Frequently Asked Questions
on Blood Thinners
Incision Care Instructions
the Doctor and Nurse
- Post Operative Visits
Generally, the surgeon will want to see you in one of their
offices between 4-6 weeks after your discharge from the
hospital. The surgeon will let you know if they would like
to see you earlier. Once you are home, call our office to
obtain an appointment. We have two office locations,
be sure to let our staff know the location that is the most
convenient for you.
It is important that you understand what medications your
should take after coming home from the hospital. At the
time of discharge from the hospital, your doctor prescribed
the medications to take once you are home. Do not take any
other medications unless your doctor has instructed you
to do so. If you are unsure of what medications you should
take, call our office.
You should not drive any vehicle until you see the surgeon
for your routinely scheduled post-operative visit. Driving
interferes with healing of the breast bone and can cause
pain. Like any broken bone, time is needed to properly heal
Common sense is the rule to tell you what you should and
should not do. Remember, you just went through major surgery.
Your body needs time to recover. Rest when you are tired.
Try to do a little more each day. Avoid any strenuous activities
and lifting weights greater than 50 pounds for the next
three months, or as directed by your surgeon.
- Return to Work
After our surgeon exams you at your routinely scheduled
post-operative visit, ask the surgeon if you are able to
return to work. You can discuss the particular requirements
of your job and the surgeon can advise you accordingly.
Review your SBE (Subacute bacterial endocarditis or Infective
endocardities) precaution card. If you did not receive one
in the hospital, let us know and we will give you one at your
Patients with artificial valves will be required to take
IV antibiotics whenever an invasive dental procedure is performed.
Examples of invasive procedures include: dental cleaning and
dental extractions. Inform your doctor or
dentist that you have an artificial valve before the procedure.
If you are unsure if you need antibiotic protection, please
call our office.
Our surgeons would like to see you every two years to check
on the status of your heart valve. Please call our office
to arrange your visit.
Notify the surgeon if you experience a change in the color,
temperature, pain or swelling in the operative leg.
Some swelling in the operative leg is normal. Remember to
elevate your legs several times a day for an hour or so. Remember
to elevate your legs higher than the level of your heart to
achieve the best possible drainage.
Periodic evaluation of the blood flow to your lower extremities
is advisable. These will be scheduled at 3 months post-operative
time, and 6 months post-operatively, thereafter, annually.
Call our office 4 weeks in advance to schedule your tests
and office visit.
Call our office if you experience any of the symptoms that
you had before surgery. Call if you experience any weakness
or numbness in your arms or legs, or any change in your vision.
A carotid duplex is a test to measure the blood flow in your
carotid artery. You will need this test 6 months after your
surgery and every year thereafter. Please call our office
and we will assist you in scheduling your test and office
Your surgeon will want to see you in four to six weeks after
your discharge from the hospital. If you have questions during
this time please call our office. Once you have been seen
by your surgeon, your care will be returned to your primary
care physician and cardiologist.
Remember, coronary artery bypass procedures are NOT a permanent
cure for coronary artery disease. You need to manage the risk
factors which contributed to your heart disease. This may
be smoking, poor diet, lack of exercise, or excessive stress.
Please discuss ways you can improve your health with your
family physician, cardiologist and surgeon.
on Blood Thinners
If you are taking anticoagulants (blood thinners) be sure
to follow your instructions. Make sure you receive instructions
before your discharge concerning who will regulate your blood
After each blood test, you need to hear from your doctor
concerning the dose of the blood thinner. If you do not hear
from their office, please call them.
Remember, many medications will interfere with your blood
thinner. Make sure you doctor and pharmacist are aware that
you are taking Coumadin. Anytime you require a procedure that
involves any degree of invasiveness, you need to inform the
physician that you are taking a blood thinner.
If you need to stop the blood thinner for any reason, check
with your doctor to review the procedure.
- I don't have the same sensation around my incision.
When will this go away?
