Recovering At Home

Recovering from surgery at home can be difficult. Get practical tips, tools, checklists and advice.

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Why Wear Emergency Medical Identification

Lessons Learned From Men and Women With Heart Conditions and Their Family

Emergency Medical Identification   

More than 117 million Americans are treated in hospital emergency rooms each year. A doctor you’ve probably never met must make

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You only have 3 choices in life. Give up. Give In. Give it everything you’ve got!

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After a Stroke -- Medications: Questions to Ask

After having bypass heart surgery, Mattie, 66, had a mild stroke two weeks after returning home. One side of my face felt numb, wet with perspiration, nauseous and about to faint,  my husband thought I was having another heart attack and called 9-1-1, ” Mattie said. “Within what is called, ‘the golden hour,’ I was treated, and told this has helped me very much.” she says.     We asked Mattie the challenges she has faced and information she thought should  be included in a new ebook, Stroke – A Guide for You and Your Family.  Mattie said, “the questions to ask about medications and side effects to report would be helpful.”                          Questions to Ask the Doctor and Pharmacist When you get a prescription, a printed description of the medication should accompany each of your medications. First, read it to see if you have the answer you need. Then ask the pharmacist to add information not covered in the enclosure. Most pharmacists will welcome the opportunity for a professional consultation.

What is each medication for and what are the expected results?

What are the generic and brand names?

How much do I take at one time? How often do I take it?

How and when should it be taken? In the morning, and/or at night? With food? On an empty stomach?

May the amount be doubled if one dose is missed? Or should I skip it?

Which are the foods, vitamins, and alcoholic beverages to avoid?

Which are the over-the-counter products that may not be used when taking the medicine? Why?

Can I simplify my drug routine: Which drugs can be taken together? 

Ask if you can take a drug just daily, weekly, or monthly rather than several times a day.

How soon should the medicine take effect? How long should I wait before calling if the medicine does not help?

If I feel better, should I stop taking the medicine?

If I have prescriptions I was given in the hospital, including pain relievers, sedatives and laxatives should these be stopped? Ask your doctor about this.

Possible Side Effects

What are the potential side effects or adverse reactions?

What are the specific side effects that must be reported immediately?

May I drive while taking this medicine?

Does the medicine affect the pulse rate? What bearing does this have on monitoring the pulse when exercising?

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Calling 9-1-1 – 188 Million Calls a Year

Get help immediately, even if a family member wants to wait

If you believe it is an emergency, it probably is. Expect a “denial” from your family member. It’s normal for someone with chest discomfort to deny the possibility of something as serious because they are frightened. Don’t let this stop you. Take prompt action anyway. Most people wait close to two hours before getting to the hospital for the medical care that they need.

Dial 9-1-1.  Or dial “O” and you will be connected to these services.

Report a possible stroke. Try to stay calm. Answer questions in clear, short answers.

If you need a translator, ask for one immediately.

Do not hang up first: Wait for instructions.

Stay calm so that the dispatcher understands you.

Focus on what you can do. Though you may be frightened, try to do everything in a steady and reassuring manner. The person will read your face and will react if you have panic in your eyes or in your voice.

You can better able to grasp the situation more fully. Trust your ability to handle everything.\

Tell yourself that you can’t panic.

Reassure yourself that you are doing your best and you will be able to help.

What to Say

Be prepared to give your name, address and apartment.

If you are at work, give address of the building and floor.

After you Call 9-1-1

Write down the name of the person’s doctor and phone number, medical conditions.

Write down the person’s current medical conditions, such as diabetes.

If you are in a private house: At night, turn on an outside light; if possible.

Or send someone out to watch for the ambulance, and to be ready to direct the rescue personnel.

Emergency department will call your doctor for your medical history, including the names of all prescribed medications. 

How to Prepare for an Emergency  

Be able to identify the early signs of a stroke, cardiac attack, or other emergency.

