After surgery, what should I expect?
Immediately after surgery, we will take you to the Intensive Care Unit. Under the direction of your cardiac surgeon, your care in this unit will be coordinated by an anesthesiologist, other doctors and nurses. Your surgeon and anesthesiologist will evaluate you daily and are available to speak with you and your family. Until you are fully awake, you will be attached to a ventilator (breathing machine) by a tube in your mouth, down your windpipe. This tube interferes with the function of the vocal cords, so you will not be able to speak while it is in place. You can communicate your needs by writing notes, mouthing words and pointing. Your hands will be lightly restrained while the tube is in place. Occasionally a smaller tube will be placed into this breathing tube to remove excess mucus. This may make you cough and feel uncomfortable for a couple of minutes.
When the intensive care team feels that you are ready, they will remove this breathing tube and place a small green plastic mask over your nose and mouth to give you moist oxygen. This moisture helps break up mucus in your lungs and relieves throat discomfort. The nurse will encourage you to cough and to take deep breaths to expel the mucus. After your breathing tube is removed, the nurse will give you small amounts of ice chips until it is safe for you to eat and drink. You will be able to drink fluids and eat the day after surgery but will be on a restricted amount of fluid.
You will be connected to specialized medical equipment to monitor your blood pressure, heart rate and heart pressures. These machines and the respirator make beeping and swishing sounds. The nurse and physician will use these machines to continuously watch your vital signs (temperature, pulse, respirations, blood pressure). Two or three tubes will be inserted into your chest cavity during surgery. These tubes drain excess air and blood from the chest. They will be connected to a machine that makes a bubbling noise. The largest tube is usually removed the following morning. A smaller tube called a Blake drain will remain in your chest for an additional one to three days.
In addition, there may be two small wires on the lower portion of your chest. These are called pacemaker wires and are inserted during surgery. Sometimes the heart beats slowly and needs a temporary pacemaker for a short time after surgery. The pacemaker wires will be removed shortly before you are ready to go home.You will have a catheter in the artery in your wrist called an arterial line to monitor your blood count, blood gas (oxygenation) and glucose levels. When the arterial line is removed, a bandage will be placed on your wrist.
You may require insulin even if you do not have a history of diabetes, as the stress of surgery may make your blood glucose increase. You will find the nurses and doctors are constantly attending to your needs, and sleeping for long periods may be difficult. You will remain in the intensive care unit approximately 24 hours. The time will vary depending on your needs and progress. You will be able to sit up once you are off the respirator and when your blood pressure is stable.
Note: You will continuously be given pain medication so sensation of pain is kept to a minimum.