About water After waking up, patients who have just undergone heart surgery will feel very thirsty and want to drink very much. This is a normal phenomenon. After a major trauma to the human body, the endocrine system in the body changes and can make a person feel very thirsty. In movies, people are seriously injured and always need water to drink, and this is the same reason. But the patient is in the hospital, with medical supervision, with intravenous fluids, the patient usually will not be dehydrated. So, this thirst is false. At this time, if you drink too much water, the water enters the intestine and is absorbed into the blood vessels and becomes part of the blood, the blood volume will increase and the burden on the heart will increase. In the early post-operative period, patients are often combined with hypoproteinemia, and this excess water runs into the tissue spaces, leading to interstitial pulmonary edema. The patient’s symptom is the inability to lie down. As soon as they lie down, they cough up a clear, saliva-like foam. Acute cardiac insufficiency even occurs in individual patients. Therefore, drinking too much water after surgery can lead to many problems. Water is very important for the recovery of the patient after surgery. Patients need water to quench their thirst, bring in food, and bring out waste products from the body. Without a certain amount of water, the patient will not recover well. So, how much water is the right amount to drink a day? What is the best way to drink it? When we say “a day”, we mean 24 hours, not “from morning to night” as people generally think. All water entering the patient’s body, including infusion, drinking water, porridge, soup, noodles, fruit, yogurt, etc., should be considered as “intake”. For the average adult, if there is no heavy sweating, heavy urination, diarrhea, etc., the total intake should be limited to about 2000 ml per 24 hours. The method of drinking water should be like drinking white wine, using a small medicine cup, a small amount at a time, evenly spread throughout the day. Do not drink from a water glass or suck from a straw. Family members should use a pen to record the amount of various foods and water each time. If you drink too much water, you will have to diuretic to get rid of the excess water, and you may have to give albumin to raise the plasma colloid osmotic pressure. This will interfere with the patient’s sleep, may lead to hypokalemia, and will increase costs. About the meal As the saying goes, a person is iron, a meal is steel, a meal is not hungry. After heart surgery, the patient has lost blood and injured flesh, and must have enough nutrition to recover. After surgery, some patients have no appetite and do not want to eat. Family members should encourage the patient to eat and do something that the patient likes, tasty and nutritious food. These foods should be mainly animal protein, including various kinds of lean meat (chicken, duck, pork, beef and mutton are all available), eggs (especially egg whites), yogurt or milk (but with high water content), avoid eating too much starchy food, and do not have to eat snapper, pigeon, crow’s nest and other “tonic” products. Each meal can eat six or seven minutes full, you can eat five meals a day, eat less and more meals. If you eat more than one meal, the digestive system will be heavily burdened, which will increase the burden on the heart, and may also affect breathing. If the postoperative diet is poor, malnutrition, forced to intravenous infusion of highly nutritious fluids and albumin, medical expenses will also increase a lot. About coughing After heart surgery, there will be some phlegm in the lungs and trachea and bronchi. If it is not eliminated in time, it will affect the gas exchange in the lungs and cause the patient to suffer from oxygen deprivation or carbon dioxide retention. Therefore, it is important to remove sputum promptly and thoroughly. There are three measures for sputum elimination, one is effective coughing, the second is physical therapy (turning and patting the back), and the third is nebulized inhalation. The patient has just undergone surgery, the wound is painful, and coughing and body therapy can aggravate the pain. The solution is to use an elastic rib fixation band. There are many brands of these straps, such as LP, and they are available in many pharmacies and sporting goods stores. Get one of the right size and tie it to your chest, as close to your armpits as possible, not to your abdomen. It should be tied a little tighter so that the strap takes some force. The sternum that was sawed longitudinally during surgery is held in place by a stainless steel wire. Factors such as osteoporosis and violent coughing may cause the wire to sever the sternum. This can be avoided by using a rib fixation band. In addition, active postoperative movement of the patient out of bed can significantly improve the