If a family member has recently had surgery, has a heart condition, a pacemaker, ask your primary medical provider for the warning signs you need to know that may indicate an emergency.

Know what to do in an emergency. Write down steps to follow in an emergency from what you have learned.

Act immediately. If your family member is experiencing signs of a heart attack. Warning signs lasting two minutes or longer — do not delay getting to the hospital.

If you believe someone is having a stroke, call immediately without waiting for things to improve.

Make every effort to remain reassuring. After EMS has been called, and you are waiting for medical help to arrive, make every effort to remain calm and reassuring. Make the person comfortable by loosening clothing, such as by opening a collar or a belt. It may actually be better for the person to be sitting rather than lying down in case vomiting occurs. Except for some water, it is best not to allow the person to drink anything. 

Ask your doctor the steps to take in an emergency. Ask symptoms that indicate you need to get to the hospital without waiting for the doctor’s return call.

Ask your doctor on which hospital he/she is on the staff.

Ask your doctor other safeguards you should consider. Particularly if you are alone for long periods of time, find out if your doctor recommends that you consider a personal response system to alert EMS.

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After a Stroke – How to Save Your Energy

It's not a question of will a stroke change your life, but how it changes it,” says Michael Ajamian, 63, an award-winning journalist, who had a stroke after bypass surgery.  When insurance payments stopped for Michael’s physical therapy, my own ‘personal rehabilitation began.’  “Using both my affected and unaffected side I work out, do tasks that interest me.  I put my unaffected arm in a sling – something called ‘constraint therapy,’ that insists I use the weaker side.  I’m an athlete in training – not just during the season – but forever because it’s the only way my brain will re-adapt. I see what I’ve been getting back what was injured in my stroke.

Men and women who have had a stroke say have a plan and work your plan:

Saving your energy may depend on asking for help when you need it. If your stamina level is low, arrange your personal activities (bathing, shaving, or washing your hair) over several hours.

Wear loose-fitting clothes at home, especially during early convalescence.  Consider wearing a comfortable, lightweight jacket and jogging pants with non-binding elastic waistbands, Velcro® fasteners, and front closures that are easy to put on and put less strain on you during any activity.

Sit rather than stand. It takes less energy to sit, so when possible, sit on a stool or folding chair while bathing, brushing your teeth, and washing dishes. Use a lightweight tray table on wheels to save yourself unnecessary walking and exertion.

Avoid reaching and raising your arms above shoulder height. Dressing, shampooing your hair, doing laundry, preparing meals, and other similar activities can be tiring-but they can be simplified. Try slip-on shoes to avoid bending down.

When you climb stairs, monitor your breathing pattern. First, breathe in deeply through your nose. Next, exhale through pursed lips as you climb a couple of stairs. Stop, rest, and breathe deeply and slowly. Continue climbing two or three steps while you exhale. Stand still when inhaling. Hold on to the stair rails whenever possible for extra support.

Try not to lift or push anything heavy. When you carry something or exert energy, always exhale before doing so. Find stores that deliver, even if they charge you extra, so you do not carry heavy packages. Order just about anything online and have it delivered within a day or so.

Look online for a delivery service in your community. A delivery service will pick up and deliver almost anything, including your medications — even a meal from a restaurant!

Hire an errand runner. Post the job on bulletin boards and stores online and see how many people are eager for the opportunity! High school and college students can go shopping, do chores, or go with you when you visit the doctor.

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How Terri’s Daily Schedule Helped Her

After Terri Fuentes’ heart surgery, her choice was clear: “Either I would do too much, too soon -- scare everyone that I’d land back in the hospital. Or, I’d give my body and mind time to heal — and pace myself,” she says. At 44, Terri wears many hats — wife, mother, homemaker and interior designer. “I needed to go back to work to pay the big hospital bills, even with health insurance,” Terri says.  

In recovering at home, fatigue after heart surgery can be overwhelming.  We asked Vivian Goslin, an occupational therapist, why being aware of time and how to balance activity, and then to rest, is especially important while recovering at home after surgery or a stroke.              

