Monday, April 15, 2024

Caring For Your Spouse After Open Heart Surgery

Can Couples Therapists Help To Normalize And Reassure

Going Home Recovery after Open Heart Surgery | Heart Care Video Series

Barbara M Murphy, Ph.D. is the Director of Research at the Heart Research Centre in Melbourne, Australia. Dr. Murphy is the leading thought leader on personality changes after heart surgery.

Her goal is to bring awareness of personality changes after heart surgery into more public discourse. Heres what she had to say about men like Alan:

About four out of five patients do experience the cardiac blues, and what we want to do is normalize it and reassure patients that it is likely to resolve in the first few months.

The heart event isnt just a physical event, its an emotional event as well, and these things are likely to happen. However, in some cases the symptoms do not resolve and can develop into full-blown depression. Barbara M. Murphy Ph.D.

The 3 Skills Needed To Manage Personality Change After Heart Surgery

For years, the medical establishment claimed that evidence did not support the notion that permanent changes in cognitive ability or mood occur after cardiac surgery.

Dr. Murphy argues that just because no research has directly looked at personality changes after open-heart surgery, we cant rule out the idea that such deficits are taking place on a smaller scale.

Science-based couples therapy can help these couples with 3 specific interventions:

  • Regulation and Co-Regulation

Regulation and co-regulation are skills we teach in science-based couples therapy. It describes being open to continuous influence by your partner in the service of collaborative emotional regulation.

For everybody, a stable, trusting relationship is linked to relatively high survival rates from cardiovascular disease, cancer, surgery, and other illnesses. Love increases the odds of living a long life and having good health.High trust partners benefit each other by co-regulating their physiologies. Put simply, they calm each other when they are unable to calm themselves. John Gottman.

  • Repair Early and Repair Often

Candace liked that idea. She told Alan that the Cardiac Blues were the herald of theCardiac Bear.

And that became a special couple code between them. Alan and Candace continued their intensive couples therapy online.

  • Dreams Within Conflict for Personality Change After Heart Surgery

The Dreams Within ConflictIntervention taught Alan and Candace a new way of discussing their differences.

Be Aware Of Dietary Limitations

Typically, surgical patients cannot eat before receiving general anesthesia. After heart surgery, many patients have a diminished appetite for several days or weeks. Discuss your loved ones dietary needs with her medical team. In general, clear liquids can be some of the best foods to eat in the days following surgery, according to St. Josephs Womens Hospital. Include simple broths, apple juice, Jell-O, tea or crackers in your loved ones diet. As your patient recovers, adding solid food in small portions is fine. Avoid greasy, spicy and heavy foods in the first day or two following surgery. Because many heart surgery patients have a diminished appetite, preparing several smaller meals throughout the day may be easier than sticking to your typical meal schedule.

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Helping In The Recovery Process

Imagine yourself being cut open right down the middle of your body. Your ribcage sawed, opened, and then clamped so that doctors can access your heart and shut it down for at least three to six hours. When its done, the heart is beating again, the ribcage is shut, and chest skin and muscle all sewn up.

And you will never be the same again. That 8-inch long and thick keloid scar will always be a reminder. Caring for yourself for a long while would be a struggle. But neither is it easy for people caring for you. Heres what they should know:

  • Patient first. You went through the ordeal. They didnt. Whatever discomfort they are feeling or however annoyed they might get because of your unreasonable requests, they should always give you a pass. No question. They should be ready with an enormous supply of patience and understanding.
  • Supporting basic activities. You still feel pain all the time. Getting up, turning on your side, lying down or sitting on the toilet are all exhausting efforts for you. They should be on standby as much as they can to assist you. They should help in administering your medication.
  • They need to take care of themselves too. It could be exhausting for them, too. The infinite supply of patience might be threatened. They should find time to recharge and relax and if possible, have a healthy and open conversation not only with you a patient but everyone else involved in your recovery.
  • Depression Is A Familiar Problem In Couples Therapy

    Pin on Celebrity Clinical Correlation

    About 1 in 20 Americans suffer from clinical depression, but over 40% of couples in therapy have at least one clinically depressed spouse.

    New research tells us that 20% of emergency cardiac patients like Alan experience clinical depression. This is significantly higher than the general population.

    The early weeks of post-surgical recovery often reveal significant cognitive, behavioral, and emotional changes.

    But over the ensuing months of recovery, Alan and Candy saw Alans personality change after his heart surgery as the most problematic and bewildering issue theyd ever faced in their 42 years of marriage.

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    How A United States President Navigated Personality Change After Heart Surgery

    Whatever your politics, its easy to admit that President Bill Clinton had significant social skills. But Bill Clinton has appeared significantly out of character in the speeches and interviews that Ive watched since his bypass surgery in September of 2004.

    President Clinton managed an impeachment, numerous sex scandals, and the #Me Too Movement with his reputation largely intact.

    But the Bill Clinton I saw in 2008 was noticeably irritated by hecklers, and sometimes said unfortunate and regrettable thinks in support of his wifes failed presidential bid.

