Convalesance Home-recovery from open heart surgery

[thetefldon]

I am due to have Aortic Valve replacement surgery in Bangkok fairly soon.  Unfortunately I can't have TAVI( via catheter inserted in groin) so I must have traditional open heart surgery. I am "painfully"  aware of what this involves and am a bit concerned about the recovery process for a 75 year old!  With this in mind I thought I might try a month or two in convalescence to help with recovery after I get out of hospital. Not sure if Thailand has Convalescence Homes like the UK, given the family care that happens here, but ideally I would like somewhere near my home(Phetchabun) or near the hospital in Bangkok where I can be comfortable, get medical care if needed, be monitored and do some guided physical therapy. If you know anywhere that might fit my needs please let me know. An idea of costs would also be useful.  Any other suggestions would also be appreciated if a convalescence home is a no go.  Many thanks.

[dddave]

I had open sternum, triple bypass surgery 5 years ago and was out of the hospital in 7 days.  There were some restrictions designed not to stress the healing sternum but I was quite comfortable at the time, I was 74.

 

A good friend, now 75 just had triple bypass surgery in Khon Kaen (Srinakarin Hosp) and he was released to home care 6 days after surgery.  I just talked with him yesterday.  He's been home for a week now. He's very comfortable and able to get about very well.

 

OP: I think you will be surprised how quickly you recover.  Modern surgical techniques seem much less invasive and traumatic to the body.  Based on my own and my friends experience, I doubt very much you'll need a month of rehab.  You will need a care-giver for a week or two but just for light assistance, like help in getting up from a chair. 

 

 

 

[The Hammer2021]

I needed care during a recent recovery period and used an agency based here in Pattaya. Would you like their number. Perhaps  they could advise. The only residential based care I know is in CM.

[thetefldon]

1 hour ago, dddave said:

I had open sternum, triple bypass surgery 5 years ago and was out of the hospital in 7 days.  There were some restrictions designed not to stress the healing sternum but I was quite comfortable at the time, I was 74.

 

A good friend, now 75 just had triple bypass surgery in Khon Kaen (Srinakarin Hosp) and he was released to home care 6 days after surgery.  I just talked with him yesterday.  He's been home for a week now. He's very comfortable and able to get about very well.

 

OP: I think you will be surprised how quickly you recover.  Modern surgical techniques seem much less invasive and traumatic to the body.  Based on my own and my friends experience, I doubt very much you'll need a month of rehab.  You will need a care-giver for a week or two but just for light assistance, like help in getting up from a chair. 

 

 

 

Many thanks for sharing that, very reassuring. It's really because of the unknown, in coping with the recovery, that I inquired about some post operative care. Also worrying(probably unduly) about complications after leaving hospital since I am 5 hours from where I get the procedure done. I have a care-giver(the wife) but wasn't sure how I would cope at home. We live on the 2nd floor so stairs if I want to go out.

[thetefldon]

1 hour ago, The Hammer2021 said:

I needed care during a recent recovery period and used an agency based here in Pattaya. Would you like their number. Perhaps  they could advise. The only residential based care I know is in CM.

Many thanks, appreciate your reply. I suspect there are local private nursing agencies up here, I shall have a chat with the locals and get my wife on the case. I will get back to you if I am struggling to find something local.

[scubascuba3]

8 minutes ago, thetefldon said:

Many thanks, appreciate your reply. I suspect there are local private nursing agencies up here, I shall have a chat with the locals and get my wife on the case. I will get back to you if I am struggling to find something local.

If you have a wife there that may be sufficient, my mum 80+ had the heart valve replacement open heart surgery in UK just my Dad looked after her and worked out fine

Edited August 10, 2022 by scubascuba3

[thetefldon]

2 minutes ago, scubascuba3 said:

If you have a wife there that may be sufficient, my mum 80+ had the heart valve replacement open heart surgery in UK just my Dad looked after her and worked out fine

Many thanks for sharing, again, quite reassuring.

