Recovering from major heart surgery, the difficult second month

Logic dictates that on the first month of recovering from major heart surgery the second month swiftly follows. I’ll try to write up a few more thoughts about my experiences, challenges, successes and more during the difficult second month of the recovery.

Slowdown of progress, or at least a perception of slowdown. This is why I call it the difficult second month. A lot of it is probably perception and expectations, but at least to me it felt as if the recovery slowed down in the second month, causing a certain amount of frustration. I had to remind myself frequently that I was only 5, 6 or 7 weeks after the operation, so still not a long time. One example was the walking, over the first few weeks it felt like I could increase the distances fairly quickly, from a mile to mile and a half and then to two miles. This probably raised my hopes how quickly I would be fit again and may be even able to start with some very slight jogging. But then I kind of hit a plateau. I still felt I made some progress (e.g. around walking speed), but it was significantly slower. I didn’t feel I could significantly increase the distances (despite doing the odd three mile walk, I don’t feel ready yet for a four or five mile walk in one go) and walking up inclines was still very tough and despite including it in my ‘training’ progress felt very slow. Accepting that things will take time (even though I knew it all along) was difficult at this time.

Mood swings. Same as in the first month they were still around, in particular related to the slowdown of progress. Again I tried to as much as possible see the positive and when I had a down phase remind myself how far I had come and that better days/times were just around the corner. That didn’t always work, but it was the only way I could think of dealing with it.

Weight control. An interesting area, as I wasn’t always sure how to handle this. While not massive I did gain some weight since returning home, what I wasn’t (and am still not entirely sure about) is the question/concern how much (if any) of it is related to water retention and how much is genuine weight gain. I tracked my weight daily (may be not the best idea?) and while I noticed daily fluctuations I also noticed a general upward trend. I also felt that my waist did grow, but again that’s difficult to track. I certainly felt that I ate more (and also ate more sugar, e.g. biscuits), partially due to the tiredness (when you’re tired you get hungry), partially for convenience/enjoyment (a few nice biscuits while relaxing after coming back from a walk, or as a reward for completing something). Either way, it’s something I feel I need to watch and since late November I’m trying to cut down my sugar intake. I can see first signs that the gain is halted, it looks like it’s even starting to go down again.

Painkiller reduction. Pain management is a key component of the recovery, if you’re in pain the recovery will be much slower. This generally worked fairly well for me. While I was in hospital I was on the maximum of 8 Paracetamol per day (2 each in the morning, lunchtime, afternoon and night). When I returned home I cut this to 6 per day by reducing the lunchtime and afternoon rations to 1 each. This seemed to work quite well, so I decided to stick with it for a while. I wasn’t entirely comfortable with it as I’m concerned about the long time impact of prolonged painkiller usage, but decided to stick with it until mid November, four weeks after leaving hospital. Then it was time to try a staged reduction with weekly changes and a goal to as much as possible get off them by early to mid December. I did this by gradually reducing doses mainly in the morning and during the day (including taking half doses, you can break the Paracetamol pills in half, they’re already prepared for that) while for the time being keeping the night dose to help with sleeping. By late November I had cut out the daytime doses and only took one in the morning and two and night. This generally went OK, I was never in real pain although I did notice that my chest was still sensitive in various (often changing) places. There were the odd very short term pains, but they went within a few minutes or even seconds. My goal is still to be off them by mid December.

Sleeping problems. I’m not sure how and why they developed, but about halfway through the second month I developed some sleeping problems. While I was tired I just couldn’t fall asleep. I also felt at times my body was tightening up for some reason, making me struggle to stay in bed, it was more comfortable to get up and walk around or sit on a chair. Quite often I was awake until two or three in the morning, then later in the morning hitting the snooze button when I originally had planned to get up at 7:30 or so in the morning. Not what I was looking for. I’m slowly feeling like I’m getting this under control again now, although I still have episodes.

Temperature struggles. After the mild autumn and winter 2015/2016 I was hoping for a repeat, but that didn’t happen, at least not for the period of my recovery. While the first few weeks in October  were still quite mild the end of October and certainly most of November turned out fairly cold, especially compared to last year. November was below the long term average, as was at least the start of December. This did cause me a few problems as I seemed to be more sensitive to the cold weather. I had to turn up the heating in my flat more than I would usually do, yet I still noticed the cold at times, in particular when there was a cold wind which for some reason I still seemed to notice. Having no permanent heating in my north facing bath room and heating up the top half (while the bottom remained at fridge temperatures) with an underpowered fan heater taking half an hour didn’t help either. More importantly the cold weather didn’t help during my walks, as I had to cope with the cold air. In some of the literature they recommend to walk indoors (e.g. in a mall) during cold weather, but that wasn’t really an option living where I live. So I just had to cope with it. I certainly did notice the cold air making it more difficult to breathe at times.

Regaining confidence. This I found an interesting and challenging balance to strike. Especially during the first 6 weeks you are physically unable to do certain things, you are in some cases also advised not to do them (e.g. twisting your upper body, lifting above a certain weight, directly showering your chest). As your recovery progresses you can slowly start or increase some of these activities again, however, this is where I found striking the right balance in increasing activity and having the confidence to do it in the first place can be tricky. While I was sure the scar on my chest had healed sufficiently I found it quite challenging to start showering ‘normally’ again instead of trying to only let the water run over my shoulders on to the chest. The confidence to just point the shower at my chest just wasn’t there. Similarly with lifting where I know I need to gradually build this up, I often worry I might do too much too early and cause damage, which in turn is probably stopping me doing some things I could actually do. Building up my general confidence I found my first trip into Reading for a haircut, lunch and some light shopping quite helpful, while I was quite tired afterwards it showed me I was able to do it, which helped to build confidence.

Rebuilding routines, getting rid of ‘bad habits’. During the first weeks of my recovery I was struggling with concentration, which led me to stop editing and posting daily pictures on my photoblog, I also wasn’t reading as much as I had hoped before the operation. Instead there was a lot of slacking and aimlessly surfing the internet, it was just easier to do. As I was able to concentrate more I started to set myself goals (e.g. edit and post at least three pictures this week) which I found quite helpful, by now I’m back to posting pictures daily. I’m still struggling to an extent with some of the slacking, it’s just so easy to do and a bad habit can be difficult to get rid of. For the time being I’m relying on willpower to overcome this, it’s not fully working just yet but I’ll get there.

Those are some of the key points from the second month, the third month is obviously just about to start now. Assuming everything goes to plan I’m aiming to start a phased return to work in a week’s time. That and whatever else I experience in the third month will be the topic for another entry.

13 thoughts on “Recovering from major heart surgery, the difficult second month”

  1. Perhaps you should look into some kind of psychological support, too? Some form of meditation (or whatever other method suits you best) could help with the mood/sleep problems.

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