What will happen after your coronary artery bypass surgery (postoperative course)

Hygiene and Incision(s) care: You can shower every day with warm water and mild soap. Do not have a tub bath for 4 to 6 weeks if you have a full leg incision. Gently wash your incision(s) and rinse them well. Do not scrub them. Pat your incisions dry with a towel. Your incision may be Itchy and dry. Put a cool wet facecloth on the incision to decrease any itchy feeling.

Care of your incision(s) means:

Leave the incision(s) uncovered. If it is draining, cover it with a loose, clean dressing. Change it when it gets wet. Many women find that there is pulling on their chest incision. For large-breasted women, wearing a loose-fitting or sports bra may help. You need to start wearing your bra 2 to 3 days after your surgery. An infection can happen days or weeks after your surgery. You should look at your incision(s) each day and check for any signs of infection:

1. Redness, warmth or swelling
2. Drainage - especially if yellow or green in colour
3. Pain or tenderness that is not helped with your pain pills
4. Chills or fever (38.0°C or 100°F by mouth)

If you have any of the above problems and cannot reach your doctor, report to the Emergency Department.

Care of Your Breast Bone: For most heart surgery, your breastbone (sternum) has been cut. If your breastbone was cut, think of this as a broken bone that has been put back together with wires. From time to time ‘clicking’ is felt with some movement or activity. If this happens, stop the movement or activity. It takes 6 to 8 weeks for your breastbone to heal. Do Not:

1. Lift more than 5 to10 lbs (2.5 to 5 kg).
2. Push, pull or strain such as, open a heavy door, a stuck jar lid or strain while having a
3. Bowel movement.
4. Lie on your stomach.
5. Push or pull with one hand.
6. Do heavy house or yard work, like raking, mowing the lawn, vacuuming, and
7. Handling wet laundry.
8. Use your arms to get out of a chair. Use your legs to push-off.

Leg Swelling: For the first few months after your surgery, your leg with the incision may be swollen. This is normal especially at your foot and ankle. Remember to:

1. Keep your legs uncrossed
2. Keep your legs and feet up when your are sitting or lying. Raise your legs on pillows
3. or use the arm rest on the couch when lying down
4. Do your leg and ankle exercises
5. Walk
6. Avoid wearing tight clothing

Constipation: Constipation may happen 1 to 2 weeks after your surgery. Straining can be hard on your healing breastbone and on your heart. To relieve constipation:

1. Be active - walk and do your exercises.
2. Eat high fiber foods. Refer to Appendix B (page 34).
3. Drink lots of fluids especially water unless you have been told not to.

Memory and Concentration: You might find that you are forgetful and have trouble concentrating after your surgery. This is normal. It should get better over the next 6 months.

Getting In and Out of Bed

The log rolling method of getting in and out of bed should be used while in hospital and when you go home.

Getting Into Bed

1. Sit on the side of the bed and cross your arms over your chest.
2. Lean down on your elbow and shoulder closest to the head of the bed. Put your opposite hand on the mattress to steady yourself.
3. Stay on your side as you bring both legs up onto the bed and roll onto your back.
4. While on your back, bend your knees. Dig your heels into the mattress to lift your bottom off the mattress. Now move yourself into a comfortable position.

Getting Out of Bed

1. Cross your arms over your chest.
2. Roll onto your side (facing the side you will get out on).
3. Stay on your side – put both legs over the side of the bed. Dig in your elbow closest to the mattress. Steady yourself by putting your opposite hand onto the mattress by your elbow.
4. While pushing with the hand on the mattress, sit up in one motion.

Sexual Activity

1. Sexual activity will not hurt your heart. You may not feel like having sex soon after your surgery. Remember to:
2. Make sure you are rested and relaxed.
3. Give yourself the time you need.
4. Wait at least 1 hour after a meal or exercise.
5. NOT support your body weight on your arms for the fi rst 8 weeks.
6. Try different positions. This may help you and your partner.
7. Check with your doctor/pharmacist before restarting any medications related to your sexual activity.

Tingling or Numb Fingers: Your ring and little fingers may feel numb and tingle. This can happen if your arm nerves were stretched during surgery. Normal feeling should return in about 4 months.

Returning to Work: You can usually go back to work 2 to 3 months after your surgery. You may think about retiring, quitting or getting a new job while you recover at home. It’s best to make a decision like this when you are fully recovered. Talk it over with your spouse/partner, family or doctor. If your job is taking care of your family, your home or yard, the 2 to 3 month rule off work applies as well.