Open Heart Surgery Recovery Is a Full-Time Job

You are now home from the hospital, and while the healing process is well underway, or you would not have been discharged, there are miles to go. There seem to be so many instructions to remember. You simply will not be up to much in the first few weeks, and in some cases, for several more. I won’t understate this. Yes, an upbeat approach by the hospital medical staff may have sent you waltzing home and it’s thrilling to be leaving the hospital, where you haven’t been permitted to sleep through the night. Yet you are returning home greatly fatigued, with a medications schedule to manage, possibly a tank of oxygen, and perhaps recurrent irregular heartbeats or other complications that remain unresolved. Now is the time to dedicate yourself to the hard work of recovery. Alternating rest and exercise, and above all patience with the physical and emotional trials ahead, is your assignment for the next several weeks.

You and your caregiver will mostly be on your own unless your particular situation requires a treatment plan that includes post-op visits from a home health care nurse. Even if that’s the case, now is the time to review any guidelines your hospital medical team has given you about what to be aware of.

If you have purchased the paperback or downloaded the e-book version of The Open Heart Companion: Preparation and Guidance for Open-Heart Surgery Recovery, from my website http://www.openheartcoach.com, it’s time to reread Chapter 5, “The Challenges You May Face.” This chapter provides detailed information not only on challenges that may arise in your recovery, but it also supplies solutions as well. For example, on the subject of feeling isolated: “This is the time to find other open-heart surgery survivors and their caregivers to talk to. Swap stories, share information, hear what other families have gone through. Just knowing that you are not alone as you go through your rehabilitation can lift the veil of isolation. There can be a tendency to hold one’s surgery and recovery experiences too privately, but not reaching out to others will only deprive you of receiving compassionate support. If you are feeling isolated, do yourself a favor: reach out to friends and family, and look for a heart surgery support group locally or online.” However, whenever in doubt about what you may be experiencing specifically, contact your designated medical liaison for professional diagnosis or medical attention. No question or concern is too trivial.

For most of us, there is a difficult recovery challenge from the time we leave the hospital until we are healed and strong enough to enroll in a local rehab program. That’s one of the reasons for my book, to bridge this gap as so little medical attention is focused on the recuperation period that lasts anywhere from four to eight weeks. We thought getting through surgery was the biggest hurdle. However, the hurdle is greater when we are home on our own with not much progress to report fast enough -- and without all those experts in the hospital to lean on.

Every recovery is different. If you’ve been told to expect improvement “two days forward, one day back,” you might be disappointed to experience instead only one good day (a period of energetic spunk) followed by two, three, or even four days of just plain feeling lousy. Even to meet the assignment of increasing your walking time from five minutes to ten minutes a day may feel like an insurmountable task at first. You may also be swinging in and out of temporary depression. (In my case, I wished the discharge nursing staff had emphasized the psychological challenges of recovery, not just the physical stresses.) Or, you may feel “off,” and think you might be coming down with a virus. That might be the case, but feeling off can be due to other things as well: you may have become anemic (as I did); you may be having an allergic reaction; sleep deprivation may have caught up with you—there are many possibilities. Know that everyone goes through discouragement, yet those who are informed to expect ups and downs will fare far better.

Recovery after surgery takes time. There’s often a feeling of “being all alone.” Because I, and dozens of patients and caregivers who were interviewed for The Open Heart Companion, have gone through open-heart surgery recovery ourselves, I offer the help you need via a free monthly phone support group, a newsletter specifically on recovery, a highly informational paperback (also available as an e-book), and general practical tips. Stop by my site at http://www.openheartcoach.com to see how we can help you recover faster.

Maggie Lichtenberg, PCC, a recent open-heart surgery thriver, is an open heart coach to heart patients and their loved ones, a professional speaker, and frequently published author. To subscribe to her free online newsletter, Heart To Heart, send a blank email message to HeartToHeart-On@zines.webvalence.com. To learn more about Maggie's free phone support group and other programs go to http://www.openheartcoach.com.

Knowing Heart Attack Signs Can Save Your Life

Chest pain is the most common heart attack sign but it is important to understand that there are different kinds of chest pain. Many people with coronary artery disease suffer from angina pectoris which is chest pain or discomfort when the heart is not receiving enough blood. It normally occurs when the heart is working harder, such as during exercise or physical activity, but goes away when the activity is stopped.

