Cardiothoracic Surgery Patients Guidelines

BEFORE SURGERY

Medication: You must not take any drugs containing aspirin or Plavix for one week before the surgery. These drugs may cause you to bleed more than normal. If you are on coumadin, aspirin, Plavix, please check with your doctor about when you should stop taking these medications.

You must stop smoking. Smoking constricts the coronary arteries, produces excess secretions in the lungs, raises blood pressure and increases the heart rate. The potential for complications increases after surgery if you continue to smoke.

The night before surgery: You may not eat or drink anything after midnight the night before the surgery. This helps decrease any nausea and vomiting associated with anesthesia. You may take your normal morning pills with small sips of water. If you are diabetic, check with your doctor about your diabetic medicines.

Advance Directives/Health Care Proxy/Living Wills: If you have completed a living will or named a proxy, bring copies with you for your medical file.We encourage you to discuss any important personal values and/or medical care preferences with your primary care physician, cardiologist or cardiac surgeon prior to admission. If you have not completed a proxy or living will document, forms are available through St.Vincent’s Medical Center's Admitting Office.

Testing: You will need a chest X-ray, a urine test and EKG of your heart and blood tests before surgery. These tests will be done in the hospital before surgery.

The day before surgery and the following morning, you will need to scrub your abdomen and legs several times with a special soap to kill germs,which will be provided.

Please bring a list of all the medications you take with the dosage and frequency written down and present it before surgery. Please bring the list again the day of surgery for the nurse.

Do not bring valuables, such as jewelry or money, with you to the hospital.

Permission: Your Surgeon and Physician Assistant will explain the surgery and risks to you and ask you to sign a consent form.

AFTER SURGERY

Be Watchful: If your chest wound is red, painful, hot, swollen or drains (especially pus), tell your doctor at once.

Care of Your Incisions: You will be encouraged to shower daily with warm water and a mild soap to keep your incisions from becoming infected. Avoid deodorant soaps, creams, lotions or cocoa butter. If your incision was made in your breastbone, do not lift anything over 10 pounds for three months after surgery.Your breastbone needs time to heal properly.

Temperature: You will be taking your temperature twice a day, morning and evening. If your temperature goes to 101 or higher, take two Tylenol and call your surgeon at once.

Weight: You will weigh yourself every morning. Tell your surgeon if you gain more than four pounds in one or two days, or if you notice increased swelling in your legs, or feel short of breath.

Exercise: To increase blood flow and improve muscle strength, it is important to gradually increase your level of activity.Walking is one of the simplest ways to help yourself recover.Walk at least three times a day, increasing your distance as you can tolerate. Climb stairs once a day if possible.

Sternum Precautions: Do not lift, push, or pull more than 10 pounds for three months to allow your sternum to heal properly.

Driving: We do not recommend you drive a car for at least one month. If you were to get into a car accident your healing sternum would be at risk. You may be a passenger.

Surgical Stockings: Wear the stockings during the day and remove at bedtime. Have a family member help you apply them in the morning.

Elevate Legs: While sitting, elevate your legs above the waist to help prevent leg swelling.

Nutritional Needs: Good nutrition is important for healing. It is very important that you reduce your salt intake to prevent fluid retention that may overload your heart and cause it to work inefficiently.We recommend you eat low fat, low cholesterol, high fiber foods.

Follow-up Appointments: Please schedule an appointment with your Cardiothoracic Surgeon one week from discharge. You will also need to make a follow up appointment to see your Cardiologist one to two weeks after discharge.

Cardiac Rehabilitation: By joining a cardiac rehabilitation program, you can improve your chances of resuming a healthy, active lifestyle. Ask your cardiologist when you should join.