Cough After Open Heart Surgery

Managing Pain After Open Heart Surgery

Managing your pain is an important part of your recovery after heart surgery. In addition to keeping you comfortable, pain control can help speed your recovery and reduce your risk of developing certain complications after surgery, like pneumonia and blood clots. Your pain level should be managed to the point that youre able to get up, walk around, cough and take deep breaths after surgery.

After heart surgery, you need to be able to move with some degree of comfort to aid the healing process, Dr. Tong says. Keeping your pain level manageable will help make sure your recovery stays on track.

You may leave the hospital with a prescription for pain medication and detailed instructions on how to use those medications to manage your pain.

People are often apprehensive about taking narcotic pain medications because of the risk of addiction, Dr. Tong notes. That is a healthy and very reasonable fear and an important conversation to have with your doctor. There are safeguards in place to stem opioid abuse and protect you from abusing medications. When it comes to prescription pain medication, for most people, its a matter of listening to your body. If you need it, take it. If you dont, dont.

If you have concerns about bringing narcotics into your home, or if you have a history of substance use disorder, be honest with your doctor. Theyll be able to discuss your options with you and determine a pain control plan with you.

Wearing Certain Types Of Clothing Might Be Hard During Surgery Recovery

Usually in discharge, they tell you to wear button-down clothing for a while, but what they dont tell you is that your skin is super sensitive and wearing tight clothing even a couple of months after might be hard. For women, wearing bras might be tough. Try to find comfortable sports bras you can unclasp or undershirts. I tend to wear bras now that dont have underwires and have a t-shirt cotton feel.

You May Experience Collarbone And Sternum Pain After Open

Sometimes you can have prolonged collarbone and sternum pain. Collarbone pain and sternum pain can be caused by the trauma of the surgery on your body or sternal wires. This pain can be sometimes helped with cardiac rehab or a resternotomy. However, make sure to communicate with your doctor about your pain to make sure its normal. After this past open heart surgery, Ive had a lot of pain and clicking in my shoulders and chest. Its caused a lot of chronic pain but working with physical therapy has helped me regain strength.

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What It’s Used For

If you need surgery, it probably means that several of your coronary arteries are blocked and the blockages are widespread. The most common symptom of coronary artery disease is a type of chest pain called angina. This pain is usually described as a squeezing, pressing or burning pain in the center of the chest or just below the center of the rib cage. The pain may spread to the arms , abdomen, lower jaw or neck.

Other symptoms of blocked coronary arteries may include:

• sweating
• palpitations

Some people mistake these symptoms for indigestion.

Some people with coronary artery disease do not have any symptoms. For them, the severe chest pain of a heart attack may be the first warning that blood flow to the heart has become critically low.

Sometimes, the location of the blockage makes bypass surgery the preferred treatment. If your doctor recommends surgery, he or she has probably considered other options. These can include drug therapy, balloon angioplasty and stents. The most likely factors pushing your doctor to recommend surgery are evidence that you have widespread coronary disease, or symptoms that you are experiencing that cannot be controlled with drugs.

Effect Of Different Thoracic Anesthesia On Postoperative Cough

Zhenzhu Chen, Qinglong Dong, Lixia Liang

Department of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University , , China

Contributions: Conception and design: Q Dong Administrative support: Z Chen Provision of study materials or patients: L Liang Collection and assembly of data: Z Chen Data analysis and interpretation: Z Chen, Q Dong Manuscript writing: All authors Final approval of manuscript: All authors.

Correspondence to:

Background: The objective of the study is to retrospectively analyze the cough status after double lumen tube and spontaneous respiration thoracic anesthesia, to compare the degree of influence of anesthesia and surgical factors, and to investigate whether spontaneous respiration anesthesia can reduce the incidence of cough.

