You have just learned that heart surgery is inevitable. Here is a quick checklist to ensure you are ready. This is not to scare you, your spouse, or your loved ones. This is so that as a team you go into this experience completely prepared and ready.

10 Things to Know & Do BEFORE Heart Surgery

1. Say a prayer. Bring the whole family together and the ones that can’t be there have on the speaker phone. There is a tremendous amount of stress running through every vein of the family upon hearing that a loved one is having heart surgery. Get everyone together and pray together. There will be people involved that may not believe in God, but they need this experience just as much. Others perhaps have never prayed or just never prayed out loud in front of others. Remember, this is just your family. Be as innocent and raw as your all were when you were young. This is not a time for being reserved. This is a moment, and a powerful moment that unites, encourages, and lifts you up to the Lord our God. The best way to do this is have everyone say a prayer (just a few words) out loud, and yes, even the kids, if there are any involved.
   
2. Get your Will in order and updated. If you have never done a Will seek legal advice to ensure this is done properly. It will take some time and perhaps a little money, but it is something that needs to be done. If you have already written a Will take the time to make sure it is up to date.
   
3. Discuss and sign your Advanced-Directives. This is a form that you will get from the hospital that allows you to elect certain choices governing certain decisions and actions by your family and doctors only if the worst circumstances arise. It will not be a comfortable discussion for many and the choices are hard to make. Don’t rush through this. If you have a spouse, please take the time sit together and read through all the choices and choose the ones that are right for you. Everyone’s circumstances and views on the many decisions that must be made on an Advanced-Directive are unique. There is no right or wrong answers, only the answers that work best for you and your family. If you are uncertain about any choices seek spiritual advice and of course pray about this.
   
4. Write a letter to everyone in your life. This is very time consuming and my own personal experience proved that this is one of the most difficult things you will ever do. Just so you know, I could not finish it. I had five days to write it and when I got to my children and wife I choked. I could not finish it. It was a tearful, emotional, and trying exercise. I personally wanted to say everything and didn’t want to miss anything about anyone and their value to my life. Based on my own struggles completing this, here is my advice. Start with your spouse and children. I went the other way. I started where it was easier; friends, co-workers and other family. I believe the emotions swelled in me and this prevented me from completing this. Just start with your spouse and finish that letter. If you can finish this, then move onto your children. A hint would be to write one sentence for each at a time. Don’t try to write the whole letter entirely. Good luck on this.
   
5. Pack your bag for the hospital. I know this seems silly but don’t forget the essentials: toothpaste, toothbrush, brush/comb, deodorant, razor, etc. Pack exactly like you are going on vacation, except leave out the fancy cloths. Pretend you are going on a vacation that allows you to lounge around in pajamas, robes, slippers, etc for a few days. Take the most comfortable things you have to wear. After surgery and a few days of recovery you will be asked to take walks around the hospital to help regain your strength. Take some comfortable slippers. I personally took Crocs and they were perfect. Also, don’t forget your own entertainment. There will be so many hours of just relaxing and resting. In between the naps you will need to keep your mind occupied. What ever does that for you, books, crossword puzzles, etc, take it with you. TV alone will not accomplish the task, trust me.
   
6. Talk to your doctor. Many doctors are very busy. This is a very specialized skill. Their limited time does not correlate to a lack of caring. To take full advantage of this opportunity, create a list of questions prior to talking with your doctor. I didn’t and know now that I should have been more prepared. Here are just a few questions that will help you get started:
   
   • When I arrive at the hospital will I be able to see and talk with you beforehand and before getting any sedation?
     
   • If I am nervous, what can be done to help relax me prior to the surgery?
     
   • When I arrive at the hospital, where will my family wait, how much time will I be able to spend with them before surgery, will they be able to visit me in pre-op?
     
   • What discomfort will I have in the first few hours after surgery?
     
   • How long will the surgery take?
     
   • Will someone keep my family informed on my progress? If so, how often?
     There are so many questions you will have running through your mind in the days or hours before surgery. Take the time to write them down and ask them. If the person you ask doesn’t know the answer, ask them who does know the answer. The more information you have, the more comfortable you and your family will be.
     
7. If you can, have a family dinner the night before. Go to your favorite restaurant and enjoy a healthy and fulfilling meal. For some patients this is not possible. For those of you that can schedule this, do it, and do it right. Talk to the restaurant and explain what this is all about. Many restaurants will go out of their way to make this special. I personally went to the Olive Garden with my entire family, all 18 of us, kids, and all, and we had a great night. This dinner will give you an opportunity to share the information you know (see number 6) and the camaraderie and fellowship will be terrific. Keep the dinner upbeat, and let everyone know that “sad” or “maybes” are not on the menu that night. Saying good night after dinner will be difficult for many. Just give everyone hugs, tell them you love them, and head back home for a good night’s rest.
   
