Post surgical CABG advice

• By martzj
• Posted June 18, 2009 at 8:49 am
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Hey there Sue,

You can ask for charted proof that Robert doesn't have a fever of 100 or pneumonia before agreeing to take him home. THey won't release a patient to a taxi.
I'm guessing Robert is desperate to get the heck outta there, but if he has fever (not supposed to be discharged if there is fever of 100 or more), chances are there is infection that could easily escalate and he would have to be readmitted.

At home, he will need his boatload of meds to be picked up from pharmacy and counted out into one of the mulit-day pill boxes. He will be dazed and may have trouble with things sticking in short term memory until pumphead effects wear off.......that will take weeks. Watch out for pain or sleep meds to definitely alter behavior at night.....My mom wandered around muttering she needed to take her pills and holding the empty pillbox (she'd already finished her daily allotment) in a confused fashion.

He needs to weigh himself every morning when waking....3 pounds or more gained overnight can be a sign of congestive failure starting...or worsening. Doctor must be called if there is that sudden 3 or more pound fluid gain.

The vein stripped leg may hurt him more than the chest surgery and it is important to keep pets or small children off that leg until it heals.....watch it for swelling, thighness, redness and fever.

Depending on his appetite he will need help with meals for first weeks......Mother was to exhausted and week, listless, sore to have will to prepare foods. I stewed chicken and steamed veggies, oatmeal and bread (she is tiny).

Expect him to have trouble managing even simple decisions...and conversations. It is residual from extreme surgical procedures. Avoid stressing him with chit chat or needless decisions about every little thing.

Write out list of meds, how may dosages and what time each day. Write out simple schedule he can glance at if he needs to to help him remember what steps he has already done......I put a check mark by
Breather each time mother used her pump inhaler, so she could see....otherwise, she couldn't remember. Just too confused from surgery + all those meds. (at 71).

Hope this helps in some way. Personally, I find it disturbing that a hospital would talk about discharging a patient while knowing he currently has pneumonia. Make sure someone on staff signs off on his discharge papers in your presence and that they take his temperature at time of departure too. All this needs to be signed off on.

take care,
Jaynie

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• By martzj
• Posted June 18, 2009 at 8:59 am
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ps. Hide the smokes if you can and kindly let him know that you won't be providing any or able to help him recover if he insists on smoking again. Smoking during bypass recovery is an instant way to create deadly spasming.
Non-negotiable. The smoking means his lungs are full of goshawful tar and crud which are making it hell for both lungs and heart to work right. NOW is the perfect time to start the smoking cessation since he's feeling like kaka anyway. Nicotine withdrawal will cause facial ticks and anxiety, so the heart & pain meds will already be helping him through that first month of stress and pain.

Keep aware of your own stress and fatigue limits too if you are his caretaker for now...You have your own heart issues to monitor! : )

Jaynie

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• By gracie62
• Posted June 18, 2009 at 9:17 am
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Sue:
Get him some DVDs, books if he is into reading, cross words or anything that will keep him busy. While I slept a lot in the first few weeks home from the hospital, I also got bored out of my mind. I am used to being active. As Jaynie said, my leg from where they harvested veins was almost worst than my chest. I remember waking up and feeling it first and being confused as to why my leg hurt so much. I was in a fog, but very much aware of what I could not do and it was extremely frustrating. Fortunately, I had some books, even though it took rereading pages time and again to comprehend sometimes. I also had my husband get seed for our bird feeder. Sitting and watching the birds and squirrels was very relaxing.

He will be irritable. He will want to charge right back into his old life, but someone needs to help him temper that. Having that surgery is like going from 120 mph to 10 mph with no one telling you they are putting on the brakes. You are thrown into a stand still you aren't prepared for.

Bursts of energy are common, but you learn real quickly you pay for overdoing. He needs to pace himself, above all else, and allow himself to heal physically and mentally.

I wish you both all the best -

Dianna

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• By south127
• Posted June 18, 2009 at 7:14 pm
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Thanks Ladies....You're the best!!

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• By MMaslek
• Posted June 19, 2009 at 8:05 am
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Bring a small pillow for the ride home. If he cradles it against his chest it makes the ride much more bearable.

Make sure he moves around. He needs to walk around inside the house often & walk outside the house a couple of times a day. The first day I made it 3 houses down before I had to come home. It was a start. It'll build up the muscles and help in his recovery. Long term sitting leads to blood clots.

Try to adjust his diet immediately. No weaning. Start out as he intends to go on otherwise he'll think it's okay to have this or its okay to have that when its really not. Take advantage of the scared period to make the adjustments.

No smoking. He'll be miserable but guess what? If he smokes, he'll still be miserable & something could go seriously wrong. Heart surgery sucks... he's going to be cranky either way. Might as well get the quitting out of the way. Don't let anyone smoke around him. It's hard enough to quit without the temptation.

Don't take any negative comments personally. He's just lashing out. But at the same time listen to him because his body will tell him what he needs. Rest & quiet helps.

Good luck & I hope the recovery goes smoothly!!!

Amy

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• By Winglover
• Posted June 19, 2009 at 7:25 pm
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South127,
Not sure if your friend as Medicare or not, but if he does you can have his discharge put on hold. When he first came to the hospital a representative should have given him a paper to sign that explains his rights. On the paper it should give you a number to call. Once you explain your reason why you feel he is not ready for discharge they will review his case for up to three days, continue care, etc. I went through this numerous times with my father. Wish I had stopped them from discharging him from a Cardiac Step Down unit directly to a Nursing home "so he could get stronger". I knew he was no where near ready, but did not realize I could challenge the medical personnel. Wish I had stopped them because within 36 hours he had a respiratory arrest. Your friend should never be discharged if he has a fever or is not breathing well. Just thought I'd let you know my experience.

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• By south127
• Posted June 19, 2009 at 9:45 pm
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Thanks, he is home and has a nurse visiting twice a day.
He sounds good...and his only complaint is the pain in his leg.

Sue

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