What You Need to Know After Surgery

Jennifer DeLong: Hello. My name is Jennifer DeLong and I'm one of the advanced providers that works at Shipley's Cardiothoracic Center. We work closely with the surgeons in the operating room, as well as in the hospital both before and after surgery. You will meet myself or one of the other advanced providers that works with our surgeons during your hospital stay.

There are six things that I would like you to know. After your surgery is completed, you will be taken to the intensive care unit where you will be on a breathing machine with a tube in your mouth, and you will be under the effects of anesthesia. The nurses in the ICU will ensure that you are kept as comfortable as possible. Our goal is to have you off the breathing machine in about six hours.

When you wake from anesthesia, it will be very important to try to remain calm, breathe easily with the breathing machine while the ICU team works to get the breathing tube out. You will likely have an IV in your neck, as well in your wrist. You will also have chest tubes in. We work quickly to try to remove all tubes, IVs, and wires in a safe manner, usually within the first three days.

You will spend your first night in the ICU. The first morning after surgery, the nursing staff will help you get up to the chair. It is not uncommon for you to be on medications that support your blood pressure immediately after surgery. We work quickly and safely to get these off as well. Once all these medications have been turned off, your vital signs are stable, you will be transferred to our step down unit.

You will be assisted in walking to the surgical progressive care unit, which is also known as SPCU, with the nursing staff and physical therapy. They will assist you and have a wheelchair available if you need it for some portion of the walk. It will be important to walk at least three times a day and utilize your incentive spirometer. You will be taught how to use this by the ICU nurse and the respiratory therapist. We would like you to do this at least 10 times an hour. I recommend that if you are watching TV, you pick it up and do it three to four times on each commercial break, and you will surpass your minimum goal of 10 times per hour.

Another important thing to know is that we will establish a pain medication regimen that is acceptable, but you need to know, while we work hard to make you comfortable, we cannot make you pain free. As you progress and we remove your chest tubes, we expect that your pain level will decrease. Once all of your chest tubes have been removed and you have recovered, usually within five to seven days, we will begin discharge planning.

You will be sent home with a home healthcare nurse that will come and visit you the first three days in a row, and after that, they will establish a routine and schedule with you. They will be checking your vital signs, your wounds, and have direct access to notify us of any abnormalities or problems that you may have. You will also have a follow up appointment in our postoperative care clinic with one of the advanced providers who works closely with the surgeons in approximately two to three weeks following discharge.

During your postoperative appointment, we will go through your surgery, address any questions you have and when you can return to normal activities. It is important for you to know that once you are discharged from the hospital, you have access to a provider 24 hours a day, seven days a week by telephone. There is always somebody available to speak with you should you have any concerns or problems that need addressed after office hours. You will have ample opportunities to ask questions of the surgeons, advanced providers and our nurse navigators.