    What struck me was the relative silence within the medical community. President Clinton was exhibiting an acute personality change after his open-heart surgerybut hardly anyone qualified to comment was talking about it.

    What Should I Expect During Recovery At Home After Heart Surgery

    The first six to eight weeks after heart surgery are usually the most challenging. You may recover quite quickly if you were in good health before your operation. However, your recovery may be slower if you were very ill before surgery or if you experienced any complications after surgery.

    Remember that you should see slow steady improvement as you recover. Call your family doctor if you have or develop any condition that seems to get steadily worse over three days.

    • Managing follow-up appointments

      What kind of follow-up appointments will I need after my heart surgery?

      Once you are home from the hospital after your heart surgery, please arrange the following appointments:

    • Within the first week you are at home, call to make an appointment to see your family doctor to have your sutures or clips removed. Remember to bring the removal kit you were provided with before you left the hospital.
    • Your heart surgeon may see you two to three months after your surgery for a follow-up appointment. Please refer to your personal discharge documents for details. Call 604-522-6800 to arrange this appointment.
    • You should also expect a call from a cardiac rehabilitation program. Referrals are made automatically when you are discharged and you do not need to initiate this call yourself.
  • Pain or tenderness
  • Make an appointment with your family doctor if your incision continues to drain and/or you note any signs of infection.

    When will my incision heal into a scar and how do I care for it?

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    Cognitive Decline Is A Hot Potato

    Its ironic what a hot potato can be.

    One of the best-kept secrets in medicine is the brain damage caused by bypass surgery.

    Its not uncommon for surgeons to field questions about uncharacteristic outbursts of anger post-surgery.

    Heres a startling truth. Medical Journals have been reporting on personality changes after open-heart surgery since 1969.

    If the medical profession is reluctant to discuss this issue in-depth, perhaps couples therapists might start the conversation instead.

    Personality Change From Particles In The Blood

    Caring for Your Incision after Cardiac Surgery

    The heart-lung machine extends the surgical time by pumping blood to keep the patient alive. During open-heart surgery, the pumping action of the heart is stopped.

    We now have reason to believe that this mechanical pumping action introduces tiny pieces of plastic debris, fat particles, and toxic gases into the bloodstream. Unfortunately, once in the bloodstream, these particles migrate to the brain.

    The problem is that these particles begin to clog small blood vessels, decreasing the amount of blood and oxygen from flowing to the brain. Unfortunately, all open-heart surgery patients experience some degree of this blockage during surgery, and for many, the damage is irreversible.

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    The Cardiothoracic World In Brief

    In 2017, there were nearly 377,800 cardiovascular surgeries performed in North America. The 2021 forecast is that this will rise to more than 461,000.

    With advances and medical science and technology, the mortality rate from open-heart surgery is meager at less than 2%. The number of cardiothoracic surgeons in the USA is just in the thousands. One concern is that by 2035, there might not be enough surgeons to handle all the caseload.

    Life At Five Months After Open Heart Surgery

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    Blog Post by A.W.About this Blog

    In this blog I will follow my everyday journey of living with familial hypercholesterolemia . I am sharing my own experience with this inherited disorder, and how I manage it daily from what literature I read on the topic and what my doctors say to how I live my life . This is solely a personal account that might or might not offer some insight on what to expect when diagnosed with this condition. This blog does not offer advice, in any way, to anyone suffering from this disease.

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    New Research Offers New Insight On The Cardiac Blues

    We now know that nearly 80% of these patients experienced some flashes of anger, tearful sadness, anxiety, depression, and sometimes frequent nightmares.

    I learned a lot about Alan and Candace during their assessment when they returned to intensive couples therapy:

    I knew something was profoundly different about Alan, Candy said. Alan was a highly decorated member of the Special Forces. He served 3 tours in Vietnam, breezed through Harvard Business School, and ended his career as a respected business leader. I have never seen him anxious or depressed. It was alarming.

    What Kind Of Cognitive Decline What Kind Of Personality Change

    Take Them A Meal

    Another study followed cardiac patients 3 years after their encounter with a heart-lung machine.

    The cognitive decline found in 31% of the patients was described as significant. Specifically, dates, names, and numbers elude them. These patients are also experiencing mood swings and serious depression. In 30% of cases, they have even contemplated suicide.

    Open heart surgery is also an expensive event. Its performed about a half-million times every year at a cost of around 100K or more. We can do better in helping couples to manage the emotional aftermath.

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    What To Avoid For Sternum Healing

    For the first 6 weeks after surgery, a person should avoid lifting anything that causes them to strain. This could be a heavy grocery bag, briefcase, backpack, a pet, or a child.

    Activities to avoid for the first 3 months after surgery, or until a doctor says it is safe to continue, include:

    • household activities that strain the chest or upper arm muscles, such as mowing the lawn, vacuuming, and mopping the floor
    • sports such as tennis, golf, cycling, weight lifting, running, and vigorous aerobics
    • pulling the body up using the arms, such as getting into a high truck or SUV

    People heal at different rates depending on a range of different factors, including their underlying state of health and their age.