Numbness around the incision is normal and can persist for
up to six months.
- The leg that the vein was removed continues to
swell. Is this normal? What should I do?
Swelling of the leg where the vein was removed is normal.
This could last for several months. The remaining veins
need to learn how to take over for the role of the harvested
vein. This will take time. In the meantime, elevating the
legs higher than the level of the heart for extended periods
throughout the day will reduce the swelling.
If swelling is present in both legs (unless veins were taken
from both legs), please call your family doctor.
- When can I drive?
At your routinely scheduled post-operative visit, your surgeon
will tell you when you can resume driving from a surgical
perspective. The final say in determining if you can resume
driving will be up to your family physician.
Incision Care Instructions
- Clean the incision with soap and water. You may do this
in a shower. Do not rub the incision harshly, pat dry gently.
Do not take a bath until the incisions are healed.
- If the incision is reddened and the skin in taunt, apply
warm compresses to the wound for 10 minutes three times
- If the incision begins to drain:
- Clean incision with normal saline solution.
- Dry with gauze and cover the draining part of the
incision with sterile gauze.
- Do not put any antibiotic cream or lotion on the
- Call your surgeon if:
- You develop a fever of 101 degrees, or you develop
- The redness around the incision spreads.
- The swelling increases in size.
- The area becomes warm and tender.
- The drainage, increases, changes color and/or consistency,
or becomes odorous.
- Your doctor may want to see you in the office.
If the wound is opened, packing may be necessary. Initially,
the packing may need to be changed 2 to 3 times a day. If
your insurance permits, we will ask a home care nurse to
assist in the care of your wound at home. The nurse can
teach you or a family member how to do the dressings.
As the wound heals, the frequency of dressing changes will
decrease to once a day. Home care will usually bring supplies
or you may get the supplies from a drug store.
- Your doctor may give you specific instructions for your
incision care. The following instructions are general
- Clean around the wound with soap and water. If able
to shower, remove dressings and allow the wounds to
be cleaned under the flow of water from the shower.
Do not take a bath with open wounds until your surgeons
indicates that it is permitted.
- Loosely pack the wound with 1/4 inch plain gauze.
Do not force the packing in, only place it lightly at
the bottom of the wound. This packing will absorb the
secretions and help wound healing.
- If the dressing is to be applied as "Wet to Dry,"
soak the gauze in normal saline, then squeeze out most
of the fluid so the dressing is damp. When removing
the gauze do not wet it again. This drying action is
what helps the wound to heal. The dressing adheres to
the infected material in the wound and when the dressing
is removed, it helps remove the infected material.
- If the skin around the wound appears to be closing,
but the deep part of the wound still needs packing,
call your surgeon. The wound heals from the inside to
If the skin closes before the deep part of the wound
has healed, infection may recur.
- If you have swelling in the leg with the incision, elevate
the leg so the leg is higher than the level of the heart.
Lie on your couch and prop your leg up so it is higher
the level of your heart. Do this for 30 minutes at a time,
as often as you can.
- Remember to eat nutritious foods. If you are diabetic,
control your glucose levels. Good nutrition promotes healing.
Exercise will also enhance wound healing. By increasing
the circulation to the wound, better wound healing occurs.
- Smoking interferes with wound healing. It constricts the
blood flow to your incisions. Every effort should be made
to quit completely and immediately.
the Doctor and Nurse
The surgeons and nurses of Park Cardiothoracic and Vascular
Institute are here to help answer your health questions. General
questions pertaining to your health, recovery, or cardiovascular
needs may be addressed in this section of our web site. The
intent of this section is to answer general health questions,
not replace the advice of your physician. It is not possible
to give specific health advice without meeting you, examining
you, and obtaining a detailed health history. General questions
may be asked of either the surgeon or nurse. They will be
reviewed each week and answered the following week.
If you have questions for the surgeon, simply email:
If you have questions for the nurse, simply email: