Suggestions for open heart surgery recovery
December 29, 2020 9:19 AM Subscribe
My father-in-law is having open heart surgery in mid-January and we want to make his recovery as comfortable as possible. We’re looking for help in making that a reality.
My Father in Law (60) is having open heart surgery in the next couple weeks and we are wondering if there are any physical objects that might make his recovery more comfortable or add a bit of ease. Due to Covid no one will be able to be with him at the hospital and they expect his stay there to be a minimum of five days post surgery. Looking for recommendations on things to have at the hospital with him, at home once he returns and general items that might be of use or aid his healing.
My Father in Law (60) is having open heart surgery in the next couple weeks and we are wondering if there are any physical objects that might make his recovery more comfortable or add a bit of ease. Due to Covid no one will be able to be with him at the hospital and they expect his stay there to be a minimum of five days post surgery. Looking for recommendations on things to have at the hospital with him, at home once he returns and general items that might be of use or aid his healing.
As a former ICU nurse, I would strongly recommend a portable charger for his phone. (There are plenty of outlets in hospital rooms, but they're often far away from the bed. You've either got a charging cable strung across half the room making life difficult for your nurse and adding one more thing for you to get tangled in, or your phone is on the other side of the room and you can't get to it when you want it.) Everyone remembers to bring their phone but at least half forget a charger -- you cannot have too many ways to charge your technology when in the hospital.
Also, if he's planning to bring a tablet, I'd recommend a cheap stand for it. Something that can sit on the overbed table so he doesn't have to hold the tablet himself. Surgery is surprisingly tiring, and tablets (or even smart phones after enough time) get heavy. Especially since he can't have in-person visitors, anything that makes communicating with his friends/family easier is good.
I think most heart patients are given a heart pillow for splinting the incision, but depending on how big a guy he is, it may be smaller than is optimal. You want something big enough to span the entire torso and reasonably firm. Throw pillows are often just right. (His nurses or therapists will teach him the pillow splinting technique if he hasn't been told about it already. Basically, any time you use your abs to move, you hug a pillow tight against your chest. This stabilizes the sternal incision, making the muscles pull against the fresh incision less and can significantly reduce movement-related pain.)
My best wishes for a smooth surgery and an uneventful recovery!
posted by emilyanemone at 10:10 AM on December 29, 2020 [7 favorites]
Also, if he's planning to bring a tablet, I'd recommend a cheap stand for it. Something that can sit on the overbed table so he doesn't have to hold the tablet himself. Surgery is surprisingly tiring, and tablets (or even smart phones after enough time) get heavy. Especially since he can't have in-person visitors, anything that makes communicating with his friends/family easier is good.
I think most heart patients are given a heart pillow for splinting the incision, but depending on how big a guy he is, it may be smaller than is optimal. You want something big enough to span the entire torso and reasonably firm. Throw pillows are often just right. (His nurses or therapists will teach him the pillow splinting technique if he hasn't been told about it already. Basically, any time you use your abs to move, you hug a pillow tight against your chest. This stabilizes the sternal incision, making the muscles pull against the fresh incision less and can significantly reduce movement-related pain.)
My best wishes for a smooth surgery and an uneventful recovery!
posted by emilyanemone at 10:10 AM on December 29, 2020 [7 favorites]
This may be something of a pain in the ass to make happen but is extra critical under pandemic circumstances: ALL chats with the doctor (and other people, especially when they're delivering recovery-related and post-dismissal training and suggestions), including when they blitz through on rounds, need to happen on a conference call with ideally two other family members or other designees, at least one of whom is taking detailed notes. Whatever you need to do that your dad can do that easily - teach him how to Facetime and/or call two people, and teach him how to record a video or voice memo for emergencies - figure that out now and do test runs.
Even if all other factors are optimal, anesthesia and cardiac surgery and torso surgery generally leave a person with short-term memory dysfunction, including the ability to firmly make new memories in vivid detail. Add in pain management, probably some level-fiddling on other medication and O2 sats, this all will make your dad an unreliable narrator and scribe. Medical professionals are generally pretty good at remembering this as far as consent goes, but that's usually with the next of kin/authorized decisionmaker in the room. I'd be worried about that now until the hospital proves it has working protocols to avoid this problem.
Hopefully he will be assigned a PT or OT who will also be documenting post-op care instructions before discharge and then will be working with him after, but don't assume.
