Recovering From Your LVAD Surgery
Your recovery begins in the ICU immediately after surgery and continues in the step-down unit. Your medical team will help you gradually regain physical strength and range of motion, while continuing to monitor your vital signs. During this time, your medications will be adjusted to stabilize your heart function with your new pump. Echocardiograms may be done to see how your heart is adjusting to the LVAD, and all invasive lines or tubes will be removed as you progress.
Physical and Occupational Therapy
Once all of your vital signs are stable, it will be very important for you to begin physical therapy so you can sit up, get out of bed and eventually walk. Your nurses and physical therapist(s) will work with you to maintain or rebuild your strength, flexibility and coordination. To keep your recovery moving forward, it’s very important that you perform the exercises given to you by the physical therapists in between their visits.
Meanwhile, an occupational therapist will help you learn how to safely and comfortably do everyday tasks like dressing, washing and getting around with your LVAD. It may feel awkward at first, having your LVAD equipment with you all the time. But with practice and with support from your medical team and loved ones, it will soon become second nature. (You may want to visit the Community Forums to see how other LVAD patients made the adjustment.)
Protecting Your Sternum
Because your surgeon will have had to cut through your breastbone (also known as your sternum) to implant your LVAD, you will need to protect the sternum from injury so it can heal. During the first six weeks after surgery, you’ll need to:
- Be careful not to lift more than ten pounds
- Avoid reaching backward
- Keep your arms close to your sides when doing things like getting out of your bed or chair
- Stop what you’re doing if you feel your sternum pull or ache, and avoid that activity until you check with your doctor
Caring for Your Chest Incision
Your nurses will show you how to clean your chest incision while it heals. Their specific guidelines may vary, but typically they will instruct you to use soapy water on your hand or a washcloth to gently wash the incision(s) up and down. Do not rub the incision until the scabs are gone and the skin is completely healed. Do not put any salves, oils or lotions on the incision unless you’ve been told to do so.
Be sure to contact your doctor if signs of infection appear:
- Increased drainage or oozing from incision
- Redness or warmth around the incision
- Increased opening of the incision line
- A fever of higher than 101 degrees Fahrenheit (38 degrees Celsius)
- If you have diabetes, and your blood sugar levels begin to vary more than usual
Itching, tightness and/or numbness along your incision are normal after surgery. You will be given a prescription for a pain medication before you leave the hospital.
An important part of your recovery is learning about your LVAD equipment—how it works, how to maintain it, and what to do in case of an emergency. While you are in the hospital, you and your caregiver(s) will receive detailed training on your LVAD, including:
- The basic purpose and function of your LVAD and its components: controllers, power sources, backup equipment and maintenance
- LVAD settings and alarms
- Emergency contacts and procedures
- Driveline care and precautions, including sterile dressing change and preventing infection
It may feel overwhelming at first, having to learn a new technology right after a major surgery, and you may feel nervous about having to make sure your device is working properly at all times. But remember: your medical team will give you thorough training on how to use and maintain your device, and you won’t leave the hospital until you’ve mastered it.
Read more about LVAD devices and equipment, including links to specific device manufacturer patient guides.
Leaving the Hospital
When your LVAD team decides you’re ready, you’ll either go home or move to an LVAD-trained rehabilitation facility to continue your recovery.
Before you leave the hospital, both you and your caregiver will need to have completed your LVAD training and testing (written and hands-on) and have shown that you or your caregiver can correctly change your driveline exit site dressing. You will also have to be physically strong enough that you need only minimal assistance with basic tasks.
You’ll most likely go home on the following medications:
- A standard regimen of heart failure medications, tailored to your needs
- Blood thinners
- Pain medications
- Any other medications for non-heart-failure-related conditions that you need
You may have mixed feelings about going home. On the one hand, you may be relieved, while on the other hand, you may be nervous about maintaining your LVAD equipment and driveline site on your own. Remember that you will have written instructions for everything, regular follow-up visits and access to your LVAD team 24 hours a day in case of emergency.
After you return home, you’ll have appointments at regular intervals (usually frequent at first and becoming less frequent over time) at your VAD clinic. Remember always to bring your backup equipment with you to these appointments and whenever you leave your home.
During the clinic visits, you may have your vital signs checked, your exit site checked, blood drawn and echocardiograms performed. Your LVAD numbers and history will be checked and any problems will be investigated. The LVAD team may also want to check your backup controller. It’s important to bring a current medication list with you to each appointment and bring up any issues or concerns you may have.