[The Hammer2021]

10 minutes ago, thetefldon said:

Many thanks, appreciate your reply. I suspect there are local private nursing agencies up here, I shall have a chat with the locals and get my wife on the case. I will get back to you if I am struggling to find something local.

I dealt  with two agencies  but used one. One offers overnight care, accompaniment for air travel  etc.

[dddave]

OP.

You will be better off if you make some advance preparations.  Thai hospitals do not seem to be very good at providing aftercare information.

Consider purchasing or renting if possible:

 

Raised toilet frame.  An aluminum frame with a toilet seat that sits over standard toilet with arm rests that make getting up less stressful on sternum.

 

Possibly, a walker.  I only needed mine for four of 5 days.

 

A cane or "trekking" stick (they have a wrist loop that aids in stability, also they fold up into a convenient size. (Lazada)

 

Put extra cushions on your favorite chair to make the sitting position high enough so you can get up from the chair without pushing off.

 

You said you lived on 2nd floor.  Test the handrail to make sure it's solid as you will be leaning on it more than usual.  If there is no handrail, I strongly suggest you arrange for one to be installed.

 

They may not warn you that some of the post surgical medications they will give you can cause dizziness, especially when you stand-up after sitting for a while.  Never stand quickly and just start walking.  Stand slowly and just stand stationary for 30 seconds.  If you feel at all light-headed, just give it a minute.

For the first month or two, always try to sit in the rear seat of any vehicle.

 

 

[thetefldon]

2 hours ago, dddave said:

OP.

You will be better off if you make some advance preparations.  Thai hospitals do not seem to be very good at providing aftercare information.

Consider purchasing or renting if possible:

 

Raised toilet frame.  An aluminum frame with a toilet seat that sits over standard toilet with arm rests that make getting up less stressful on sternum.

 

Possibly, a walker.  I only needed mine for four of 5 days.

 

A cane or "trekking" stick (they have a wrist loop that aids in stability, also they fold up into a convenient size. (Lazada)

 

Put extra cushions on your favorite chair to make the sitting position high enough so you can get up from the chair without pushing off.

 

You said you lived on 2nd floor.  Test the handrail to make sure it's solid as you will be leaning on it more than usual.  If there is no handrail, I strongly suggest you arrange for one to be installed.

 

They may not warn you that some of the post surgical medications they will give you can cause dizziness, especially when you stand-up after sitting for a while.  Never stand quickly and just start walking.  Stand slowly and just stand stationary for 30 seconds.  If you feel at all light-headed, just give it a minute.

For the first month or two, always try to sit in the rear seat of any vehicle.

 

 

Once again many thanks. Some things I hadn't considered. Especially the toilet seat. I will probably buy a walker too. The handrail is about the strongest thing in my Thai built house???? A couple of questions if I may? What about sleeping? Presumably on your back? Raised pillows? Any mods needed to the bed? I assume(possibly wrongly) that I will get some coaching regarding getting out of bed etc.

[thetefldon]

3 hours ago, The Hammer2021 said:

I dealt  with two agencies  but used one. One offers overnight care, accompaniment for air travel  etc.

Much appreciated.

[SantiSuk]

On 8/10/2022 at 12:04 PM, dddave said:

I had open sternum, triple bypass surgery 5 years ago and was out of the hospital in 7 days.  There were some restrictions designed not to stress the healing sternum but I was quite comfortable at the time, I was 74.

 

A good friend, now 75 just had triple bypass surgery in Khon Kaen (Srinakarin Hosp) and he was released to home care 6 days after surgery.  I just talked with him yesterday.  He's been home for a week now. He's very comfortable and able to get about very well.

 

OP: I think you will be surprised how quickly you recover.  Modern surgical techniques seem much less invasive and traumatic to the body.  Based on my own and my friends experience, I doubt very much you'll need a month of rehab.  You will need a care-giver for a week or two but just for light assistance, like help in getting up from a chair. 