Results: The probability of cough decreases with the increasing of postoperative time . The probability of cough is similar between group SE and group SB . The probability of cough in group T is significantly higher than other groups at any time point . In group T, the symptom of cough is the most severe, the scores of physiological, psychological, and social parts of LCQ are the lowest, and the VAS score is the highest , but all these are similar in group SE and group SB . The duration of antibiotic application, the days of chest drainage tube indwelling, and the days of hospital stay are all lower in group S than in group T .

Submitted Apr 18, 2018. Accepted for publication May 15, 2018.

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When To Call A Doctor

• If you notice an opening in your incision, even a small one
• If you notice blood after coughing
• If coughing causes severe pain
• If you cannot brace an incision because it is is too painful
• If you feel too weak to cough or are not strong enough to cough effectively
• If you have difficulty breathing or cannot catch your breath

How To Cough After Surgery

When you feel the urge to cough, you should brace your incision if you have had a chest or abdominal surgery.

That means taking your hands or a small pillow and hugging it to your incision when you cough, applying gentle but firm pressure. This bracing action will help support your incision and reduce the stress on the site.

If the incision is on your chest, such as after open-heart surgery, hug a pillow to your chest directly over the incision. If you had abdominal surgery, you would do the same over the abdominal incision while slightly tensing the stomach muscles.

If no pillow is available, you can use your hands to brace the incision, as the pillow is primarily used for comfort.

Even if your incision is not on your chest or abdomen, bracing may help with pain control. Crossing the legs can also provide bracing if your surgery was in the genital or rectal areas.

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Dry Cough After Cabg About This

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You May Experience Memory Loss And/or Brain Fog

There are a couple of things that can cause memory loss and brain fog after open-heart surgery. If you were put on bypass, it can cause these issues. It is also called pump head. Post-operative cognitive dysfunction can also cause memory loss. Both of these are usually short-term but can have the possibility of long-term effects. For the first six months, I really struggled with memory loss and brain fog. As time went on, it started to get better and I started to regain my memory and wasnt so foggy-headed.

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Life At Five Months After Open Heart Surgery

Blog Post from My Journey with Familial Hypercholesterolemia and Heart Disease

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Blog Post by A.W.About this Blog

In this blog I will follow my everyday journey of living with familial hypercholesterolemia . I am sharing my own experience with this inherited disorder, and how I manage it daily from what literature I read on the topic and what my doctors say to how I live my life . This is solely a personal account that might or might not offer some insight on what to expect when diagnosed with this condition. This blog does not offer advice, in any way, to anyone suffering from this disease.

Toddler With Chest Pain Trouble Breathing Cough After Heart Surgery

John Harrington, MDConsultant for Pediatricians

A 3-year-old boy with chest pain and trouble breathing that had developed over the past 24 hours was brought to the emergency department. The parents reported that his most prominent symptom was a cough. The chest pain appeared to worsen with coughing. He had undergone open atrial septal defect repair about 3 weeks before presentation.

HISTORY

A 3-year-old boy with chest pain and trouble breathing that had developed over the past 24 hours was brought to the emergency department. The parents reported that his most prominent symptom was a cough. The chest pain appeared to worsen with coughing. He had undergone open atrial septal defect repair about 3 weeks before presentation. He had been otherwise healthy. Several family members recently had a GI illness. However, the child had no vomiting, diarrhea, or fevers.

PHYSICAL EXAMINATION

Alert, playful, and afebrile child. Heart rate, 103 beats per minute blood pressure, 88/61 mm Hg and respiration rate, 28 breaths per minute, with oxygen saturation, 98% on room air. He had notable intercostal retractions and grunting. Cardiovascular examination revealed normal rhythm, with distant heart sounds. Pulses were 2+, capillary refill was less than 2 seconds. He had mild abdominal distention, with a palpable liver edge at 3 to 4 cm. Physical findings otherwise normal.

