the oxford heart centre - oxford university hospitals · the right food one of the best ways to...
TRANSCRIPT
The Oxford Heart Centre
Information for patients
page 2
Contents
Introduction 3
OxfordHeartCentrecontacts 3
Informationaboutyouroutpatientappointment 4
Getreadyforsurgery 6
Eatingforahealthyheart 6
Preparingtoleavehome 10
Consentingtotreatment 13
Settlingintotheward 14
Yourhealthcareteam 15
Family,friendsandvisitinghours 16
Beforetheoperation 17
YourstayinCardiothoracicCriticalCare(CTCC) 18
Recoveryaftertheoperation 21
Goinghomefromhospital 23
Homeactivityprogramme 26
Exerciseschedule 28
Activitiesguide 30
Aftercareandrehabilitation 34
Driving 36
Sexualrelations 36
Howfamilyandfriendscanhelp 37
Contactnumbersforcardiacrehabilitation 38
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IntroductionIfyouarecomingintotheOxfordHeartCentreforanoperationyoumayhaveanumberofquestionsaboutwhatwillhappenwhileyouarehere.Thisbookletisdesignedtoansweryourquestionsandprovideinformationaboutwhattoexpectandhowtolookafteryourhealthwhenyougohome.
Ouraimistoprovideahigh-qualityservicetoourpatients.Wethereforewelcomeanysuggestionsyoumayhave.Helpustoimprovebyfillingoutapatientsatisfactionsurveyorbyspeakingtoamemberoftheseniornursingteam.YouwillfindcopiesofthesurveyinsidetheinformationfolderskeptbyeverybedontheCardiothoracicWard.
Thisbookletisdesignedtocomplementthemanyotherpublicationsavailabletoyou.Furtherinformationcanbeobtainedfrom:
• TheBritishHeartFoundationTel:02079350185/www.bhf.org.uk
• Thehospitalwebsite:www.oxfordradcliffe.nhs.uk/heartcentre
OxfordHeartCentrecontactsPre-admission and Discharge Liaison NursesForadviceandsupportwhileyouwaitforyouradmissionandalsoafterdischargespeaktothePre-admissionandDischargeLiaisonNurses.Theyarethefirstpointofcontactifyouhaveanyquestionsorconcerns.
Tel:01865220274
Ward clerksForhelpwithclaimformsanddetailsofaccommodationavailablelocallyaskoneofthewardclerks.
Tel:01865572635/572663
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Senior Nursing TeamTheSeniorNursingTeamcomprisesamatronandwardsister,allofwhomcanbecontactedviatheward.
Tel:01865572662/572661orviathehospitalswitchboard:01865741166.
InformationaboutyouroutpatientappointmentWhenyouarereferredforcardiacsurgerywewillsendyouanoutpatientappointment.Atthatappointmentyouwillseeadoctorwhowillexplain:• whattheoperationinvolves• anyassociatedrisks.
Tips• Makealistofthequestionsyouhaveandbringthemalongto
theappointment.• Bringarelativeorfriendalongtosupportyou.
AppointmentsIfyouandthesurgeonagreetogoaheadwithsurgery,youwillbegivenaplaceonawaitinglist.Wewilltellyouwhentoexpecttoreceiveanadmissiondate.
Pre-admission ClinicYouwillneedtoattendthePre-admissionClinic(PAC)beforeyouareadmittedforyouroperation.Ifyouroutpatientappointmentisinthemorning,youmaybeofferedtheopportunitytostayandattendthePAConthesameday.Alternatively,youwillbesentanappointmenttoattendthePACafewweeksafteryouhavebeenaddedtothewaitinglist.
AtthePACyouwill:• seethePre-admissionandDischargeLiaisonNurse,adoctor
andthephysiotherapist
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• receiveinformationaboutyoursurgery• havesomemedicalcheck-ups• discussplansforyourdischargeaftersurgery.
YouwillalsohaveachestX-rayandanECGtracingofyourheart,andbloodsampleswillbetaken.Itisagoodideatobringsomeonewithyou.NoneofthetestsyouwillneedtotakeatthePACwillaffectyourabilitytodrivehomeafterwards.APre-admissionClinicappointmentusuallytakesthreetofourhoursintotal.
Ifyouarehavingheartvalvesurgeryyouwillbegivenaletterforyourdentisttosigntosayyourmouthisfreefromsignsofinfection.Ifyouarehavingheartvalvesurgeryanddonothaveadentist,werecommendyoucontactyourGPsurgeryforadviceonhowtofindanNHSdentistinyourareaassoonaspossible.Ifyouareunabletoprovideconfirmationthatthereisnoactiveinfectioninyourgums,youroperationmayhavetobepostponed.
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GetreadyforsurgeryThe right foodOneofthebestwaystoprepareforyouroperationistogetyourdietright.Beingwell-nourishedandatagoodweightforyourheightwill:• promotewoundhealing• giveyoustrengthtomakeaspeedyrecovery.
WhenyouattendyourPre-admissionClinicappointmentthenursewillbeabletotellyouifyouareunderweight,atahealthyweightforyourheightoroverweight.Ifyouareunderweight,thenursewillgiveyouadviceandmayreferyoutothedietitian.Ifyouareoverweight,losingafewpoundsbeforetheoperationwillbehelpful.
Losing weightAimtoloseamaximumof2lbsperweek.Crashdietsmaycauserapidweightlossbutdon’tprovidethevitaminsandnutrientsyouneedtobeinthebeststateofhealthforyouroperation.Preparingforheartsurgeryisoftenatimetotakestock.Manypeopleusethischancetothinkabouttheirdiet,andtomakeplansforkeepinghealthyinfuture.
EatingforahealthyheartWhat matters the most?• Eatagoodintakeofoilyfisheachweek.• Eatatleastfiveportionsoffruitandvegetableseachday.• Reduceyourintakeoffat,particularlysaturatedfat.• Reducethesaltyoueat.
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Oily fish Eattwotothreeportionsofoilyfisheachweek.Ifyouhavediabetes,orareawomanofchildbearingage,keeptoonetotwoportionsofoilyfishaweek.• Oneportionis140gofcookedfish.
Oilyfishisagoodsourceofomega3fattyacids.Theycanmakethebloodlesslikelytoclotandpromotearegularheartrhythm.Examplesofoilyfishincludeherring,kippers,mackerel,pilchards,sardines,sild,salmon,troutandfreshtuna.
Warning• Smokedfishisquitesaltysokeepitfortreats.• Tinnedtunadoesn’tcount,unfortunately,astheomega3oils
arelostinprocessing(freshtunaisfine).