 

 

 

I agree entirely with this assessment. I had a triple bypass at Bumrungrad 4 years ago, age 67. Much easier than I expected.

I'm back again now and had a replacement hip a couple of days ago. Same again - I'm taking baby steps with a walker already.

[dddave]

On 8/10/2022 at 4:50 PM, thetefldon said:

Once again many thanks. Some things I hadn't considered. Especially the toilet seat. I will probably buy a walker too. The handrail is about the strongest thing in my Thai built house???? A couple of questions if I may? What about sleeping? Presumably on your back? Raised pillows? Any mods needed to the bed? I assume(possibly wrongly) that I will get some coaching regarding getting out of bed etc.

As long as your bed is high enough so it's easy to roll into a sitting position and then get-up without pushing with your hands there should be no problem.

It was actually uncomfortable to sleep on my sides for the first two weeks but I do not recall any specific instructions not to do so.  I did use extra pillows to sleep sitting up a bit. 

One uncomfortable part of recovery is the need and necessity to frequently deep cough to clear the unusual amount of mucous your lungs will make. It can be quite uncomfortable, especially in the first week.  My recovery team gave me a small pillow to clutch to my chest when I did cough.  It made it a bit less painful and also protects the sternum somehow.  If they don't give you one, just use a small throw pillow. 

Sleeping sitting up a bit seemed to lessen coughing at night.

They will also probably give you a blow toy.  It's a device you blow into as long and as hard as you can that measures and helps increase your lung volume and breathing force.

 

You may not feel you need the walker once you are home but a fall could possibly cause complications so best to be on the safe side and use it until you feel really steady.

 

Not much more I can think of.  Just keep in mind during the first few weeks of healing you always want to keep your arms and shoulders forward.  No reaching back like when putting on a shirt or jacket. 

It is really important to be your own advocate.  If you have questions you feel aren't fully answered, press for the answers.  if there are any instructions you don't understand, clarify them.  Ask them to explain what every medication they give you is and what it does and what possible side effects you may experience.  

One final item.  You mentioned you lived 5 hours away from where you'll have the surgery.  That is a long way.  Perhaps you should consider getting a hotel room fairly close to the hospital for the first two or three days once you are discharged, just in case something comes up or there is something you want checked out.  Best of luck.

 

Edited August 11, 2022 by dddave

[thetefldon]

13 hours ago, dddave said:

As long as your bed is high enough so it's easy to roll into a sitting position and then get-up without pushing with your hands there should be no problem.

It was actually uncomfortable to sleep on my sides for the first two weeks but I do not recall any specific instructions not to do so.  I did use extra pillows to sleep sitting up a bit. 

One uncomfortable part of recovery is the need and necessity to frequently deep cough to clear the unusual amount of mucous your lungs will make. It can be quite uncomfortable, especially in the first week.  My recovery team gave me a small pillow to clutch to my chest when I did cough.  It made it a bit less painful and also protects the sternum somehow.  If they don't give you one, just use a small throw pillow. 

Sleeping sitting up a bit seemed to lessen coughing at night.

They will also probably give you a blow toy.  It's a device you blow into as long and as hard as you can that measures and helps increase your lung volume and breathing force.

 

You may not feel you need the walker once you are home but a fall could possibly cause complications so best to be on the safe side and use it until you feel really steady.

 

Not much more I can think of.  Just keep in mind during the first few weeks of healing you always want to keep your arms and shoulders forward.  No reaching back like when putting on a shirt or jacket. 

It is really important to be your own advocate.  If you have questions you feel aren't fully answered, press for the answers.  if there are any instructions you don't understand, clarify them.  Ask them to explain what every medication they give you is and what it does and what possible side effects you may experience.  

One final item.  You mentioned you lived 5 hours away from where you'll have the surgery.  That is a long way.  Perhaps you should consider getting a hotel room fairly close to the hospital for the first two or three days once you are discharged, just in case something comes up or there is something you want checked out.  Best of luck.