RADIOGRAPHIC STUDY

ANSWER: POSTPERICARDIOTOMY SYNDROME

CLINICAL MANIFESTATIONS

DIAGNOSTIC STUDIES

TREATMENT

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Heart Pillows Can Help Reduce Pain After Surgery

Because of the increased risk of pneumonia and respiratory issues after surgery, patients are asked to cough and breathe deeply frequently so their lung fully expand and to get rid of phlegm. As part of the recovery process, patients also breathe into a device called an incentive spirometer multiple times a day for the first month to keep their lungs healthy after surgery.

Having a heart-to-heart hug with these pillows can lessen pain and makes movement more manageable for patients whove recently undergone coronary artery bypass grafting, valve repair or valve replacement. Clasping the heart pillow offsets the pain and safeguards the incision site.

Patients embrace the heart pillow whenever they need to brace themselves for movement that might cause pain or injury to the incision site. If your pain is well managed, the more you will be able complete breathing exercises and walking that are important to your recovery, says cardiothoracic vascular surgeon Philip Bongiorno, MD.

Why Is My Father

Answered by: Dr OP Yadava | CEO & Chief Cardiac Surgeon, National Heart Institute, New Delhi

Q: My 64 years old father-in-law underwent heart bypass surgery last month. He recovered well and was discharged from hospital after a weeks time. After a week he developed continuous cough and his blood test results showed a high WBC count – approx 17,000. He is unable to sleep because the moment he tries to lie down he starts coughing and his stomach starts shaking vigorously and is uncontrollable. The doctors suspect some issue with the diaphragm, however, the ultrasound does not show any abnormality. What could be the cause of his condition? Please advise.

A:Breathing difficulty after bypass surgery can develop for multiple reasons including lung infections, diaphragmatic problems, fluid collection around the lung and failing heart. In view of the fact that the WBC counts are high and he has continuous cough, one has to rule out infection of the lung and pneumonia, which is easily done by a chest x-ray. I think, you should contact your treating cardiac surgeon/cardiologist and they should be able to sort out this problem.

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Does The Pain Disturb The Respiratory Function After Open Heart Surgery

Ana Beatriz SasseronI Luciana Castilho de FigueirêdoII Kerolin TrovaIII Andréa Luciana CardosoIV Núbia Maria Freire Vieira LimaV Sarita Colasanto OlmosVI Orlando PetrucciVII

DOI: 10.1590/S0102-76382009000500010

• Related content

INTRODUCTION METHODS PRESULTS DISCUSSION

REFERENCES

1. Arcêncio L, Souza MD, Bortolin BS, Fernandes ACM, Rodrigues AJ, Évora PRB. Cuidados pré e pós-operatórios em cirurgia cardiotorácica: uma abordagem fisioterapêutica. Rev Bras Cir Cardiovasc. 2008 23:400-10. View article

2. Schuller D, Morrow LE. Pulmonary complications after coronary revascularization. Curr Opin Cardiol. 2000 15:309-15.

3. Mueller XM, Tinguely F, Tevaearai HT, Ravussin P, Stumpe F, von Segesser LK. Impact of duration of chest tube drainage on pain after cardiac surgery. Eur J Cardiothorac Surg. 2000 18:570-4.

4. Brasil LA, Gomes WJ, Salomão R, Buffolo E. Inflammatory response after myocardial revascularization with or without cardiopulmonary bypass. Ann Thorac Surg. 1998 66:56-9.

5. Mueller XM, Tinguely F, Tevaearai HT, Revelly JP, Chioléro R, von Segesser LK. Pain location, distribution, and intensity after cardiac surgery. Chest. 2000 118:391-6.

6. Goldwasser R, Farias A, Freitas EE, Saddy F, Amado V, Okamoto V. III Consenso Brasileiro de Ventilação Mecânica: Desmame e interrupção da ventilação mecânica. Sociedade Brasileira de Pneumologia e Tisiologia. J Bras Pneumol. 2007 33:S128-36.

Article receive on Monday, June 1, 2009

Coughing And Breathing Exercises

Coughing and deep breathing is a technique used to help keep the lungs clear during the first few days or weeks after surgery.