Vivian explained that “it helps us guide ourselves by thinking of everything we do around time: we use time to orient ourselves: When we wake up in the middle of the night, the first thing we invariably think about is what time it is.” It helps,” Vivian told us, “to build a structure into the day, so we know what we’re going to do until it becomes second nature, and lets us be more accountable to ourselves and others.”    Vivian recommends how to manage time to the best effect:

Awareness of time helps to organize the whole day. As you are recovering at home, record how much time it takes you to accomplish everyday activities, such as getting up, bathing, dressing, exercises, and eating, you can estimate the time you need for your daily routine without feeling rushed. It’s not a test of your abilities; it’s simply a way of gathering information to add quality to your day. 

Aware of time will help you follow your schedule. We think of everything we do in terms of time, whether it's morning, afternoon, or evening. We are used to doing certain things at set times. Even when there is difficulty with the concept of time, if you connect the things you do with it, you will develop a structure to your day. Such structure has built-in discipline and accountability, so you are more likely to feel good about yourself when you own your own time.

To stay organized visit www.cozi.com to download a free calendar, to-do and shopping lists

Digital watches and clocks are easier to read than their analog counterparts. The whole time, such as “8:45 a.m.,” can be seen at a glance, so you may find these easier to understand. Some people set an alarm as a reminder to take their medications and to keep track of other things they wish to remember.

It's easier to set realistic goals when you focus on time. We are better able to harness our energies around goals when we are conscious of time. It helps us to prioritize activities and then apportion our time accordingly. When you have positive attitudes toward time, you will find it an ally, and not something you need to compete with.

Terri’s daily schedule – during her early recovery days  

7:30  Wake up; take a resting blood pressure.           (See my kids off to school) 9        Take meds Breakfast; relax/read/watch TV 10     Shower; rest, get dressed 11        Meds; rest/Make phone calls 12       Walk; (inside/out); relax; eat lunch.  2          Relax. Plan dinner 3          Kids home/Walk; then take pulse 4         See friends; snack, meds 6         Eat dinner 7         Relax/TV 8:30   Get ready for bed; Meds before bed; take blood pressure

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After a Stroke – Questions Nurses Can Answer

Before you leave the hospital, during the last few days are the most important time to practice — as well as you can — sitting up and maintaining your balance, transferring from the bed to a chair or wheelchair, dressing, eating, bathing, and doing exercises. At home, these activities will continue with a family member or other helper assisting you.                         Nursing care at home is especially valuable if the family member who has had the stroke is elderly, has arthritis, high blood pressure, or heart or respiratory conditions that require special medical procedures, such as giving injections and monitoring blood pressure and pulse.  Arranging for one or several visits from a home-care nurse adds to the family’s  confidence: it can provide reassurance they need to manage on their own.             Specific Questions Nurses Can Answer

Are there detailed instructions on medications, diet, physical therapy, speech therapy, and occupational therapy in my hospital discharge plan? Are there instructions that the primary caregiver needs to have explained?

What should the primary family caregiver and other helpers know about care at home, including the scheduling of medications, monitoring pulse and blood pressure, incontinence, the depression, disorientation?

Are there side effects from the medications that need to be reported to your primary care doctor?

What do the family caregivers and other helpers need to know about the purpose and scheduling of each of the medications? Are there potentially serious side effects from the medications that we should be aware of?

Should blood pressure be taken at home? If so, how often? Is there anything else that we should monitor at home and record for the visiting nurse, physical therapist, or doctor?

What are the signs and symptoms the family and other helpers need to recognize that may indicate an emergency?What medical supplies or other equipment are needed during the recovery process?

Is there anyone on the nursing staff who can answer questions over the phone after the family member has left the hospital? If so, write down their name(s) and phone number(s.) At hospitals and other larger medical facilities, it's important to get the specific phone extension numbers or direct dial numbers.

