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what to expect

  • 1.  what to expect

    Posted 05-30-2021 13:29
    Hello, I'm going in for OHS soon to remove a tumor in my atrium. I'm wondering what to expect after the surgery. I don't know how long I will be in the ICU, what tubes and wires I will be connected to, and how long I'll have to stay in the hospital. I'm also worried that I'll be a burden to my wife after I come home and am considering asking to be taken to a rehab/nursing home after I'm released. Has anyone here recently had OHS and would like to share their experience with me? Thanks Kevin

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    kevin roth
    retired
    athens NY
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  • 2.  RE: what to expect

    Posted 05-31-2021 00:47
    I had OHS 8-years ago to repair my mitral valve.  In my case it was minimally invasive, robotically assisted.  Yours may be a more invasive approach, don't know.  In my case there were plenty of tubes and a catheter but overall there was not much pain and the recovery was not bad at all.  You should let us know if you are having a sternotomy or mini sternotomy so folks here who have had the same can comment.  I do know that even sternotomies and mini-sternotomies have advance through the years so that most people now do quite well with them.  A mini-sternotomy is preferable if you have a choice between the two.  Your surgeon or hospital should be able to inform you regarding expected time in the icu and in the hospital as well as other questions regarding what to expect during your stay and recovery.  So yes, I recommend you ask those questions of them as well as those who have been through it.  In my case, I probably worried far more about it than I should have.  Best of luck with your procedure.

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    Ed M
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  • 3.  RE: what to expect

    Posted 05-31-2021 01:13
    Hi Kevin. I would hope that a nurse or your doctor could provide more information for you. Please reach out to them. I can tell you your recovery will be very individual for you. A lot depends on your overall physical health at this point, your activity level. other health concerns, and to some extent your age, but I have known a friend in his 80's who recovered quite nicely within weeks, though he did have some problems because he tried to do too much and did not think it would be as difficult as it was for him.

    Again, each case is individual, and many of us on here have had OHS for bypass, (as myself--I am 64 yrs old), or valve replacement or Aortic repair, so some things may vary. Myself, I was only in the hospital 3 1/2 days including the day of surgery. Everyone has heart monitor of course, arterial line in the wrist to monitor blood pressure and draw blood samples, an IV line and what they call an introducer in the neck, (jugular vein), which in your case may also include a line to monitor the pressures inside your atrium. You will have 2 chest drains or tubes from the bottom part of your chest, and they will monitor how much blood and fluids are coming from the area of your surgery. In my case, those came out the end of the 2nd or 3rd day. Since they are operating on your atrium, you may have a temporary pacemaker connected or have an irregular heartbeat after surgery if you don't already have that. I had 2 small wires in my skin on my chest, but they did not have to use them for a pacemaker and they were removed the day I went home.

    You will have a breathing tube for hopefully a short time. Mine was only in for 2 hours after surgery, but some people require longer period of time. Fortunately, they were wonderful and gave me enough sedation that I wasn't uncomfortable with the tube but not so much that I couldn't wake up and breathe on my own. I really don't remember any of that time except right before they pulled the tube, yet my wife said I was signing to her for some time.

    You will have a catheter to monitor your urine output and usually includes a sensor to monitor your temperature. You may have several IV drips to regulate your blood pressure and fluid status, and they will monitor you continuously.

    As I said, I am not familiar with the differences for your particular surgery, but with my bypass, I was up in the chair the first night, then spent most of the days up in the chair and walking in the hall 3 times per day, which got easier the farther along I was and the more tubes were removed.

    Since you are actually having part of your atrium removed, you may have a slightly longer recovery, so please don't be discouraged if you don't progress as quickly as you would expect. Your doctor's office is the very best place to get advice on what to expect in your case. Please call them. They should have someone who can speak with you and your wife and give you details on what to expect with this particular operation, plus they will know your current health status. You can discuss with them the possibility of needing to go to a rehab facility for a short time as well. In my case, I came directly home.

    The weeks after your surgery, you will be gradually increasing your activity level and once your sternum is healed, (6-8 weeks), you will be able to do more as far as lifting and such. I am 6 1/2 weeks out and I am walking 2-3 miles per day, exercising in cardiac rehab and driving again, (for the past week).