8. Discuss with your doctor prescribing Zanex or something similar to take when you wake up at home the morning of your surgery. In my case, I was prescribed Zanex and it really helped with the nervousness and anxiety of the day’s event. For me, it was just a relaxer. I am the kind of person that needs to feel in control, and if not, I can get very irritable or anxious. The Zanex took the edge off, and allowed me to stay calm and relaxed until arriving at the hospital. My surgery was fairly early in the morning and even wanting to sleep in, I couldn’t. I awoke earlier than normal and my mind began racing immediately. Taking the prescription helped tremendously. By 6:00 am I was relaxed and ready for the next 3 hours of events.
   
9. Before midnight drink a big glass of water. Although for many not having anything to drink or eat is not a challenge, for me this was not easy. I felt dehydrated and wished I would have done this. I don’t suggest a “midnight snack” but a big glass of water would have been nice. For many others, we have morning routines, and often times that may include coffee or a special breakfast. Make sure that you don’t fall into the routine and accidentally or sleepily eat or drink. Place a note on the coffee machine, sink, or refrigerator reminding you not to eat or drink. I know this may sound silly, but remember your mind will have so much going on.
   
10. Say a prayer. Right away when you wake up, kneel down, or sit comfortably, and just say this prayer. “God you were awake before me today, knowing every outcome already, and your plans for me are already made. I am so grateful for this. I don’t have to worry or concern myself with today. You have already intervened and Your plans for me are assured. Thank you God for the amazing life, full of love, pain, passion, heart ache, excitement, loneliness, challenge, friendships, fun, joy, happiness, sadness, and mostly, for just letting me have a life really lived. I pray I have glorified you and done Your will more than mine. I pray today that I have peace, and only the kind of peace that Your love for me can provide. You know my heart, every vein, artery, and valve, You are the master surgeon. Do Your amazing work and I accept it entirely. I pray this is Your holy and precious name, Jesus, Amen.”
    

10 Things to Know and Do AFTER Heart Surgery

1. Know that your first few minutes of conciseness will be painful. Depending on the surgery you had, you will probably have a breathing tube inserted, and your hands will be anchored to the bed. You won’t be able to talk or move. The nurses and doctors are watching very closely and know every sign of discomfort and are doing what they must to ensure you awake fully and can breathe on your own. In my case, my memory of this now is very faint. I do remember the discomfort, but also remember drifting back to sleep quickly and the second time I awoke they were removing the tube. I also have closterphobia and knowing before hand that my hands would be tied to the bed helped me deal with those brief few seconds of conciseness. They do this so that you don’t inadvertently remove or yank something loose. Go into surgery knowing this and remind yourself when you first awake that you will be okay. Many people I have talked with after surgery don’t even remember this, so for some, this advice is unnecessary.
   
2. You are going to sleep and sleep and sleep. My surgery was at 11:00 am on Friday, November 14th, 2008. I was put under sedation around 10:00 am. Other than the brief few seconds mentioned in number 1, the first real vivid memory I have is that of waking up and being able to tell time at 4:00 am. I don’t remember 4:05 am. I woke up and fell back asleep so many times. I do remember breakfast, so I know by 7 or 8 I was fairly aware of what was going on, but remember sleeping constantly throughout the first day.
   
3. Your first walk. Shortly after surgery, normally within the first 24 hours the nurses will get you up to take a few steps. I remember walking about 20 – 30 steps down the hallway and then returning to a recliner in the room. This was grueling, but it is a very important milestone to early recovery. Be excited and eager to do this, even with all the things hooked and attached to you. The nurses won’t let you fall, and there are absolutely no expectations of speed or distance. Just that you do it is important.
   
4. Your breathing exercises – The Spirometer. Let me introduce you to your best friend after surgery. You will be instructed to do breathing exercises every hour or more frequently in some cases. TAKE THIS SERIOUSLY. This is one of the most important activities for a full recovery. Your lungs need to be exercised. In my orientation appointment prior to surgery they took a baseline and I was able to max out the meter. This won’t come easy for many days after surgery. The scale goes from 0 – 2500. I remember my first day only getting the meter to around 800. The second day, working very hard at this, I think 1000 was my highest number. Keep working at this. You can’t do it too often. You can’t over exercise the lungs after surgery. I will forewarn you that it is very painful for the first several days. I found that holding a pillow against my chest while doing the exercises allowed me to inhale harder. Please take this seriously. It is hard to believe that something plastic and small is so meaningful, but it is.
   
5. Your hormones. This is not a gender thing anymore at this stage. During surgery your glands that produce hormones are disrupted. You are going to feel different side affects both emotionally and physically. Some patients report that even after several weeks, their hormones are not in sync. My personal experience was closer to 3 weeks. You will experience sweating episodes that will feel like a fever breaking. You will possibly experience sudden and shifting emotional swings, taking you from elation to tears. You will possibly find it hard to concentrate. Your mind might be all over the place. All of these are normal. Just relax and let your body recover. Everything will get synced and your hormones will normalize.
   
6. Avoid depression at all cost. What you are trying to do is avoid the negative answers to all the questions that will be racing through your mind. “I am going to be okay?” “Will I be able to do…again?” “What is the rest of my life going to be like?” “Will I ever feel normal again?” “Can I get through this?” And hundreds more like these. Every one of these questions has both positive and negative answers. You are fighting to avoid the negatives. It won’t be easy. You will need to keep your mind busy and on positive things. Okay, so how do you do this? Here are a couple recommendations that helped me.
   