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After Heart Surgery – Questions About Returning to Work

Terri says jokingly, “once I knew I was going to live after heart surgery, one of the first questions I asked my doctor was when I’d be well enough to go back to work?”  Her cardiologist and she had not spoken about her work: from the form I filled out, he knows I am an interior designer. “We didn’t talk about how I respond to its pressures.  Certainly I didn’t bring up my apprehensions about keeping up, or in this economic climate, my job security. We talked to Terri when she returned to work, four months after her surgery, for a new ebook, Heart Attack – A Guide for You and Your Family. Most doctors are hesitant to bring up personal subjects about work and financial concerns, fearing that it invades a person’s privacy, as well as being out of their realm. So the whole area of work and its stresses can go unnoticed, especially if the doctor sticks strictly to medical questions. Millions of men and women successfully return to work after a heart attack or bypass surgery.  For Terri, at 44, working at home part of time remains an option because of the computer, overnight delivery, and Skype, and eliminates the need to commute. Terri’s father, whose bypass surgery five years before Terri’s surgery, was asked to take early retirement, which he viewed as unwelcome reward for his hard work. Yet, like many others, with new found time, he enjoys personal interests that he previously was too busy to pursue. Questions Terri and her husband asked as they looked at her work

Can I do the work I once did? Is it possible for me to return to the same job?

What do I need now to do my work? Do I need to rest more frequently?

Can I work either part-time or full-time? Can I work at home?

Should I do another, less demanding kind of work even if I am paid less?

If my work entails standing for long periods of time, can I instead work sitting down?

What transportation can I use to get to work?

What are my financial resources? Do I have enough to cover my needs on a long-term basis if I am unable at first to have the same earning power?

What am I entitled to get in unemployment insurance and disability benefits?

Do I need to think about moving closer to my place of work? What are the advantages and disadvantages of living somewhere else? Is it worth it to me financially and emotionally?

Do I need to think about a shared living arrangement to reduce my expenses, to bring in additional income, or to create a feeling of added security? 

How do I want to spend my time? Do I want to spend the time differently than I did up to now? What are the interests that I’d like to pursue?

How do these changes affect my family?

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After a Stroke – Encouraging Communication

Betsy Mandel was determined to find ways to get her mom to start talking again since she had her stroke. The speech and physical therapists had cautioned Betsy: “Insurance will run out for therapy,” they said.  “Someone may even tell you your mom has gone as far as she can go. Don’t believe it!  Years after of a stroke, the brain will continue to adapt itself and can bring about a return of what was lost. Your help is needed to continue the speech training, along with assisting in repeating daily activity tasks and exercise.”   Betsy acted on the old Buddist saying: “use everything.”  “Out came our old family photographs. Baby pictures and summer days at the beach covered the dining room table.  Slowly, very slowly, a smile crossed my mother’s face.  And some times tears,” Betsy said.  “And I shut up, giving my mom time to think, talk, or not.”       Before Leaving the Hospital: Questions for Speech Therapists Whether the stroke is on the left side of the brain, the right side, or in deeper structures, it can alter the ability to comprehend and express oneself. The stroke may affect listening, attention, remembering what was heard or seen, pronouncing sounds, visual perception, reading, recalling words, forming ideas into spoken messages, spelling, writing, and computing numbers. One person may experience few of these changes, while another may find many affected. Regardless of the type of communication change, therapists can evaluate how the stroke has disrupted a person's ability to communicate and begin to work on building and strengthening communication skills and developing new ones. Speech/language pathologists help people communicate, and that involves far more than speech alone. Increasingly speech/language pathologists are offering guidelines to the entire family on how to encourage language in “teachable moments” that take place naturally throughout a typical day. Only when the work begun by the speech therapists is continued always, is there a chance to reclaim what was lost in the stroke.

Has speech therapy been prescribed? Are instructions in my written hospital discharge plan that needs to be explained?

What sources of information – books, apps, games, or other instructions my family need to know?

What should the family and me know about an evaluation that has been made?

