Patient's Guide to Heart Transplant Surgery
Almost immediately after your surgery, the physical therapist will begin to work with you. Even in the earliest days after surgery, exercise is important to cut down on your chances of getting lung infections, blood clots, and bedsores. Exercise in this early period will also begin to build up your strength for getting out of bed and walking. As time passes, exercise will be important to regain the strength you lost while you were sick. Once you are at home and living your new life, exercise is important to keep you strong.
With a few exceptions (discussed below) you can return to your normal activities and exercises. We encourage you to walk as much as possible both during your recovery and when you are completely well. Be sure to rest during exercise as indicated. Always remember, moderation is the key when getting back into shape.
Your physical therapist will work with you daily while you are in the hospital. Your exercise program will be designed in a progression that will improve your strength, endurance, and coordination. The physical therapist will review your exercise program with you before you go home. He/she will also setup appointments to see you on your clinic days in order to follow your progress and to advance your program as your strength improves.
First, you will be asked to do breathing exercises by both your nurse and physical therapist. These exercises are very important for getting your lungs back in shape after surgery and for preventing lung infections. The lung exercises will include taking deep breaths in and pushing the air out. You will be given a small breathing device, called an incentive spirometer, to practice your breathing. We will also use this to monitor your progress.
You will be asked to cough. Both coughing and deep breathing will cause pain over the chest incision at first. Your nurse and therapist will teach you how to splint the incision by holding a pillow and your arms over the incision to reduce the pain as you exercise. But you will find the more you do the breathing exercises, the easier it gets and the less it hurts.
Leg and Foot Exercises
You will be asked to do leg and foot exercises in bed. You do these to keep blood from pooling in your legs and forming clots. These exercises also work your muscles and keep pressure sores from forming on your heels. The exercise include wiggling your toes, pointing your foot toward your face, bending your knees upward, rotating your legs at your hips, and tightening the muscles of your legs and bottom.
Changing Positions in Bed
You will be asked to change positions in bed with the help of your nurse. This is important in order to avoid pressure sores from lying on one part of your body for too long. Changing positions will also exercise your lungs. Like the breathing exercises, changing positions will give you some pain over your incision. You can splint the incision in the same way as described above.
Sitting, Standing and Walking
Before you know it, you will be sitting up with your legs over the side of the bed and getting ready for your first walk. Exercise at this point will begin with some sitting exercises for your legs. Walking will begin soon after your surgery and will progress slowly as you are able. You will also begin a bicycle exercise program as soon as your therapist and doctor feel you are strong enough.
You will be taught gentle arm exercises, which are very important in preventing loss of movement or tightness in your shoulder joints, and neck. You will also be shown stretching exercises to do before walking. Remember that the exercise program begins early. It is tailored to your needs, and will be essential to putting you back on the road to recovery.
When you exercise each day, there are certain things you should remember to do:
- Warm up by doing stretching activities.
- Push yourself to a peak level of activity and try to maintain it for several minutes to ensure a good workout for your heart and other muscles. Any exercises like cycling, rapid walking and swimming are great.
- Cool down by repeating the slow stretching exercises or walking.
For the first eight weeks after surgery, avoid the following activities to allow your chest bone and incisions to fully heal:
- Do not lift heavier than ten pounds.
- Do not push or pull objects heavier than ten pounds unless instructed to do so by your therapist or nurse.
- Do not do sit-ups, push-ups, or pull-ups.
- Stop any activity that causes pain or pulling across your chest.
You may resume sexual activity after your transplant. In the first few weeks after surgery, however, you may find that pain along your incision may limit your activity to a certain extent. Just remember that during the first eight weeks after surgery, any activity or position that causes pain or pulling across your chest, such as bearing weight on your arms, must be avoided.
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