White fishWhitefishisstillahealthychoicebutcontainsonlysmallamountsofomega3comparedwithoilyfish.
How to increase oily fish intake easily• Puttinnedfish(intomatosauceifpreferred)ontoastasa
quicksnack.• Chopupsomemackerelorsalmonandaddtoasaladorpizza.• Grillorbarbecuewholetrout,mackerel,herring,kippersor
sardines.• Havepoachedkippersforbreakfast.• Tryrollmops(pickledherring)asalightsnack.• Trymackerel/salmonpâté(buyormakeyourown).
Fruit and vegetablesThesecanbefresh,tinned,frozen,driedorasjuice,butonlycountjuiceandmushroomsasoneportiondaily.
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Rough guide to portion sizes
Vegetablesraw,cooked,frozenorcanned 2fulltablespoonsSalad 1dessertbowlDriedfruit ½-1tablespoonGrapefruit/avocadopear ½fruitApples,bananas,orangesandothercitrusfruit 1fruitPlumsandsimilarsizedfruit 2fruitsGrapes,cherriesandberries 1cupfulFreshfruitsalad,stewedorcanned 2-3tablespoonsFruitjuice 1smallglass(150ml)
Easy ways to eat five fruits and vegetables in a dayBreakfast• Havegrilledorcannedtomatoesormushroomsontoast.• Addslicedbanana,strawberriesordriedfruittocereal.• Haveapieceoffruitorcartonofjuicewitharoll.
Lunch• Dipfingersofrawvegetablese.g.carrots,celery,cucumber
andsweetpeppersintolow-fatsoftcheese,salsaornaturalyoghurt.
• Addfresh,driedortinnedfruittopackedlunches.• Fillsandwiches,pittabreadorbaguettesfullofsalade.g.sliced
tomato,gratedcarrot,lettuce,cucumber,sweetcorn,coleslaw.• Addcookedortinnedvegetablestocannedsoupsormake
yourown.
Dinner• Addmixedvegetables,sweetcornorpeastocookedpastaor
rice.• Cookpotatoeswithcarrot,sweetcorn,swedeorcabbageand
mashtogether.
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• Quicklystirfryfreshorfrozenvegetableswithchicken,meatorquornandspices.
• Addextravegetablestoboughtsauces,curries,pizzaetc.• Stuffanappleorstonedpeachwithcurrantsordates,bakeit
intheovenormicrowaveandservewithcustardoryoghurt.
Tip:alltypesoffruitmakeanidealsnackatanytimeofday.
Reduce your fat intakeWhicheverfatyouuse,useitsparingly.
Somefat,likethatinoilyfish,isgoodforyourheart.Otherfat,likethehardersaturatedfats,cancausehealthproblems.Thesefatsarefoundin:• animalfatsuchasbutter/lard/dripping• fatinmeatandmeatproductse.g.pâté,pies,sausagesetc.• fatindairyproductsincludingcheese,milkandcream:choose
lowfatvarieties• fatincakes,biscuits,piesandconfectionery.
Choosespreadsandcookingoilshighinmonounsaturatedfattyacids(e.g.olive,rapeseed)orpolyunsaturatedfattyacids(e.g.sunflower).Avoidthosehighinsaturatedfat(e.g.butter,lard)ortrans-fattyacids(e.g.hydrogenatedvegetableoil).
Eat less salt• Trytoreduceyourintakeofconvenienceandverysaltyfoods
e.g.cook-insauces,processedmeats,packetmixesetc.• Avoidaddingsalttofoodwherepossible.Betteralternatives
includepepper,garlic,herbs,spicesandlemon.
Keep your alcohol consumption low• Menshouldnotdrinkmorethan21unitsperweek.• Womenandanyonetakingwarfarinshouldnotdrinkmore
than14unitsperweek.
Ifyouwouldlikemorespecificadviceaboutfoodandyour
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heart,orwouldlikealittlemoresupport,pleasecalltheDieteticDepartment.
DieteticDepartment:01865221702/3
Other useful resources
BritishHeartFoundation14FitzhardingeStreetLondonW1H6DHwww.bhf.org.uk
FoodStandardsAgencywww.eatwell.gov.uk
BritishDieteticAssociationwww.bda.uk.com
PreparingtoleavehomeBelongingsTheOxfordRadcliffeHospitalsNHSTrustacceptsnoresponsibilityforthedamageortheftofpersonalitemsunlesstheyhavebeenhandedoverforsafekeeping.
BenefitsIfyourstayisprolongedyouwillneedtotelltheDepartmentofSocialSecurity,listedinYellowPages,ifyouarereceivingIncomeSupportoraSocialSecuritypensionorbenefit.Somebenefitsmayhavetobereducedduringyourstay.
Ifyoucontributetoaninsurance/pensionscheme,whichallowsclaimstobemadewhenyouareapatientinhospital,theTrustwillmakeanadministrativechargetocompletetherelevantforms.
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Give somebody your contact detailsLetyournextofkinorclosefriendknowyourtelephonenumberandaddresswhileyouareinhospital:
CardiothoracicWardLevel2JohnRadcliffeHospitalOxfordOX39DU
Tel:01865572663
What to bring with youPackabagforyourstay.Pleasebringcomfortableclothestowearduringthedaye.g.tracksuit;loosefittingnightclothes;dressinggownandslippers;toiletrybag;towel;readingmaterialandstationery.Weaskthatladiesbringinanon-wiredsupportivebratowearaftertheirsurgery.
Current medicationsPleasefollowtheinstructionsonthegreenleafletgiventoyouatthePre-admissionClinicandbringinallofyourmedication,intheoriginalcontainers,inthegreenbag.
ValuablesPleasedonotbringinalotofmoneyorcreditcards.Wealsoaskthatyoudon’tbringanyothervaluableswithyouunlessyouabsolutelyneedthem.TheTrustcannotacceptliabilityforanylossordamagetoanythingyoubringwithyou,unlessithasbeenhandedoverforsafekeepingandyouhaveareceipt.
Going homePlanyourreturnhome.Youwillbegiveninformationabouthowlongyoucanexpecttostayinhospitalatyourpre-admissionappointment,orwhenyouaretransferredbacktotheward.Youwillneedtomakearrangementsforsomeonetotakeyouhomeondischargeandforsomeonetostaywithyouforoneweekafteryougohome.Wewillaimtogetyouhomeintimeforlunch.