    A small 2019 observational study examined rates of sternal healing at midterm followup after open heart surgery. Midterm followup occurred between 13 and 21 months after surgery. At this point, the researchers found that the sternums of 65.9% of the people had healed. They also found that younger people healed faster.

    Additionally, an older 2015 study assessed the CT scans of 197 people recovering from coronary artery bypass graft surgery. The researchers found that it takes at least 3 months for the sternum to heal completely. The sternums of almost all of the people involved in the study were completely healed 24 years after surgery.

    Get Specific Instructions From The Surgical Team

    Medical instructions for post-heart surgery care may vary by individual circumstances. High risk patients, individuals with diabetes and other special populations may have different recommendations for caregivers. Talk to the nurses at the hospital for specific post-op caregiving instructions . Remember to ask about wound care, mobility, diet and medications if the medical team doesnt make clear recommendations.

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    What Happens After Heart Surgery

    After your heart surgery is done, youll be moved to the intensive care unit . Youll recover in the ICU for at least one day. Youll then move to a regular hospital room for continued rest and care.

    How long you stay in the hospital depends on the surgery you had and how your body responds to it. Each persons recovery is different. Your hospital team will keep a close eye on you and make sure youre healing as you should. Theyre also prepared to notice and respond to any problems that come up.

    As I Sit Here And Write This Blog I Realize How Important It Is For People Who Have Had Or Who Are Going To Have Open Heart Surgery To Understand The Aftercare This Care Will Start In The Hospital With The Nurses And Therapists You Will Go Through Bouts Of Depression Anger Mood Swings And Of Course Guilt You Will Think To Yourself Can I Do This You Can And You Will Get Through This Very Difficult Time First You Have To Realize That Your Body Has Just Undergone A Major Trauma

    Open Heart Surgery: What to Expect (English CC)

    As I sit here and write this blog, I realize how important it is for people who have had or who are going to have open heart surgery to understand the aftercare. This care will start in the hospital with the nurses and therapists. You will go through bouts of depression, anger, mood swings and of course, guilt. You will think to yourself, can I do this? You can and you will get through this very difficult time. First you have to realize that your body has just undergone a major trauma.

    Your body will determine its own healing time. Nothing the doctors tell you is written in stone you should use it as a guide. You have to deal with the pain, so dont be afraid to ask for relief. It can take a few days to get out of Intensive Care. Dont panic if it is longer than you were told. You will be placed in what they call a Step Down Unit. All of your tubes should be removed and you will be able to walk around.

    At first you will be very weak, so take it slow. Always keep your thoughts positive. You will be given a machine to breathe into. You must do this according to the instructions. It is so important to build up you breathing and lung capacity. Walking will be a chore take it one step at a time and walk as much as you can. Sit in a chair, dont lie in bed. Do not think about the future take one day at a time.

    Always remember keep a positive attitude and dont think too far ahead. Do not rush the healing process.

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    Reasons To Call Your Doctor

    If you feel any of these symptoms, report them to your doctor or nurse:

    • Palpitations or a heart rate greater than 120 beats per minute when you are at rest, or a change from a regular to an irregular pulse.
    • Increased fatigue or shortness of breath at rest.
    • Temperature greater than 101 degrees more than one time, or chills for 24 hours.
    • Excessive redness, swelling, soreness or drainage from any wound site.
    • Swelling in your ankles and hands with a weight gain of two or more pounds in one day or five pounds in one week.
    • Abnormal pain or other symptoms that do not go away with your medication.
    • Pain in the calf of your leg.

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    How Long Should I Maintain Sternal Precautions

    If your healthcare provider asks you to follow sternal precautions, they should be able to tell you when you no longer need to follow the precautions. In general, your breastbone should be healed within about four to six weeks following your open heart surgery, and sternal precautions should be lifted at that time.

    Again, follow the advice of your healthcare provider regarding when to stop following sternal precautions.

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    Emotional And Mental Feedback Loops

    There is a feedback loop between the recovering cardiovascular system and the onset of clinical depression. But there are many other emotional feedback loops that can be acutely pressured by open-heart surgery.

    A research project undertaken in 2015 was published in Australian Family Physician. It showed that while over 80% of the 160 patients interviewed at two area hospitals would like to have received information about the cardiac blues, only a few couples ever received it.

    Pick Up The Slack With Family

    Feeling blessed to be alive, Aortic Dissection Survivor Randall Parr ...

    Every family has unique circumstances and arrangements for how things are done. Figure out ways to pick up the slack for your spouse in a way that makes sense for your familys needs. If you have kids, you might give them rides to and from afterschool obligations and make sure their needs are met. Other ways to make family life easier for your spouse post-surgery might include:

    • Doing the household chores
    • Going to the pharmacy to pick up medications

    Enlisting help from other family members and friends

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