Repeated several times per day, the cough and deep breathing exercises are a very effective tool to prevent pneumonia and atelectasis, a lung condition where the lungs don’t expand the way they should.

The technique varies slightly between facilities and physicians, but the general idea is the same. To perform a CDB exercise:

Take a deep breath, hold for several seconds, and slowly exhale.

Repeat five times.

Brace your incision, and attempt to cough deeply.

Repeat the entire procedure every one to two hours.

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What To Expect After Open Heart Surgery Pain Management

Pain management is a big concern for most people who undergo heart surgery. There are many things to think about and we want you to know that you are not alone! Nikhil Kumar MD and Angelia Nadiak, CNP, talk about how your care team works together to make sure your pain is managed. Each person is different and each pain plan is unique to each patient.

Kevin Hodges MD, joins the discussion to add a surgeons perspective on pain management and goals for helping our patients have a smooth recovery.

What to Expect After Open Heart Surgery Pain Management

Care Of Your Incisions

As you heal, your incision will look better and the soreness will go away. Changes in the weather, too much or too little activity and sleeping in one position too long may cause increased soreness. You may also feel numbness or itching or see redness or swelling, which will also stop with time. To care for your incisions, we suggest:

• Wash gently with mild soap during your daily shower. Dry carefully with a towel. Pat it dry Do not rub the incision.
• If you have small pieces of white tape over your incision, you must remove them after you have been home for seven days. If the strips come off on their own, you may leave them off.
• If your incisions are puffy, have areas of redness, are oozing, or begin to open slightly, call your surgeon.
• Women should wear a bra. A good support bra will reduce the tension placed on the incision. If the bra bothers you, you may put a small piece of gauze under the bra for added comfort.
• For discomfort or soreness, you may use a heating pad. Apply it four or five times per day on the low setting for about 20 minutes each time. If needed, take pain medication prescribed by your doctor.

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Tools To Help With Your Recovery

Breathing treatments are medicines that are inhaled. They help to open the airways so that you can breathe freely. They also aid in removing mucus. You will be given the treatments that fit your specific needs.

The incentive spirometer and Acapella® tool will help you to keep your lungs expanded, remove mucus, and aid with coughing. Your doctor and respiratory therapist will decide which of these tools is best for you. You will be taught how to use either an incentive spirometer or an Acapella® tool, and your care team will continue to assist you with using it properly.

Heart Pillows For Electrophysiology And Cardiac Cath Lab Patients

Patients who undergo procedures that open the sternum, like coronary artery bypass grafting, valve repair or valve replacement surgery, receive the larger, firm heart-shaped pillows, but Genesis cardiac patients with different types of procedures receive a different type of heart pillow.

A generous group of Genesis volunteers sews and donates smaller, softer heart-shaped pillows for patients who experience procedures in the Cath Lab or Electrophysiology Lab. These colorful pillows can come in solid colors or wild prints and patterns. The volunteers happily use whatever type of fabric they can find. These heart pillows prop up patients, provide comfort and offer a personal touch.

Each year, an average of 3,500 heart pillows go home with Genesis cardiac patients including the firm postoperative pillows and the soft ones made by volunteers. For cardiac patients, Genesis heart pillows offer a huggable memento that lasts long after scars heal.

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You May Feel Like Youre On An Emotional Roller Coaster

Recovering from open-heart surgery involves physical and emotional healing. The recovery process uses emotional and physical energy.

If you feel upset or emotional in the weeks after your operation, dont worry this is a normal reaction. Many patients report these feelings up to three months after the operation:

• Mood swings that may include depression, fear, anxiety, loneliness, helplessness and anger

• Crying easily for no apparent reason

• Lack of energy or motivation

• Getting easily frustrated

• Having good days and bad days

• Feeling more emotional or sentimental than normal

Even though you may feel drained physically and emotionally, its important to follow guidelines for good self-care:

• Get dressed every day

• Walk daily within your limits

• Get plenty of rest