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Pleaseencourageyourcarertoreadthisbookletbeforeyouareadmitted.Wewillgladlyansweranyquestionsfrombothpatientsandcarers.PleasecontactthePre-admissionandDischargeLiaisonNursesifyouneedanyadvice.
Travel arrangementsPleasemakeyourownarrangementsforcomingintohospitalandgoinghome.
Informationontraveltothehospitalandparkingcanbefoundonthehospitalwebsitewww.oxfordradcliffe.nhs.ukinthe‘Findus/contactus’sectionandinpatientinformationbooklets.
Personal problemsSocialworkersformpartofthecaringteamandareavailabletohelpyouoryourrelativeswithproblemsthatariseasaresultofyourillnessandstayinhospital.Yournursewillhelpyoucontactthem.
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ConsentingtotreatmentBeforeyouhavesurgeryadoctorwillaskyoutosignaconsentform.Youshouldhaveagoodunderstandingoftheproposedprocedureandtheriskofcomplications,asexplainedtoyoubyyourdoctor.Ifyouhaveanyquestionsorconcerns,beforeoraftersigningtheconsentform,thenpleasefeelfreetoraisethesewithyourmedicalteam.
HaveyoureadthePatientConsentLeaflet?Ifnotpleaseaskyournurseforacopy.
Youcanalwaysrefusetreatment.Ifyouhavesignedaconsentform,butafterwardschangeyourmind,youcanstillwithdrawyourconsent.Thisdoesnotaffectyourrighttoalternativeformsoftreatment.
Ifyouareunhappyaboutyourtreatmentandwishtoleave,tellanurseoradoctor.Youcanusuallyleavewheneveryouwantbutthedoctormayaskyoutosignaformtakingresponsibilityforleavingifheorshedoesnotthinkyoushouldgo.
Allmembersofstaffarerequiredtowearidentificationbadges.Ifyouareunsureaboutsomeone,pleaseasktoseetheirbadge.
Resuscitation policyRarelyapatientmayunexpectedlycollapseiftheirheartstopsbeating(cardiacarrest).Itisournormalpolicytoattempttorevive(resuscitate)patientsinsuchsituations.Ifyouareinanywayunsureaboutthis,orwishtodiscussthispolicy,pleasefeelfreetodosowithyournurseordoctor.
Helping staff to learn – clinical teachingTheOxfordRadcliffeHospitalsisateachingtrust,thereforestudentsmaybepresentwhenyouseethedoctor:ifyouwouldpreferstudentsnottobepresent,pleasetellthenurseordoctor.
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SettlingintothewardThe thoughtof anadmissionmay to somepeople seem ratherfrightening.Weareallheretohelpyouwithanyworriesorproblemsandwillansweranyquestionsyoumayhaveduringyourstay.
Don’t compare yourself to other people!Itistemptingtocompareyourownprogressandrecoverytootherpatientsontheward,butthiscancauseworryifyourtreatmentisnotthesame.Everybodyisdifferent;youwillhavethetreatmentthathasbeenplannedspecificallyforyou,sodonotworryifitisdifferentfromyourneighbour’s.
Privacy and dignityWeareproudtoconfirmthatduringyourstayontheCardiothoracicWardyouwillhaveyourownbedroomwithen-suitefacilities.
Your detailsWhileyouarestayingontheward,yournamewillbedisplayedonawhiteboard(noticeboard)forthemedicalandnursingstaff.Theboardwillnotdetailyourmedicalinformationbutwillbevisibletostaff,patientsandvisitors.Inordertoprotectyourconfidentialityandinlinewithdataprotectionlegislation,wewouldliketoaskforyourconsenttoyournamebeingshowninthisway.Ifyouhaveanyquestionsaboutthisorwouldpreferthatyournameisnotshown,pleaseinformyournurseonadmissionorassoonaspossible.
Wewillaskyoutowearanidentitybraceletatalltimeswhileyouareapatientinthehospital.Thisidentifiesyouandalsocontainsabarcodewithinformationusedtoidentifyyouifyouneedabloodtransfusion.
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YourhealthcareteamThepeopleyoumaymeetduringyourstay:
DoctorsThesurgicalteamisleadbyaconsultantsurgeon.Therestoftheteamincludesspecialistregistrarsandseniorhouseofficers(SHOs).Doctorscometothewardtoseepatientsfirstthinginthemorningand/ortheevening.
Nurses and healthcare assistants
Duringyourstayyouwillbelookedafterbyspecialistnursesandhealthcareassistants.Studentnursesalsotrainontheunitandmaycareforyouwithsupervisionfromatrainednurse.
PhysiotherapistsThephysiotherapistwillmeetwithyoubeforeyoursurgeryandgetyouonthemoveagainafterwards.
DietitiansAdietitianisavailableifnecessarytoprovidespecificdietaryadviceandtocareforyourindividualdietaryneeds.
Pharmacist
Thepharmacistsvisitthewarddailyandgiveadviceaboutyourmedicationaswellasmakingsureyouhavethecorrectdrugstotakehome.
RadiographersRadiographersmaytakeanX-raypicturewhennecessary,eitheronthewardorintheX-rayDepartment.
Ward clerks
Wardclerksprovideusefuladviceandinformationaboutadministrativedetails,e.g.workrelatedmedicalcertificates.
PhlebotomistsPhlebotomistsaretrainedprofessionalswhovisitthewardtocarryoutbloodtestsasrequestedbyyourdoctors.
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HousekeeperThehousekeepermakessurethewardiskeptclean,overseesthecateringneedsofpatientsandhelpswithnon-nursingtasks.
PortersPorterstransferyoufromthewardtotheatreorotherdepartmentswithinthehospital.
Family,friendsandvisitinghoursFamilyandfriendsareimportanttoyouwhenyouareinhospital.Whileweencouragepeopletovisit,youwillprobablyfindthatyouareverytiredimmediatelyafteryouroperation.
Preferred visiting hours: Cardiothoracic Ward• 3.00pm-8.00pmeveryday.• Restperiod1.00pm-3.00pm–allvisitingisdiscouraged
duringthistime.
Ifthisisdifficultforyourrelatives,thenpleasespeaktothenursingstafftodiscussalternativearrangements.
Preferred visiting hours: Cardiothoracic Critical Care (CTCC)• Open.• Restperiod1.00pm-3.00pm–allvisitingisdiscouraged
duringthistime.
Twopeopleareallowedatthebedsideatanyonetime.Itisnotanappropriateenvironmentforyoungchildrenbutspecialarrangementscanbemade.Visitorsmaybeaskedtowaitinthewaitingroomiftheunitisparticularlybusy.
