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Home > Cardiac Rehabilitation

Cardiac Rehabilitation After Cardiothoracic Surgery

Cardiac rehabilitation (CR) is an important component of post operative recovery of a patient, who has undergone coronary artery bypass graft surgery or any form of open heart surgery. Recent published reports have clearly indicated that CR results in better patient outcomes and not only it helps in speedy stabilization of health but also, encourages resumption of effective daily activities faster. CT majorly focuses on early mobilization & return to gainful employment besides specialized attention on cardiac risk factor modification, optimal medication, education and counseling with regards to changes of lifestyle. As well, in-patient CR after cardiac surgery, provides a bridge between acute care discharge and independent living at home and guide patients back on the road to clinical stability and functional independence, while initiating the process of secondary prevention.

Cardiac rehabilitation starts right from the moment the operation is over. However, the in-hospital part of the rehabilitation is looked after by the doctors, nurses, physiotherapists and other trained medical and para medical personnel and therefore it shall not form a part of this review. We shall be focusing on the rehabilitation as applicable when the patient leaves the hospital. Infact leaving the hospital itself to some is a joice occasion but for others it makes them feel apprehensive. Some times, these feelings are prompted by concerns about leaving the security of the hospital with its expert medical team and equipment. However, one must remember that no patient is allowed to go home until the doctors think that the condition is satisfactory and therefore there should be no room for any apprehension on this account. Recovery from the heart surgery usually takes 4-6 weeks. During this time, you start to build up your strength and get back to your normal routine. When you first get home, your activities should be the same as they were in the hospital. Do a little more each day. Rest when you are tired. Don't overdo it. Don't set goals. Face each day as it comes. Do things pragmatically and within your capabilities. Do not compare yourself to some one else. No two people are alike, neither in their looks, nor behaviour, so how can they be alike in their recovery?

Your Emotions
It's normal after surgery to have a "let down" or depressed feeling. You may be tearful or may even cry. At times you may be irritable. Some people have bad dreams. Others have a loss of memory or can't concentrate. These emotions should go away by the end of your recovery (4-6 weeks). There is no embargo on speaking or interacting socially, as long as you do not feel tired & exhausted.

During the first week after surgery, your chest incision may be bruised. It may also itch, feel numb or be sore. At times your back or shoulder may also feel sore. All of these things are common and will go away slowly.

For back and shoulder soreness, maintain good posture and move your neck & shoulder muscles in a normal way. A good posture means sitting or walking straight, do not slump. Do not raise your hand above the shoulder height and do not lift heavy weights. A mild pain reliever may also help. If a vein graft was taken from your leg, you may notice some swelling. Elevating your legs will help. If an arterial graft was used from your arm (Radial Artery), you may notice some numbness in your thumb and index finger. This will improve with time. It takes 6­12 weeks for the breastbone to heal completely. Wires hold this bone together, but you can't feel them. During this healing time you may notice slight clicking or movement of sternum (breast bone) when you breathe or turn. This is common and should go away when your sternum heals. Women may find that wearing a brassier can add support and reduce pain. Choose a comfortable but a firm and fitting brassier that is not binding.

Walking & Exercises
Take several short walks between times of rest. This keeps you from getting too tired while you are building your strength. You can climb stairs, but take your time and go slowly. Sit down and rest if you become tired, short of breath or dizzy. Do not cross your legs while sitting as it hampers blood circulation in the legs and increase the chances of clot formation in legs. Do the amount and kind of exercise your doctor or physiotherapist suggests. Exercise improves muscle tone and strength after surgery. You can start going out of house for short walks, but always keep help at hand.

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