The very best recovery outcomes are when alllll the instructions are followed. It means if the PT tells you to walk 250 steps on your first day home and increase by X steps a day, you follow those instructions to the letter instead of overachieving. If they say use a walking aid for X days, there are not extra points for graduating early. If they say drink so many ounces of water, measure the water. Do not half-ass and do not try to "win" the instructions. But you have to know what the instructions are to do that, and this can be really difficult information to collate under even the best of circumstances.
posted by Lyn Never at 10:12 AM on December 29, 2020 [4 favorites]
Even if all other factors are optimal, anesthesia and cardiac surgery and torso surgery generally leave a person with short-term memory dysfunction, including the ability to firmly make new memories in vivid detail. Add in pain management, probably some level-fiddling on other medication and O2 sats, this all will make your dad an unreliable narrator and scribe. Medical professionals are generally pretty good at remembering this as far as consent goes, but that's usually with the next of kin/authorized decisionmaker in the room. I'd be worried about that now until the hospital proves it has working protocols to avoid this problem.
Hopefully he will be assigned a PT or OT who will also be documenting post-op care instructions before discharge and then will be working with him after, but don't assume.
The very best recovery outcomes are when alllll the instructions are followed. It means if the PT tells you to walk 250 steps on your first day home and increase by X steps a day, you follow those instructions to the letter instead of overachieving. If they say use a walking aid for X days, there are not extra points for graduating early. If they say drink so many ounces of water, measure the water. Do not half-ass and do not try to "win" the instructions. But you have to know what the instructions are to do that, and this can be really difficult information to collate under even the best of circumstances.
posted by Lyn Never at 10:12 AM on December 29, 2020 [4 favorites]
I had heart surgery in May with an 8-day hospital stay (6 of those days in the ICU). I was treated at the children's hospital because my operation needed to be done by a pediatric surgeon (though I'm in my 30s), and because I was at the children's hospital, I was allowed a single guest despite COVID. I did a lot of research before my hospital stay about what to bring and am happy to share what I learned with you.
I found most of what I needed at the hospital was provided. Things I brought that were nice to have handy included lotion, lip balm, a blanket and pillow from home for comfort, a robe, an eye mask, pajamas with tops that opened in the front, some street clothing for wearing home. I ended up needing my pre-surgery daily medications due to a stocking issue and would suggest bringing them just in case. I didn't want entertainment as much as I expected because I was pretty out of it for much of my stay (which may or may not affect your father-in-law -- I developed delirium), but I'm glad we packed my phone and charger, headphones, laptop and charger and Kindle (though I don't think I read at all). You'll need to weigh the desire for passtimes against the risk of theft, I suppose -- my wife could guard my things.
For my recovery at home, the most important purchase was a recliner. I found getting in and out of bed was daunting and getting comfortable in a flat bed next to impossible at first. I slept in the electric recliner for the first few weeks. That the recliner was electric instead of manual made getting up even easier, as you are initially not supposed to use much upper body strength. I've heard some people find sleeping in bed with a wedge after sugery is acceptable. I didn't find the wedge we got particularly helpful though. This probably won't be relevant to your father-in-law, but for posterity I'll say that front closure bras without underwires were also important to have.
Happy to answer any follow-up questions. Best of luck to your father-in-law for his surgery!
posted by reren at 10:17 AM on December 29, 2020 [1 favorite]
I found most of what I needed at the hospital was provided. Things I brought that were nice to have handy included lotion, lip balm, a blanket and pillow from home for comfort, a robe, an eye mask, pajamas with tops that opened in the front, some street clothing for wearing home. I ended up needing my pre-surgery daily medications due to a stocking issue and would suggest bringing them just in case. I didn't want entertainment as much as I expected because I was pretty out of it for much of my stay (which may or may not affect your father-in-law -- I developed delirium), but I'm glad we packed my phone and charger, headphones, laptop and charger and Kindle (though I don't think I read at all). You'll need to weigh the desire for passtimes against the risk of theft, I suppose -- my wife could guard my things.
For my recovery at home, the most important purchase was a recliner. I found getting in and out of bed was daunting and getting comfortable in a flat bed next to impossible at first. I slept in the electric recliner for the first few weeks. That the recliner was electric instead of manual made getting up even easier, as you are initially not supposed to use much upper body strength. I've heard some people find sleeping in bed with a wedge after sugery is acceptable. I didn't find the wedge we got particularly helpful though. This probably won't be relevant to your father-in-law, but for posterity I'll say that front closure bras without underwires were also important to have.
