topic Re: managing open heart surgery in Among Friends

managing open heart surgery

beth58 — Sun, 27 Oct 2019 21:46:50 GMT

We have just learned that my husband (77 yeaers old) will need open heart surgery . The thought is terrifying . Neither of us have any experience with surgeries beyond my having the kids. I know he will be fine - it's the aftermath I'm frightened of. We have no family in the area. We have friends but I wouldn't feel right about asking them for help. He'll be in the hospital for 4 days and then we are on our own. I would really appreciate any advice any of you might have. on handling this. Will I be changing dressings ? Do I need to hire a nurse? Should I rent a hospital bed? Our house has 5 levels. How much pain will he be in?

Sorry about all the ranting. You can tell I'm a bit overwhelmed.

Re: managing open heart surgery

millieshops — Sun, 27 Oct 2019 21:57:58 GMT

@beth58I'm sure it's overwhelming. I do wish I knew enough to help you plan, but I don't. I can tell you, though, that my BIL had open heart surgery at about your DH's age. He's 91 now and still amazing all of us.

I did live near my sister at the time, but I don't believe they had in-house help. They did live on one floor though, but someone else will have to talk with you about stairs. I'm sure some will have excedllent info for you.

Re: managing open heart surgery

Somertime — Sun, 27 Oct 2019 22:06:00 GMT

@beth58 I can imagine how terrified you both must be. The Social Worker at the hospital will speak with you. You will have a choice either rehab or home care. They will make the arrangements for whatever choice you make. If you chose home care, someone will come to your home, help with getting him washed, dressed and walking. He will not need a hospital bed but a portable toilet in the beginning would be helpful. Is there somewhere on the first floor that could be used as a bedroom? Stairs will be difficult for a few weeks. Otherwise whatever bedroom you use will be fine as long as there is a bath near.

Make a list of questions, so when you meet with the Social Worker, she will be able to answer them. He will be on medicine until he heals.

Prayers for you both!

Re: managing open heart surgery

gtx — Sun, 27 Oct 2019 22:12:16 GMT

When my husband had a stroke, the hospital and the rehab facility both had a lot of information, questions about our home, how equipped we were to bring him home, and suggestions about what we would need. I'm sure that will be available to you. They wanted to know if we had family, friends, neighbors who could help. If not, they could recommend Home Health Care or a nurse, whatever you will need.

Make a list of your questions so you won't forget to ask.

Re: managing open heart surgery

Carol Diane — Sun, 27 Oct 2019 22:12:43 GMT

My dad had open heart surgery at about 80. He didn't need a nurse or hospital bed. He was fine. A nurse came a few times a week in the beginning and he went for therapy. The only scary part was when I walked into ICU the next morning and he thought things had happened that didn't. He was in about 4 days also. He lived a long time after that and was still driving from NJ to Florida at 88.

Re: managing open heart surgery

Janey2 — Sun, 27 Oct 2019 22:32:10 GMT

The hospital social worker and the doctor can help with all these questions. Every case is different. The only thing I will say is that many people are depressed for a little while after the surgery. Make sure there is someone to help him through this time.

Re: managing open heart surgery

CatsyCline — Sun, 27 Oct 2019 22:46:38 GMT

You might want to talk with his cardiologist office and ask them for help - they will coordinate his care but once in Hospital, the Hospitals have patient care coordinators. Post surgery he may go to cardiac rehab for a short stay. Once your husband is home, there are visiting nurses for a period of time, but Medicare alone does not cover full nursing care. If you have a Supplement review your coverage, full nursing care may be part of your insurance.

Whatever you do, do NOT let them discharge him without a good plan in place. i learned from my mother's multiple surgeries, the squeaky wheel...you know what i mean. All the better if your husband can go to rehab for those critical days post-op. Wishing you the best and take good care.

My mother was in the cardiac floor with Afib, post hip replacement. she was in trouble, her heart rate was 200 and it could not be lowered. She had a team of caregivers and there was a patient care coordinator, a Hospitalist and a Cardiac specialist onstaff. When she was discharged, after 3 weeks, She had pseudomonas and they recommended SNF rehab for her IV antibiotic regimen. She insisted on going home and it was my niece who had to deal with the IV and all that went with it. . Now my mother has Plan F Medicare which is one of the top shelf levels and even at that level she did not qualify for 24/7 nursing care, only the VNAs

Re: managing open heart surgery

doxie1 — Sun, 27 Oct 2019 22:50:28 GMT

@beth58

Your feelings are normal. I had a 87 year old neighbor that had it with no problems other than he had to limit stair climbing. I highly suggest that you take a deep breath and chill a little. Then get pen and paper and start writing ALL of your concerns no matter how small. Take this to the doctor and have an honest dialogue with him or her.

Your doctor knows your husbands health and can better guide you as to what may be needed. It is important to write them down and not think you will remember all of them.

It sounds like the two of you are pretty healthy to live this long with no surgeries!

