Caution: Watch for signs of bleeding, if you are taking a blood thinner. Let your doctor know right away if you have:

• Black stools
• Pink or red urine
• A lot of bruising or unexplained swelling
• Severe headaches or abdominal pain
• Vomit that looks dark coloured
• Bleeding from nose or gums
• More than usual menstrual periods

If any dental work or surgery is planned, let the dentist or surgeon know that you are on anticoagulants. Your doctor may ask you to stop taking them for some time.
Spectacles
After any open-heart surgery, there is water retention in the body. Even the lens of eye gets swollen and therefore you may get haziness of vision and inability to read small prints. Please do not change lens of your glasses as this problem will go away automatically in 4-6 weeks time and you would be able to see normally once your lens tension returns to base line.
When should the doctor be contacted
Call the Doctor on duty if there is any problem, viz. if there is any sign of infection (redness, swelling or discharge from the incision), fever, chills, increased fatigue,shortness of breath , increased swelling on ankles, weight gain over 2 Kgs in 5 days, change in heart rate or rhythm or any other sign or symptom that seems disturbing.
Returning to Work
For sedentary workers, the average is four to six weeks. For persons who must perform heavy work, the time is six weeks or longer, varying from patient to patient.
Routine at home
Patients should follow these principles:

• Get up at normal hour
• Bathe or shower daily if possible
• Always dress in regular clothes (Don't stay in sleeping clothes during the day) & take interest in personal grooming
• Take a rest period in the mid morning, at mid afternoon or after a period of activity

A typical six weeks' programme week's programme
Week 1

• Light activities
• Avoid any heavy lifting, stooping or bending
• Limit visitors
• Frequent 5-10 meters walks around house and garden
• Stairs - when essential, go slowly and rest mid way

Week 2

• Gradually increase to moderate activities, more moving and for longer times
• Walking 10-15 minutes twice daily at comfortable pace
• Start receiving visitors

Week 3

• Continue increasing activities
• Half day outings and small social outings, but not too late at night
• Walk 15-20 minutes twice daily

Week 4-5

• Longer activity times, faster walking
• Carrying light weights
• Walking 20-30 minutes, aim to walk 1 mile twice daily
• Social outings; such as cinema / theatre / temple
• Restaurant up to 3 hours

Week 6

• Most activities, unless exceptionally heavy
• Drive your car
• Normal sexual activities
• Return to job

The role of primary care physician in cardiac rehabilitation is of paramount importance and therefore it is important that they be involved in this process right from the day zero, i.e. when patient leaves the hospital or still better even when the patient is in the hospital. Cardiac rehabilitation programme should never be run under the aegis of the surgical services and should either be under a dedicated physician based at hospital· or under a physician providing domiciliary service. Tertiary care specialists, that is the cardiac surgeon and cardiologist, should provide ancillary support only. This I reemphasize because most patients continue visiting the tertiary care specialists and the latter also for obvious commercial reasons, keep entertaining them but this is to the detriment of the patient. I once again repeat all patients must return to the primary care physicians and be in their regular care and appear to tertiary care set ups only for anecdotal checkups.