Returning to Activity After Heart Surgery
For the first six to eight weeks:
- Gradually increase your activity. You may do light household chores, but do not stand in one place longer than 15 minutes.
- Do not lift objects greater than 20 pounds (your doctor may give you a different number if appropriate). Also, do not push or pull heavy objects.
- It is OK to perform activities above shoulder level, such as reaching for an object or brushing your hair. But, do not hold your arms above shoulder level for a long period of time.
- You may climb steps unless they have been restricted by your doctor. You may need to rest part of the way if you become tired. Do not climb up and down stairs several times during the day, especially when you first arrive home. It is better to plan activities to go downstairs in the morning and back upstairs when it is time for bed.
- Pace yourself - spread your activities throughout the day. If you become tired, rest and schedule unfinished activities for another time.
- Walk daily. Your doctor or cardiac rehabilitation specialist will give you guidelines for walking when you return home.
- Get a good night’s sleep. If you feel tired, go to bed early. Be careful not to nap too much during the day or you may have difficulty sleeping at night.
- Check with your doctor to confirm activity guidelines.
For many people with coronary artery disease, a cardiac rehabilitation program provides an excellent opportunity to begin an exercise program, learn about your heart disease, and learn strategies to change your lifestyle to prevent further progression of your disease.
Your family doctor can give you information about programs in your local area (cardiac rehabilitation is covered by most insurance companies) or you may go to the American Association of Cardiovascular and Pulmonary Rehabilitation website* to search for a program, or call the Cardiac Prevention and Rehabilitation program at the Cleveland Clinic Foundation 216.444.9353.
You should eat a healthy diet to help you heal. Your doctor will tell you if you should follow any special diet instructions. It is common after surgery to have a poor appetite at first. If this is the case, try to eat smaller, more frequent meals. Your appetite should return within the first few weeks. If it does not, contact your doctor. Learn more about a healthy diet after heart surgery.
Your doctor will tell you when you may resume driving, after your sternum has healed and your reflexes have improved. This usually occurs about six to eight weeks after surgery, however, you may resume driving quicker if you had minimally invasive surgery. During this time, you may be a passenger as often as you like. If you take long drives during the first eight weeks after surgery, stop every hour and walk for 5 to 10 minutes.
Return to Work
You will need to take time to recover, usually about six to eight weeks (may be earlier with minimally invasive surgery). Your doctor will tell you when you can return to work. If you have the flexibility at your job, ease back to your work schedule. If possible, start back at half-time and gradually increase back to your normal routine.
What is occupational therapy?
Occupational therapy (OT) helps cardiac patients regain self-care skills and adapt activities after surgery so they can be as independent and as safe as possible during their recovery. Occupational therapy at The Cleveland Clinic helps patients reach their highest level of functioning, become self-reliant and build a balanced lifestyle of work and leisure.
How is occupational therapy different from physical therapy and cardiac rehabilitation?
Occupational therapy is designed to help patients perform activities of daily living, such as bathing, dressing, grooming and more. Physical therapy (PT) focuses on helping patients build strength and improve coordination, balance, endurance, flexibility and mobility. Cardiac rehabilitation is different from OT and PT. Cardiac rehabilitation focuses on helping patients make healthy lifestyle modifications to reduce risk factors for coronary artery disease. Cardiac rehab also includes the development of an exercise program to build physical activity endurance.
What is an occupational therapist?
Occupational therapists (OTs) are professionals who teach cardiac patients how to complete self-care and functional tasks while following sternal precautions to protect their chest incision after surgery. They meet with patients before they go home from the hospital to ensure they are prepared for their recovery at home. OTs perform an assessment and make recommendations based on a patient's home environment, setup and routine activities to increase the patient's overall independence and safety.
An OT can provide information to help patients:
- Make changes to the home or workplace to ensure safety
- Use adaptive equipment or devices to aid with daily activities such as bathing, grooming, dressing, cooking and eating
- Conserve energy while completing daily activities
OTs work with patients while they are engaged in a functional activity (such as self-care or light house work) so they can provide energy conservation techniques, deep breathing exercises, and any activity adaptations that may be needed.
What is adaptive equipment?
A few examples of helpful adaptive devices include a bath stool in the shower or tub, grab bars around the toilet or tub, and long-handled shoehorns and sock grippers. Your OT can show you catalogs that have a wide variety of assistive devices you may order.
How can I receive occupational therapy?
To make an appointment with an occupational therapist, please talk with your physician who can write up an order for OT services. If you feel you can benefit from occupational therapy, do not hesitate to ask your physician for a referral.
How many visits will I need?
Occupational therapy sessions vary, depending on each patient's personal needs. An individualized treatment plan with specific goals is developed after the first appointment, which includes an evaluation and recommendations. The following appointments check your progress and review or expand your program. Many outpatient family health centers offer occupational therapy services in your community.
Many patients and their partners feel nervous about resuming sexual activity after heart surgery. The amount of energy it requires to perform intercourse with a spouse or regular partner is similar to climbing about one or two flights of stairs or walking about one half mile (0.8 km) at a brisk pace. If you cannot perform these activities without becoming tired or short of breath, please allow additional recovery time before resuming sexual activity. For the first six to eight weeks, use positions which limit pressure or weight on the breastbone or tension on the arms and chest.
- Keep in mind that a sexual relationship has both physical and emotional aspects
- Talk openly with your partner
- Allow a gradual return of sexual activity
- Have sex when you are rested and physically comfortable
- Create realistic performance expectations - it may take time to return to an active sex life
- Be caring honest and loving with each other
Soon you and your partner will return to a satisfying emotional and physical relationship. Anxiety on the part of either partner, as well as some medications, may interfere with sexual arousal or performance. Discuss any difficulties with your doctor.