Driving After A Heart Attack And A Stent
If you had a heart attack and a stent at the same time, you should not drive for at least two weeks. If you have a stent put in without having had a heart attack, NZTA guidelines state you should wait at least two days before driving again.
Different rules apply for Class 2, 3, 4 or 5 licence and/or a P, V, I or O endorsement.
The Cost Of Not Supporting The Patient
The most important aspect of suboptimal outcomes is the damage to patients’ lives and those of their families, but there are financial consequences as well. Having highly trained medical personnel perform a complex and costly repair is not a good use of medical resources if the patient then fails to recover for a preventable reason.
Patients who are depressed or anxious and therefore have suboptimal recoveries but do not die have postsurgical medical costs two to three times greater than patients with a normal recovery . Thus, in terms of both cost and utilization, it is beneficial to manage the mental part of the recovery.
Breathing And Coughing Exercises
You will have some fluid in your lungs after the breathing tube is removed. If this fluid collects in your lungs, you could develop pneumonia. To prevent pneumonia, a respiratory therapist or nurse will help you learn deep breathing and coughing exercises. Do these exercises as you are told to. Holding a pillow tightly to your chest when you do your coughing exercises also helps. For breathing exercises, you may use a device called an incentive spirometer. Using this device helps your lungs recover. There might be phlegm or secretions in your throat, especially if you smoke. It can sometimes be difficult to get the phlegm or secretions out of your throat, but it is very important to do so. Your healthcare team may give you breathing treatments containing special medicine to help you get rid of the phlegm.
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Driving After Heart Bypass Surgery
If you had a heart attack and heart bypass surgery at the same time, NZTA guidelines state you should not drive for at least four weeks. This additional time is to allow your sternum to start to heal before you get back behind the wheel.
Even if you have heart bypass surgery without having had a heart attack, you still need to wait four weeks before getting back behind the wheel.
Different rules apply for Class 2, 3, 4 or 5 licence and/or a P, V, I or O endorsement.
Travelling Overseas After A Heart Attack
If you have planned or are planning an overseas trip, it’s best to discuss these plans with your doctor.
Each airline has a different policy for air travel following a heart attack. You may be advised not to travel until your condition is stable. It’s recommended that you contact your airline prior to booking your flight. If you’re going overseas, you’ll need a travel insurance policy that will cover you for pre-existing conditions.
If you are planning on travelling to a country that has a time difference, you will need to discuss your medication regime with your doctor or pharmacist.
If youre back behind the wheel, you may also be thinking about going back to work.
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How To Prepare For Open
Tell your doctor about any drugs you are taking, even over-the-counter medications, vitamins, and herbs. Inform them of any illnesses you have, including herpes outbreak, cold, flu, or fever.
In the two weeks before the surgery, your doctor may ask you to quit smoking and stop taking blood-thinning medications, such as aspirin, ibuprofen, or naproxen.
Its important to talk to your doctor about your alcohol consumption before you prepare for the surgery. If you typically have three or more drinks a day and stop right before you go into surgery, you may go into alcohol withdrawal. This may cause life-threatening complications after open-heart surgery, including seizures or tremors. Your doctor can help you with alcohol withdrawal to reduce the likelihood of these complications.
The day before the surgery, you may be asked to wash yourself with a special soap. This soap is used to kill bacteria on your skin and will lessen the chance of an infection after surgery. You may also be asked not to eat or drink anything after midnight.
Your healthcare provider will give you more detailed instructions when you arrive at the hospital for surgery.
New Air Travel Checklist For Heart Patients
People With Heart Disease Urged to Take Precautions Before Flying
Researchers say the guidelines for safe air travel among people with heart disease vary and are supported by little concrete information. But a review of the available research shows people with heart disease can reduce their risk of complications onboard by following a few simple steps.
Although the risk of angina, heart attack, and irregular heartbeat or other major complications is small among people with stable heart disease, researchers say heart-related problems account for a high percentage of all in-flight medical emergencies. They also say that certain groups may be at an increased risk for in-flight heart-related incidents. Those concerns prompted the U.S. Federal Aviation Administration earlier this year to mandate that an automated external defibrillator be placed onboard all passenger-carrying aircraft with a maximum payload capacity of more than 7,500 pounds.
