tired so be sure to nap often. Even on days toward the end of a week (when I had been walking for the same time for several days)if I felt like doing more - I didn't. Sometimes I would try to walk faster but I stuck to the plan.
At 3 weeks I was told that I could start jogging. I began jogging the distance between two telephone poles and then walking 7 more telephone poles and then repeating until I had 20-25 min. in.
My advice is stick to a plan, follow the plan and be patient.

 

[George]

They'll have you up ASAP

They'll have you up ASAP

I think you'll find that the nurses in the cardiac unit will push you to get on your feet, but are trained to observe, & sense your limit. The first few times they had me up & walking, they had my wife follow behind me with a wheelchair, & I used a walker. A physical therapist worked with me, too. My body definately told me when I needed to sit down! I have a form of Muscular Dystrophy, so walking has been somewhat difficult for several years. They took this into account, but did have me on my feet on the 5th day post-op. As to the issue of the sternum healing. I HAVE to use my arms & a cane to stand up from a sitting position. Obviously, this is not recommended, but I had no choice. My surgeon assured me that I wouldn't tear anything loose, but that it would make for a more painful recovery. He was correct.

 

[Der Biermeister]

Jeff -- I guess I didn't make myself clear about the crutch. I had said "a different kind of operation", which I thought would convey that a crutch CANNOT be used for OHS. Sorry for the confusion.

 

[paulk]

I was in moderate shape before surgery, but I'm not an athlete. By the 4th day in the hospital, I was walking a LOT. Slow of course, but often. I was extremely antsy, and would walk laps until I tired, then rest, then walk some more. I was taking 1mi/30min walks 2 weeks after surgery, 1.5mi/30min walks @ 3 weeks, 2mi/30min walks @ 4 weeks. While walking, I could tell when I was pushing too hard, so I would back off. The point is to gradually increase, and listen to your body. I still slow down on hills (sigh).

-Paul