Wearenotabletoaccommodateflowersorplants.
OnadmissionyouwillbegiventelephonenumbersforthewardandCTCC.Pleasenominateonememberofyourfamilytophoneintoaskafteryourprogressandtellallotherfamilyandfriendstocontactthatpersonforupdates.
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BeforetheoperationOn the day of admissionBeforesettingoutonthemorningofyouradmissionpleaseremembertotelephonethewardtoconfirmthatthereisabedavailableforyouandaskwhattimeyoushouldarrive.Ifthereisnotabedavailable,wewillrescheduleyouradmissionassoonaspossible.
Pleasebringwithyouitemslistedonpage11andallyourcurrentmedication.Whenyouarriveontheward,youmaybeaskedtotakeaseatinthewaitingareawhileweprepareyourbed.
Ananaesthetistwillseeyoubeforeyouroperationtodiscussyouranaesthetic,andwillbehappytoansweranyquestionsthatyoumayhave.Heorshewillprescribesomemedicationthatrelaxesyoubeforegoingtotheoperatingtheatre.Moreinformationaboutyouranaestheticiscontainedintheleaflet‘Youandyouranaesthetic’whichyouwillbegivenatPre-admissionClinicorontransfertoCardiothoracicWard.
Ifyoudidnotseethephysiotherapistatpre-admissiontheywillseeyoubeforetheoperationtoexplainsomeoftheexercisesthatwillhelpyoubreathemoreeasilyafteryoursurgery.
Youroperationwillnormallybescheduledtotakeplacewithin48hoursofyouradmission.Occasionallyitmaybenecessarytopostponeyouroperationbecauseofanemergency.Youroperationwillthenberescheduledforthenextavailableoperatingslot.
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YourstayinCardiothoracicCriticalCare(CTCC)Afteryouroperation,youwillbetransferredintotheCardiothoracicCriticalCareUnit(CTCC).Thisunitisdesignedtoprovideintensivemedicalandnursingcareafteryouroperation.Onadmissiontotheunityouwillhaveanursecaringonlyforyouonaone-to-onebasis.Asyourconditionimprovesyouwillbemovedtothehighdependencyareawhereonenursecaresfortwoorthreepatients.
Breathing Duetotheanaestheticyouwillbeunabletobreatheunaidedstraightaway,soyouwillneedsomehelpforashorttime.Whenyouareasleepintheanaestheticroom,asmalltubewillbepassedthroughyourmouthintoyourairway.Thisallowstheanaesthetisttouseamachinethatwilldoyourbreathingforyou.Asyoubegintowakeupyoumaybeawareofthistube.Trytorelaxandlistentothenurse’sadvicetotakedeepbreaths.
Thetubewillberemovedassoonasyouareawakeenoughtobreatheonyourown.However,youwillneedtowearanoxygenmaskforabout24hours.
Afterthetubeisremoved,yourthroatmaybealittlesore,andyourvoicealittlehoarse,butthiswillgetbetter.Rememberthisisonlytemporaryandispartofyourrecovery.
Whenthebreathingtubeisinplaceyouwillbeunabletotalk.Therewillbeanursewithyouthewholetimewhowillhelpyoucommunicatebyaskingyoushortquestionsrequiringanodorshakeofyourhead.
Eating and drinkingAllofyourfluidsandmedicationswillbegiventhroughnarrowtubesinyourveins,calleddrips,butyoucannormallydrinkafterthebreathingtubeisremoved.Youmayfeelsickattimesandifthishappensyournursewillgiveyousomemedicationtorelieve
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thefeeling.Whileyouarenotdrinkingoreatingyoumayfeelthirsty.Mouthwashesandicecubesareavailableasoftenasyouliketohelpwiththis.
Chest drainsTubescalleddrainsareusedtoremoveanyexcessblood,fluidorairremaininginyourchestaftersurgery.Youwillhaveoneortwogoingthroughyourskinintoyourchest.Thesearenormallyremovedwithin24hoursofyouroperation.
Removalofchestdrainscancausepain,butyouwillbegivenpainreliefbeforetheprocedure.
Heart monitorYouwillbeconnectedtoaheartmonitortocontinuouslyassessyourheartrateandrhythm.ThismaycontinueafteryouaretransferredtotheCardiothoracicWard.
Youwillalsohaveasmallplastictubeputintoanarteryonyourwrist.Thisiscalledanarteriallineanditwillmeasureyourbloodpressureveryaccurately,everysecond.ThislinewillberemovedbeforeyouleaveCTCCtoreturntotheward.
Youmayalsohaveasmallwirethroughyourskin,whichcanbeattachedtoapacemakerifrequired.Thiswillberemovedbeforeyouleavehospital.
Toilet facilitiesWhenyouareasleepfortheoperation,acatheter(finetube)willbepassedintoyourbladdertodrainurinewhileyouaretoodrowsytogotothetoilet.Itmayfeelalittlestrangebutitisusuallyremovedthedayafteryouroperation.Thisdoesnothurt.Youmayalsobeconstipatedafteryouroperation.Youshouldletyournurseknowifthishappens.
SleepingImmediatelyafteryouroperationyoumayfinditdifficulttosleep.Ifyoudohaveproblemssleepingpleaseletyournurseknowasthedoctorcanoftenprescribemedicinestohelp.
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Occasionallysomepatientsexperienceveryvividdreams;thesecanbedistressingbutareperfectlynormalandwillpass.Ifyoudoexperiencethese,letyourdoctorornurseknowsothattheycanreassureyou.Yoursleeppatternmaybedisturbedforafewweeksbutitusuallyresolveswithoutmedication.
Pain reliefWhenyouwakeupyoushouldnotbeinalotofpain,asyouwillhavebeengivenaverystrongpainkiller.Ifyoudosufferanypainatallpleaseletthenursesknowandtheycanthengiveyoumorepainkillers.
Patient-controlled analgesia (PCA)APCApumpallowsyoutomaintainaconstantlevelofpainreliefbydeliveringaprescribeddoseofpainmedicationasandwhenyouneedit.
ThePCApump,containingmorphine,isconnectedtoadripthatisplacedinavein.Youaregivenabuttontopresswhenyouareinpainandmorphineisthengivendirectlyintothevein.Sometimesmorphinecancausenauseabutwecangiveyouanti-sicknessmedicationtoreducethis.
Asasafetyprecaution,thePCApumpwillonlyallowmedicationtobedeliveredeveryfiveminutes.Youcangetanotherdoseofmedicationwhenthegreenbuttonisilluminated.Ifyouhaveanyquestionsregardingpatient-controlledanalgesiapleasespeaktoamemberofstaff.