Happy to answer any follow-up questions. Best of luck to your father-in-law for his surgery!
posted by reren at 10:17 AM on December 29, 2020 [1 favorite]
Suggesting an electric toothbrush - the muscles you use to do the easiest things are going to surprise you, and standing with your elbow at shoulder height and pushing it back and forth is harder than you think. It doesn't have to be expensive, because disposable battery ops are $9 each or so, and you throw them away when the battery konks out. It will probably last him the first six or seven weeks of recovery with no problem.
posted by halfbuckaroo at 10:39 AM on December 29, 2020 [1 favorite]
posted by halfbuckaroo at 10:39 AM on December 29, 2020 [1 favorite]
My dad had open heart surgery 3 years ago in his mid-60s. He developed pretty bad delirium that lasted even after he was discharged, so be prepared for that. The memory loss never totally resolved, he has some permanent short term memory dysfunction, but in the 2 weeks immediately following surgery he had significant memory and executive function problems, was belligerent, refused medications at times, and just overall sort of a tough guy to be around. This was exacerbated by his pain.
A recliner was really important to him as he couldn't push up with his arms to get out of bed, so he stayed in the recliner all day. If he doesn't already have one, getting one that has the stand-assist will be even better. The other thing that was really helpful was a frm pillow with arm straps--he held that to his chest whenever he coughed or had to do anything else that would make his abs or chest move.
Most of all I would prepare yourself or whoever else will be caring for him at home for a rough couple of weeks. He will not be able to do even the simplest household tasks and will really need hands-on help with things like making his meals, possibly getting to/from the bathroom depending on where it is, etc. My dad really looked terrible when he first came home, then rallied and was VERY dedicated to his cardiac rehab, etc. for a few months. Three years out he's sort of settled in the middle and is doing pretty well overall, though hasn't ever fully recovered his physical stamina that probably has more to do with some other chronic issues. His heart is doing great and his checkups have been positive, and he definitely wouldn't still be here if he hadn't had the surgery!
posted by assenav at 10:43 AM on December 29, 2020
A recliner was really important to him as he couldn't push up with his arms to get out of bed, so he stayed in the recliner all day. If he doesn't already have one, getting one that has the stand-assist will be even better. The other thing that was really helpful was a frm pillow with arm straps--he held that to his chest whenever he coughed or had to do anything else that would make his abs or chest move.
Most of all I would prepare yourself or whoever else will be caring for him at home for a rough couple of weeks. He will not be able to do even the simplest household tasks and will really need hands-on help with things like making his meals, possibly getting to/from the bathroom depending on where it is, etc. My dad really looked terrible when he first came home, then rallied and was VERY dedicated to his cardiac rehab, etc. for a few months. Three years out he's sort of settled in the middle and is doing pretty well overall, though hasn't ever fully recovered his physical stamina that probably has more to do with some other chronic issues. His heart is doing great and his checkups have been positive, and he definitely wouldn't still be here if he hadn't had the surgery!
posted by assenav at 10:43 AM on December 29, 2020
recommended for all hospital stays: EAR PLUGS.
posted by misanthropicsarah at 12:07 PM on December 29, 2020 [1 favorite]
posted by misanthropicsarah at 12:07 PM on December 29, 2020 [1 favorite]
Please be very, very mindful of his mental state. My father–and this is quite common, I've learned–simply gave up at some point after a successful surgery, and never left the hospital, dying after a spirited session of CPR. Anything you can do to buoy his spirits and keep him in a positive mental state will be extremely helpful in getting him to the other side of the river, so to speak. Wishing you and your loved one success in the OR and afterward!
posted by ivanthenotsoterrible at 3:55 PM on December 29, 2020 [1 favorite]
posted by ivanthenotsoterrible at 3:55 PM on December 29, 2020 [1 favorite]
Ivan, that's so sad and I'm sorry. To that end, music is powerful, so loading the phone or a cheap tablet with music is good. When I visited my brother after his cancer-induced strike, I played some familiar music for him, and he perked up in response. Good luck to you and your Dad, indy.
posted by theora55 at 4:33 PM on December 29, 2020
posted by theora55 at 4:33 PM on December 29, 2020
If you can afford a recliner, go out and buy one. It has to be the automatic kind, where you push a button, not use a crank.
All the other important things he’ll likely be discharged with, like a heart pillow/teddy bear (a regular pillow isn’t firm enough), a spirometer, an oximeter, and a blood pressure monitor. He’ll need a walker for the first couple of weeks.
posted by Violet Hour at 9:30 PM on December 29, 2020
All the other important things he’ll likely be discharged with, like a heart pillow/teddy bear (a regular pillow isn’t firm enough), a spirometer, an oximeter, and a blood pressure monitor. He’ll need a walker for the first couple of weeks.
posted by Violet Hour at 9:30 PM on December 29, 2020
This thread is closed to new comments.
Hope all goes well—FYI my dad is now 84 and doing well!
posted by bookmammal at 9:27 AM on December 29, 2020 [2 favorites]