What to expect

Please arrange your transportation home well in advance of your discharge from hospital. We attempt to give you one day's notice, but that can change in the morning. On the day of discharge your family or friend should arrange to pick you up by 10:00 am. Please allow for possible delays due to paperwork being prepared and checking of final tests.

You should also arrange for someone (family, friend, neighbour) to be home or available to you for the first few days you are at home. This person can help with meal
preparation, shopping, housekeeping, etc. Patients often find it helpful to ask their nurse for pain medication before they leave the hospital to make the trip home more comfortable. 

When traveling long distances in a car, it is recommended that you make frequent stops to stretch your legs and have a snack. Wear light, loose-fitting clothing!

Following cardiovascular surgery, you can normally return home four days after surgery to continue your recovery. There are times, however, when your recovery might be slower and you may, therefore, need additional therapy and or resources. This section will hopefully provide you with important information about discharge options.

Returning home

When returning home following surgery we recommend that someone is available to assist you with this transition. You may feel tired and normal tasks such as showering or preparing food might be more challenging than usual. It is normally not necessary to have someone with you 24 hours a day; however, it is a good idea to ask someone to visit throughout the day. Help at home can be arranged through homecare and other community resources.

Homecare / CCAC (community access centre)

Homecare services are provided in the community to those who need specific professional services such as nursing, or help with personal support (bathing), a couple of times a week. A CCAC coordinator will assess for eligibility prior to bring discharged.

Repatriation to local hospitals

If you have been transferred from a local hospital and you still require medical care, our team will assist to return you to your local hospital once you are medically stable.

Inpatient rehabilitation

The interdisciplinary team at the Schulich Heart Centre will assess your need for further therapy. In the case that you are recommended for inpatient rehabilitation, a social worker will help you complete an application. There are a variety of inpatient rehabilitation programs in the city and surrounding areas. These include cardiovascular active, medical, geriatric and stroke. It is Sunnybrook's policy that you apply to more than one facility when applicable. The social worker will meet with you and discuss appropriate options.

Due to scarcity of available beds, and the brief admission to acute care, inpatient rehabilitation in Toronto can only be guaranteed to patients who need further treatment to manage independently.

Instructions about follow-up appointments, prescriptions and activity will be given to you before you go home.

1. Arrange with your family doctor (or whomever is covering) a follow-up appointment one week after discharge. If you are taking the blood thinner warfarin or Coumadin®, you will need to see your family doctor earlier for monitoring of this medication (usually 2-3 days after discharge).
2. Cardiologist – arrange this appointment 4-6 weeks after discharge.
3. Surgeon – as instructed at time of discharge. Call the surgeon's office to make the appointment.
4. Bypass and Valve Registry Clinics – the cardiovascular surgery service runs follow-up programs to assess the results of your surgery. You will be contacted by the cardiovascular database manager or the prosthetic valve registry concerning follow-up appointment times.

1. Extreme tenderness, redness or yellow/green drainage from any of your incisions
2. Angina/chest pain (similar to what you experienced before surgery)
3. Fever of 39° Celsius (100° Fahrenheit) or higher for more than 24 hours
4. Any flu-like symptoms that last two to three days
5. Shortness of breath that goes on for more than a few minutes after activity has stopped or while you are at rest
6. Weight gain of three pounds for two days in a row
7. Fatigue or tiredness (that is much worse than you had before surgery) that doesn't improve in two to three days
8. Severe bruising for no reason
9. Pain in the chest/neck/shoulder that is worse when taking a deep breath

You can resume driving four to six weeks after surgery (consult your cardiologist about this). You may be a passenger at any time but in the recovery period after your surgery, avoid sitting in the front passenger seat, where there is an airbag. You may also want to consult your insurance company to see if they have any specific guidelines. Start by driving in local areas; avoid highways until you feel much better. When on a longer trip, stop every hour and a half to get out and stretch.

Wearing your seat belt is essential and will not harm your incision. A towel or small pillow may be used to prevent rubbing/irritation on your incision. You may still have some chest or neck stiffness that will be noticeable when you turn.

Changes may be made to your medications after you have had your surgery. A new prescription will be given to you on the day that you are discharged – take only those medications, unless told differently by your doctor. Your nurse will review all your medications with you before you go home. If you have any further questions, contact your doctor or pharmacist.

Important things to remember when taking your medications:

• Know the name and purpose of your medication(s).
• Know how and when to take your medication and for how long.
• Know what the common side effects are and what to do if they occur. 
• Take only the amount of medication your doctor has prescribed.
• If you miss a dose of your medication, do not take double the dose. Instead, take a single dose at the next regular time.
• Please review your medications with your doctor regularly during your follow-up visits.
• Try to take your medication(s) at the same time(s) each day.
• Ask your doctor or pharmacist for advice before buying non-prescription medications.
• Go to only one pharmacy whenever possible.
• Keep an updated list of your medications in your wallet.
• When traveling, keep your medications in your carry-on luggage.
• If you are on many medications, a pill organizer or blister pack may be helpful to you. Discuss the various options with your pharmacist. 
• Do not change your dose or stop a medication without consulting your doctor.

Each patient experiences pain/discomfort in a different way. After heart surgery, you may feel discomfort in the chest and wound sites for a number of weeks, due to the healing process. This pain/discomfort may also be in your arms, neck and shoulders. This has been described by patients as a dull ache, stiffness or pulling, sensation and is usually relieved by pain medication.

While you are in hospital, pain medication will need to be taken routinely as you may experience more pain/discomfort in the early phase of recovery. As you begin to feel better, you will gradually need less of your pain medication.

A pain medication will be prescribed for you to take at home and will allow you to be active with minimal discomfort. When you are experiencing less pain and discomfort you can switch to plain Tylenol.

If the medication is not providing relief, or you are having angina or any other chest pain, contact your family doctor.

Constipation may occur as a result of your pain medication, reduced activity levels or iron supplements. Make sure you are eating foods high in fibre (fruit, whole grain breads and cereals), and drinking adequate amounts of liquid each day. Do not strain. If constipation is a problem after you go home, talk to a pharmacist or your family doctor.