Each issue features a motivating topic from Maggie’s recently published book, The Open Heart Companion: Preparation and Guidance for Open-Heart Surgery Recovery (Open Heart Publishing, June 2006). My selection of a topic for this month is taken from Chapter 4, "Organize a Home Team." The book’s Table of Contents, leading surgeon and cardiologist endorsements, and ordering information is on the website: www.openheartcoach.com/TheBook.html.

How to Organize a Home Team, Part 1

Appoint a friend to pre-schedule a rotation of five to ten helpers

Even if you have very little time before your heart surgery, organize a Home Team before you go in. And if you are just home from the hospital, it’s not too late. Make a list of people, family and friends (but not your primary caregiver) who would be glad – even honored – to be called to help out. Pick a leader among these friends and engage her or him to contact the others about the tasks ahead. Set up a revolving schedule of assignments for your first three to four weeks at home.

A friend? Why not your caregiver?

Who will your primary caregiver be -- your spouse, your partner, a friend, another family member? The scenario is this. Suddenly your caregiver, your close personal ally, has the extended responsibility for all previously shared arrangements – nursing aid, household tasks, transportation, medical and social plan coordination. This is why it's a good move to line up a Home Team to pitch in. Your primary caregiver needs assistance and taking care of too. Once you are home and recovering, he or she is now “on” 24/7. He or she also needs continuing acknowledgment, appreciation and love from you. Plan to regularly express your gratitude. Find out how s/he is feeling – every day. Though sometimes you won’t feel like it, remember to smile, and show you care!

Five basic tasks to assign

1. Dinner nightly

Some friends will like to prepare a home cooked meal for both patient and caregiver, while others can pick up a heart healthy take-out meal. Since the reality of landing back home means the primary caregiver has antenna focused on you continuously, your caregiver loved one will appreciate the sit-down break at dinner time.

2. Buddy system

During the many hours and days of convalescence, neither patient nor primary caregiver wants to feel isolated at home. Anticipate a buddy system in advance. Is there a friend who has been though open-heart surgery who will agree to check in with the patient regularly? Whom the heart patient can call spontaneously? Many smaller questions can be answered this way, by a friend or family member. Naturally, any substantial recovery question requires picking up the phone and calling your designated medical professional. Maybe you know, or know of, a former heart patient who also is a medical professional? Arrange chat times (perhaps twice weekly) with him or her. Primary caregiver and patient should also plan regular phone time with a best friend independently, to be free to let their own hair down — to tell it like it is!

3. Running errands

Who – friend or neighbor – would be willing to be counted on to run to the pharmacy? To deposit or pick up laundry or dry cleaning? To shop for staples at the supermarket? To buy a box of thank-you notes? Recruit a list of volunteers beforehand.

4. Housekeeping

In the hospital take-home instructions, there are very specific physical directives that must be honored while the sternum (breastbone) is healing. You are not to lift more than five to ten pounds for six weeks. As well, you are to avoid pushing/pulling activities with your arms, and also avoid heavy one-armed lifting for three months. This eliminates carrying groceries, carrying a toddler, vacuuming, shoveling snow, mowing the lawn, raking leaves – even wiping up a kitchen counter with a sponge can be challenging in the first couple of weeks. So best schedule others for regular housekeeping duties for at least four to six weeks and/or consider hiring a house cleaner for the short term.  

5. Chauffeuring

An open-heart patient may not resume driving for six to eight weeks – until the sternum is fully healed. You can ride in a car as soon as you’re home – to a medical appointment, to the store, to eat out. However, all these outings become a lot of driving for the primary caregiver, so line up chauffeur volunteers!

 

Here is another response to the May Heart To Heart topic, Lingering Cognitive Challenges, with an invitation to contact Mary Ann if you would like to be in further discussion at MaryAnn.Keppler@valueoptions.com:

I had aortic valve replacement in 2004 and still have some lingering cognitive issues.  My memory is not what it used to be, and just plain focusing and concentrating can be difficult.  So, needless to say, I was glad to read your article about these lingering effects.  I’ve only found limited articles related to this, and most just explain the cause, not the long term issues of dealing with the cognitive changes.  Can you recommend any articles or sources that have more information about managing these changes?  As I mentioned, most medical articles describe what causes the cognitive changes, but few discuss what and if these changes will dissipate.  I’m wondering if it’s going to get worse as I get older (I’m only 46 now).  If there’s something I can do to improve my cognitive functioning, I’d sure like to try!  Any information or direction you can provide would be greatly appreciated.

Thanks, Mary Ann, MaryAnn.Keppler@valueoptions.com:

Last month I printed Alison Pierce’s share, which also included an invitation to be in touch but the email address was incorrect. The correct address for the following quote is Alij093050@aol.com:

I had a surgical repair of my aorta seven years ago.  I am doing well although I am on a considerable amount of medication.  My chief complaint is considerable cognitive changes.  I read with interest your statement that lingering problems were more prevalent in older "survivors".  I was 51 when I had my dissection.  My problems were exacerbated by the fact that I "coded" on the table and was subsequently revived 3 times.  I might have had cognitive problems due to the "pump-head" theory but the impact was increased by oxygen deprivation during "codes".  I am aware of my "short falls" and try to compensate for them.  The saddest part of my condition is that I have very limited memories of my life and marriage with my first husband.  He died very unexpectedly in 1997 and we never had any children.  My current husband tries to fill in the gaps but he has no idea about my past life.  I digress.......my point is that it is not always "older" people that develop significant cognitive changes after "open-heart" surgery.  If anyone wants to contact me I am more than willing to communicate with them.  My e-mail address is alij093050@aol.com.                         —   Alison Pierce, Northfield, MA

Feedback Request

Please email me at Maggie@openheartcoach.com with your observations and experiences which will be informative to others for future issues of Heart to Heart.  Please include your name, city and state.  Please also tell me what else you would like to see covered in this monthly newsletter. Thank you!

 

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