Is there a speech therapy staff member who will answer my questions after I leave the hospital? If so, write down his or her name, phone number, and extension.

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Stroke Emergency! What to Do

Arthur and Br­­­­­­yna Marantz were apprehensive about his returning home. “So much had changed in our lives and we were now on our own,” Bryna said.  Her main concern was how she would handle an emergency.  If it was another emergency, some reoccurrence what steps should she take?

We interviewed them for the new ebook, Stroke — A Guide for You and Your Family.  Bryna said, “like us families are concerned about how to handle an emergency, but others rationalize that they have a good doctor, so they do not have to know what to do if an emergency occurs.”  

“Every minute counts,” the slogan of the American Academy of Emergency Medicine.  Medical intervention at onset of a stroke can reduce negative physical consequences.

During a stroke, most people have one or more of these symptoms:

sudden weakness or numbness of the face, arm, or leg

loss of speech or trouble speaking or understanding speech

dimness or loss of vision, particularly in only one eye or half of both eyes

sudden onset of blurred or double vision

unexplained dizziness

sudden onset of unsteadiness, lack of coordination, falling, or difficulty walking

sudden excruciating headache

recent change in personality or mental abilities, including memory loss.

Some warning signs of stroke are common and relatively easy to spot. Other signs are harder to detect, particularly a transient ischemic attack — known as a “mini- stroke.”

More information coming

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Stroke Victim says: “It's like waking up in Thailand”

“It's like waking up in Thailand,” says Tom Watson, 65, whose ‘personal speech therapy,’ continues long after insurance covered his formal sessions.  He attends an aphasia group once a week, uses computer software designed for people with aphasia, and watches Sesame Street with his grandkid’s which helps him relearn basic language skills.

We asked Tom about his experience in recovering his speech for a new ebook, Stroke – A Guide for You and Your Family – to ask what he would like to see included. Tom said: “In the hospital and then in rehab, you receive speech and language therapy – it’s an important first step to regaining skills and adapting to problems.  Then, just when you still have a great deal of work to do, insurance payments end.  It must not stop there. You keep at it, until you get back what you've lost,” Tom says.  “Use everything that helps you – kid’s books, video games, the computer, software, magazines, an iPad -- anything that interests you.” Some men and women who have had a stroke are unable to understand what is said or seen.  A stroke may affect their ability to write, spell, gesture, or speak. Or make themselves understood. “Please give me a glass of water” one person may say and it comes out “Put the store in the table” or something unintelligible “Wile dare pender glissen. ”                          Learn About Aphasia • Aphasia does not affect intelligence. People who have survived a stroke remain mentally alert, even though their speech may be — either temporarily or always — difficult to comprehend because it is jumbled, fragmented, slurred, or totally incoherent. In thinking of these trying days, Tom says, “you sit down with yourself, with your faith, and say, ‘This too shall pass.’” • Almost all people with aphasia have some difficulty understanding spoken language. For example, some people may not associate the spoken word with an object or picture. “I may ask him to pass me his plate and get a fork,” says the wife of a stroke survivor. “This is where family members play a vital role in encouraging communication and reestablishing the self-esteem that is lost in this devastating experience,” she says. • Someone who has had a left-hemisphere stroke may have difficulty understanding conversation, speaking, gesturing, concentrating, listening, reading, or writing. The person also may have a right-sided weakness or paralysis. • Someone who has had a right-hemisphere stroke may have problems with using good judgment, concentration, memory, or reasoning. This person may speak excessively, be self-involved, find that time and space concepts are difficult, and neglect the left side of the body or environment.