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Why Activity Restrictions Matter
Suboptimal medical outcomes sometimes occur with patients who have had completely successful cardiac surgery. The patient may recover more slowly, have trouble resuming the activities of daily living , and have trouble going back to his or her presurgical life and occupation. In the extreme case, the patient may die. When it became clear that the difference in outcomes was not always the result of the particular patient’s illness or the quality of the medical care provided, researchers began to look at psychological causes. The resulting studies have linked factors such as depression and anxiety to the observed suboptimal outcomes. In patients who had undergone coronary artery bypass grafting , depression and anxiety were associated with higher hospital readmission rates , and depression predicted an increased risk of death . The unaddressed question is this: Why do patients who have had a successful surgical procedure end up feeling depressed or anxious?
We have seen numerous examples, some tragic, of the consequences of inadequate postsurgical guidance. In response, we propose a change in the content and delivery of activity guidelines, with the goal of getting patients back to their pre-surgical life as soon as possible. We believe that through minor changes in how patients are treated after surgery, physicians and other clinicians can strengthen, rather than damage, patients’ psychological well-being and improve their recovery.
When To Call The Doctor
- You have chest pain or shortness of breath that does not go away when you rest.
- Your pulse feels irregular — it is very slow or very fast .
- You have dizziness, fainting, or you are very tired.
- You have a severe headache that does not go away.
- You have a cough that does not go away
- You are coughing up blood or yellow or green mucus.
- You have problems taking any of your heart medicines.
- Your weight goes up by more than 2 pounds in a day for 2 days in a row.
- Your wound changes. It is red or swollen, it has opened, or there is more drainage coming from it.
- You have chills or a fever over 101°F .
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Activity Restrictions And Recovery After Open Chest Surgery: Understanding The Patient’s Perspective
The Indiana man was a fine horseman who treasured his horsesthey were almost like family to him. Then he had surgery to repair an aortic aneurysm. One of his physicians told him that he could never ride again and that he should sell his horses. Fearful of jeopardizing his life and not knowing what else to do, the man complied, but doing so plunged him into a depression that lifted only when he was well enough to see that the physician’s advice was wrong. He now owns and rides horses again.
Cardiac surgery patients at a major Texas hospital are told on discharge not to lift anything heavier than a half-gallon of milk . The door to the cardiac rehabilitation facility in the same hospital requires a 14-pound pull to open, yet no patients have died or have even been injured from opening this door.
Do the activity restrictions that patients are given after major surgery affect their recovery? Can the activity restrictions increase the risk of morbidity? Can bad advice kill a patient who has just had a successful surgical procedure?
What Risks Are Associated With Flying Too Soon After Surgery
The risks of flying too soon after surgery can differ according to the type of surgery youve had and your specific health concerns.
Cardiac and vascular effects of general anesthesia typically dont last long and wont necessarily affect your flying risk.
Even if you havent had surgery recently, long-distance travel can the risk of blood clots in some people. Blood clots are most likely to form in deep veins in the legs, a condition known as deep vein thrombosis .
If you dont have other risk factors, its not always dangerous to fly after surgery.
A of anatomic pulmonary resection patients at the Mayo Clinic found no significant difference in the risk of complications between those who traveled by air compared to those who used ground transportation.
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Preparing For The Surgery
Preparation for open heart surgery starts the night before. A person should eat an evening meal as usual but must not consume any food or drink after midnight.
It is a good idea to wear loose, comfortable clothing to assist with restricted movement following surgery, but wear whatever is comfortable.
Be sure to have all personal medical information on hand. This might include a list of medications, recent illness, and insurance information.
It is normal to feel anxious before an anesthetic, and people should not hesitate to seek reassurance from the healthcare team.
The doctor may request that the person washes their upper body with antibacterial soap. A member of the healthcare team may need to shave the persons chest area before they can have the anesthetic.
The doctors may also need to run tests before surgery, such as monitoring the heart or taking blood samples. A doctor or nurse might place a line into a vein to enable the delivery of fluids.
After the medical team has completed the preliminary tasks, the anesthesiologist will administer general anesthesia.
How To Lower Your Risk For Blood Clots
Sitting still for long periods can restrict blood flow and increase the risk of developing blood clots.
Here are a few ways to improve your circulation while traveling:
- While seated, extend your legs straight out and flex your ankles so your toes point toward you. Hold for 15 seconds.
- If space allows, pull one knee up toward your chest and hold for 15 seconds. Alternate and repeat 10 times.
- Get up and walk for a few minutes every hour.
- Skip alcohol but drink plenty of water to avoid dehydration.
- Wear compression stockings to help keep blood from pooling in your legs.
Its also important to be aware of any signs of blood clots, such as redness, swelling, tenderness, and pain.