The chest pain associated with a heart attack can occur at any time, most notably in the morning, and is of long duration and continuous. People with a history of angina may experience more frequent anginal attacks in the weeks or days before they have a heart attack.

The chest pain is often described as severe, as if something was crushing the heart attack victim's chest; a heavy, squeezing or extreme pressure sensation. Some people have described it as a tightness of the chest or burning sensation. The pain itself usually begins in the center of the chest. Then it can radiate outwards and affect the shoulders, neck, jaw, or arms. These chest pains will last 15 to minutes and are not relieved by resting or taking nitroglycerin.

The signs of a heart attack for women and older adults can be different. Often their symptoms present as atypical chest pains. This means it feels more like indigestion or heartburn and can include nausea and vomiting. Women are more likely than men to have a silent or unrecognized heart attack. For women they will also experience shortness of breath and fatigue and weakness of the shoulders and upper arms.

Older adults will often seek medical attention for a variety of symptoms including difficulty breathing, confusion, fainting, dizziness, abdominal pain or cough. They often think they are having a stroke when in fact they are suffering a heart attack.

Other symptoms that occur during a heart attack are responses to the damage that the heart is undergoing during the attack. Anxiety, tachycardia (rapid heart beat), and vasoconstriction (narrowing of the blood vessels) occur in response to sympathetic nervous system stimulation. This results in cool, clammy, mottled skin. The respiratory center of the brain responds to pain and blood chemistry changes by increasing respiration rate. Death of heart tissue causes inflammation that causes an increase in white blood cells and an elevation in temperature.

Depending of the location and amount of infracted (dead) heart tissue other signs of heart can include high blood pressure, low blood pressure, nausea, vomiting, or bradycardia (slow heart rate). Irritation of the diaphragm can cause the hiccups as well. In extreme cases the first sign of a heart attack is a sudden death. This is particularly likely in the event that a major blood vessel is completely blocked.

It is utmost importance to seek medical attention at the first signs of heart attack. The sooner a heart attack victim receives medical attention the better their chances of survival.

Keeping away from heart problems

Question : I AM in my early 30s and recently I went for a blood test. The results showed that I have an elevated blood cholesterol level. I was advised to take a fish oil supplement to prevent cardiovascular disease. Can you tell me which fish oil supplement is good for me?
Answer : PREVENTION is always better than cure. If the cholesterol level is not well-controlled, it may lead to cardiovascular disease later. Excessive cholesterol in the blood will increase the risk of atherosclerosis and eventually lead to heart attack or stroke.
Fish oil is the richest source of Omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Clinical studies have shown that regular intake of fish oil can reduce the risk of a fatal heart attack by 20 per cent and lower elevated triglyceride levels.
A high-grade fish oil concentrate is sourced from fish such as sardine and anchovy that are caught from clean waters. These types of fish have a shorter life cycle and are non predatory as they are feed on plants; thus there is less possibility of these fish accumulating environmental toxins like mercury, lead, dioxin and etc. Furthermore, fish oil that undergoes molecular distillation and a proprietary purification technology (super refining) to further reduce the trace impurities and environmental toxin has an excellent safety profile. Normally fish oil supplements are produced as either Omega-3 triglycerides or ethyl esters. Many scientists believe that triglycerides form is more bio-available (70 per cent better absorbed) than the synthetic ethyl esters form.
Besides taking fish oil, reduce or avoid red meat, animal fats and their products, organ meat, fried food, sweet desserts and alcohol consumption. Drink plenty of plain water and take more fruit and vegetables. Exercise regularly too for optimum health.

Depression after heart attack

There are several factors can lead to depression after heart attack. The stress of being in the hospital, the fear of another heart attack, time away from work can all contribute to feeling depressed, helpless, down and despondent.

Do many people suffer depression after heart attack?

Not surprisingly, the answer to this question is yes. Recent studies show that as many as 65% of people who have a heart attack report feeling depressed, down and despondent. A general state of despair. Moreover, women, people who have been depressed before, and people who feel alone and without social or emotional support are at a higher risk for feeling depressed after a heart attack. Two new Canadian studies have shown that More than twice as many women than men tend to fall into chronic depression after suffering a heart attack and are more likely to lead lives of poorer quality following their treatments.

Being depressed can also make it harder for you to recover. However, depression can be treated.