Itisveryimportantthatyouhaveminimalpainsothatyoucanperformyourdeepbreathingandcoughingexerciseseffectively.Thisisbestdonebyhavingsmallbutregularamountsofpainrelief.
Itiseasiertokeeppainawaythantogetridofitonceyouhaveit.Donottrytogowithoutpainkillers.Youwillprobablyneedthemregularlyforatleasttwotothreeweeksafteryouroperation,andsomepeoplewillrequirethemforlonger.Everyoneisdifferent.
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RecoveryaftertheoperationWhenyouarestableandthedoctorsarehappywithyourconditionyouwillbetransferredfromCTCCtotheCardiothoracicWardtocompleteyourrecovery.Thisisapositivemovetowardsrecoveryanddischargehome.Onthiswardonenursecaresforagroupoffiveorsixpatients.Atstaffchangeovertimesthenursewhowillcareforyouforthemorning/afternoon/nightwillcomeandintroducethemselvestoyou.
Mobility / washingOnceyouarewellenoughyouwillbeabletogetoutofbed,sitinthechairandinduecoursetakeashortwalk.Veryquicklyyourmobilitywillimproveandyouwillgainconfidence.Thenurseswilllookatyourwoundseverydayandgiveyouanypainkillersyouneed.Assoonasyouarereadywewillhelpyoutohaveashower.
Eating againMostpeoplehavenoproblemeatingaftersurgery,butitisperfectlynormaltoloseyourappetiteforawhile.Youwillusuallyhaveyourfirstmeal(evenifitisonlysouporicecream)withinadayofyouroperation.Yourappetiteshouldimprovegraduallysothatbythetimeyouleavehospitalitisclosetonormal.Howevereverybodyisdifferentanditmaytakesomepeoplelongertoregaintheirappetitethanothers.
Meals in hospitalMostpatientsreceivethreemealsadaywhiletheyareinhospital:breakfast,lunchandaneveningmeal.Drinksareservedthen,andatothertimesduringtheday;ahotdrinkisavailablebeforebedtimetohelpyousettledown.Mealsareservedinthewardsataboutthefollowingtimes: Breakfast7.30am-8.00am Lunch12noon-12.30pm Supper6.00pm-6.30pm
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Youmaychoosefromaselectionofmealsbroughttothewardandservedbyamemberofthecateringteam.Youwillbegivenamenutomakeyourchoices–theseareusuallyhandedoutatbreakfasttime.Ifyouwouldliketoraiseanypointsaboutthecateringserviceatanytimeduringyourstaywithus,pleaseasktospeaktothewardhousekeeperwhowillpassonyourcomments.
Ifyouhaveparticulardietaryrequirements,foreithermedicalorreligiousreasons,pleasetellyournursesothatappropriatearrangementscanbemade.Somepeoplemaybeindividuallyreferredtothedietitianforadviceregardingspecificdietaryproblemsoriftheirappetiteispoorforaprolongedperiod.
Pleaserememberthatalthoughwerecommendalow-fat,high-fibredietinthelongterm,youwillbeundergoingmajorsurgeryso‘healthyeating’guidelinesarenotreallyapplicableduringyourhospitalstay.Ifyoufindthefoodinhospitalisnotaslowinfatandhighinfibreasyournormaldietpleasedonotworry.Trytoenjoyyourfoodwhileyouareinhospitalandresumeyournormalhealthyeatinghabitswhenyouarefullyrecovered.
Improve your breathingSoonafteryouroperationyoumaybeabitworriedabouttakingdeepbreathsandcoughing.Thephysiotherapistwilltakeyouthroughbreathingexercises.Itwillbeimportanttorepeattheseexercisesfrequentlythroughouttheday.Itwillalsobenecessaryforyoutocoughinordertoclearphlegmfromyourchest.Althoughthismaybeuncomfortableitisvitaltodothistopreventachestinfection.
Thephysiotherapistwillguideyouthroughtheseexercisesandassistyouwithashortwalkassoonaspossible.Beforeyougohomewewouldexpectyoutobewellenoughtoclimbtwoflightsofstairswiththephysiotherapist.
Wearealwayskeentoensurethatallaspectsofthecareyoureceivemeetyourexpectations.Ifyouhaveanyconcernsorsuggestionsaboutthecareyouhavereceivedpleasespeaktoyournurseorthewardsister.
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GoinghomefromhospitalThelengthofyourstayinhospitalwillnormallybeaboutfivetosevendaysaftertheoperation.Donotworryifyouaresenthomebeforeorafterthistime;peopletakevaryingperiodstorecoverfromsurgery.
Weadvisethatthereissomeoneathome,oryoustaywithsomeonewhocanlookafteryou,forthefirstweekafteryourstayinhospital.Ifthereisnoonetolookafteryou,thenpleasediscussthiswithyourGPorthepre-admissionnursebeforeadmission.
Youwillneedtoarrangeyourowntransportintoandoutofhospital.IfthisisimpossibleforyoupleasediscussthiswithyourGPorpre-admissionnursebeforeadmission.Itisbetteriffriendsorrelativescantakeyouhome.
Yourreturnhomemarksthestartofareturntofitnessandlifeasnormalaspossible.Itisusualtofeelapprehensiveandinsecureaboutleavinghospital.Itwilltakeafewdaystosettledownathome.Manypatientshaveanenormousbuilduptotheirsurgery,andwhenitisovertheymayfeelasenseofanticlimax.Toreachfullrecoveryyoushouldbeginwithasmallamountofphysicalactivityandincreaseitgradually.
Duringyourrecoveryyoumayexperiencegoodandbaddays,andarangeofemotionsandphysicalsymptoms.
EmotionsIrritability,milddepression/moodswings,tearfulness,lossofconcentration,vividdreams/sleepdisturbances.
Physical symptomsTiredness,visualdisturbances,sweats(especiallyatnight),palpitations,lossofappetiteandsenseoftasteandaheightenedsenseofsmell.
Allthesesymptomswillpass,butiftheypersistandyoufeel
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unwellyoushouldnothesitatetocontactyourGP,especiallyifyouhaveatemperatureorprolongedpalpitations.Youshouldavoidhavingyoureyestestedforeightweeksaftersurgerytoallowanyvisualdisturbancestosettle.
