Questions on Home Care after Surgery in Virginia

[MIF519]

To all:

My aortic valve replacement surgery is in less two weeks, March 12, at Fairfax Hospital with surgeon Dr. Massimiamo. I'm confused about when to make arrangements for discharge planning. Should I be doing this now? I have preadmission screening on March 10 and I understand that speaking to a case manager on discharge planning is part of that day's scheduling. But will that give me enough time to make arrangement to rent a hospital bed (which I would like to do), or to arrange in advance for home health care services, visiting nurses, or companion services? (I live alone but will have some family support from my mother and sister during the first week). Or does the hospital's staff take care of all of this and I am needlessly worrying? This is my first surgery, and so I would appreciate advice or the benefits of other folks' experience on planning and the necessity for these services.

Thanks in advance,
Marc

 

[WayneGM]

I don't know about the U.S., but in Canada privately paid personal home care workers are typically available 7/24 at very short notice in most urban communities. I don't know about renting the hospital bed, although there were brochures in the room so I think it could have been arranged pretty quick. However, you have to do it. I wouldn't rely on the hospital staff doing it.

Everyone is different, but I didn't make any special arrangements. I just prepared the home to make it easier to access what I needed to get along. However, I was only home alone during the day. That said, I think I could have managed if I had to. The hospital bed would have been nice, but I used lots of pillows in bed and a lazy boy recliner in the living room and they worked just fine.

Best wishes and good luck with your surgery and recovery.

 

[hensylee]

If it is dr ordered, you need to get with your doctor's office now. If you are going to hire someone, you need to get it done now. Your dr may order (by prescription) a hospital bed if he feels it's needed and allo this should be arranged ahead of time, I believe. Takes time for the insurance company to approve these things. You sure you will need help at home, besides your family? Others will have comments. Give 'em time; they'll be along

 

[Granbonny]

Marc

Marc

First..Good luck on your surgery...I am sure you will do great. .It is good to know you will have your Mother/Sister the first week at home..Question? Do they live nearby....if not..have them cook/freeze some food that you could microwave and get them to stock up on plenty of juices/ect....before they leave...I think like others have said..I don't see any need for a hospital bed..if you have a comfortable recliner..sofa..and lots of pillows..Buy one of those form type pillows that you can find at Wal-Mart..made for sitting in bed to read..Neighbor brought me one and it helped... .also a plastic pill box..(weekly) that you can put your meds in for the day..Most come home with a handful of meds to take..Most of these will probably be elimated after you see your surgeon 3 weeks post-op.. ..Let us know if you have any other questions...Bonnie

 

[Phyllis]

Marc, I put you on the calendar so we can help you climb this mountain. Best wishes to you.

 

[Cooker]

Hi Marc...wishing you well...I am sure you will do fine.....If the hospital bed is paid for by insurance I might would but you will be ready to get in your own bed asap!!!...My wife went back to work the day after my surgery, what a peach ...just kidding ...she is great..... My dear MIL stayed with me and I booted her out after a week or so .... I slept in my bed the first night home and sat in the recliner during the day.... when I was not trying to play superman(mistake) ...it was not nearly as bad as I thought it would be....I hope it will be the same for you.

 

[tprice54]

make plans

make plans

I too only used the recliner method for the first week or so. My wife was home with me for the first week, then was able to stop in during the day to check on me. Definetly get the pill box...it can be confusing and the pain meds will keep you foggy. Try and make a back up plan in case of any of those"bumps" in the road.

 

[Susan BAV]

Hi Marc -

To the best of your ability, I'd suggest you get all your ducks lined up in a row in advance; because you're probably not going to feel very well for several days post-op (or possibly several weeks).

My surgeon's office had some papers and lists and such in regard to preparation, and I read quite a bit of suggestions here also. I like lists. So I made lists and had several lists lined up...

Everyone's surgery and recovery seems a bit different for each of us; but most surgeons won't let you drive post-op for four to eight weeks. And most surgeons won't let you push or pull or lift over 5 or 10 pounds also for that same amount of time. You'll also need some kind of transportation for cardio followups and/or lab tests.

Also, from what I've read here, it's not terribly unusual for many valve replacement patients to develop at least one post-op complication and sometimes that necessitates a brief rehospitalization. It may not happen but I just thought I'd mention that also.

The surgeon's office will probably give you something called an incentive spirometer with specific instructions and BE SURE AND DO THEM because it can really make a difference, no matter how boring it may be.

Pain is different with all of us also. I took morphine and oxy-whatever while I was hospitalized but only needed Extra-strength Tylenol when I got home, and that was just so I could do my spirometer breathing exercises. Everyone's pain threshhold is different. I'm not tough but I just hate having to take any med I can avoid. And I had piles of meds I already had to take for a few weeks post-op. I had to make lists and schedules of all of that too to keep it all straight. Maybe a pillbox will help.

Hope this is helpful. Glad you found the site and hope all goes well for you. Take care and post again .