Being told by doctors that you should take up exercise, adopt a new diet, stop smoking, etc. etc. etc. can certainly make you feel helpless, in fact, you will probably have good days and bad days following your release from hospital. However, most people start to feel better as time passes. People that are quickly able to get back to their usual routines normally notice a drop in anxiety faster than those that don’t.

So what exactly is depression?

Depression, be it after a heart attack or not, is a medical illness, like diabetes or high blood pressure and not just somebody going crazy. This is important both for the sufferer and family members to understand. The symptoms of depression may include some or all of the following:

Feeling sad or crying often

Losing interest in daily activities that used to be fun

Changes in appetite and weight

Sleeping too much or having trouble sleeping

Feeling agitated, cranky or sluggish

Loss of energy

Feeling very guilty or worthless

Problems concentrating or making decisions

Thoughts of death or suicide

Can heart disease trigger depression or depression trigger heart disease?

Either of the above may be true, one thing seems clear. The two are often found hand in hand, therefore controlling one may help control the other.

According to The American Academy of Family Physicians research has shown that people who are depressed and have pre-existing cardiovascular disease have a 3.5 times greater risk of dying of a heart attack than patients with heart disease who are not depressed. In a recent study, depression was shown to be associated with an increased risk of developing coronary heart disease in men and women. Depression was shown to increase mortality related to coronary heart disease in men but had no effect on mortality in women.

How can the risk of relapse be avoided?

The risk of relapses, be it of heart disease or depression, can be greatly reduced by living a healthy lifestyle, and your doctor will instruct you on this. However, some important lifestyle modifications are avoiding alcohol, illegal drugs, smoking, start a regular exercise program, eating a balanced diet, manage stress, join a club, meet new people or take courses in things that interest you. Finally, try to get sufficient rest and sleep.

For more heart health related information visit www.AllAbout-Heart-Disease.com - a site that offers user-friendly articles, tips and advice for avoiding heart disease, getting the edge on risk factors and living your life to the full!

Begin a Cardiac Rehabilitation Program For a Heart Healthy Lifestyle

Two months after my open-heart surgery, through my cardiologist’s referral, I was cleared to begin a physician-sponsored cardiac rehabilitation program – a program of exercise and risk-factor education for individuals recovering from serious heart procedures and heart disease.

Some patients are healed enough to begin sooner, some later. The gym facility where I live in Santa Fe, NM, called the Center for Living Well, is spaciously housed in the basement of our one hospital. In the last thirty years, thousands of cardiac rehabilitation programs have sprung up far and wide in the U.S. alone, all featuring similar characteristics.

In my book, The Open Heart Companion: Preparation and Guidance for Open-Heart Surgery Recovery (Open Heart Publishing, 2006) I advise, "systematically increase your walking every day, to the point where you can visualize and look forward to the strength retraining and aerobic stamina offered in a good cardiac rehabilitation program. Once your doctor finally approves you for cardiac rehab, you will discover what may be a new experience, or the reawakening of an old pleasure -- going to the gym!"

Beginning a cardiac rehabilitation program is truly an exciting moment. I was finally up to moving my body for real. I knew I had made tangible progress or I wouldn’t be there. I was assigned an exercise physiologist, or case manager. After a general orientation (completing a detailed questionnaire, learning to take my pulse, oxygen usage and rhythm monitoring guidelines) I was given a personal exercise worksheet. Preferably three times a week for one hour, I was to track my gentle progress forward in a customized program -- using the treadmill, bike, stairs, UBE machine (aerobic ergometer), and so on. Adding weight training to the regimen was to come later, at the discretion of my case manager. In addition, numerous classes (stretching, therabands, free weights) and support groups (smoking cessation, stress management, osteoporosis and diet education) were all available in the package. Once a month there was an “Ask the Cardiologist” Q&A hosted by one of the New Mexico Heart Institute cardiologists. Most of all, the staff were caring, devoted, highly attentive, good-humored professionals. There was a palpable air of camaraderie and developing friendships that evolved into a memorable support group experience for me.

