You’ve just had open heart surgery and you’re now recovering at home. Mercy Healthcare Services, a San Diego-based Home Health Agency specializing in post-open heart care, have put together this video guide just for you. In our 4 videos, we talk about the top reasons why patients get re-admitted to the hospital and what you can do to prevent them.
One of the top reasons post-open heart patients get re-admitted to the hospital is a condition known as Heart Failure. Heart failure is when the heart does not pump or fill with blood well. This causes the heart to lag behind in its job of moving blood throughout the body.
This can lead to symptoms such as swelling, trouble breathing, and feeling tired. If you have heart failure, your heart has not actually "failed" or stopped beating. It just isn't working as well as it should.
So, what are the symptoms of heart failure?
1. Changes in breathing. Every morning, when you get up, you need to check and look for changes in breathing.
Ask yourself these questions:
Can I breathe as well as I normally can?
Am I getting out of breath doing things I can normally do without a problem? Doi
Am I coughing more than usual?
Did I use more pillows than usual to sleep last night?
2. Changes in weight
Weigh yourself every morning after urinating but before eating. Write down your weight on a calendar. Then ask yourself:
· Has my weight gone up or gone down compared to yesterday? If so, by how many pounds?
· Has my weight gone up or gone down compared to a week ago? If so, by how many pounds?
3. New or worse swelling
Ask yourself:
· Are my ankles more swollen than usual?
· Do my sock and shoes feel tighter?
· Do my clothes feel tighter at the waist?
· Do my rings fit more snugly?
4. Changes in your ability to do everyday things
Ask yourself:
· Can I do all the things I normally do, such as get dressed on my own, make meals, or go for walks?
· Do I feel dizzy or more tired than usual?
· Do I have any new symptom? .
· Do I have I like pressure or pain in my chest?
Now that you know the symptoms of heart failure, what should you do?
If you:
Can breathe easily,
Don’t have chest pain,
Weigh the same as yesterday or last week, and
Can stay active
Then: YOU ARE OFFICIALLY IN THE GREEN ZONE, AND THIS ZONE IS YOUR GOAL
Keep up the good work!
Make sure to keep weighing yourself every day, continue to eat a low salt diet, and keep all your medical appointments!
However, if you’ve noticed these following symptoms:
▪ Gained 3 pounds in 1 day or 5 pounds in 1 week
▪ Are more short of breath
▪ Have more swelling in your feet, ankles, legs, or stomach
▪ Feel more tired
▪ Have a new unusual cough
▪ Need to sleep sitting in a chair or have trouble breathing when lying flat
Then: YOU ARE NOW IN THE YELLOW ZONE, WHICH IS A WARNING ZONE.
▪ If you are experiencing these symptoms, you might need to take extra medicine. You need to call your doctor’s office as soon as possible to find out what you should do.
Finally, if you are experiencing severe symptoms such as
· Struggling to breathe even at rest
· Have crushing chest pain or discomfort that is separate from your incision
Then you will need to call 9-1-1- immediately.
DVT
Another reason why open-heart patients get re-admitted to the hospital is because of a Deep vein thrombosis, often called a DVT or blood clots. DVT occurs when blood clots form in the deep blood vessels of the legs and groin. These blood clots can block the flow of blood from the legs back to the heart. Inactivity, a leg injury, smoking, medical conditions (such as heart disease), and certain types of surgery, including an open-heart surgery, can make a DVT more likely.
So what are the symptoms of a blood clot?
Symptoms of a blood clot include:
· Swelling in the affected limb
· Warmth
· Pain or tenderness
· And color changes including redness, paleness, or other changes in skin color.
If you have these symptoms and think you have a blood clot in your leg, you need to call your doctor right away or go to the nearest Emergency Room. Blood clots in the veins near the surface of the skin are less dangerous but blood clots in the deep veins of the leg are more serious and are more likely to travel to the lungs.
So, while you’re at home recovering, here are some things you can do to prevent a blood clot:
· Walk every 2-3 hours to get your blood circulation flowing
· Don’t sit for more than 4 hours before moving around
· Perform exercises like foot flexing every 30 minutes
· Wear compression stockings
Abnormal Heart Rhythm
One of the most common problems that can happen after open-heart surgery is an abnormal heart rhythm. We each have a built-in electrical system in our heart that controls our heartbeat. After open-heart surgery, the electrical signals that control the heartbeat can become abnormal and cause an abnormal heart rhythm. Abnormal heart rhythms are also called "arrhythmias."
Symptoms of an abnormal heart rhythm include:
· feeling like your heart is racing, skipping beats, or beating out of sync.
· dizziness or lightheadedness
· chest or neck discomfort
· mild shortness of breath
· weakness or fatigue
· anxiety
More severe symptoms include:
shortness of breath at rest,
chest pain,
or fainting.
While you were in the hospital, your doctor may have started you on a medication to control your heart rhythm or your heart rate. Examples of these types of medications include beta-blockers like Metoprolol, calcium channel blockers such as Verapamil or Diltiazem, anti-arrhythmic drugs like Amiodarone, or digitalis glycosides such as Digoxin. You may also have a blood-thinner prescribed to you like Xarelto, Eliquis, or Coumadin.These medications should be taken as directed by your doctor.
So what should you do if you’re having symptoms of an abnormal heart rhythm?
If you are experiencing these mild symptoms (show PowerPoint on the side of the screen) please call your Cardiologist or Surgeon to discuss your plan of care.
If you are experiencing severe symptoms like shortness of breath at rest, chest pain, or fainting, please call 911 immediately or go to the nearest Emergency Department
What do I do about pain after my open-heart surgery?
After being discharged from the hospital, you will still have some pain, which is normal after open heart surgery.
So how will you know when to call your surgeon’s office versus having to go to the nearest ER?
If you have incisional pain, which is pain that feels like pressure or burning at the incision site, you can call your surgeon’s office for additional orders or directions.
If you have epigastric pain, which is pain felt under your ribs in your upper abdomen, it is also safe for you to call your surgeon’s office.
On the other hand, there is pain that must be addressed immediately by either calling 9-1-1- or going to the nearest Emergency Room/
If you have crushing chest pain that feels similar to the pain you had before surgery or chest pain that happens when you are moving around or exercising, then you need to call 9-1-1 immediately or head to the nearest Emergency Room.
Doing “daily weights” is a little more than just stepping on the scale each day. Here are some tips to make your weight as accurate as possible:
1. Weigh yourself first thing in the morning, after using the bathroom but before breakfast.
2. Use the same scale every day. Make sure that your scale is on a hard floor and not on a rug or carpet.
3. Wear the same amount of clothing every time you weight yourself.
4. Record your weight in your heart failure log each day.
5. If you are just getting home from the hospital, weigh yourself on your scale right away and record it. Your weight may be different than the hospital
