Questions

Esme12, ASN, BSN, RN · Dec 11, 2013

He has a dressing, and it was changed today by a home health nurse :/
His blood sugars aren't being checked, but I will bring my monitor with me, just so I feel better lol.
He was discharged 4 days post op, much earlier than I had anticipated so my mom is there with him now. I guess he is doing a lot of walking and even helped prep dinner! NOT what I'd expected, lol. I think he is having a hard time because he has now quit smoking, for the first time in 45 years.

Four days is average for uncomplicated CABG these days......I remember when we kept them snowed for DAYS, times have thankfully changed.....remember he is just recovering from a surgery.....he was broken before...now he is fixed. If he isn't diabetic he doesn't need his glucose checked.

Let him do what he wants....let him move around. He was technically sicker before the open heart. He will feel worse before he feels better. Many patients feel GREAT post CABG, they feel lucky to be alive. Some patients experience something that is called post pump euphoria they are high on life and want to thank everyone for being alive including the janitor.....they FELL GOOD! and then about 5-6 days in they want the address and phone number of the driver who was driving the mack truck who ran them over so they can personally kill the driver. They will wonder if it was worth it...they feel like crap. This too will pass very soon....don't fret.

In reality it will take a couple of months of fatigue before the will feel "normal" again....all normal.

Like I said before.....be a daughter....give him love.

ComeTogether, LPN · Dec 11, 2013

sallyrnrrt, ADN, RN · Dec 11, 2013

dilaudid is more than adequate, different patients have different tollerance with opiods, shockingly my husband has done quite well on on 5-10mg norco he is five weeks post cabg, i did have surgeon double wire his sternum...... he is an engineer, and already back to work........litteraly went back to work for about two hours 2-3 days at 3wk post op, with me driving.......off all pain meds 3-4 wks......since double wired, able to drive at four weeks....but really waited till five wks.

Esme12, ASN, BSN, RN · Dec 11, 2013

I Dilaudid should be fine for his pain. I live 1100 miles from family and I know exactly how you feel....give your dad a hug from all of us!!!
Positive thoughts and prayers for his speedy recovery! ((HUGS)) Good luck on your exams! Have a safe journey!

MendedHeart · Dec 12, 2013

is your father a diabetic? if he is not , there is no reason to be checking his sugar. glad he is able to prep etc.....
yes CABG go home 4-5 days post op.......

This is not true. We check our patients sugars regardless if they are diabetic or not. Tight glucose control is crucial in preventing sternal wound infections and in aiding the healing process. Now, if he had normal blood sugar for a day or so pre discharge then he probably fine. I have been working with CABG patients for 6 years. Its not the meds that increase his BS its the surgery and stress on the body. The stress responce increases blood sugars .If he was recieving insulin, then they were elevated at one point. If they are back to normal now, fine, thats awesome. Im.sure they would have told him if he needed to check them, so probably not, thats why I was simply ASKING if he was still checking them, that great if not and one less thing to worry about. Usually it takes longer than four days for them to stabilize but I have seen it in a few otherwise healthy patients. Wonder why he still has a dressing? Good luck to him..walk,walk,walk!

ComeTogether, LPN · Dec 13, 2013

I getcha. His BS has been under 100 all along. He even has awesome blood pressure.....a little too awesome if you ask me. I'm keeping an eye on it bc its gotten pretty low a few times. But overall He's doing well. Walking a lot and getting up with no assistance. His biggest complaint is that he can't sleep poor guy. Man I never want to go through this kind of surgery!!!

Drsg is on the 3 wounds from his "garden hoses" as he puts it haha. I mis understood my mom.

Esme12, ASN, BSN, RN · Dec 13, 2013

I getcha. His BS has been under 100 all along. He even has awesome blood pressure.....a little too awesome if you ask me. I'm keeping an eye on it bc its gotten pretty low a few times. But overall He's doing well. Walking a lot and getting up with no assistance. His biggest complaint is that he can't sleep poor guy. Man I never want to go through this kind of surgery!!!
Drsg is on the 3 wounds from his "garden hoses" as he puts it haha. I mis understood my mom.

Why too awesome? The blood vessels are fixed and the heart is getting oxygen now. He was sicker before the operation. Watch his B/P because that can mkae him dizzy but DO NOT HOLD any meds without calling the MD many cardiac patients need these meds for reasons other than B/P control!

Have him call his PCP if he can't sleep...I'm gad he is doing well!

ComeTogether, LPN · Dec 15, 2013

It was 93/46 so I was getting a bit concerned. I didn't hold anything I called the doc to see what he wanted to do. I would never hold anything that was scheduled. He's def. Not on the bp med for hypertention so I knew there was a reason he was on it. Md thinks catdiologist will lower it this week.

MendedHeart · Dec 15, 2013

Did he give you hold parameters?

Half our patients on BB and other cardiac meds that affect BP will have hold parameters for SBP

ComeTogether, LPN · Dec 21, 2013

Did he give you hold parameters?
Half our patients on BB and other cardiac meds that affect BP will have hold parameters for SBP
Sort of. He had me hold it the next day and the cardiologist ended up cutting the dose in half. He's doing really well with the only concern being quiet lung sounds on the right side. HH nurse is keeping an eye on it and I'm back home now.