À quoi dois-je faire attention en postopératoire ?

Vous ne devez pas vous allonger sur le flanc, vous devez éviter de vous lever ou de vous mettre debout en portant toute la charge du corps sur un seul bras et vous ne devez pas lever les bras au-dessus de votre tête. D’autres recommandations incluent l’utilisation régulière de médicaments, la mobilité autant que possible et la marche à intervalles réguliers ainsi que la respiration profonde, le gonflement d’un ballon ou l’utilisation d’un appareil à trois flux.

Quand puis-je commencer à marcher en postopératoire ? Combien de temps puis-je marcher ?

Transférés en unité de soins intensifs en postopératoire, tous les patients sont mobilisés plusieurs heures après l’arrêt de la ventilation mécanique, sous l’assistance d’infirmières. Il n’y a aucune contre-indication à la marche, même après leur sortie vers la clinique d’hospitalisation l’autre jour. Les patients peuvent et doivent marcher régulièrement à intervalles réguliers, à leur discrétion, après leur retour à la maison ; cependant, le patient doit éviter de se fatiguer. Le problème dépend absolument de l’état du patient.

Quand puis-je sortir ?

Les patients peuvent sortir quand ils le souhaitent après leur retour à la maison. Bien entendu, il est conseillé de porter des vêtements adaptés aux conditions météorologiques.

Quand puis-je prendre un bain ?

Il n’y a aucune contre-indication à prendre un bain, à moins que la plaie ne soit frottée grossièrement et à condition que la plaie soit immédiatement séchée après le bain. Cependant, il est recommandé aux patients d’éviter de prendre un bain jusqu’à ce que la plaie purulente soit cicatrisée et que le pansement soit arrêté. Ces patients peuvent se laver uniquement la tête ou le corps peut être nettoyé avec du savon et une serviette propre.

Dois-je avoir un pansement ?

La plaie sera laissée ouverte le jour 2, si les incisions sont propres et sèches. Une préparation désinfectante, Opside, est pulvérisée sur les plaies. Pendant ce temps, une couche protectrice est créée sur la plaie. La plaie sera maintenue fermée si elle est humide ou si des fuites ou des saignements sont observés. Vous aurez besoin d’un pansement si de telles plaintes surviennent après votre sortie. Sinon, le pansement n’est pas nécessaire.

Que dois-je faire pour garder les plaies propres ?

Vous devez changer fréquemment de vêtements et, en particulier, les femmes doivent porter un soutien-gorge et garder la zone intermamaire propre. Vous devez absolument éviter de vous gratter les plaies. Si vous êtes diabétique, vous devez faire vérifier votre glycémie à intervalles réguliers et éviter tout ce qui peut augmenter la glycémie. Vous devez consulter un endocrinologue, si nécessaire, pour réguler votre glycémie. En particulier, les femmes peuvent se procurer de la gaze propre en pharmacie afin de garder les plis inframammaires et les zones intramammaires au sec.

Quand aurai-je une visite de suivi ?

You will attend follow-up visit I month after you are discharged. Date of follow-up visit is also written on a report, also known as epicrisis, which will be delivered to you before you are discharged.

May I lie at supine position?

All patients should avoid lying at flank position for I month, if chest cavity is opened on mid-line (median sternotomy); patients may lie at supine position or at beech chair position. Patient should be assisted while getting out of the patient or a strap should be wrapped to footboard to get support, if patient lies supine.

May I accept visitor?

Crowded visitors should be always avoided, if you leave in a small room. Microbes will highly appreciate you, if your room is poorly ventilated. Risk of contamination will be high. Visitors should stay for a short time, while they should also avoid hugging and kissing the patient; room should be always ventilated well (maximum I visitor per day). You should especially stay away from any one with infectious disease. lt is not unnecessary to stay away from residents of the house. We recommended your family members washing hands frequently rather than use of disinfectants.

There is leakage at lateral side of the chest wall? What should I do? Should I fear?

