Issues affecting recovery from open heart surgery
How many of you heard from you cardiac surgeon that you would feel great in a couple of months after open heart surgery? Did you bounce back fast, or are you finding it a long slow process of feeling like you have recovered? I consistently have told patients it takes a year to heal up completely from open heart surgery. One month for the vessels to heal, two months for the muscles, three months for the bone to mend, three months for blood counts to return to normal and a year for inflammation to settle down, and strength to return. I bet most didn’t hear those comments before going into surgery. This is information gleaned from 20 years of working with post operative open heart patients.
Common complications of open heart surgery
The first few months present the most challenges. What types of challenges? Well in cardiac rehabilitation the challenges we faced most included:
- Heart rhythm problems – usually atrial fibrillation and tachycardia, followed by heart blocks requiring pacemakers, rarely ventricular fibrillation and ventricular tachycardia
- Plueral Effusions -A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity. This creates shortness of breath, anxiety, a feeling of drowning
- Anemia – blood counts that don’t return back to normal, produces fatigue, shortness of breath, activity intolerance
- Infections of the surgical site or where the harvested graph occurred
- Pump head - in some patients, the use of the cardiopulmonary bypass pump can cause foggy thinking and confusion after surgery
- Nerve damage – it isn’t uncommon for patient to have their ulnar nerve irritated and experience numbness of the fourth and fifth fingers of their hand. The technical term is brachial plexopathy. My belief it this is due to the prolonged position they are in during the operation places stress on the neck which pinches the nerve.
- Diaphragm nerve damage due to phrenic nerve injury. This causes the diaphragm to only have limited ability to work causing permanent shortness of breath problems.
- Vocal cord nerve damage. Cardiac surgery represents a risk to normal voice function as the nerves serving the larynx (voice box) are near the heart.
How to manage complications in recovery of open heart surgery
If you or your loved one is having a hard time recuperating, know that these type of complications do occur, and are not that unusual. Keep notes of the issues you are finding as you recover. Don’t be afraid to report even minor problems to your healthcare provider, as they may be able to be addressed and the sooner they are addressed the better.
If you are finding you just aren’t bouncing back, either due to fatigue, shortness of breath, lightheartedness, anxiety – make sure you talk to your physician about this. Be persistent, come in with a list of what you are concerned about. Often this is where cardiac rehabilitation is very helpful, as the clinicians are very familiar with these complications and can assist in communicating their finding with the physician and educating the patient on the implications to them. This helps to get referrals to the appropriate providers, whether it is pulmonologist, physical therapy, emergency room, surgeons. And we all know how easy it is to navigate through our US healthcare is…..yeah right!