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Your Eating Habits May Change
You may notice that youve lost your appetite or you just feel too tired to eat. This is common, so be patient. Your appetite will soon be back to normal.
We suggest you try eating frequent, small meals throughout the day. You need proper nutrition to enable your body to heal and get stronger.
We recommend a diet low in fat, cholesterol and sodium and high in protein. Good sources of protein include fish, eggs, dairy, beans and nuts. Limit the amount of salt in your diet to 2,000 milligrams a day. Foods known to be high in salt include restaurant food, soups, pizza, bacon and other processed meats.
Don’t Take Your Meds As Prescribed
You may shrug off pain medication because you heard it’s addictive or it makes you constipated, nauseous, or woozy. But skimping on your medicine isn’t smart.
Pain can sometimes interfere with your sleep, appetite, and ability to get around, Whiteson says. And that can make it harder for your body to heal. Ultimately, the goal is to get off medication, but not before you’re ready.
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Drive Before You’re Ready
If your doctor tells you not to get behind the wheel — whether it’s for 2 weeks or 2 months — it’s for a good reason. Your reaction time may be slower and you could get into an accident. Until you’re ready to handle it, get lifts from a friend or family member. Or ask them to do your errands for you.
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
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Go Back To Work Too Soon
Like Saggio, you may be tempted to return to your job ASAP. But don’t give in.
“I’ve seen plenty of people try to do work while they’re still in the hospital — with a computer and cell phone,” Whiteson says. “They’re not coherent, let alone able to make good decisions.”
Plan in advance for time off and ask your doctor when you can return.
Tips To Help You Heal
Keeping the following things in mind will help you heal after heart surgery:
Listen to your body, especially in the first two months after surgery.
The vast majority of your healing about 80 percent of it occurs during the first two months after your surgery. During this time, you will attend cardiac rehabilitation and continue to gradually increase your activity level.
It is very important to work on increasing your activity level before cardiac rehab starts because in most programs this will be six weeks after surgery. Youll want to do as much as possible, but you may find that you tire easily or need to stop and rest during activities that you used to do with ease. Listen to your body. Make sure that youre not pushing yourself too hard and risking injury or complications.
Follow your doctors recommendations.
When it comes to resuming specific activities, its important to listen to your doctor. For example, you may need to wait at least six weeks before riding a bicycle or lifting things because your breastbone needs time to heal. Talk to your doctor about when you can start driving again.
After the first two months, the rest of your recovery will probably move more slowly. The remaining 20 percent typically takes almost a year. During this time, you should expect to continue to regain strength and endurance.
Eat right and get active when youre ready.
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What About Traveling By Car
The risk of developing DVT comes from lack of movement, whether youre traveling by air, rail, or road. Youre also at an increased risk for DVT if you go home and spend too much time in bed.
You can lower your risk for DVT by moving your legs whenever possible. If youre traveling by car, plan to stop and stretch your legs every hour. Once youre home, avoid sitting for more than 4 hours at a time.
Beyond 6 Weeks Of Recovery
If you had open heart surgery and the surgeon divided your sternum, it will be about 80% healed after six to eight weeks. By that time, youll generally be strong enough to get back to normal activities such as driving, Dr. Tong says. You can probably also return to work, unless your job is physically strenuous.
Most importantly, this is the time to start a cardiac rehabilitation program.
This is a monitored exercise program designed to increase your hearts endurance. Through cardiac rehabilitation, you can gradually increase your activities, and your doctors will watch your progress closely. Youll also learn more about how you can change your lifestyle and diet to keep your heart healthy.
Working through a cardiac rehabilitation program is the best way to find out when youre strong enough to resume the more strenuous activities you enjoy.
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Youll Play A Key Role In Managing Your Pain
Post-surgical pain is unavoidable but can be managed in a variety of ways. Because of recent national legislation changes, physicians can prescribe no more than a seven-day supply of opioids to patients at the time of their hospital discharge.
Weaning yourself off opioids as soon as possible is important. You may need less than a seven-day supply, depending on your condition. Some patients do not require any opioids for pain management.
Other options for pain management include:
Oral and topical analgesics such as acetaminophen and Salonpas patches
Applying a warm cloth to the area, using caution near the incision because nerve sensitivity may be decreased, causing the skin to burn
Relaxation techniques such as meditation and guided imagery
If you are on long-term opioids, you should meet with your prescribing physician to begin to wean down to the lowest dose possible before surgery.