More information coming

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After a Stroke — Help Needed. Who Will Do What, When

Leaving the hospital after his stroke, was a mixed blessing for Arthur Marantz, 75, looking back at it, a year ago.  “I was the go-to person in my family and beyond.  Now I was the one who needed people helping me — paid help was needed, my wife, Bryna, couldn’t shoulder the complete burden.” he said.   Life after Arthur’s stroke, Bryna says, “felt as through I’d been handed a script I hadn’t studied. Even now looking at him, you never would suspect he had a stroke.  He has no paralysis, he is outgoing and generally in good spirits. Yet we have traded places in our traditional roles,” she says. The responsibilities for personal investments and managing their home and property are hers for the first time in more than forty years of marriage.  “When we go out to dinner, I do the ordering and pay the check — which sometimes causes some surprised glances!  He finds it too confusing to read the menu, handle money, or sign a credit card,” Bryna says. Bryna is one of an estimated 70 million caregivers who assist a family member in the U.S.  We talked to Bryna about her experience for a new ebook, Stroke – A Guide for You and Your Family.  “For months, I was a part of almost all of my husband’s waking hours.  Gradually, I was beyond exhaustion,” she said: “Even if it is on a part-time basis — and probably not covered by insurance, someone who assists can give a caregiver a chance to rest and renew, to leave the house for a few hours to do other things that matter without worrying about leaving their loved one alone.”                           Help that may be needed 

Is help needed to provide personal care, handle housekeeping, other household needs?

Is someone needed to assist managing medications — to take them, handle changes, report side effects to the doctor?

Who is on hand that can recognize warning signs of a situation to report it to the doctor  before it becomes acute?

Who will be responsible to shop, prepare nutritious meals, and understand dietary restrictions?  

Is there someone in your home to keep track of doctor’s and therapist’s appointments, keep a list of important names and phone numbers of doctors, therapists and other services?

Can someone provide transportation and sit in on follow-up medical appointments?

Is someone available who could recognize the warning signs of a situation to report to the doctor before it becomes acute?

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HEART ATTACK -- A Guide for You and Your Family

From Kirkus Book Review

Weiner outlines an extensive plan to make life work after or while contending with a heart condition.

This thoughtful, temperate and encouraging program will principally aid those who have just returned home from a hospital, and likely surgery, for a number of cardiac issues.

The guide runs from professional advice to personal, anecdotal experiences. The personal aspect of the book has a profoundly empathetic spirit — important, you-are-not-in-this-alone warmth—that’s particularly appreciated when one’s in the dumps…

Weiner suggests plenty of clear ways to work through the emotional fallout: diet, exercise, physical therapy, home nursing, medications and procedures, curbing expectations, as well as managing medical records and appointments, and understanding your medical bills.

more information coming

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A Roadmap From Men and Women with a Heart Condition

Let’s start with the most basic activities: getting into and out of bed, dressing, bathing, preparing breakfast, walking around in the house, and then going outside.

Try to have the bed near the bathroom, at least for the first few days at home. If at first you find that it is difficult to walk to the bathroom, or if the bathroom is far from the bedroom, use a commode chair. It’s O.K. to ask for help.

Do some slow stretches before getting out of bed. Bend your knees and hips, then straighten them a few times; raise your arms overhead a few times or at a height comfortable for you, then lower them. Take a deep breath while you raise your legs or arms and exhale when you lower them.

To get up from the bed, slowly raise your body from a lying to a sitting position. Make sure you feel strong enough to balance without getting dizzy or experiencing difficulty breathing. Continue to sit on the bed with your feet down for two or three minutes, then slowly get up and stand for a few seconds.

By moving slowly and not making abrupt changes in your position — you’re less likely to become dizzy or faint. If you are straining in order to get to a sitting position in your bed, it may be because your bed is too low or the mattress is so soft that it doesn’t give you the leverage you need to maneuver.

For the video “transferring someone from bed to a chair go to YouTube. Step-by-step instructions, along with other transfers, show you how to do this safely.

Complete bed rest actually deconditions the body. It lowers the heart’s pumping capacity and reduces the capacity of the lungs, alters your heart rate and blood pressure, and increases your susceptibility to pneumonia. These metabolic changes may adversely affect the healing of heart muscles. Get out of bed and dress every day.