   • I loved building models when I was young. My wife bought me a model to put together. Although I never finished it, those few hours spent working on it kept me from getting bogged down in depression.
     
   • I love movies. I watched everything I had never seen and many of my favorites all over again. Have someone rent you a bunch of movies and just relax.
     
   • Puzzles and crossword puzzles. Many people I have talked with have told me about keeping their minds occupied with puzzles.
     
   • Writing and reading. I love to read. There is nothing like a great book to take your mind away. I think I read more in the month of recovering than I had in years. I also love writing and was overwhelmed with ideas and enjoyed having the idle time to get them on paper.
     
7. Family matters. Your family needs to be helpful, understanding and patient. Even in the hospital, your family is a major part of recovery. The rest they allow, the conversations, and the time they spend with you is critical. Although they want to be there, having some down time and not feeling obligated to entertain or interact is a must. Family needs to really respect this. It is not easy to tell loved ones to “keep it down”, “give me some quiet time”, or “not now”, but you will have to speak up to keep control over your environment. Remember, they are just there because they love you and are trying to do what is right for you. You can’t hurt their feelings at this point. But they can hurt your recovery by not giving you enough resting time. When you get home after surgery, you need to do nothing but rest and recover. Find a place to sit, kick your feet up, and be comfortable. My place was on the couch, but a recliner would do too. I didn’t want to feel secluded or out of touch and wanted to participate with things, and being in the living room allowed me to stay connected and close for when I needed things. For the first 3 – 4 days, other than taking walks through the house as the doctor will recommend, just do nothing! Don’t fix your own food, don’t get your own drinks, and don’t worry about laundry, housework or anything else. Just relax. Your body needs the rest and believe it or not, by not pushing it, you are accelerating your recovery process. Make arrangements with family or friends to do everything for you. Have someone explain the rules. No interruptions, lengthy conversations unless you initiate them, and to be observant, and to frequently ask if you need something. Also, don’t be bashful. I am one of those types of people that like to do things for myself. This is not the time for this. Can I say just relax one more time. Relax, rest, and recover. Give your body the rest it needs.
   
8. Appetite. I lost approximately 30 lbs from November 6th to December 10th. My appetite was extremely depressed. In talking with many survivors, they also had decreased appetites. This is normal, but won’t last forever. There will be a day when your appetite screams back to life. I don’t mention scream lightly. Mine was December 10th around 2:00 pm. I had a great day, felt very good and was sitting on the couch watching a movie. All of the sudden I was hungry. Hungry like I had not eaten in days. Thankfully, my wife had removed from the house all the foods I shouldn’t eat. Had they been there I would have eaten them. I wanted to eat everything I could find. This was not an emotional eating binge. This was physiological. My body was ready to eat again and it was not shy about telling me. I needed to loose a few pounds and was very happy being at a weight I should have been at for many years now, so it was very important to control my new found appetite. No one told me this would happen and it was quite a shock. Everyone I have mentored after their surgeries has reported a similar incident, so it will happen most likely. Be ready, but keep control and eat right. Diet is so important for the recovery process. Get rid of anything in the house that has sodium over 200 mg. You don’t need it. It is non-perishables, have someone box them up and get them out of the house. You will be amazed how healthy, robust, and tasty the foods you can find with low sodium are. I have found pasta sauce that has only 160 mg of sodium. Healthy foods are out there but don’t believe the labels just because it says “Heart Health”. Read the labels and if you don’t know exactly what you should be looking for and avoiding, talk to your doctor or nurses and be a smart consumer at the store.
   
9. REHAB. Get yourself involved quickly into a cardiac rehabilitation program. Nationally only about 30% of heart surgery patients ever enroll in rehab and only 80% of those complete the program. This is a tragic statistic. There are many reasons why and almost all of them have to do with financial restrictions, either insurance or out of pocket money. I started a charity called AHealedHeart locally to help pay for people’s rehab that can’t afford it. I am that convinced of its impact and importance on a full recovery. If you can’t afford rehab, talk to your doctor about ideas to make that happen. There is always a way. Even for those that return to work quickly, make time to get 4 sessions of 40 minutes each doing cardio every week. Just walk slowly on a treadmill or similar. I won’t get into advice on working out. The experts in cardiac rehab are the ones to share this. Prior to being released from the hospital ask your nurse to have someone from cardiac rehab to come visit with you. If you have to exercise on your own and at home or a local gym, at least make an appointment with the Cardiac Rehab center near you to discuss the pitfalls and guidelines that you should follow. If they won’t provide this consult for free, find a rehab center that will. Many rehab centers have classes that are open to family and non-patients just for education purposes. If your local rehab center doesn’t yet, ask them to start up a program.
   
10. Pray. You have been given extra time. Yes, the marvels of medicine and the skills of your surgeons and doctors have provided that mechanism, but it is His will. Now is not the time to believe anything other than God wants you to do more of His work.
    
    I pray that your surgery will be successful, your recovery swift and full, and that you are exhilarated by the extension of life and accomplish amazing things after surgery.