 

Great stuff. Thanks for answering in such detail. It really is appreciated.

[thetefldon]

16 hours ago, SantiSuk said:

I agree entirely with this assessment. I had a triple bypass at Bumrungrad 4 years ago, age 67. Much easier than I expected.

I'm back again now and had a replacement hip a couple of days ago. Same again - I'm taking baby steps with a walker already.

Many thanks and good luck with the recovery.

[sanuk711]

XXXX....Got it wrong again

Edited August 12, 2022 by sanuk711

[NancyL]

This is a rather pricey recommendation, but three years ago when we totally remodeled our condo, we bought this adjustable bed from Home Pro:  https://www.homepro.co.th/p/1151273  I have a congenital heart defect with a couple of leaky heart valves, so I've been advised to sleep with my head elevated for years.  We've managed to do to this with home modifications, but thought we'd do it properly with the remodeling and really made the day for the sales gal at the local Home Pro when we bought the bed.

 

Very glad we did.  I discovered that slightly elevating my feet also reduced ankle swelling and slight elevation of Hubby's head (not as much as mine) eliminated his slight snoring.  Recently I injured my back and this bed was a God-send to getting comfortable.

 

It's been very reliable and I wish we'd bought it years ago.

[lopburi3]

6 hours ago, NancyL said:

This is a rather pricey recommendation,

3 years ago and they have only sold 2 units per link -Indeed at 180k a bit pricey as electric beds are available for about 20k single wide here for those not too heavy.  Never found non level conductive to sleeping (from hospital stays) as need to turn often - but have almost learned to dose off in a recliner as pass the 80 mark.  

 

[NancyL]

15 hours ago, lopburi3 said:

3 years ago and they have only sold 2 units per link -Indeed at 180k a bit pricey as electric beds are available for about 20k single wide here for those not too heavy.  Never found non level conductive to sleeping (from hospital stays) as need to turn often - but have almost learned to dose off in a recliner as pass the 80 mark.  

 

We bought ours in the store.  I doubt most people would purchase an item like this online.

 

It was a little cheaper in the store and came with many extra goodies like pillows, sheets, duvet, etc, that we were able to select.

 

Hospital beds aren't as comfortable because they're designed to be easy-to-clean and don't seem to "breathe" as well as a conventional mattress.  Same problem with a recliner.

 

 

[lopburi3]

22 minutes ago, NancyL said:

We bought ours in the store.  I doubt most people would purchase an item like this online.

 

It was a little cheaper in the store and came with many extra goodies like pillows, sheets, duvet, etc, that we were able to select.

 

Hospital beds aren't as comfortable because they're designed to be easy-to-clean and don't seem to "breathe" as well as a conventional mattress.  Same problem with a recliner.

 

 

Not talking hospital types as electric beds are starting to be a thing it seems.  Several makers offer full single width (3.5 feet) and normal style bedframe and some offer thicker mattress (but suspect that limits sitting up somewhat).  But the fact it has helped you makes up for any high cost I suspect.  

[NancyL]

2 hours ago, lopburi3 said:

Not talking hospital types as electric beds are starting to be a thing it seems.  Several makers offer full single width (3.5 feet) and normal style bedframe and some offer thicker mattress (but suspect that limits sitting up somewhat).  But the fact it has helped you makes up for any high cost I suspect.  

Yes, I've seen less expensive models that look like some of the "custom" build frames we had before where there were several choices of elevation for the head and used a conventional twin bed mattress.  These never held up very well.  Or in the U.S. our regular twin bed frame was sturdy enough that we could elevate the head with bricks under the legs of the bed.  Never could find a conventional twin bed frame in Thailand that looked sturdy enough.  

 

This bed, while expensive, is much, much better.  Frankly, we're at a stage in our lives and without children or others waiting to inherit, that we might as well spend our money on being comfortable.