Questions about the operation

[Englander]

Hi,

I understand that the surgeon breaks our ribs in order to operate. How much pain is there in the week after the operation? How do the ribs recover - is it just naturally with a lot of pain killers?

How much can you do for yourself in the first few days. Can you get out of bed to take a shower?

Thanks

Englander

 

[Ross]

They do not break the ribs, but they do separate your sternum and pretty much butterfly you on the table. The pain isn't all that bad. First few days, they give you heavy duty pain control and then slowly taper you to Tylenol or something like it. Extra Strength and perhaps with Codeine if needed.

Your pretty much a basket case for the first 2 weeks or so. You will not be allowed to shower or bath normally for quite a while after surgery. Bedside baths only. You will be up and walking around within 24 to 48 hours. That's a given. The exercise is needed to work the nasty drugs out of your system and keep your lungs healthy.

You might find this link below helpful to you:
http://www.sts.org/doc/3563

 

[elphie]

Ross,
The hospital had me in the shower just 3 days after my surgery. I don't remember any restrictions except I know I didn't let the the water hit my chest for a while.

 

[hensylee]

Mornin, Englander welcome to VR. You will have lots of answers before the day is done. Some will probably find a site for you where you can go to actually view the surgery. The surgery is an awesome operation that will change your life as you now know it - for the better. The recuperation time, in total, is rather long but getting back to work is probably 6 weeks. In hospital you are taught what to do at home, how to exercise, how to breathe (these two are MOST important) in order to get your heart and lungs working at full capacity.

Showering - I actually showered pretty soon after coming home. I was in the hospital for six days, so my shower was within a couple days of returning home, while someone stood by in case I needed help. Showering may be one of the last things on your list, tho.

There are many threads right here in VR about the things you want to know, so if you just search in the heart pre-surgery threads you will learn much of what you need to know.

We are right here 24/7 for anything you might want to talk about.

 

[Les]

They had me showering the first day out of ICU. Used a mild soap and they instructed to wash the suture area gently and pat dry. ( felt wonderful...)

 

[Simon Gee]

I had my AVR in London's Royal Brompton hospital and was in the shower the next day - it felt good too!

But, let's be honest, there is s great deal of discomfort after the op. I had extensive bruising on both wrists where they'd struggled to get a needle in my pathetic veins. I also had a small burn on my forearm (I never did find out where that came from - I think the operating table) and that hurt!

Lying down is the main probem - you can't. Lots of pillows are essentail for the first few weeks; you gardually find you can get lower by removing them one at a time until - hey presto - you can lie down again! It took me about four weeks.

I don't want to frighten you with any of this - my operation was in 2000 and i remember discomfort, not real pain. And I'm a guy, and we don't do pain!!

Good luck,

Simon

 

[Nancy]

Think of the sternum splitting like a broken bone that has to be wired together. That's about what it's like. My husband has had 2 sternum valve surgeries and 1 HeartPort surgery (through the side, between the ribs, which were just spread apart). You will have pain medications for a while in diminishing strengths. Some people just report being uncomfortable, others say they have some pain. Pain tolerance is an individual thing.

Your surgeon will want you to be as comfortable as possible because they want you to be able to move around and walk and use the spirometer, all of which will help you in the healing process.

They really don't want you leading a completely sedentary life, even after you have just gotten home. You will be told to walk each day.

Joe always hit the shower a few days after he got home, being careful to keep the incision area and other drain areas dry. While in the hospital, I gave him complete sponge baths once he was out of ICU, as he says, "to keep the flies off him", LOL.

 

[Tom F.]

The pain is typically controlled with drugs. Remember that we are all different and react to this surgery differently, therefore you might need a bit more pain meds, or maybe less. But if you need more ask for it, no time to be shy. I had a shower at the hospital 4 days post op, just before I left. I showered each day at home, and the first few tired me out. But the key to recovery is to keep moving. My doc told me that at 6 weeks post op your chest is about 80% healed, however some healing continues for months. There really is nothing to fear about the recovery if otherwise you are in good health. Just remember always that it takes time.

 

[catwoman]

Englander:

I had surgery on a Tuesday, went home Monday. Showered that day. Did sitbaths in the hospital. It was uncomfortable to shower, which I was warned it would be -- raising the arms is uncomfortable. Washing my hair in the shower was even more uncomfortable. I stayed w/ my parents for first 2 weeks out of hospital and my mom took me to a nearby salon to get my hair washed on Tuesday. I did it myself after that, and it was definitely uncomfortable. Also, blow-drying my hair wasn't the most pleasant thing I'd done.
But like everything else in life, you move past that pretty quickly. You appreciate life much more.