condition of the lungs and avoid respiratory complications. Wound pain is inevitable, and pain medication can be taken if necessary. Regarding stool problems Fasting before surgery and eating less and moving less after surgery cause some patients not to have stool for several days after surgery. When stool is retained in the colon for a long time, the water in it will be absorbed by the intestinal wall and the stool will become dry, leading to difficulty in defecation, and individual patients even need to pick the stool out with their fingers. Therefore, after surgery, you should actively defecate every day, not necessarily a lot, as long as it is clean. Patients can increase the amount of fruits and vegetables they eat (diabetics can only eat more cucumbers and tomatoes) and more coarse fiber. If necessary, you can take laxative medication or use open-loop. Some patients are older and have less sleep. When they return to the ward after surgery, they sleep a little during the day, three or four times a day. At night, they can’t sleep, they toss and turn, which affects their rest, and the next day they don’t have energy, and they sleep again during the day, which affects eating and getting out of bed. Finally, simply sleep upside down. The solution, one is not to sleep more during the day, the second is to take sleeping pills at night. Some patients actually drink more water and cough as soon as they lie down, which affects their sleep. These patients must be treated by the doctor on duty. Regarding pain Most patients undergoing heart surgery have a median sternotomy. After the sternum is sawed longitudinally, the wound is held open with a spreader, and patients with coronary artery bypass also have their left chest wall elevated to free the internal thoracic artery. Therefore, in addition to the sawing of the sternum, there will be some contusion of the chest wall tissue and even small fractures. Post-operative pain is predetermined and the degree can vary; forcing it is not necessary. Within 24 hours after surgery, the patient usually does not feel pain because the effect of the anesthetic (mainly fentanyl-like drugs) during surgery has not worn off. However, starting the next day, the pain becomes intense. The key to alleviating this pain is the aggressive application of morphine-based analgesics, either orally, by injection or by continuous pumping. Don’t worry too much, because with medical control, very few patients develop drug addiction as a result. This pain medication is used worldwide in large and widespread amounts each year, and there is no evidence that it adversely affects the patient’s brain. If the patient does not have severe respiratory insufficiency or violent vomiting, for example, the pain medication can be used without fear of some unlikely side effects. Regarding fever If there are no infectious lesions in the heart, cardiac surgery is generally a sterile procedure. However, almost 100 percent of patients will develop a fever after cardiac surgery. If there is no infection, this fever usually lasts 3-4 days and can last up to 2 weeks. The reasons for this are the effect of extracorporeal circulation on the body and the absorption of residual blood, fluid and necrotic tissue in the body. This kind of fever is distinctly different from the fever caused by infection. First, the patient’s body temperature is usually around 37.5C°, most of them do not exceed 38.0C°, and it is very rare to see more than 38.5C°. Secondly, the patient does not have chills or fever before the fever, but usually feels slightly warm. Third, the patient has no symptoms of toxicity, such as no appetite, peripheral aches and pains, general weakness and depression. Fourth, the antipyretic drugs such as indomethacin and Tylenol are very effective. Fifth, the patient’s blood image is not high. Therefore, patients with fever after surgery need not be nervous, just pay attention to the above, take a good temperature measurement and tell the doctor truthfully how they feel. After surgery, the patient has artificial foreign bodies in the heart (such as prosthetic valves, patches, shaped rings, sutures, etc.), so if there is a microbial infection, there is a possibility of infective endocarditis, leading to serious complications. If the surgeon determines that the patient has a higher than normal likelihood of infection, antibiotic therapy will be intensified. These are my experiences as a cardiac surgeon for more than 20 years for your reference. If you read this and say, “I don’t have these problems.” Then you’ve done a great job. If you say, “That’s so true! Why didn’t I see it earlier?” Then it’s just that we’re not close enough. But you can still pass on your personal experience and this article to others around you who are going to have heart surgery so that they can take the easy way out. Finally, I wish you all the best in your surgery and post-operative recovery.