Patient Timeline to Surgery and Recovery

Transcription

1 Patient Timeline t Surgery and Recvery First visit: Meet with Surgen Cmplete histry and physical exam. Review medical recrds and test results. Discuss treatment ptins. Plan fr surgery, if needed. D ther tests befre surgery, if needed. Share review f findings with referring dctr. Secnd visit: Pre-p Wrk-up Have bld drawn in the lab and a chest x-ray dne. Meet with a nurse practitiner r physician s assistant t discuss surgery. Update histry and physical. Review medicines and discuss plan fr taking them. Discuss what t expect during surgery. Sign cnsent fr surgery. Meet with Learning Center nurse. Meet with Anesthesia Screening Clinic nurse. If yu are an inpatient, yu may meet a physical therapist r ccupatinal therapist. They will meet with yu t discuss sternal precautins and pssible pst discharge equipment. 5-14Days befre surgery Vitamins, Herbs, Diet Supplements, and Medicines stp taking (See sectin in binder called Medicatins and Herbs Which Affect Bleeding ) Yu shuld fllw the surgen s instructins n stpping ver the cunter and prescriptin medicines befre their surgery. Stp taking all vitamins, herbs, and diet supplements fr days befre and up t 7 days after surgery. Yur surgen s ffice will determine when t stp taking all anti-platelet drugs (aspirin and Plavix ). Stp taking nn-steridal anti-inflammatry drugs, and aspirin-cntaining prducts fr 7 days befre and 7 days after yur surgery. This includes ibuprfen, Advil, Mtrin, Nuprin, Orudis, and Aleve.

2 Stp taking Cumadin 5 days befre yur surgery. D nt restart this drug until tld t d s by yur dctr. It is all right t use Tylenl (acetaminphen). 3 Days befre surgery Stp drinking alchl 3 days befre surgery. When mixed with anesthesia, it can have serius effects n yur bdy. Day befre surgery Smene frm First Day Surgery (FDS) calls the day befre (r the Friday befre if yur surgery is n Mnday) with instructins. If they d nt call by 1 p.m., please call If yu have a cld, fever, r illness the day befre surgery, please call yur surgen s ffice between 8:00 and 4:30 pm, Mnday thrugh Friday. After hurs and n weekends, please call the hspital peratr (608) and ask t speak with the cardiac surgery physician assistant n call. Night befre and mrning f surgery befre hspital arrival The night befre surgery, eat a light supper small amunts f lw fat fds. Stp eating slid fd and drinking milk r juices with pulp at 7:00 pm. After 7:00 pm, drink nly clear liquids (apple juice, white sda, tea, brth, Jell-O, weak cffee, water) until midnight. After midnight, d nt eat r drink anything. This includes water, ice chips, gum, candy, and chewing tbacc. This is imprtant t prevent getting stmach cntents int yur lungs during surgery. The evening befre and the mrning f surgery, yu need t shwer with an antibacterial sap called Hibiclens. Yu will get this sap during yur clinic visit. Scrub gently frm yur neck t yur tes fr 2-3 minutes. Avid scrubbing t hard. Yu shuld nt break the skin. Rinse ff, d nt apply any ltins r pwder t the skin. Avid getting Hibiclens in yur eyes r genitals. Please remve all make-up and fingernail plish. This includes clear nail plish. Try yur best t have a restful night befre surgery. The mrning f surgery, brush yur teeth and rinse, but please d nt swallw. Take yur mrning medicines that yu ve been tld t take with a small sip f water. D nt take ptassium r vitamins since they may make yu sick n an empty stmach. If yu have diabetes, please fllw the special instructins abut yur insulin r ral medicines that yu ve been given. Please leave all jewelry, rings, large sums f mney, and credit cards at hme. Bring any inhalers r CPAP equipment, yur glasses, eye drps, hearing aids, dentures, prstheses, r ther special equipment that yu will need during recvery. Be sure these items are labeled and in a case, if apprpriate. Feel free t bring pajamas, a rbe, nn-skid slippers, and ther persnal items. All rms are private and TVs are prvided at n charge. 2

3 Bring a calling card r yur cell phne if yu wish t make lng distance calls. Yu may bring in yur laptp. All f the rms have wireless internet access. Please leave yur belngings in the trunk f yur car the day yu check in. Once yur rm is ready, yur family can bring yur things t yu. Day f surgery Arrive at First Day Surgery (FDS). Arrival time fr a first start surgery is 5:30 a.m. Yu are tld a different time if yur surgery starts later in the day. Please see the sectin in yur binder called Yur Heart Surgery and Hspital Stay fr details. Meet with surgen befre surgery fr questins. A persn frm Anesthesia takes yu t the perating rm (OR). Yur family is guided t the waiting area. This is n the secnd flr in the C5 sectin. Surgery starts. Yur family is updated by the OR staff during yur surgery. Surgery is finished. Yur family is guided t the Cardithracic Surgery Unit n B4/5. Yur surgen updates yur family. Yu arrive n the unit n B4/5. Yur family may visit after yu are settled in yur rm and have had sme time t recver (this may be 1-2 hurs). There is a breathing tube in yur muth. Yu are nt able t speak while this is in place. It is taken ut as sn as yu are awake enugh t breathe well n yur wn. When it is remved, yu may talk and begin taking ice chips and liquids. Yu have several tubes and lines in after surgery. Please see the sectin in yur binder called Cmmn Tubes and Lines fr details. Yu hear nises such as the beep f the mnitr and the bubbles frm the chest tubes. These are nrmal. Yu can bring ear plugs and let yur family knw yu prefer t wear them. Yu may have wrist restraints when yu first wake up. They limit mvement f yur hands. This is t prtect yu frm hurting yurself while yu are waking up frm anesthesia. Yur nurse may have yu sit n the side f the bed the evening f surgery. Day after surgery (Pst-p Day #1) The cardiac team sees yu daily t check n yur prgress. This is called runding. The time f day may vary. It culd be early mrning, late afternn, r evening. Several members f the cardiac team may be present. They first meet utside yur dr t discuss yur prgress. Then they cme int yur rm t update yu and answer yur questins. Please see the sectin in yur binder called Yur Health Care Team fr a list f the peple caring fr yu. Tubes and lines start t be remved based n hw yu are ding. Yur diet is advanced frm clear liquids until bwel mvement is achieved, then heart healthy diet. Physical therapy and ccupatinal therapy may see yu t start helping yu get up and mve t the chair and walking. 3