The day I left the hospital I remember seeing the sky & trees and thinking I had never seen a bluer sky (even up in the Rocky Mountains!) or greener leaves.... Having a new lease on life was well worth the discomfort!

 

[Englander]

Thanks for all for your replies.

This site is excellent. I feel really glad that I know that if I have any questions about this operation, or anything related, I just need to log onto my computer and ask you.

Englander

 

[Dee]

Hi Englander,

From what I understand, they cut the sternum with a saw, then it is tied back together with wire ties, they do not come out. I didn't have any stitches on the outside of my incision, only the inside. They used tape on the outside that came off after about 2 weeks or so. They keep you well medicated for the first few days, they don't want you in much pain, when you're in a lot of pain, you're not taking deep breaths etc....you'll find out that is one of the important things out of surgery, is taking a lot of deep breaths and coughing to get those lungs working again and to not let fluid settle in them. I had a hard time taking the deep breaths after surgery and wasn't able to cough very well, I ended up with pneumonia 2 weeks post op and had to be hospitalized for 3 days. So remember to cough and take the deep breaths!! The spirometer is your best friend!

I took my first shower in the hospital about 3 days post op. Once I was home, I used a shower chair in the shower for saftey reasons and because I didn't feel like standing that long. I had someone else wash my hair for me for a while. They really don't want you raising your arms above your shoulders for a while, if you need to, just raise one at a time, not both at once. They also don't like you bending over very much at first, so the chair made everything a lot easier. I also rented a hospital bed for the first few weeks. Our only bedrooms are upstairs and I sure didn't feel like climbing stairs. As Simon said, you won't want to lay flat for a while, so the hospital bed came in handy for that reason also, I could adjust the bed wherever it felt good at the time. My insurance paid for it too!

You'll probably think of more questions as your surgery date draws closer, don't be afraid to ask. That's what this site is all about!! I only wish I would have found it before my surgery instead of after. Don't get me wrong, I'm so thankful I found it, and it has really been a God send for me. It just would have made the surgery less frightening if I kinda knew what to expect. I didn't have a clue and didn't even have the chance to do any research or anything. I had 3 days from the time I found out that I even had a heart problem until the surgery and all 3 of those days were spent in the hospital. Find out as much information as you can, then you'll know what to expect and there won't be any surprises! And remember, the anticipation of it is far worse than the actual surgery itself!!

Take care~DeeDee

 

[Raverlaw]

Englander,

I had surgery on Friday and was up walking around Saturday afternoon. I had sponge baths in the hospital and went home on Tuesday. I showered at home the next day and just avoided getting the water directly on the incision.

The sternum takes about 8 weeks to heal completely. The incision was healed after two weeks.

I was in pain the day of surgery and the morning after, mostly due to the chest drain tubes being very uncomfortably placed. Once those were taken out, I went off pain meds completely and never needed anything stronger than Tylenol at home.

Breathing is SO important - as Dee said, if you don't clear those lungs out by breathing deeply and coughing up the gunk that collects while you're on the pump, you'll develop pneumonia.

The surgery is well worth the temporary discomfort. I wish I had had it sooner.

 

[Birky]

operation

operation

Don't remember the 1st day much. Had surgery late in day so by the time my family saw me it was late. Was awake off and on. I think I got to ICU around 9pm and early the next morning they had me up and walking. Took out the drain tubes that morning and one of the lines in the shoulder area. Later that afternoon I was moved to the cardiac floor. It was more uncomfortable than painful. I have a pretty high tolerance to pain and I did have a pain pump for 2 days which helped tremendously. The rehab people were there every morning at 5:45 to walk me and then again later in the morning. Walk, walk, walk, I didn't get a shower to after the first appointment with the surgeon. Around 1 month. Was in the hospital 11 days and then went back again for another 4 due to problems with the rythm of my heart. All okay now with the medication. I wish I would have found this sight prior to my surgery.

 

[Marge]

Englander, I think the amount of pain and discomfort varies a lot depending on the individual, hence the different responses you are getting.