I was accepted into the program provided I agreed to wear a wireless heart monitor during exercise. What a good thing! My heart was still ricocheting in and out of irregular rhythm (atrial fibrillation). There was always someone at a computer screen monitoring my rhythm. If, as is more likely with exertion, my a-fib returned, even if I didn’t notice, a nurse or exercise physiologist would check in with me. How was I feeling? Did I feel lightheaded? Did I need to slow down? Maybe end my session for the day? Your pulse is x, let’s check your blood pressure.… Since a patient’s inclination may be to push through (my common approach in the past), the permission to simply stop, give yourself a break, can be welcome. I felt completely taken care of. With so many dedicated professionals around me, and the new friends I was making, I could never run too far into trouble. Although physically challenging at times, the cardiac rehab environment made for a positive, confidence-returning experience.

In the book, Heart Attack: Advice for Patients by Patients (Yale University Press, 2002), most of the eleven contributors go out of their way to rave about their cardiac rehab program experience. “The highlight of my day…”, “I credit the program with getting my life back on track…”, “I’ve been a member now for ten years and I know it is keeping me healthy…”, “My wife is now in the program with me. We’ve made some great friends….” The social and emotional support received can be priceless. Rather than returning to one’s previous gym or yoga class, many heart patients take advantage of ongoing membership in their cardio-directed program.


Maggie Lichtenberg, PCC, a recent open-heart surgery thriver, is an open heart coach to heart patients and their loved ones, a professional speaker, and frequently published author. To subscribe to her free online newsletter, Heart To Heart, send a blank email message to HeartToHeart-On@zines.webvalence.com. To learn more about Maggie's free phone support group and other programs go to http://www.openheartcoach.com. Article is free to reprint as long as author’s bio remains intact.

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Information on Hip and Thigh Pain

The hip is a ball-and-socket joint, surrounded by large muscles. The ball, the round head of the femur (thigh bone), is set deeply in the acetabulum, a deep socket or cavity in the pelvis. The joint is very stable. The majority of long-term hip problems are associated with aging, disease (such as arthritis) and fractures. But pain in the hip and thigh also can be caused by injury to muscles, tendons or bursas, usually from a fall, a blow or overuse.

Hip pain in athletes involves a wide differential diagnosis. Adolescents and young adults are at particular risk for various apophyseal and epiphyseal injuries due to lack of ossification of these cartilaginous growth plates. Older athletes are more likely to present with tendinitis in these areas because their growth plates have closed. Several bursae in the hip area are prone to inflammation. The trochanteric bursa is the most commonly injured, and the lesion is easily identified by palpation of the area.

Quadricep, hamstring, and Iliotibial band injuries can be quite painful. However, there are several ways to help stablize muscular pulls. Compression braces can help provide stabilization to the torn muscle fibers and improve the ability to walk or help protect from futher injury. Ice packs and cold wraps help reduce pain and inflammation, and pain relief gels can provide temporary relief of painful symptoms. Many athletes use magnetic products to stimulate blood flow and reduce pain.

One of the biggest causes of hip and back pain is the psoas muscle. These problems include but are not limited to lower back pain, sciatica, disc problems, knee pain, pelvic tilting, digestive problems, infertility, and menstruation pain. You could also experience scoliosis, a difference in the length of your legs, kyphosis, sacroiliac pain and accentuated lumbar lordosis.

Bursitis in the hip usually involves the hip socket and causes tenderness, pain, and swelling on the outer part of the hip where some of the large buttock muscles attach. Bursitis in the hip can cause pain that spreads to the buttocks and down as far as the knee. Bursitis in the hip can be caused by activities such as speed-walking, aerobic dance, or carrying a baby on your hip. It also can be caused by conditions that alter the normal tilt of the pelvis, such as having one leg shorter than the other.

As the pain improves, gradually begin to exercise. It is best to work with a physical therapist to learn proper exercises and how to advance your activity. Swimming may be a good option because it stretches the muscles and builds good muscle tone without straining your hip joint. However, swimming does not build bone mass. When you are ready (a physical therapist can help determine that), slowly and carefully resume walking or another activity against the resistance of gravity.

A hip fracture can change the quality of your life significantly. Fewer than 50% of those with a hip fracture return to their former level of activity. In addition, while recovering from a hip fracture, several possible complications can be life-threatening. These include pneumonia and a blood clot in the leg, which can dislodge and travel to cause a clot in the lungs. Both are due to immobility following a hip fracture and hip surgery.

A groin pull can be caused by a quick change in direction while you’re moving—often occurring in sports such as hockey, tennis, and basketball. A groin pull can result in pain, tenderness, and stiffness deep in the groin, making activity difficult.

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