Activity guidelines

First week
While at home for the first week to ten days, your level of activity should be similar to the hospital activity routine that you reached prior to your discharge. Often patients complain of feeling tired when they first arrive home. It is important to remember:

• Rest as much as possible for the first day or two when you arrive home
• Continue breathing exercises, arm and leg exercises and walking
• May need to support incision when coughing or sneezing
• Take several short walks with rest periods in between rather than one long walk
• Avoid temperatures that are too hot or cold to decrease the chance of fatigue
• Visitors should be restricted for the first couple of weeks. Don't be embarrassed to leave the room to rest if you feel tired

Remember NO lifting of objects that are more than 5 lbs.

Stairs
Begin to climb stairs slowly. Hold onto the hand rail and take one step at a time. When going up the stairs, lead with your good leg first. Rest every fourth step for about half a minute. When going down the stairs, lead with your operated leg first. Because stairs take a lot of energy to manage, try to restrict going up and down the stairs to once or twice a day for the first two weeks.

Second and third weeks
Continue with breathing exercises, arm and leg exercises and walking. You may wish to take on levels of activity which would be normal of your under quiet circumstances. These might include:

• Lifting and carrying light objects (less than 10 lbs) for short distances
• Participate in short social gatherings
• Doing some light housework, such as setting the table, dusting or washing dishes
• Gradually resuming your sexual activities
• Stairs - As you feel stronger, you can start to go up and down stairs in the regular way instead of taking one step at a time.

Fourth and fifth weeks

• Continue with breathing exercises, arm and leg exercises and walking
• Gradually increase daily walks to at least 30 minutes per day
• Chores such as light yard work, washing the car or preparing meals may be started
• Discuss returning to work with your cardiologist

Six to eight weeks
Your sternum (breastbone) should now be healed. All activities you preformed prior to surgery may be resumed gradually and sensibly. If you never exercised prior to your surgery, discuss this with your doctor, nurse or physiotherapist.

Do not

• Lift anything heavier than 10 lbs such as; suitcases, groceries, children, briefcases, furniture. Heavy lifting puts a strain on your healing breastbone.
• Open stuck windows
• Push, pull or reach with your arms
• Resume household chores too soon

The time it takes you to return to work depends on the kind of work you do. If your job is physically demanding such as requiring heavy lifting or pushing heavy objects you may have to wait longer (i.e. 3 months) than someone whose job is less strenuous. If your job is stressful, a gradual return may be necessary (6-8 weeks).

Most people wait until after their 4-week check-up with their cardiologist before deciding when to return to work. 

A significant question that many patients and families ask is if sex is safe. Some of the common questions are:

Will having sex be dangerous?
Often recently diagnosed heart patients worry that physical exertion of any sort, including sex might trigger another cardiac event.

Why is the patient or partner so disinterested in sex?
Many people experience a loss of interest in sex in the weeks or months following cardiac surgery. This can be a result of depression, medication, or the exhaustion that is common during recovery. Sexual performance problems include reduction, or lack of desire, difficulty becoming aroused or erect.

Although physical recovery is unique to each person, it is important to recognize the emotional recovery of you and your partner, plays a role in sex. Part of the recovery period is trying to understand how sex fits into the new normal. Heart disease can challenge the self- image of both the patient and partner. For the male heart patient, the notion that masculinity is measured by sexual prowess adds unnecessary pressure to their recovery. For some people, there may be a fear of not being attractive because of the scar. Sexuality is a fundamental part of life and a significant aspect of our health.

Here are some important points to remember:

• Anxiety about sexual function is normal for heart patients, it usually passes with time
• Pace yourself
• You are not the only one with concerns; your partner is probably feeling anxious too. Talk about your concerns, and accept that learning again to have sex is part of the recuperation.
• Sexual intercourse requires about the same amount of energy as climbing two flights of stairs, if you can manage that without any shortness of breath or chest discomfort then you are probably ready to have sex

Many patients find that their sex drive has decreased after the surgery. This is not permanent. You will be able to return to your normal sex life.

It is recommended that you begin with simple activities such as hugging, kissing, and touching and resume intercourse as you become more comfortable physically.

For both the male and female, positions not creating pressure on the breastbone such as side-lying are often tolerated best. As you resume sexual activity it is recommended that you avoid the following situations:

• Being overly tired or upset
• Having just had more than 1 or 2 alcoholic drinks
• Having eaten a large meal within the past 2 hours
• Having an unfamiliar partner
• Stop and rest if you get overtired or if chest pain develops. Use your imagination, relax and enjoy, but above all, please be patient!