Drop-like clear or hemorrhagic leakage is not a sign of infection in postoperative course. If the fluid is very viscous, you should better visit a doctor. Leakage can be observed at puncture sites of drains, which are placed to control bleeding, after drains are withdrawn in postoperative course. This leakage is not an abnormal condition. Wound dressing can be performed, at daily intervals, using gauze.

I feel irritation, prickling and pain on chest wall, but not on incision line. Is there any problem?

Your sternum, breastbone, is divided during surgery in order to expose heart. Next, bilateral chest walls are opened to the level of bilateral breast using a device, also known as retractor. Therefore, muscles on anterior chest wall and ribs are impinged, and accordingly, you may feel pain on your chest wall. Moreover, vascular grafts are obtained at left side of the chest wall or even at both sides of the chest wall in some patients, and therefore, it is totally normal to feel numbness on anterior chest wall. Even if you cannot see them, those wounds will heal, resulting with pains similar to stretching, retraction, pinprick or stabbing. They are all expected conditions in postoperative course. They will alleviate over time. Regular use of pain killers will assist you overcoming this period easier.

I feel pain and numbness in my arm. Why?

An incision is carried out on skin of your arm to obtain arterial graft in coronary bypass surgery. Therefore, pain on incision line is an expected outcome. Numbness is originating from injury of tiny nerve ends, while vessel graft is obtained. It will regress over time. Doing proper exercises (opening and closing hands) will facilitate recovery. You can also use stress balls.

Will I take medicines, which I use before surgery?

You will use only medicinal products, which are prescribed. You can use medicines for other conditions (diabetes, asthma, insomnia, depression, panic attack, epilepsy etc), along with medicinal products you are prescribed.

I cannot get medicines in absence of a report. What will I do?

Medicinal product report allows you get medicines, which will be sufficient for 3-month therapy, without paying patient share. Such reports are valid for 2 years. You can get all medicines, which are prescribed. Exceptions are Plavix, Karum and Pingel. You should pay full price of those medicines. However, if you have an angiography report, which documents implantation of stent within 6 months, those medicines will be also covered by your insurance. Your medication therapy will be planned when you attend follow-up visit. Therefore, a report will be issued for medicines, which will be used continuously.

How long I will use those drugs?

You will take your medicines regularly, until you attend follow-up visit. You will be prescribed medicines again, if your stomach medicine (Omeprol) and blood thinner (Plavix) are exhausted.

When can I drive?

You will be informed whether union is achieved in breastbone, when you attend follow-up visit. You may drive at short distance, if union is verified for breastbone.

May I have sexual intercourse?

You may have sexual intercourse, if you are informed that union is achieved in breastbone and you are allowed to lie at flank position at follow-up visit.

May I have journey in postoperative course?

You may travel to your residence with vehicle, train or plane, immediately after you are discharged. You should have breaks at 2-hour intervals and have a short walk, if you travel in car. There is no need to transfer patients to home with ambulance.

Pain, chest pain; back pain?

Muscle stiffness and bone pain are possible outcomes secondary to limited mobility in postoperative course. You should walk and move as much as possible to alleviate those pains. You are recommended Novalgin, a pain killer, when you are discharged. However, if there is no response to the medicine or if you feel tired, you may take Voltaren or similar preparations (Diclomec, Cataflam etc.) instead, provided high doses are avoided. You may apply hot towel on back and flank region along with recommendations written above. If pain persists despite all those measures, you should better visit a doctor?

How long will I use Triflow?

You should use Triflow, which is supplied for pulmonary exercise, for one month in postoperative period. You do not need to use the device, if you can walk outdoor without any complaint.

How long will I wear compression socks? You should wear socks up to I month in postoperative course; you will not need them after limited mobility disappears and you start walking outdoor.

Why are my feet swollen?

Les pieds et les chevilles gonflés sont des affections transitoires, secondaires à une mobilité limitée des jambes et à divers médicaments (par exemple, le Diltizem). Vous pouvez placer un ou deux oreillers sous vos pieds pour soulager le gonflement, lorsque vous vous couchez le soir. Le gonflement peut réapparaître la nuit. Cette méthode n’est pas valable pour les gonflements graves, qui peuvent susciter des inquiétudes et nécessiter un traitement diurétique.