I had very little pain and not that much discomfort. What pain I did have was controlled quite easily with pain medication. (I do realize from accounts of other people here that I was very lucky.) The worst pain I had was when sneezing! And a series of sneezes will really make you feel as though your chest is coming apart. When you feel a sneeze coming on, your best bet is to clutch a small HARD pillow to your chest to cushion it. The hospital where I was gave me a "heart pillow" (shaped like a heart) for this purpose.

The physical therapy people will get you out of bed very early. It is important for your recovery that you not be sedentary. Typically, the first thing they will teach you will be the correct way of getting in and out of bed to spare as much discomfort to your healing chest as possible. Then they will get you from the bed to a chair, and then they will have you walking around the ward several times a day. They will also want you walking a set amount each day once you get home.

You will also have respiratory therapy, so you will be breathing properly as soon as possible. Typically, this is done with the aid of a thing called an "incentive spirometer" that you breathe into. You will be told to continue using the spirometer on a regular basis after you go home.

I had surgery on a Thursday and was discharged the morning of the following Tuesday. The evening before I was discharged I said that I wanted to take a shower, and they let me. I washed my hair too. It was really a relief. Once I was home I showered with no problems. My discharge instructions said not to take tub baths for at least four weeks or until my incision healed (out of concern for possible infection), and to shower with warm, but not hot water, and to use a "mild" soap on the incision area.

Some people use a chair or stool in the shower in case they get light-headed. It is also a good idea to have somebody at hand the first few times you take a shower, just in case.

I know a lot of people have trouble lying down in bed for some time after the surgery, and some have to sit up in a recliner for a while. I never did have much trouble of that sort. I was really worried about having to sleep on my back, which I've never been able to do! But from almost the beginning, even at the hospital (once the chest tubes were out) I was able to sleep on my side. I used a lot of pillows at the beginning (six I think was my grand total) but got rid of them one by one.

I did all the normal everyday things of personal care myself after I got home. Got myself in and out of bed, dressed myself, took my shower myself, etc. But your energy level is pretty low for at least a couple of weeks and you probably don't want to plan on doing household work, cleaning cooking, laundry, etc. I was lucky there too -- my husband is a great cook, so I never had to worry about getting food. We just let the cleaning slide for a while.

Oh, lifting is a big no-no for a while too! No more than five pounds for the first month, 10 pounds the second. And nothing that will twist your sternum as it heals. I soon realized that opening car doors, refrigerator doors, or unscrewing tight lids on jars was tricky. You really can use someone around most of the time to help the first few weeks.

I hope some of this helps.

 

[dawnwit15]

Welcome

Welcome

Welcome to the site my friend. About the pain. I think my opinion of the spreading of the ribs is major discomfort. While your in the hospital they have you doped up so it's not that bad. Also, once they take the chest tubes out which drain the fluid, it's easier also. Once you get home, it's a little tougher. The coughing and sneezing is the worst because you feel like your going to split in half, but rest assured you won't. Like everyone else said, you have to cough to get the congestive gunk up and out to avoid pneumonia. It's all uncomfortable but it is tolerable. We all got through it and you will too. Don't worry your doc won't send you home without pain meds so you'll be ok. Good luck to you.
Dawnwit15

 

[Englander]

Thanks again for all your helpful replies.

I think the non-heavy lifting part will be the most frustrating part. My wife and I have a baby girl who is about 14 pounds and not being about to lift her will be depressing.

I suppose a good thing is that my wife is on maternity leave and therefore she will be with me 24 hrs a day during my recovery, poor girl !!

I was going to start a new job in July. The company have been really good and have agreed to let me start in September.

Englander

 

[KathyH]

Welcome to the site Englander. As you can tell you have alot of different answers. My chest incision was glued instead of stitched and I was able to shower on my 3rd post op day. As far as pain, I wasn't able to take narcotics as they were making my bowels stop working so I only had extra strength tylenol for pain. It didn't take all my pain away, but it was dueable. Believe it or not, I had more pain with my hystectomy I had.
You will not have any energy to do much for awhile, so it will be good that your wife is there with you. Honestly, as the others will tell you, the worst part is the waiting for the surgery. Read all the posts you can and that will prepare you for what to expect. Any questions, there are plently of people to answer them. Good luck.
Kathy H

 

[tobagotwo]

As Hensylee suggests, look through the threads in presurgery for a great deal of information. As Marge pointed out, everyone has a somewhat different story, different pains, different complications, different recovery. However, the commonalities will show through in the reading.