Pain controlInhospitalyouwillbegivenregularpainkillers.Whenyougohomeyouwillneedtocontinuetakingtheseregularly–theywillhelpwithyourrecoveryandpreventpainfrombuildingupandbecominguncontrollable.Paracetamoltabletscanbetakenonceyourprescribedpainkillersfromhospitalhavefinished.Ifyouhaveanyquestions,orifyourpainisnotcontrolled,pleasespeaktoyourGP.
Other ways that may help control pain• Makeyourselfacoughcushionoruseafoldedtowelto
supportyourwoundwhenyoucough.• Useseveralpillowsinbed.Thesewillactasalevertohelpyou
situp.Rollontoyoursidewhengettingoutofbed.• Useahighbackedarmchairwitharmreststominimisethe
effortneededtopullyourselffromalow-lyingunsupportedsetteeorsofa.
• Adailybathorshowerwillhelpreducemusclestiffness.• Informationonrelaxationtechniquescanbeobtainedfrom
yourlocallibraryortheinternet.• Gentlemassageofachingmuscles.
Activity and sleepDuringthefirstweekathome,continuewiththeroutineandlevelofexerciseyoufollowedinhospital.Aimtograduallyincreasethedistancethatyouwalkdaily,sothatbyfourtosixweeksafteryoursurgeryyouareabletowalktwotothreemilesperday.Ifyouhavedifficultieswithwalkingduetootherhealthconcernsyourphysiotherapistcanadviseyouonalternativeformsofexercise.
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Youwillfeeltiredatfirstandarestafterlunchisagoodidea,butdonotsleeptoomuchduringthedayasyoumaynotsleepatnight.Itisoftenagoodideanottohavetoomanyvisitorsintheearlydaysathome.
Don’tliftanythingheavierthantenpoundsinweightforthefirstsixweeksfollowingsurgery,forexamplebagsofshoppingorsmallchildren,asthisputsstrainonyourbreastbone.Aftersixtoeightweekstheboneshouldbehealingwellandyoushouldbeabletodohouseworkandlightgardening.Youcannormallyresumedrivingsixweeksafteryouroperationbutyoushoulddiscussthiswithyourdoctorfirst.Anyheavyliftingormanualworkandanythinginvolvinglargearmmovementsshouldbeavoidedfor12weeks.Thetableonpages31and32outlinestheserestrictionsinmoredetail.
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HomeactivityprogrammeThephysiotherapistshavedevelopedthisprogrammetohelpyou.Theywilldiscussitwithyoubeforeyouleavehospitaltogohome.Thisprogrammeistohelpyoutoreturntoyournormalactivitiessafelyandregainyourfullstrengthaftersurgery.
Itisaguidetohowmuchactivitytodo.However,takenoticeofhowyouarefeelingandadjustyouractivityaccordingly.
Iftherearesomeactivitiesyoudo,whicharenotincludedintheguide,askyourphysiotherapistwhenyoumaystartdoingthese.
Walking• Atfirst,walktwicedailyforfivetotenminutes.• Trytoincreaseyourwalkingbyonetotwominuteseachday.• Walkatacomfortablepace.Youshouldbeabletokeepupa
conversationwhileyouwalk.Ifyoucannot,slowdownalittle.• Walkundercomfortableconditions.• Keepyourselfwarm.• Donottakethedogwithyouinthefirstfewweeks.• Donotwalkifyouareunwell.• Donotwalkimmediatelyaftermeals;waitapproximately45
minutesbeforeexercising.• Trytowalkonlevelground–avoidhills(ifhillsare
unavoidable,paceyourselfmoreslowly).• Builduptoatleast20-30minutesdaily.• Ifpossiblewalkwithsomeone(atyourpace)untilyoufeel
confidenttowalkalone.
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Stopwalkingifyouexperience:• undueshortnessofbreath• chestpain• nausea• headache• inappropriatetiredness• musclecramps• dizziness• persistentpalpitations.
Rest,andifsymptomsreoccurconsultyourdoctor.
PostureYoushouldbeawareofyourpostureatalltimes–whetherlyingdown,sittingorwalking.Youneedtotryandkeepyourheaduprightandyourbackstraight.Ifworkingatadeskorcomputer,beparticularlyvigilantaboutyourposture.
Aftersurgeryyoumayexperienceback,neckorshoulderpain.Ifthispersistsconsultyourdoctor,asphysiotherapymaybehelpful.
Tips• Donotneglectanytypeofseverepain.• Inthefirstweekortwoathomeyoumayfeelverytiredand
findithardtokeepupwiththesuggestedexerciselevel.Donotbecomediscouragedasthisiscommon–persevereandyouwillcontinuetofeelbetterdaybyday.
• Walkingisanimportantformofexercise–itwillhelpyoutomakethemostofyouroperation.
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ExercisescheduleMakesureyouspaceyouractivitiesthroughouttheday.It’simportanttochangeyouractivitylevelsaccordingtohowyoufeel.Herearesomeexamplesofthekindsofactivitiesyoucandoweekbyweekafteryouroperation.
Stage 1 (the week after your operation)• Continuewiththesameexerciselevelyouhavebeendoingin
hospital.• Re-establishyournormalroutinee.g.gettingdressed,meal
times.• Restforanhourintheafternoon.• Restrictvisitorstofamilymembers.• Climbstairsslowly.• Lightactivitiese.g.makingcupsoftea/coffeeandlight
snacks.• Avoidwideorenergeticarmmovements,stoopingand
bending.• Keepitgentle!Forexamplereading,music,TV,cards,chess,
paintingpictures,potteringaroundthehouse.
Stage 2 (second week after leaving hospital)• Lightactivitiese.g.preparinglightmeals,tidyingthehouse,
tidyingupthebedroom(notchangingthesheets).• Washingdishes.• Puttinglaundryintothewashingmachine(notcarryingthe
loadorhangingitoutontheline).• Lightgardenactivitiese.g.handwateringwiththehoseor
lookingafterindoorplants.• Stoopingandbendingoccasionally.• Shortdrivesasapassenger.
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Stage 3 (third week after leaving hospital)• Lightactivitiesinthegardene.g.wateringwithasmall
wateringcan(weighinglessthan10lbswhenfullofwater).• Half-dayoutingstovisitfriends.• Shopping–forshortperiodsonly,avoidbusytimesanddon’t
carryparcelsorpushtrolleys.
Stage 4 (fourth week after leaving hospital)• Householdactivitiese.g.lightironing,hangingoutwashing
(asksomeonetohelpyouwithsheetsandtowels),makingbeds(withhelptochangethem),lightsweeping.
• Lightweeding,diggingwithatrowel,pruning.• Indoorbowls.• Watchingfilmsandsports.
