Having open heart surgery can be frightening, but sometimes there is no other choice. Heart surgery can resolve various heart conditions that would otherwise be fatal. There are various solutions to correct defective heart valves, repair aneurysms, unclog or bypass arteries, implant stents, and in the most critical cases replace an entire heart. Some people are diagnosed with a heart condition and plan their open heart surgery on their terms while others are subjected to emergency surgery to save their lives. People have different opinions on which circumstances are worse psychologically; to have the foresight of surgery in advance or to be thrust into the situation with no time to contemplate it. Sometimes the patients who know about the surgery ahead of time can feel scared, restless, angry, or depressed in the days leading up to the surgery. These healthy individuals who are diagnosed by surprise with a heart ailment seem to have the hardest time coming to terms with eminent open heart surgery. It's harder for them to wrap their head around then for example a smoker who has not taken care of themselves. Age can also influence how a patient deals with a diagnosis. Young adults seem to have a harder time coping with it psychologically than elders. Also notable is that survivors of emergency open heart surgery can often have a harder time psychologically in recovery than those who had a planned operation.
Everyone is different, but below is generally what you can expect with open heart surgery. You'll want to get your affairs in order ahead of time and plan in advance to have a stress free recovery. Many heart patients experience a period of deep introspection in the days before open heart surgery. You may question the meaning of life, why this happened to you, and you will undoubtedly want to spend quality time with your family. The evening before your open heart surgery is an important time to be spent quietly and intimately with your family.
You'll skip breakfast on the morning of your open heart surgery and won't eat anything. You'll also shower with a special 'sanitizing' soap provided by your surgeon. When you arrive at the hospital you will report to an administrative check-in where you will be required to fill out some documents. You will then have your vitals taken, and shortly thereafter you'll be sent to the cardio-thoracic surgery unit. In a good hospital your family will be allowed to accompany you. When you arrive there will be numerous doctors and nurses present, as well as your anesthesiologist. They will take your vitals again, and when your surgeon arrives they will brief you and your family on the details of the actual open heart surgery. The anesthesiologist will tell you how things will go with putting you to sleep, as well as what to expect when you wake up afterward. Your surgeon will give you a rundown of everything and give you a chance to ask any remaining questions you might have. When they're finished talking to you and your family, your anesthesiologist will likely put an IV in each arm while you are still awake. They use these to administer anesthesia and other medicine once you're on the operating table.
Next you will say your goodbyes and a nurse will lead you to the operating room. The operating room will be brilliantly lit. The operating table is typically a slightly padded table on a pedestal that looks just the right size to hold your body and nothing more. There are no railings, obstructions, or legs on the corners of the table. Bright lights beam on it from every direction making it the center of attention. These tables look kind of like an ironing board. Alongside it are surgical tools laid out in an obsessively organized fashion. By now there are usually a bunch of other doctors and nurses in the room that will have various responsibilities during the surgery. They will ask you to climb onto the table and lay down. Nurses will start connecting you with various wires, and you may be asked to sign a waiver so that a representative from a medical equipment company can observe the surgery. Don't panic, it's tacky, but it's a common practice and believe it or not is essential to new technology. Soon the anesthesiologist will begin to administer your initial anesthesia. Your surgeon may give you a final acknowledgement as you begin to feel drowsy, and before you know it you'll be in a deep sleep. At that time the crew will continue connecting wires, inserting tubes (your urinary catheter, swans catheter, and later your breathing tube and more). You will be unconscious for the rest of the surgery, but in a good hospital the staff will give your family regular updates on how things are going. Occasionally patients speak of having unusually vivid dreams, or an outer body experience, but most people simply sleep. When the surgery is finished your surgeon will come out and brief your family, and soon after they will be allowed to see you in the recovery room.
You will most likely still be unconscious when your family sees you for the first time in the recovery room. You will probably still have a breathing tube in, and it may be a little scary for them to see you this way. Most patients claim their first memory after surgery is when the breathing tube is pulled out. You'll be heavily sedated but you'll probably hear a nurse inform you that they're going to pull out your breathing tube. You'll cough for a few moments as they pull it out, and your mouth will feel annoyingly hot and dry. You'll be very thirsty but the nurse will only be able to offer you a wet swab on your lips and tongue until you are a little more alert at which time they may offer you ice chips. The amount of pain felt varies from patient to patient, but generally most heart surgery patients do not feel much pain due to the significant amount of drugs they are on. Generally speaking, patients say afterwards that the pain was much less than they thought it would be.
You will be on a lot of pain drugs in your first days in recovery. You'll probably have a morphine drip that you can administer yourself by pressing a button when you're in pain. There are automatically regulated limits to how much you can pump into yourself so you don't have to worry about pressing the button too often. Hospital stays vary widely after open heart surgery depending on which procedure you have. You will sleep quite a bit and be loopy for the next few days. Around this time you'll probably notice your incision as well as some bumps underneath it. The bumps are from the titanium wire they used to mend your ribs back together after surgery. They don't really cause any harm and aren't really noticeable unless you run your finger over them. Most heart scars fade away pretty nicely, and faster than expected. Your head will feel hazy due to the medications, and from the broad effects of surgery and being on the heart-lung(bypass) machine. After a few days you will be pushed to get out of bed and begin walking. Initially a short walk to the bathroom will seem like climbing Mount Kilimanjaro, but shortly thereafter you'll be able to do it with no problem. You will start to walk the halls of the unit with your physical therapist. Your newfound fear of coughing, laughing, and sneezing, is normal, and you'll probably be given a stuffed animal or something to hold against your chest when you do. This will counteract the pressure generated and make it more comfortable. Another thing you will dread is having your first bowel movement, but they won't let you go home until you do. When you finally do have that special moment you will be pretty close to going home if all else is up to par. You're not out of the woods when you leave to go home. It's a big milestone, but care must be taken to follow your transition plan and stay in a positive state of mind.
Even though you'll want to; the last thing you should do is go home and lay on the sofa every day. There are many things that can happen after heart surgery, arrhythmias, atrial flutter, low hemoglobin levels or blood issues, and many more that could warrant a return to the hospital. Having a positive attitude during any setbacks is the single most effective thing you can do to keep things moving along. Stay positive because once you get home your real recovery work begins.