There are outpatient services that will go in effect depending on your husband's needs.

doxie

Re: managing open heart surgery

SandySparkles — Sun, 27 Oct 2019 23:04:17 GMT

I am sorry to read about your husband's upcoming surgery. I echo the previous posts regarding the hospital's role in the discharge process. I am sending prayers of healing to the both of you.🤞

~~~All we need is LOVE💖

Re: managing open heart surgery

PA Mom-mom — Sun, 27 Oct 2019 23:15:15 GMT

@beth58 Listen to those who direct you towards the social workers and patient advocates in you hospital. They are usually great. The main thing is to not put him under undue physical stress. I think we are in the same boat. My granddaughter is having open heart surgery in early November. She is 4 years old, and they will be restructuring her aorta from its current hour glass structure. She has Williams Syndrome, and this is a common birth defect issue. We have been told that the most important issue is keeping her movement to a minimum during the 6 week healing time.

Re: managing open heart surgery

Spacrazy — Sun, 27 Oct 2019 23:42:12 GMT

First of all @beth58 please know we will be holding you close in our prayers and good thoughts for you and your husband.

Second; healthcare and it’s providers continue to make great advancements and I believe are our most important industry.

I hope y’all are secure in your choices for who and where you’ll be receiving care. You should have received a plethora of paperwork which will include a complete outline of what to expect (and when) guidelines of policies/procedures, inpatient and after care, contacts, logs to keep (and do keep them they are important).

Read and study all of this. If you need a nurse or special equipment they will tell you.

Good luck to you both !

Re: managing open heart surgery

fthunt — Sun, 27 Oct 2019 23:43:24 GMT

My only experience - my husband had a different medical situation - a home visiting nurse twice a week after released from hospital as well as a male in-training nurse. Female nurse took b/p and general review and reported back to doctor - male took husband in bathroom for bath/shaving. Check with your doctor for information regarding services in your area. They usually have a network for home health care.

In case you wonder - Medicare paid for all of it - never got a bill.

Re: managing open heart surgery

Terrywu — Sun, 27 Oct 2019 23:45:58 GMT

Hoping all goes well for your husband's surgery. We have not experienced that yet, but I a brother-in-law who under went surgery twice and is fine. I think if it were me and my husband I would check on a rehab facility. Again, the social worker will be very helpful. Will keep both of you in my prayers.

Re: managing open heart surgery

Jtdmum — Sun, 27 Oct 2019 23:47:00 GMT

@beth58 All very good questions and normal concerns. You should direct these questions and any others to your cardiologist, they deal with these situations every day, it's their job. .

Your husband will be fine. I think you will be pleasantly surprised at how much healthier and energetic he is once his heart is repaired and he is back to 'normal". As far as time frame, everyone is different, most patients feel better almost instantly.

Please dont feel bad about asking for help from others. One of my neighbors had surgery and needed help and didn't want to "bother" anybody. I wish she would have. I would have been more than happy to give her a hand.

Wishing you the very best. I hope all goes well and goes quickly so you can get back to normal -

Re: managing open heart surgery

DianeJ2 — Mon, 28 Oct 2019 00:14:10 GMT

@beth58 My dad had a four heart surgeries and an aortic repair. I spoke with his cardiologist and social worker each time and they helped me set up what he needed. He did very well at home with outpatient rehab (in patient for his aortic one, was a longer healing time ) and visiting nurse to check in. He wasn't in pain, more like discomfort at times but nothing that wasn't manageable, don't worry. My dad did get a little depressed a week after and thankfully we were aware that could happen. He had to be gently assured rehab/moving was ok for him. I always remember what his cardiothoracic surgeon told me--go in with the most positive spirit you can and that greatly helps the healing process. We did that best we could and he did amazingly well.

Basically echoing what everyone has said.... I'm sure all will be fine. Sending you healing thoughts and here if you need to talk more...

Re: managing open heart surgery

pitdakota — Mon, 28 Oct 2019 00:33:32 GMT

Hi @beth58! It is normal to be apprehensive at this point & it is good that you are asking questions and trying to prepare.

I will try to answer questions best I can from a nursing perspective. First thing I will tell you is be prepared for the first time you see your husband after surgery to have all kinds of tubes and equipment. Don't be alarmed by all of the "stuff". This is perfectly normal and doesn't mean that anything has gone wrong. As with any surgery, the surgeon will talk with you after surgery and tell you how the surgery went. The hospital may also have a program to educate patients and families before surgery. Some hospitals do and some don't.

As he progresses, those tubes and equipment will be removed. The goal is to get him up quickly. In most cases when there is no complication to prevent it, they try to get the patient up in a recliner even in open heart recovery.

Here is a website that has quite a bit of good information: https://www.healthline.com/health/open-heart-surgery

We don't know your husband's health and physical history (nor do we need to) so it is difficult to give specific information. But generally, unless there is a specific medical condition or complication, patients go straight home from the hospital.

Since you have so many levels in the house & depending on how many steps there are inbetween levels, that might present some difficulty. Make sure the discharge planner at the hospital is aware of this information.

