fever

fever is a common occurrence after the patient is operated for heart. patients are given anti pyretic tablets for the same. if the temperature lasts for more than 2 days ,the patients needs to be concerned and visit his operating surgeon for opinion. the surgeon can then change the anti biotics or prescribe new medications.usually we will wait for culture sensitivity report of the blood  and start the required anti biotics.
for fever lasting more than 5 days or sudden spurts of fever not responding to treatment,care needs to be taken to evaluate the cause of fever.there might be an element of infective endocarditis.

mobilization

mobility is an issue post cardiac surgery. after the chest drains are out and patients is free of any inotropics injections ,patients are encouraged to move sligthly. initially in bed then afterwards around the bed and then in the vicinity. patients are requested to take help from relative.

patients should try to walk with hands crossed behind back.if any patients have click of sternum

while getting up from the bed patient is trained to roll over on one side and with help of opposite hand push to get up from the bed .

patient can also take help of a large pillow to lean over the pillow on his side .

lot of walking not only improves the circulation in the body but also build lot of confidence after va major surgery .

patients are taught to take care while walking on stairs too.
this rehabilitation process will take around a months time to adjust to new ways of living . 

post operative rehabilitation post cardiac surgery

post cardiac surgery rehabilitation is a poorly addressed phenomenon in India .

patients will have dry cough. coughing will make the patient chest pain.also few patients will notice rise in temperature. this has to brought to the notice of doctor.

initial few days post surgery are very important for the patient. some patients will notice wet dressing. 

because of change in lifestyle, the body is not able to maintain the liking for food stuff and will complain of nausea every now and then. patients will be prescribed anti emetic tablets.
some patients will have serous discharge from the wound also .click of sternum needs to be taken seriously . i recommend walking with hands folded behind. gradual increasing activity at around home initially then society and when he is confident leaving city limits is encouraged. 

 cessation of smoking is paramount importance.control of blood pressure needs to be reined in. so also diabetes , sugar control. 

getting onto new life patients are anxious of having another heart attack . reassurance and medical evaluation will help. 

resuming sexual activity and physical tolerance excercises need to be addressed. 

keeping the mind occupied in some activity is very important. driving 4 wheeler is fine after recommended one month from surgery . but two wheeler driving is to be judiciously handled. 

meditation and pranayam will help in soothing the nerves. every effort is made to include the patient in the circle of society. loneliness itself is shown to be precursor of heart disease too. so want to get happy , spend atleast an hour in the circle of friends. 

diet is often overlooked and balanced diet is missing in most cases . add to it the patient might have his own calorie deficient  diet and cause loss of muscle mass which is important for generalised well being . nuitritionist can help them re balance their diet . 

weight  loss can be accompanied with severe loss of muscles which is important for generalised well being . young patients tent to exercise more and in view of low protein diet can land up in problem. so quantified nuitrition and strength training exercises are important . 

regular visits to physician and evaluation of physical well being is equally important . 

blood sugars and diabetic

diabetic heart patients are tricky to treat. the stress because of operation causes the blood sugars to shoot up necesiting the start of injection insulin.usually insulin is started during intraoperative period and continued in the post operative period till it normalizates.on an average the injection insulin dosage is fixed and patient is sent home on fixed dosage of injection insulin.the patients returns back from home for regular check up then the injection insulin is coverted to oral hypoglycemics drugs.



its been observed that the patients who return to their normal lifestyle earlier get control of blood sugars early.

sex after cardiac surgery

high incidence of cardiac surgery in younger patients  now a days.

so like life on the whole is affected , the sex life of the individual takes a hit too. change in positions where in the patient is not exerting weight over his both arms can  be a preferred option.

patients need to take opinion of operating surgeon regarding onset of exercises .doctor will advice regarding gradual resumption of activity after the sternum ?chest bone is healed completely usually at the end of 25 days.

post operative chest pain

chest pain is integral part of post operative symptoms which a patient who has undergone cardiac surgery.pain killers can relieve the pain to some extent but patient will have to choose his pain killer tablets consciously . if the pain persists in spite of guidance from the doctor , he should get in touch with the surgeon or one of his team members to get relief.pain lasts for one to week after the surgery.afterwards the patient will have drawing in sensation in his chest, which is normal.

if there is a click sound on walking or getting up from sitting position , it should be brought in notice of the cardiac surgeon . it is recommended not to walk with hands swaying , that is fold the hands at the back while walking .and in some cases the surgeon will prescribe chest binder for the patient .

sleep is affected after the surgery and patient do not get enough sleep.patient will have to take sleeping tablets for the same .still some patients will have concerns about sleeping.