Stage 5 (fifth week after leaving hospital)• Mostroutinehouseholdchores(exceptanythatinvolve
prolongedstoopingandbending),cleaningthebathroom,moppingfloors.
Stage 6 (sixth week after leaving hospital)• Bythistimeyoumaybeabletocarryoutmosthousehold
activitiesasnormalunlesstheyinvolvelargeorenergeticarmmovementse.g.vacuuming,heavygardeningorheavylifting.
• It’sagoodideatobreakuplargertasksintotwoorthreesmallertasksatfirst.
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ActivitiesguideHereisaguidesuggestingwhenyoumaybeabletostartdifferentactivitiesafteryoursurgery.Thetimingwillvaryfromonepersontoanotherdependingoneachperson’sprogress.Thetimingsarefromthedateofyoursurgery.
Initiallyit’sagoodideatobreakuplargertasksintotwotothreesmallerones.
Note:thesetablesareonlyaguideandyourdoctormaygiveyoudifferentadvicethatfitsyoursituation.
Activity Numberofweeks aftersurgerySexual intercourseAvoidweightbearingpositionsorpressureonyourwound 3-4Domestictasks:• Lifting(nothingover10lbse.g.kettle
fullofwater) 0-6• Ironing 4• Washing(light) 4• Rakingleaves 10-12• Lawnmowing 10-12• Vacuuming 10-12• Heavypushingorpulling After12• Heavydigginginthegarden After12• Heavylifting After12Work:• Lightwork 6-8• Manualwork 12
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Activity Numberofweeks aftersurgerySport:• Fishing 12• Swimming Paddling 6 Breaststroke 10 Freestyle 12• Golf Putting 2 Driving 12• Dartsandsimilargamesusing yourarms 6• Lawnbowls 6-7• Cycling Stationary 4-6 Moving 12Car driving 6Youmusttellyourcarinsurersthatyouhavehadcardiacsurgery
Twelve weeks after surgeryAfter12weeksdiscusstheactivitiesbelowwithyourGP,SurgeonorCardiacRehabilitationNursebeforestarting.Remembertoincludeawarmup/coolingdownperiod.• Jogging• Squash• Tennis• Badminton• Circuitwork/aerobics• Rowing• Canoeing• Hiking
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FoodIfyourappetiteforfoodhasnotcompletelyreturnedtonormalbythetimeyouleavehospital,itwillalmostcertainlyrecoverquicklywhenyougethome.However,ifyourappetitecontinuestobepoorformorethanoneweekafteryouhavelefthospital,youcancontactthedietitianforfurtheradviceandinformation.Tel:01865221702/221703.
Rememberthatduringyourrecuperationperiod(thefirstsixweeksorsoafterdischarge)youshouldeatwhatyoufeellikeandnotrestrictyourself.
Be kind to yourself!Healthyeatingguidelineswhichrecommendlessfat,sugarandsaltandmorestarchyfoodsandfruit/vegetablesareverysensiblerecommendationsforhealthypeople.Theyarenotidealfollowingmajorsurgery.Youneedtocontinuetoeatavarieddietafteryouroperation,but‘alittleofwhatyoufancy’maydoyougoodintheshortterm.
Startfollowinghealthyeatingguidelinesonceyouarerecoveredfromyouroperation(probablyaboutsixweeksafteryouroperation).
Mostcardiacrehabilitationprogrammesincludesessionsoneatingforahealthyheart;theseareagoodopportunitytogetmoredetailedinformationaboutthistopic.
WoundsYourchestandpossiblylegorarmwoundsmaytakeseveralweekstoheal.Thewoundswillfeeltenderandyoumayfeelbruised,numbor‘tight’indifferentareas.Youshouldcheckyourwoundsathome,lookingfor:• increasedrednessaroundthewound• oozingfromthewound• swellingorwarmth.
Ifyouareworried,tellyourGP.Anytendernesscanbereduced
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bywearinglooseclothing.Womenareadvisedtowearanon-wiredsupportivebra.Boxershortsmaybehelpfulformenwhohavehadaveinremovedfromtheirthigh.
StitchesUsuallyweusestitchesthatjustdissolve.Ifyourstitchesneedtoberemovedwewillarrangeanappointmentforyourdistrictnursetoremovethemforyou.
Dental and medical careIfyouhavehadvalvesurgery,orifyouhavecongenitalheartdisease,properdentalcarewillbeveryimportantfollowingsurgery.Bacteriafromteethandgumscanenterthebloodstreamandinfecttheheart.• Tellyourdentistwhattypeofsurgeryyouhavehad.Youwill
needtotakeantibioticsbeforeanydentaltreatment.• Tellyourdentist,doctororpharmacistifyouaretaking
warfarin.
Themedicationsyoutakemaychangeafteryoursurgery.Thenurseand/orpharmacistwillmakesurethatyouunderstandaboutanynewmedicationsbeforeyouleavehospital.Wewillgiveyoua‘medicationrecord’toremindyouwhatyouneed.
Whenyouleavehospital,wewillgiveyouaonemonthsupplyofmedicines.It’simportanttomakesureyouhaverepeatprescriptionsbeforetheonemonthsupplyisfinished.
WewillsendadischargelettertoyourGP,explainingthereasonforyourhospitalstay,andgivingdetailsofyourmedication.IfyouhaveanydetailedquestionsaboutyourmedicationpleaseaskyourpharmacistorGP.
Follow-up visitsYouwillhaveafollow-upappointmentapproximatelysixtoeightweeksafteryoursurgery.ThismaybeattheJohnRadcliffeorbackatyourlocalhospital.Wewilltellyouabouttheplansforyourfollow-upbeforeyougohome.Atthisappointmentyou
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canaskforadviceaboutmedication,workoranyothermattersthatconcernyou.Ifyouhaveaproblembeforethen,itcanbediscussedwithyourGPoryoucancontactthePre-admissionandDischargeLiaisonNurseson01865220274.
AftercareandrehabilitationAfteryourcardiacsurgeryyoumaybeinvitedtoattendacardiacrehabilitationprogramme.
Cardiacrehabilitationisaservicethatsupportsandguidespatientstomakeanynecessarychangestotheirlifestyle.Ouraimistohelppeoplereturntothequalityoflifetheyhadbeforesurgery.Inmanycasesthiscanmeanamuchimprovedqualityoflife.
What is cardiac rehabilitation?Cardiacrehabilitation:• providesadviceandsupporttopatients• helpspeopleavoidfurtherproblemsandgetbackontheirfeet
again• helpspatientstolookattheirlifestyleandmakeanynecessary
changes• istheretosupportpeoplebothphysicallyandemotionallyas
theyadapttotheirnewlife.
