Open Heart Surgery Recovery Goals: Where You Should Be
Are you recovering from bypass, valve replacement, or another open heart surgery? You’re not alone. In any given year, more than 500,000 American adults undergo these surgeries—in addition to the numerous repairs of congenital heart defects in younger patients.
One of the many scary unknowns about open heart surgery is its long, unique recovery period. Multiple factors of healing come into play, as the repaired heart itself recovers, the sternum re-fuses, and the surrounding skin and muscles heal. On top of all of this, the unused heart muscle has to be exercised and strengthened.
After the initial pre-op and day-of concerns are addressed, patients often wonder how long it will take to return to normal life—the activities of daily living that we take for granted, like driving, washing dishes, or gardening. Although recommendations differ between specialists and according to each person’s unique needs, a few rules of thumb do apply.
One full year
Accepted wisdom for recovery of open-heart surgery is that it takes a full year to completely recover. This doesn’t mean that you will be physically unable to work or be active for that time; it means gradual improvements in physical—but also mental and emotional—recovery. The goal during this first year is to increase your daily load so that, at your “heart anniversary,” you will no longer think of your heart, your incision, or your earlier limitations.
If you are going into surgery as a younger adult, without physical limitations of heart failure, or without other uncontrolled conditions like diabetes or a smoking history, you might expect a faster recovery. As I learned during my own OHS recovery before age 40, cardiovascular surgeons know what they’re talking about—the one-year mark really is a major milestone. Between surgery day and that first anniversary, though, are reachable four-, eight-, and 12-week goals.
The first four weeks
The first few weeks after surgery are challenging: at first, even walking is hard. Extreme fatigue, and up to two naps each day, is expected. Restrictions during this early phase include no lifting arms above shoulders, stairs only as tolerated (and infrequently), and avoidance of outdoors on hot days to avoid overstressing the heart. When even holding a plate is difficult, it’s hard to imagine feeling “normal” again. But, by the end of the first month, you’ll find daily walking—essential to recondition your heart—and stair climbing easier, and you may get your doctor’s approval to start driving short distances. During the first month, you should also keep track of your weight, blood pressure, and temperature every day to notice early signs of fluid retention or incision infections.
Gains by week eight
Remarkably, 80 percent of healing after open heart surgery occurs in the first six to eight weeks—the fastest improvements during the entire first year. By now, the sternal bone should be mostly healed. At this stage, you will be able to function longer without rests, drive a little bit, and raise your arms above your shoulders to shampoo or dress. Dusting, folding clothes, and washing plates are easier, too, but you might still be moving slowly as the muscles in your upper body recover. Light stretching of your arms and legs is worthwhile here to prepare for cardiac rehabilitation soon, and you might consider part-time work if you have a desk job or easy commute. It is still important here to look for redness or drainage at your incision sites as signs of infection.
Expectations at three months
After three months, even more normal activity is acceptable and encouraged. This doesn’t mean that you will feel “healed,” though; your chest may still be sensitive, and physical or mental setbacks are a natural course of recovery. Hobbies like biking, gardening, or golfing are easier at this point, though, and lifting items like laundry or groceries generally is not prohibited, especially as rehab safely strengthens the chest muscles. Many people consider a return to full-time work and vacation travel after three months focused on healing, too.
Some healing markers vary too much among individuals to set a timeline: sleeping on your side or belly without irritating the sternal wires; tolerating heat and hydration changes without an increasing heart rate; and, of course, coping with emotions. Likewise, although the concerns of scar tissue complications or infections diminish as time passes, any flare-ups of redness, drainage, severe pain, extreme weight gain, or high fever warrant a professional check-up.
Patients observe more specifically what their own challenges are within the expected recovery path, too. For example, I found myself able to lift groceries well at four months but then suddenly less so at six months because of chest muscle pain that slowed my upper-body rehab for three months. But my blood pressure, which was normal before the valve deteriorated, was steady and not a concern. Other patients will confess that heat is a challenge for longer than professionals admit, that water bottles are essential at any temperature for many months, and that a return to work might be later than you initially plan.
Remember, everyone has their own recovery pace, unique hurdles, and setbacks—from muscle pain to slower-than-expected endurance gains, to scar healing problems and more. Small setbacks, though discouraging, are common throughout the first year. But, by that heart anniversary, with your own efforts and professional care, you can wake up every day without thinking of your surgery, scar, or past limitations. As you make the recovery journey, consider a support group, like a regional chapter of Mended Hearts, or something less heart-centered like a new book club, to engage with others and keep a positive focus into the future.