I will say that traditional Medicare will not cover in home nursing or physical therapy unless there is a specific medical need that meets strict protocols. Traditional Medicare also requies the patient to be classified as "homebound" before Medicare will pay for home health services after surgery. Some Medicare replacement plans will provide limited visits if necessary post open heart surgery, But again, there must be a specific need other than just routine recovery from open heart surgery. So if you have questions regarding that, talk to them while your husband is in the hospital.

You might be thinking of how you can arrange your home so that your husband can get around to the bathroom, watch TV, sleep, etc., without having to walk too many steps at a time. You might also want to think outside the box a little for his first few days home. For example, if you have a recliner in a room that also has a bathroom on the same level, he may be more comfortable sleeping in the recliner at first. But don't forget, the goal is to move, walk, and get some exercise as tolerated during the day.

As long as he is in relatively good health and there are no complications, you should not have to hire a nurse or have a hospital bed.

Many cardiac surgeons or primary care providers refer to cardiac rehab after a specific amount of time. I think some people get cardiac rehab and a traditional rehab program in a long term care facility confused at times. So just in case, know that cardiac rehab programs are done in free standing offices and the patient goes to and from the cardiac rehab site. That means someone needs to drive him to and from for the first couple of weeks of rehab. Many times patients are cleared to drive before they finish the rehab program and drive themself to and from toward the end of the program. Cardiac rehab is not done in a long term care facility where patients stay 24 hours/day. Cardiac rehab is a highly skilled area where they have specially trained nurses and monitors that oversee the exercise of that particular patient.

Your husband will have pain, but the surgeon will prescribe pain meds. He should take them as directed and not be afraid to take them. Again, the goal is to get people up and moving so pain management is essential. Too many complications occur from people not getting up and moving around after surgery. So if someone is in enough pain that it prevents them from wanting to get up and walk a little.....that is a problem.

Here is another link about cardiac rehab that might be helpful: https://www.heart.org/en/health-topics/cardiac-rehab/what-is-cardiac-rehabilitation

Although I know it is a little overwhelming, just know that the majority of patients do absolutely fine and are getting around very well within a couple of weeks of their surgery.

Best wishes to both you and your husband.

Re: managing open heart surgery

roeroe1005 — Mon, 28 Oct 2019 00:41:23 GMT

Prayers for your husband!

My mom had quadruple by pass when she was 80 years old. Sounds scary and I remember that night when she was back in her room, my sister, dad and I were waiting for her. She looked awful - sorry to be so honest, but it did scare me.

The next afternoon she was yelling at dad that he brought the wrong color lipstick! That's how quickly she improved. And mom was not the healthiest person to begin with. She had the option to go to rehab, no, she wanted to come home. So someone would come over and check on her. I remember she had a heart shaped pillow that she was suppose to hold to her chest when she coughed.

That was 17 years ago and I'm sure the procedure(s) continue to improve. I remember my aunt having open heart surgery back in 1973. We literally were all called to the hospital to say "good bye" the night before in case she did not make it. Thank goodness those days are long gone.

You mentioned that you do not have family close by. Please be sure to put it out there to docs/hospital staff. You should not be doing this alone.

Re: managing open heart surgery

1Snickers — Mon, 28 Oct 2019 00:45:35 GMT

@beth58 My husband passed away almost 16 years ago from cancer.
He had multiple bipasses at Walter Reed and I stayed nearby. I was amazed one day when I went in and the nurse had him walking up the stairs!
They gave him a pillow to hug and it helped him when coughing right after surgery.
The house is one floor. He wouldn't tell me if he was in pain, LOL! He sat in his recliner mostly but had no trouble with stairs.
He did fine at home even walked a lot, but got an infection in his leg. So, watch infections in the leg and chest. I used Aloe from a plant and it helped.
He seemed really grumpy and I've heard that from others. But if you can put up with each other you will be fine. I had no help and that was about 25 years ago.
I think things are much improved now and you should have no problems.

Re: managing open heart surgery

RedTop — Mon, 28 Oct 2019 01:16:08 GMT

@beth58 ,

My advice is don’t do anything until instructed to do so.

A good friend had open heart surgery nearly 10 years ago when he was 74. He came home from the hospital weak, but still quite capable of doing for himself. My coworker stayed with him the first week, then she returned to work. I am not aware of him needing any specific equipment, and his wife did not change any dressing. He slept in a recliner for several weeks.

My friend rebuilt his strength by walking thru his house multiple times a day. He was not to go up and down stairs, no stretching, nor lift anything heavier than his shoes.

Being an active man, he was quite bored at home, but was diligent with the OT and PT exercises. His surgery was in February, so he was stuck inside for several weeks, and admitted he was becoming a bit depressed by the time the weather improved enough that he could walk outside to get the paper and the mail. He is doing fine, and has never had any further problems.

Best wishes to your husband with his surgery and recovery. Prayers of strength for you and all who love him!

Re: managing open heart surgery

hopi — Mon, 28 Oct 2019 01:27:06 GMT

Prayers for your husband and a smooth easy recovery.