Use a comfortable chair with your legs elevated — rest and take short naps, after you eat, walk, or when you feel tired. Your legs should be raised to avoid or reduce swelling of the ankles.

more information coming

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After Heart Surgery

A recent study, reported in the New England Journal Medicine, revealed that 2.6 million older adults end up readmitted to the hospital within thirty days after being discharged. The statistics of “post-hospital syndrome” are so alarming that hospitals are exploring the additional support needed to prevent this from happening.                   We asked Molly Stark’s, daughter, Anna, the plans she and her sister made for the home care for their mom who returned home after bypass heart surgery for a new ebook, Heart Attack – A Guide For You and Your Family. Anna said, “my mother just celebrated her 80th birthday, always a very productive women, she worked with my father to build their business.  Molly’s goal now was to stay in her own apartment. This is possible only with full time help. Her long-term health insurance policy covers certified home care aides from approved agencies.  For now, her wish is coming true. In addition, a housekeeper of many years keeps house, shops and prepares her meals, and sleeps at the apartment during the week, and on weekends mom comes to us.”   Ellen Schaper, has a different experience to report about her seventy-five year old mother, Ruth, who returned to the rehabilitation center after heart surgery because she was simply not thriving. “Ultimately my mom will go to an assisted living facility, covered by her insurance,” Ellen says. “Follow the money trail,” Ellen says. “The cost for full time daily living assistance for someone very ill and elderly is beyond most families,” she says.  “Our family, like most families today, is stretched economically and physically.

Read more information about your A Roadmap From Men and Women with a Heart Condition

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READY FOR ANYTHING After a Heart Attack – FEAR OF INTIMACY

“My wife was as scared as I was after I had a heart attack,” said Ben, “but it wasn’t a time for us to stay silent.  So we talked and decided to go at our own pace -- but to let each other know what that pace was.”    “Test the waters first,” was how Ben’s cousin described it, he had the experience because of his own heart attack. “You may want to just touch and be close, and intercourse may be something for later on, ” he said. We interviewed Dr. Wayne Sotile, a marriage therapist, who works with men and women with heart conditions, for the new eBook, Heart Attack — A Guide for You and Your Family. Dr. Sotile told us that, “the average heart rate during lovemaking is 117 beats per minute, while blood pressure increases to a maximum of 145/87 during a typical sexual encounter. Cardiovascular changes during the sexual activity usually are similar to those experienced during regular exercise.”              

Men may be troubled for varying periods of time by impotency and premature ejaculation.

The need to adjust to more passive positions to place less strain on his arms and chest muscles and to conserve his energy may be necessary. These positions previously may have been unacceptable, but they are now necessary to achieve intimacy and sexual satisfaction.

Women may react for a time with general sexual dysfunction, particularly in becoming aroused and in reaching orgasm. Women and men may be concerned about their attractiveness because of surgery scars or a pacemaker.

You may want to ask your doctor for assurance, or ask for the referral to a sexuality therapist. The benefit of coronary care programs is access to professionals of many disciplines, including support for people working through sexuality issues. Mended Hearts has more than 300 chapters across the country, whose members have had heart surgery and offer support and may also be able to refer you to a therapist.

more information coming

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After a Stroke – Questions to Ask the Physical Therapist

“It's not a question of will a stroke change your life, but how it changes it,” says Michael Ajamian, 63, an award-winning journalist, who had a stroke after bypass surgery. “A pitcher who pitches a no-hitter couldn't win without the help of the other eight players on the team,” he says. “My team was anyone who worked with me in my recovery: my doctors and therapists, my family and friends, and paid helpers. I needed them all to make it.  Even a group of grandmothers I did water aerobics with at the Y.    We asked Michael Ajamian about his victories and defeats after his stroke for a new book, Stroke – A Guide for You and Your Family, available in English and also in Spanish, from Amazon.com for $2.99. Michael’s advice shaped the Stroke ebook:  When his insurance payments for physical therapy stopped -- he said, that is just the start of the work you need to do.

More information coming soon.