 

[marie]

You should probably see about this before your surgery. I slept in my bed the first night home but had pillows stacked and I also had a wedge pillow. During the day I was in my recliner. Some do stay alone but I don't think I could have. I needed help. My husband helped me shower, put on compression stockings, taking medications, bringing me to the doctor etc. It does get a little better everyday. Make sure someone puts out stuff you may need like food, drinks, medicine anything you may need that's in a cabinet or pantry. In hard to reach places. Take care of yourself and good luck. Keep us posted when you can.
Earline

 

[Philip B]

Prep

Prep

As you've probably already gathered, everyone seems to have unique experiences with OHS.

It's a good idea to get all of the things you feel you might need after discharge lined-up before your surgery. This is especially true of the things which involve dealing with insurance companies.

At the risk of sounding morbid, my wife and I actually had things planned just in case my surgery didn't have the outcome that we expected. I don't know if that's a normal kind of thing. It's probably an unnecessary thing for a lot of folks, but I felt better because we dealt it.

Most of us seem to have not worried about getting a hospital bed for use at home post-surgery. Several members have pursued the hospital bed option. If you think you'll do better with a hospital bed, get one.

Personally, I think it's always a good thing to have what you think you will need close at hand during the early stages of the recovery process. Make sure that the people you will have helping you are flexible enough to understand what you need and how your needs change as you recover. My wife expected me to be something of an invalid when I got home. In fact, I needed very little actual help. The situation initially caused both of us a lot of stress before adjustments were made.

-Philip

 

[netmiff]

I am less than 6 months post-op, I slept in my own bed from the first day home; husband laid out breakfast cereal, cookies, snacks on the countertop to save me stretching and bending - that was a real bonus! He was around a lot, but not all the time; I only showered when he was in the house, for the first couple of weeks, working my schedule around his (I had a schedule?) I couldn't handle a full jug of milk, so there were always two or sometimes three smaller ones in the firdge. I had a slew of meds to take, and a pill dispenser box was the best thing we invested in. I was home alone a fair bit, but he (and my parents) were always only a phone call away. I had no pain med at home except Tylenol, and was OK with that. Some things were tough at first, but I really didn't care if my socks matched my track pants, or if I wore a bra or not - not that you'll have that particular problem ! Sometimes, you have to pick the battles, and only fight the ones that matter. So, if you want a glass of pop and can't handle the 2L bottle, have a glass of water and get someone to bring some cans for the next time you want pop.

If you read through the stickies about preparing homes, and some of the other threads, I am sure you will be OK.

Unless you have other medical issues, I would think that a hospital bed was overkill.

 

[DebbyA]

Marc,
My surgery was at Fairfax, with a surgeon in the same practice as yours.

Unless you discussed arranging home care in detail at the presurgery interview at the surgeon's office, I think you need to call one of the nurse practitioners to find out how it works.

At the hospital presurgery appointment, one nurse did bloodwork, etc and gave us a thorough overview of what to expect surgery day and after. Another went over the admission form very thoroughly and arranged the EKG and chest X-ray.
Neither nurse was specifically identified as a case manager.

The day of discharge, a nurse gave us a chart of week by week instructions and another of medications, and reviewed them thoroughly. After discharge, we found the surgeon's office staff to be very responsive and helpful when we called with concerns or questions.

In addition to the good advice from other posters, I recommend you have a chair and bed you can get out of easily WITHOUT USING YOUR ARMS. You may not need a hospital bed if you have those.

My surgery was also on a Wednesday, I was home by Saturday evening, and have had a pretty easy time of it. I hope you have the same experience!

 

[jeangoat]

Marc
As others have said everyone is different. I really had no real problems after surgery. I slept in my own bed (and it felt so good). Pillows are nice, but I didn't like the recliner...being short, it put too much of a slump in my chest and straightening out was not compfy! I actually slept on my side...a nurse at the hospital showed me how to do that with pillows.
The biggest problems I had were pants zipperss and buttons and snaps, so I wore sweat pants for a couple weeks! Also socks were hard to get on so since it was winter, I wore my fleece loafers a lot. Oh, the can opener was painful to use...just torqued my chest too much (we have a manual one). Husband washed my hair the first couple of times...again, the use of both hands at once bothered the sternum. Have a pillow or small blankey to cushion the seat belt across your chest.
Probably have loose tee shirts or sweatshirts or shirts in general at first..the feel of heavy or rough material on my incision didn't hurt but bothered me no end.
My husband went back to work the 3rd day I was home and it worked out fine. He left things out for me as others mentioned.
Hopefully you will feel so good with a properly working heart, that you will sail through those early recovery weeks! Remember breathe, breathe and walk, walk, walk!
Best wishes!

 

[cp172]

Marc,

I was happy to trade my hospital bed for the one at home. I had no problem adjusting as I stacked pillows as necessary. Also my surgeon ordered home nurse care without my knowledge.When they called I made sure they had been approved by insurance company which they were.

I pray all will go well for you.