Chapter 5. The Challenges You May Face
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Resting late one afternoon a few weeks after my homecoming, droopy and irritable with the open-heart convalescent reality, I began to itemize in my mind all the issues I might have investigated in advance. True, I had established some excellent links to professional specialists. But I hadn’t asked questions about recovery. That weary day I acknowledged the gaping checklist of recovery challenges facing me. Had I known to be on the lookout for conditions like serious constipation, excessive fatigue, symptoms of depression, I would have acted sooner to get advice, and to nip the rascals in the bud. That day I began scribbling down a “wish-I-knew-beforehand” list to be shared eventually with you.
Here are a number of red flags to become acquainted with beforehand, for open-heart surgery recovery planning. I offer items to focus on for before, during, and following the weeks after heart surgery. The observations are drawn from my own experience, plus perspectives from dozens of other open-heart patients. This is a partial list only. I welcome feedback from you, the reader, so that I may add your suggestions in a future edition of this book.
Every body is one of a kind
Discuss your particular uniqueness – highlights about you physiologically – with your surgeon, your anesthesiologist, and PA early on. The medical professionals are focused only on getting you through a specific surgery. Don’t count on anyone zeroing in on the sideline details of the medical questionnaire you so carefully completed. It may be in the doctor’s folder but don’t trust that it will get consulted again before any number of critical encounters. Everyone is so busy in every medical unit in the hospital. In a very few years life seems to have over-elaborated itself with fax machinery, computer laptops, incessant email, and ubiquitous cell phones. Just plain living has sped up to such a degree that we are running faster and harder than ever before, and nowhere is this more evident than in hospital settings. So you must point out, proactively, where you need to be heard the most. Personnel at well-run hospitals are indeed going to ask you repeatedly to spell your name, reiterate date of birth, and recap the medications you are allergic to. Be concerned if they do not. But you must also educate them about your particular history and concerns. For example, for me a chronic pain can arise below my left shoulder blade if I am lying flat on my back for more than a few minutes. Once I tell a medical technician about this, we can negotiate the actual amount of time I will need to remain in a certain position. Maybe, lying on my side for a given test could work just as well. You need to have any and all concerns ready to be discussed at the appropriate junctures.
If suddenly you are told you have coronary artery disease, or a heart valve that needs repair, and you’ve considered yourself “healthy” up until that pronouncement , chances are you will assume you will have a straightforward recovery. Even if you are blessed with a reasonable recovery, anticipate limitations. The actual experience of ongoing post-operative conditions – particularly the ones that follow – is stressful. Healthy healing will depend upon how proactive a role you take in your own recovery.
Infection is a possibility and worth discussing with your surgeon. Question what the medical guidelines are for antibiotic administration before and after surgery to prevent infection. Care of your wound will be monitored during your hospital stay, however home instructions are very important to honor. The several take-home instructions I’ve seen ask the patient to immediately report fever above 100.4 degrees Fahrenheit, or above 38 degrees Celsius, or if you run a low-grade fever for more than two or three days. Since the immune system is compromised from the shock of open-heart surgery, it’s wise to stay away from crowds and any individual who has a cold or a flu. Immediately following surgery we are simply at higher risk for viruses and bacterial infection.
Phone your designated medical liaison to alert them to any persistent fever. Once home, yes, hopefully you have survived the risk of infection in the hospital. Now it’s imperative to keep up your vigilance on your own. Occasionally, recovering patients come down with an infected incision, or a systemic infection. Most serious is endocarditis -- bacteria infecting the heart’s inner lining.
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Copyright © 2006 Maggie Lichtenberg. All Rights Reserved.
The content in this chapter is not intended as a substitute for medical or professional counseling advice. The reader is encouraged to continually consult his or her physician on all health matters, especially symptoms that may require professional diagnosis and/or medical attention.