I did well on Fentanyl, rather than the standard morphine. I had tramadol (Ultram), afterwards, also excellent. However, tramadol is fairly reactive, and it's about a 50/50 shot as to whether you can take it, considering some of the other drugs commonly taken by VR candidates.

I got to shower on the third day, only after the emergency pacemaker wires were removed. I had both hands over my head, vigously washing my disgusting hair in mere seconds: I couldn't wait. Thinking back, the nurse would probably have had a conniption fit, if she'd known. But I was fine, and never felt dizzy at all. There were no restrictions on getting the skin staples (instead of sutures) or incision site wet.

I had major pain one night, with the chest tube still in, but they gave me toradol, and it was quickly manageable. Taking the chest tube out was just a shlooping sound, with no pain. Catheter didn't hurt coming out either, but first time peeing is a real exciting moment. Pacemaker wires pinched coming out, but I think on the third day, they were probably starting to heal in.

It was not unbearable. It certainly wasn't fun, but it wasn't as horrible as I feared, either. (For me, anyway. There are plenty here who would - with good cause - violently dispute that statement from their own experiences.) I'm not ready to do it again for at least fifteen years, but I know I'll be able to face it when my reoperation does come up.

As far as sneezing: don't. Just don't. Grab your nose hard, as high up as you can and say, "fish!" or do whatever you have to, but do NOT sneeze. Coughing can be controlled with the pillow, a hiccup is not usually too bad. Sneezing is like a train wreck.

Best wishes,

 

[Gemma]

Hi Englander,
After establishing what day and time it was (Tuesday, 5pm - operation was Tuesday morning), one of the first things my boyfriend Jim said in ICU was "my chest aches a bit". I looked at his nurse and we both laughed - it just seemed such a ridiculous situation. She gave him extra pain-killers of course, but I do think that bit of humour helped a lot.
Anyway, as soon as he was out of ICU and on the main ward, the only complaint he really had was about the hospital beds (obviously different to the one Dee had) - he apparently got up one night to turn the mattress over - yes, he did it himself - onto the firmer side, and blames that bed for his bad back. I think he ended up sleeping in the recliner chair next to his bed for the last 2-3 nights in hospital. He also had trouble sleeping because of the noises on the ward, other people's machine's beeping, oxygen whirring, nurses walking up and down... Once home, he slept in bed with lots of cushions to start with, then a week or two later was lying down normally.
He was given a bucketload of tramadol to take home, but ended up only taking about 8 and returning the rest to the chemist - they gave him wild hallucinations and made him feel a bit out of touch with reality, so he got by with paracetemol instead.
He didn't have a spirometer - the man in the next bed did, but apparently Jim's lungs were healthy enough not to need it. He was shown breathing and stretching exercises by the physiotherapist whilst in the hospital. From what I remember he had a shower at the hospital, but I couldn't tell you when exactly that was. He had a bath about 2 or 3 weeks after the surgery, with no problems (although I'm not sure this is recommended by the doctors).
He had the chest drains, neck IV thing, one arm IV and catheter removed the morning after surgery, and was just on an oxygen thing which was up his nose for the 2nd day (what's it called? - know he didn't like it, said it smelt funny!), not attached to any monitors at all - the nurses just came round every hour to check his blood pressure, ask if he'd been to the loo, etc. The pacing wires (which go through a tiny hole in your chest, and are there in case of any arrhythmias) came out on the Saturday. He had some kind of aversion to using a bedpan so walked to the bathroom about 24 hours after his operation. Apparently he wasn't supposed to walk so soon, but it didn't do him any harm and was better than not going!!!
See the kind of things you find out here!! Walking's the most important thing you can do, a bit further each day, and breathing and having naps when you're tired. It's no good trying to stay awake all day because it just won't happen at first.
I seem to be rambling again! Sorry, hope this has been of some help. And maybe it's worth getting your wife on here too at some point to say hello so she knows how the forum works and can post on your progress when you're in hospital.
Gemma.

 

[danielgilboa]

After all that great advice I just want to add-

I had my first shower 2 days out of surgery. It was GREAT! that's when I begun feeling human again. I shaved, washed my hair and felt like new. I could'nt shower on my own for a few days, but it made no difference (a nurse showered me). It was recommended to wash and soap the incision right from the begining.

You have a project comming up. We are realy glad to share our experience with you (I think it serves us as much as you...) Do you have a date?

Keep your head up! Daniel