    Best of luck on your surgery and recovery, and please keep in touch and let us know how you are doing!

    Dennis

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    Dennis Danner
    Retired RN
    [Punta Gorda, FL
    [Phone]
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  • 4.  RE: what to expect

    Posted 05-31-2021 07:49
    Kevin,

    I had open heart surgery 40 months ago in connection with a quintuple coronary artery bypass.  Many or perhaps most people on this site have had open heart surgery for one reason or another.

    Despite, the different medical reasons for our surgeries, what to expect in the aftermath of a sternotomy should be the same subject to differences in recovery issues relating to those medical issues.  I am not a doctor and I urge you to speak to your surgeon in order to obtain specific advice on what to expect, particularly in your situation, but I will share some general information regarding sternotomies.

    Your sternum is going to be closed with what was one described to me as something similar to baling wire, and it will take anywhere from 8 to 12 weeks on average for your sternum to heal and for you to be released by your physician from what they call "sternal restrictions." These restrictions are geared towards allowing your sternum to heal properly and include instructions not t stretch your arms overhead, not to lift more than 5 or 10 pounds and generally how to move, including how to lie down and getup from a bed.  It likely will include instructions not to drive. The nursing staff should provide you with detailed instructions and they are generally available on the internet. The bottom line is that your sternum will heal and, sometime around 3 months post-surgery, your doctor will give you the all clear to resume normal activities.  For me that included weightlifting, weighted dips and things like handstand push-ups. So be patient, and you will get where you want to go eventually.

    What happens immediately after surgery is something best described to you by someone else, since I remained in a 2 week medically induced coma post-surgery for reasons totally unrelated to the sternotomy.  By the time I awoke, I was mostly tube-free and pain-free except when I coughed or sneezed.  I would note, though, that the breathing tube which most heart patients have when they first wake from surgery may or may not even be an issue for you since your surgery is for tumor removal.  Again, ask for details from your surgeon.

    As to ICU and hospital stay, I was told a couple of days for ICU and a week in the hospital, which turned into a 3 week stay in ICU due to my unusual complications.  Again, ask your doctor about how it works for your medical condition.  And I think that rehab is an excellent idea because physical therapists are the salt of the earth and they will teach you and your wife how to deal with all this.

    Finally, you will not be a burden to your wife, just as she would not be a burden to you if this was happening to her.  She loves you and will want to help in every way possible.  In fact, if you're like me, you'll quickly be complaining to her that you're not dead yet and you can walk around the damn block by yourself.

    Good luck and good health.

    Ira

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    Ira Reid
    Hoboken NJ
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  • 5.  RE: what to expect

    Posted 05-31-2021 08:18
    Hello Kevin
    I'm glad you got in touch with this group because we have, among us, so much first hand experience. It's an excellent sign that you are being proactive about what to expect.  I'll just add a couple things to what's already been well said.

    Since you know you'll be having OHS focused on the atrium of your heart, I recommend that you and your wife look in now on what rehab facilities are available to you so you already have a short list when time for discharge comes.  Discharges can take place on very short notice so it reduces stress on the two of you make decisions when you are freshly post-op if you've already done some investigation. While you'll be getting up, walking when you leave the hospital, there's still need for quite a bit of support at home so some time in a rehab facility can be very helpful. What rehab centers may your circle of contacts have used and what do they think of them? How is her health and what family, friends, neighborhood resources does she have?  What is travel time to rehab centers and how will she get there?  COVID precautions are decreasing so I hope your wife can visit you in the hospital and rehab center.

    Having a home health nurse and PT come to your home once you get there is a good idea.  Medicare/supplemental insurance generally cover this.  If you're still on private insurance, you might want to look into your coverage. Having trained eyes on you in the early days at home brings peace of mind and you can ask so many questions.

    From the day of surgery onwards, be VERY faithful to the incentive spirometer- which is a little device to help you take deep breaths and clear mucus from your throat and upper respiratory track.  This helps you better get oxygen to your red blood cells and avoid pneumonia.  CONTINUE at home and by this I mean 2-3 months or for as long as you are producing mucus.  Get it out of you!  Warm salt water gargles can help cut through mucus to spit it out. There is increased mucus production post-op for quite a while.  Plan to monitor your temp at home too; I recommend getting a "digital point and shoot" model.  A pulse oximeter to monitor how much oxygen is being carried in your blood is simple to use; sold on Amazon for about $15.  And I expect you may already have a B/P cuff and can use it.  You'll keep a little log of your numbers. Which includes weight.  Anticipate a sodium restriction in your diet.

