Activities of Daily Living are the tasks which people perform as part of their daily lives and include work, home-duties, self-care and leisure tasks.
Following your cardiac surgery there are some activities that you should not do for a while to ensure that you allow your sternum to heal effectively and to have a good recovery. These guidelines are based on two principles – the amount of energy required and the positions and movements that are required for you to do the activity.
As everyone is different, this information is a guide only. Your Doctor may make changes to suit your specific needs and goals. Be aware that different surgical procedures may also affect your recovery rate.
It is important not to overdo it as during the initial recovery period all activities are considered as work by your body. You will begin to return to normal levels of activity around 2 to 3 months. Remember to gradually increase your activity levels. Therefore, you need to listen to your body and rest when you are tired. You may find that everyday activities are initially quite tiring. If some activities are associated with undue fatigue, decrease your activity level and build up again more slowly.
When at home, it is important to continue with regular rest breaks during the day, especially during the first fortnight at home. You may find visitors tiring so try to limit these initially.
AVOID STRENUOUS MOVEMENTS FOR 3 MONTHS
- Avoid straining, heavy lifting, pushing or pulling activities. Do not hold your breath while doing these activities e.g., carrying heavy groceries, pull starting the mower, pushing a wheelbarrow, picking up young children, shifting furniture, opening tight jar lids etc.
- Avoid activities that cause a shearing or twisting movement of your breast bone i.e. heavy carpentry work, swinging a golf club, casting a fishing rod etc.
- Avoid sharp & jerky movements e.g., Whilst shaking out clothes, dusting, gardening, carpentry work.
Following your surgery some people continue to sit in the shower for energy management and safety. This is usually a simple measure of acquiring a bathboard (if over a standard bathtub) or a shower stool or chair (if a shower recess). Transferring on/off low surfaces may be difficult, particularly for the taller person e.g., toilet seat, lounge chairs. Remember you should not be pushing yourself up, nor using grabrails for support.
Your Occupational Therapist will be able to advise you of the most appropriate equipment for your needs.
It is recommended you bring all of the most commonly used items in your home to waist level to minimise the amount of bending and reaching that you need to do. If you do not live on the ground floor, remember climbing stairs requires more energy than walking. Therefore, take your time and walk up slowly. If you have an upstairs bedroom, there is no need to change where you sleep. Initially, organise your day to minimise the amount of times you use the stairs.
Driving can usually be resumed 6 weeks after surgery though you should confer with your doctor for medical and legal reasons. You may also need to check your car insurance policy to identify any restrictions.
As a passenger, you are still legally responsible to wear your seatbelt. Use a cushion/pillow for comfort and if the seat belt irritates your incision area.
Consider the type of vehicle you will be travelling in as you should not be pulling yourself up and into the vehicle.
Initially, drive short distances for short periods of time in non-peak hour traffic.
Gradually, increase the distance and time period as you become more comfortable and secure with driving again. Extended car trips should be delayed until your follow-up visit to the doctor. When travelling, stop every 1/2 – 1 hour and walk around to improve circulation in your legs and to prevent swelling.
You should not expect to resume total responsibility for household duties for 3 months after discharge, until your doctor gives you clearance.
After your first 2 – 4 weeks at home, you may gradually resume more light duties, e.g., light dishes, folding small items, dusting, laundry (do not remove from machine nor hang out the clothes), light cooking, light sweeping.
Activities such as making your bed, vacuuming, and mopping should be avoided for about 2 – 3 months, or until specifically allowed by your doctor.
Very heavy housework (e.g., shifting furniture, scrubbing the bathroom, cleaning ceilings) should wait until closer to 3 to 6 months before you resume them, or until specifically allowed by your doctor.
Usually sexual activity can be resumed during the first fortnight following discharge, or when both partners feel that the time is appropriate. As with any activity, it should be undertaken within guidelines. These guidelines include the following:
- Find a comfortable position and adopt the more passive role initially. Avoid putting weight through your arms and shoulders during sexual activity for 3 months post-surgery.
- Wait for at least an hour following meal or alcohol consumption.
- Avoid sexual activity when you are tired or stressed.
- Use a room of moderate temperature.
As with any physical activity, your heart rate will increase, but this is a normal response and should not alarm you. Check with your doctor if you have any concerns.
Light gardening (e.g., watering, light weeding, tending pot-plants) can be resumed 2 – 4 weeks post-surgery. Ensure you are seated and in a shady area.
- Initially start with light activities such as reading, videos, television, cards, light crafts and other light tabletop activities.
- Sewing, knitting and handicrafts can be resumed for small items and for short periods only.
- Small social outings can usually be resumed 2 – 4 weeks post surgery.
RETURN TO WORK
As a general guide:
- Individuals involved in sedentary occupations (e.g., clerical, managerial, supervisory) may usually return to work at 6 – 8 weeks.
- Manual workers may usually return to work after about 3 months. Some heavy manual workers may be off work for longer periods of up to 6 months, depending on the demands of their job and what physical condition they are in.
- Negotiate with your employer a return to work program that may involve reduced working hours, lighter duties, more rest breaks and fewer responsibilities to have tasks performed by deadlines. This is so you can ease back into work.
- Consider the amount of physical, mental and emotional stress involved in your job.
- Consider the amount of driving involved and also the type of vehicles you will be using. You need your doctor’s clearance for returning to driving in a work capacity.