Youcanhavecardiacrehabilitationeitherinhospitalasanoutpatientorinthecommunitysettingsuchasaleisurecentre.CardiacrehabilitationinOxfordshireissuppliedbynursesandexercisephysiologists,withfurthersupportfrompsychologistsanddietitiansifneeded.
Whenyouaredischargedfromhospitalyouwillbereferredtoyourlocalcardiacrehabilitationteam.Thecardiacrehabilitationteamwillusuallycontactyouwithintwotofourweeks,eitherbytelephoneorbyletter.Theywillaskyouvariousquestionsabout
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howyouarefeelingandhowyourrecoveryisprogressing.Ifyoudonothearfromthempleasecontactthemonthenumberlistedonpage39:ifitisnotlistedyoucancontacttheCardiacRehabilitationDepartmentattheJohnRadcliffeHospitalon01865220251andtheywillbeabletogiveyouthetelephonenumberofyourlocalcardiacrehabilitationteam.
IfyouliveinOxfordshireaCardiacRehabilitationNursewillcomeandseeyouonthewardandintroducethelocalservicetoyou.Theywillthencontactyouwithintwoweeksofdischarge,andgiveyouinformation,adviceandtheopportunitytotakepartinourprogrammeofsupervisedexerciseatalocalleisurecentreorhospital.
Steps towards a healthier life Youmayalreadybedoingsomeorallofthese.• ConsiderstoppingsmokingwiththesupportofyourCardiac
RehabilitationNurse,practicenurseorlocalsmokingcessationservice.Therearemanywaystohelpyouwiththis,sopleasedonotbeafraidtoask.Thisisthemostsignificantchangeyoucanmakeinpreventingheartdisease.
• Eatawell-balancedlow-fatdietwithplentyoffruitandvegetablesandoilyfish(seepage7).
• Takeregularphysicalactivity.StartbyfollowingtheguidelinesprovidedbythephysiotherapistattheJohnRadcliffeHospital.
• Trytoreducecircumstancesthatcauseyoustress.• Keepyouralcoholintakewithinrecommendedguidelines.
Menshouldnotdrinkmorethan21unitsperweekandwomenandpeopleonwarfarinshouldnotdrinkmorethan14unitsperweek.
• VisityourGPforregularcheck-upsofyourbloodpressureandcholesterollevels.Wesuggestyouhaveyourbloodpressurecheckedtwotothreeweeksafteryouhavebeendischargedandagainatthreetosixmonths.
• Ifyouarediabeticmakesurethatyourbloodsugarsarewellcontrolled.
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DrivingTheDVLAguidelinesadvisethatyoushouldnotresumedrivinguntilfourtosixweeksafteryouroperation.However,itisadvisabletodiscussthiswithyoursurgeonsixweeksaftersurgery,whenyouhaveyouroutpatientappointment,orwithyourGPifthisappointmentislaterthansixweeks.
IfyouholdaLGV/PCVlicenceyoucannotdriveforthreemonths.TheDVLAmayaskyoutotakeanexercisetestbeforereturningyourlicencetoyou.YouwillneedtocontacttheDVLAtodiscussthis.• 08702411879• www.dvla.gov.uk.
ContacttheDVLAwithinthefirstcoupleofweeksafterdischargefromhospital,asitcantakeawhiletoarrangethetest.
Toensureyourpolicyremainsvalid,youmustinformyourinsurancecompanythatyouhavehadcardiacsurgery.
Seatbeltsmustalwaysbewornbutyoumayfindapadorcushionbetweenyourchestandtheseatbeltmorecomfortable.
SexualrelationsAftercardiacsurgerysometimespeoplefearthattheexertionofsexualintercoursemayplaceaddedstrainontheirheartsorcausethewoundtocomeapart.Thiswillnothappen,althoughthewoundmaybesoreforafewweeks.
Theexertionofintercourseissimilartoclimbingtwoflightsofstairs.So,providingyoucancopewiththisamountofactivityitisunlikelyyouwillexperienceproblems.
Talkthingsoverwithyourpartner;keepitsimpleuntilyourconfidencereturns.
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Ifyouexperienceproblemsonceyouhaverecoveredfromyoursurgery,pleasediscussthemwithyourcardiacrehabilitationorpracticenurse.Donotworry–thereishelpavailable.Anorganisationwhichcanhelpyouis:• SexualAdviceAssociation:08707743571• www.sda.uk.net
Localorganisationsarealsoavailable–yourCardiacRehabilitationNursewillbeabletogiveyoucontactdetails.
HowfamilyandfriendscanhelpCardiacsurgerycanhaveanenormousknock-oneffectforfamily,friendsandcarersaswell.
Youmayexperiencemanyanxietiesandyouremotionsmaybevariable(e.g.‘WillIgetovertheoperation?’;‘WillIgetbacktonormal?’).Thesefeelingswillpassasyourecoverandyoubegintoreturntoyournormaldailyactivities.However,ifnegativefeelingsdon’tgoawayandyoufeeltheyaregettinginthewayofyourrecovery,pleasetalktoyourCardiacRehabilitationNurse,practicenurseorGP.
Yourfamilyandfriendswillalsobeconcernedandfeelanxious.Itmayhelptoshowthemthisbooklet.Cardiacrehabilitationcanalsoofferinformationandsupporttoyourfamily,friendsandcarerifrequired.
Furtherinformationoncardiacsurgery,cardiacrehabilitationandlifestylechangesareavailablefrom:• BritishHeartFoundation• www.bhf.org.uk
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ContactnumbersforcardiacrehabilitationJohnRadcliffeHospital,Oxford 01865220251
TheHortonGeneralHospital,Banbury 01295229753(Part of the Oxford Radcliffe Hospitals NHS Trust)
Cheltenham 08454223535
Gloucester 08454223535
HighWycombe/Aylesbury 01494526161 Ext2025
Luton&Dunstable 01582497469
MiltonKeynes 01908243966
Northampton 01604545345
Reading 01183226638
Swindon 01793646221
Warwick 01926495321 Ext4927
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OMI2597
Ifyouneedaninterpreterorneedadocumentinanotherlanguage,largeprint,Brailleoraudioversion,pleasecall
01865 [email protected]
JennyMitchellPre-admissionandDischargeLiaisonNurse
Version1,April2011ReviewApril2014
OxfordRadcliffeHospitalsNHSTrustOxfordOX39DU
www.oxfordradcliffe.nhs.uk/heartcentre