    Absolutely plan for attending a formal cardiac rehab program once your surgeon clears you.  The actual supervised exercise you do there is important as well as the nutritional advice; the opportunity to talk to other post-op people is invaluable.

    So, some food for thought.  Certainly use "Dr. Google" to investigate terms, answer questions as a supplement to what you learn from your surgeon.  Be sure you have an "after-hours" phone number for the surgeon when you're discharged.  And don't hesitate to use it, weekends or not. Your hospital may also have a nurse line to call too.

    And you have this group for support.  It's amazing how our bodies begin healing right away.  It may take perhaps more time than you anticipate, everyone is unique on this.  But think of one year as a marker.  Your chest incision (sterniotomy) will be about 80% healed in about 4-5 months.  You'll use a pillow in the car between you and the seat belt as well as ride in the backseat to protect yourself for as long as your surgeon tells you.

    Best wishes
    DE

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    Doris Edwards
    Retired RN
    Dublin, Ohio
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  • 6.  RE: what to expect

    Posted 05-31-2021 09:33
    Hi Kevin, 
    Usually your surgeon will be able to tell
    you about length of stay, but nothing is
    written in stone when it comes to surgery
    and hospitalizations.

    I had my OHS 2 years ago, and initially was
    told 3 days in Intensive care and then home
    after a week.  My surgery did not go as planned
    so doctors then had to make alternative plans
    as time went on

    When I left the hospital, I was not bedbound
    or unable to take care of myself.  I was a bit slow
    but could cook a meal, bathe myself and keep myself
    dressed and busy with hobbies during the day.

    The old days of bedbound patients after OHS is now
    over.  Everyone in my Heart Rehab was freshly out of 
    the hospital and surgery and walking treadmills every
    morning.

    Please talk to your Doctor or representative at the 
    Hospital.  My family and I saw short videos of what
    was to be expected for me as a Heart Patient before
    I ever signed into the hospital.

    Mary





  • 7.  RE: what to expect

    Posted 05-31-2021 13:36
    Hello Kevin,  Just want to give you a little info about making this experience a lot less stressful for you.
    I have had 2 OHS--A CABG x 4 and years latter a CABG X 2. MUSIC--MUSIC--MUSIC.  When you want to destress and chill. Put on
    your phone or I-pad or what ever you use. On the T V  go to YOU -TUBE. endless music --Broadway--    name the entertainer ,, BBC-Proms--
      ABBA- on and on and on.. What ever puts a smile on your face. What ever brings back good times or good experiences. Your
    mind leaves the hospital. Set your self up now and have your wife  involved.  Worked for me and many many others  ENJOY.
    Good luck and let me know how this went.
    Best regards,
    David Rosen.  Chapter 206-Palm Beach County, Fla.
        ​

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    David Rosen
    Lake Worth FL
    (561) 969-7010
    DavidRosenLake WorthFL
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  • 8.  RE: what to expect

    Posted 06-01-2021 08:00

    Kevin,

    I know you'd like answers, but please ignore most responses from this forum, describing their experience.
    You are unique (thank you God) and your experience will be unique.
    Simply talk with your medical team about your surgery.
    They will NOT have the answers you want, but must respond with generalities, like "...normally, the ICU stay is 28 hours (or whatever)...".
    Same with all your other questions.  Your experience may or may not be "normal".  Healthy people have struggled for months after OHS and so-called unhealthy people have recovered quickly and gone back to work in 6-8 weeks.  There are lots of variables that determine the timeframe.

    You will be given rather detail post-operative instructions, again somewhat "cookie cutter" items.  It is important that both you and your caretaker understand and follow the instructions. If you experience any complications, you will have a phone number to call (24x7) or if "serious", get to the emergency room.

    (Personally, I was blessed with an ideal OHS and recovery experience, but that is irrelevant to you).

    Good luck and have a great day.

    Don



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    Donald Striegel
    Indianapolis IN
    (317) 786-8066
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