4 Yu will learn abut sternal precautins t prevent prblems with yur incisin. Yu get ut f bed t sit in a chair in the mrning. Yur gal is t get ut f bed and sit in a chair at least 3 times per day. A gd time t sit in a chair is when eating. Yu start walking in the halls. Yur gal is t walk in the halls at least 4 times per day. Yu cugh and deep breathe using an incentive spirmeter (breathing tl). This helps t prevent pneumnia. Yu shuld d this 10 times each hur while yu are awake. A case manager helps yu with any discharge needs like rehab stay r hme health. Peple frm ther services meet with yu based n yur needs. Pst-p Day #2 until discharge The cardiac team runds n yu every day. All tubes and lines are remved except an IV and the telemetry patches. There are sme exceptins t this. Yu cntinue building strength by walking, sitting in a chair, and taking part in yur daily care. Yu cntinue yur breathing exercises. A member f the cardiac team discusses discharge with yu. Please see the sectin in yur binder called Hmeward Bund fr details. A persn frm cardiac rehab meets with yu n pst-p day 3-4. Discharge day (Pst-p Day #4-5) A pharmacist reviews yur medicines with yu. Yur nurse reviews yur discharge instructins with yu. Other members f the health care team such as a case manager, ccupatinal therapist r physical therapist may meet with yu befre yu leave. Yu pick up yur medicines at yur pharmacy f chice befre yu get hme. Yu limit yur lifting and driving t help yur breastbne heal. Yu shuld nt lift mre than 8 punds fr 6 weeks. Yu shuld nt drive fr 4 weeks. Yu will be given further instructins when yu see the cardiac surgen. Yu cannt sleep n yur side fr ttal f 12 weeks. Other fllw-up care such as having bld drawn in the lab is arranged as needed. Recvery after the hspital Every patient is unique in hw he recvers and feels after heart surgery. Hwever, there are sme cmmn experiences shared by many pst-heart surgery patients. Please see the sectin in yur binder called Hmeward Bund fr details. Weigh yurself daily. 4

5 Measure yur bld pressure and heart rate daily. Please recrd these numbers and bring them t yur fllw-up visits. Increase yur daily activity slwly. Keep yur weight lifting limits in mind. Rest and recver. Take part in ther activities as yu feel ready. D nt lay n either side fr 12 weeks after surgery. First fllw-up visit (abut 1 week frm discharge) Yu may need t have bld drawn in the lab and a chest x-ray r ther tests dne befre yur fllw-up visit. This will be discussed with yu befre yu leave the hspital. Yu meet with a nurse practitiner r physician s assistant t discuss prgress since discharge. Yu may nt see yur surgen at this visit. Fllw-up with primary care prvider in 2-4 weeks frm discharge. Cardiac rehab will start 2-4 weeks frm discharge. Cardiac rehab is prgram develped t help participants learn abut heart healthy life, exercise and methds t reduce stress. This prgram can last by number f visits yur insurance cmpany may allw. Final fllw-up visit (abut 4 weeks frm discharge) Yu may need t have bld drawn in the lab and a chest x-ray r ther tests dne befre this fllw-up visit. This will be discussed with yu befre this visit. Yu will meet with a nurse practitiner r physician s assistant first, then yur surgen. If all is ging well, yu will nt need t be seen in cardiac surgery clinic again. Yu may resume driving 4 weeks frm surgery unless yu are taking narctic pain medicine. Fllw-up with cardilgist in 4-6 weeks frm discharge r as advised by yur surgen. 6 weeks after surgery: The amunt f weight yu may lift is increased frm 8 punds t 20 punds fr 6 mre weeks. Yu need t sleep n yur back fr 6 weeks mre. 12 weeks after surgery: Yu may resume yur nrmal daily rutine. Yur health care team may have given yu this infrmatin as part f yur care. If s, please use it and call if yu have any questins. If this infrmatin was nt given t yu as part f yur care, please check with yur dctr. This is nt medical advice. This is nt t be used fr diagnsis r treatment f any medical cnditin. Because each persn s health needs are different, yu shuld talk with yur dctr r thers n yur health care team when using this infrmatin. If yu have an emergency, please call 911. Cpyright 5/2017 University f Wiscnsin Hspitals and Clinics Authrity. All rights reserved. Prduced by the Department f Nursing. HF#7246 5