(i) Make sure you understand discharge medicines correctly. The best way is to write down the name
and dosage of medicines as you have understood, in your language and get confirmed by the nursing
staff or the doctor. In case of confusion, purchase the medicines and get it checked. IT IS VERY
IMPORTANT TO UNDERSTAND THE DOSE OF ALL MEDICINES SPECIALLY ACITROM , IF
(ii) Confirm about follow-up visit. Usually patient is called for follow-up visit after one week, and the
sutures can be removed on the same day. This saves an extra visit.
(iii) Confirm if you are required to undergo any investigation on your follow-up visit. If yes, ensure that
you have proper forms for that. Confirm the timings and other requirements, like deposition of
investigation charges, on the day of discharge from the respective laboratories.
(iv) Keep your discharge-summary in safe manner, and bring it on each subsequent visit. It is the
complete record of your preoperative condition and your operation.
(v) Meet the dietitian and get the diet chart prepared.
(vi) After discharge, if any problem arises, bring the patient to outpatient department on Monday, Wednesday and Friday in afternoon.
However, if urgent attention is required, patient can directly be brought to the ward.
Recovery after discharge
1. Stay:After discharge from the hospital, the patient is advised to stay in Delhi or nearby place for a period of one week, so that the patient may approach the hospital, if needed. The patient can go to his/her home town after the first follow-up visit.
2. Bathing: You can have bath one week after your operation. Avoid extremely hot or extremely cold water. Any ordinary soap can be used. Gently clean you operation site with soap and water but not rub it. Do not apply the soap cake directly on the incision. First apply the soap on the palm and then with your palm gently apply it on the incision. After bath, pat dry the operation site with a clean and soft towel.
3. Activity: Patients are encouraged to perform light activities from the beginning. Patients should perform all their personal activities without any help. Patients should participate in light house-hold activities from very beginning and as time passes, level of activity can be increased. One should work without getting tired and feeling short of breath and should rest in between. However, patients are advised not to lift weight (more than 4 kg) for about 2 months during which time the bones in the incision are healing. Usually patient can return to normal life after a period of 6 to 8 weeks. There are few special aspects of your activities:
(i) STOP ANY ACTIVITY IMMEDIATELY IF YOU FEEEL SHORT OF BREATH, NOTICE IRREGULAR HEART BEATS, FEEL FAINT OR DIZZY, OR YOU HAVE CHEST PAIN. REST UNTIL THE SYMPTOMS SUBSIDE.
(ii) Rest:You require 8 to 10 hours sleep, including the day time naps. Take rest between your activities and exercise. Rest for 30 minutes after your meals. DO NOT REMAIN IN THE BED ALL THE TIME. A proper balance of rest and exercise is essential for your recovery.
(iii) Walking :This is one of the best form of exercise as it increases blood circulation throughout the body and also to the heart muscles. Gradually increase your walking speed and duration. Walk at your own pace. Stop and rest if you get tired. In poor weather, you can walk indoors. Do not take a walk immediately after meals.
(iv) Climbing Stairs: Unless advised differently by your doctor, you can climb stairs. Climb slowly. Stop and rest if you become tired or short of breath. When using the handrail, do not pull yourself up with your arms, use your legs.
(v) Driving/Travelling: You can travel as a passenger in a car or train at any time. However, long journeys should be avoided for first two weeks. Avoid driving, outdoor bicycling, motorcycle/scooter riding for 6 weeks after surgery.
(vi) Sex: You can resume sexual relations after 4 to 6 weeks when you are comfortable with your other activities. The level of exertion during intercourse is similar to walking approximately half a mile at a brisk pace or climbing two flight of stairs. When you can perform these activities without becoming fatigued or short of breath, sexual activity can be resumed.
(vii) Lifting/Pushing/Pulling : You should not put too much strain on your breastbone
while it is healing. Avoid lifting, pushing or pulling anything heavier than 4 kg for 6 weeks after surgery. This includes carrying children groceries, suitcases and pushing or pulling any other heavy object.
(viii) Work: Check your surgeon before returning to work, but most patients are fit to return to work after 6 weeks of operation, provided the work does not involve strenuous physical activity.
4. Care of Operation Site:
One week after operation, wash the operation site daily with mild soap and Luke-warm water. Avoid vigorous scrubbing. Pat dry the operation site with a soft, clean towel. Do not apply any lotion, cream, oil or powder on your incision, unless prescribed by your cardiac surgeon.
5. Smoking/Chewing Tobacco or Pan Masala:
SAY NO TO SMOKING AND ALL FORMS OF TOBACCO. Smoking can further damage your already compromised lungs and can also increase the chances of your valve getting clotted. Chewing tobacco, pan or pan-masala may damage the teeth and gum which may become a potential source of infection to your valve.
Limit your visitors for the first couple of weeks. Visitors may transmit some communicable disease unknowingly. Also, too many visitors may disturb your rest and relaxation.
Eat well balanced meal. Avoid fatty, fried foods and foods high in salt and cholesterol. For 4 to 6 weeks. Take high protein diet, fresh-fruit and vegetables. Discuss about your diet with the dietitian at the time of discharge. Patients who had undergone valve replacement with an artificial valve and are receiving oral anticoagulants (ACITROM) should avoid foods rich in vitamin K. These include green leafy vegetables (spinach, cabbage, lettuce), broccoli, cauliflower, tomatoes, carrots, butter, olive or corn oil and eggs.
Alcohol may alter metabolism of several drugs and can thus increase or decrease the effect of drugs. Thus, alcohol should better be avoided.
If any of the following symptoms/signs develop, come to the hospital and meet the doctor:
(i) Reddened and swollen wound, warm to touch.
(ii) Any type of discharge from the wound
(iii) Fever with chills
(iv) Fever with temperature more than 100ºF two times in 24 hours.
(v) Increasing ankle swelling and abdominal distension
(vi) Excessive vomiting
(vii) Heart rate more than 150 beats/minute
(viii) Shortness of breath NOT relieved by rest
(ix) Coughing up bright red blood
(x) Sudden numbness or weakness in arms or legs
(xi) Sudden severe headache
(xii) Fainting spells
(xiii) Bright red stool
(xiv) Unusual bruising or bleeding from gums/nose
(xv) Skin rashes.