You will be given a list of your medicines when you leave the hospital. It is important to bring this list with you to all of your visits to see a doctor.

Take only those medicines on your list. Medicines you were taking before the operation may not be needed and could be harmful to you if taken after surgery. If you have questions about your medications, talk with a pharmacist or your cardiologist.

When you leave the hospital, you will be given a 30 day supply of any new medications. Your cardiologist will review these new medications with you at your follow-up appointment (usually 7 to 10 days after you leave the hospital), and discuss any changes in your doses at that time.

It is very important to take your medicines as directed. Many people find that keeping track of their medication on a chart or using 7-day pillbox can help them remember to take their medicines.

Take your medicines during the times you are awake because you need your rest. Do not set alarms to wake up at odd hours of the night to take medicines.

Remember to take medicines with food, unless otherwise instructed, to prevent nausea or upset stomach.

Avoid stopping or starting any medicines unless you talk with your doctor first. If one medicine causes problems for you, there may be another type that can be substituted that will work better for you.

If you are taking Coumadin (Warfarin) when you leave the hospital, a pharmacist will review this with you. You will be given a booklet with information about Coumadin in your discharge packet. Blood tests are necessary to regulate the dose of this medication properly. Before you leave the hospital, you will receive instructions about when blood tests will be needed.

Talk to your cardiologist or primary doctor before taking any nonprescription (over-the-counter) drugs. Please keep all medications out of the reach of children.

• Poor appetite is normal. It is normal to have a poor appetite for a week or two after surgery.
• Food may taste different. Food may not taste the same or "right" for a while. This may be due to some of the effects of anesthesia and new medications.
• Cold foods may be more appealing. Cold foods may seem better than hot foods, which can have odors that bother some people.
• Small meals may be preferable. You may find it easier to eat several small meals spread throughout the day rather than three large ones.
• Do not diet. Your body needs calories from food to heal well. During this recovery time, it is not a good time to go on a diet or try to lose weight.
• Avoid alcohol. You may be taking pain pills and sleeping pills during the first month after surgery. It is recommended that you avoid alcohol, or, limit yourself to one drink per day with food. One drink is equal to 5 oz glass of wine, 4 oz of beer, or 1.5 oz. of alcohol in a mixed drink.
• Get plenty of protein. Eating a well balanced diet that includes protein will help you heal and build muscle. Sources of protein include lean red meat, fish, chicken, beans, and low-fat dairy products.
• Avoid foods high in fat. A diet low in fat and cholesterol is recommended for a healthy heart. However, if you were not on this type of diet before surgery, do not try to change your diet during the first month after surgery. Switching to a new way of eating may cause you to eat less, and this may slow healing. After you have healed, it is recommended that you slowly change your diet. For more advice and help in learning about heart healthy diets, call the Kaiser Permanente Multifit Program.
• Avoid cholesterol tests for 3 months. Cholesterol tests will not be accurate until 3 months have passed. When you do get a cholesterol test done, ask for a Full Lipid Panel. This type of test will tell you more information, including your level of good cholesterol (HDL), bad cholesterol (LDL) and triglycerides.

Key Points to Remember
Eating a well balanced diet is important for your recovery and healing. It also minimizes the risk of infection. To eat a well balanced diet, eat a variety of foods every day. Try to eat enough to maintain your current weight. This is not the time to lose weight.

Limit foods that are high in salt or foods that are processed. Eating these types of foods may cause fluid retention and lead to shortness of breath.

If your appetite is not very strong:
• Try eating smaller meals more frequently.
• Eat foods that you like, even if they are "not on your diet".

If you are experiencing nausea and/or vomiting:
• Try eating smaller meals more frequently.
• Avoid eating sweets and fried or fatty foods.
• Eat slowly and chew your food well.
• Eat dry foods such as toast or crackers. They seem to help ease an upset stomach. Drink cool, clear beverages, such as apple juice.
• If the smell of food makes you sick, try to stay out of the kitchen if possible while your food is being prepared.
• Avoid lying down for at least 2 hours after eating.

Contact your Kaiser Permanente Health Education Center or Department for information about the cardiac nutrition classes offered or contact a Kaiser Permanente registered dietitian. You can also find information about heart healthy eating, a health encyclopedia, and other resources online at your physician’s Home Page at kp.org/mydoctor.

SMOKING
If you smoke, quitting is one of best things you can do for your health. Some health risks caused by smoking or second hand smoke exposure include:
• Increased risk of lung and heart disease
• Increased cholesterol deposits that can damage blood vessels in the heart and worsen heart disease
• Increased risk of blood clots in the heart and brain, which can be very harmful
• Decreased levels of the good cholesterol (HDL) in the blood
• Disturbances in your heart rhythm that can lead to sudden death

Quitting smoking is not easy. Contact Kaiser Permanente’s Multifit program, the cardiac rehabilitation program, to learn about programs to help you quit smoking. Your local Multifit program’s contact information is contained in the Programs and Classes section of this document. You can also use an award-winning, personalized online smoking cessation program called HealthMedia Breathe® at kp.org/healthylifestyles or by calling the free telephone counseling program, California Smoker’s Helpline, at 1-800-662-8887.

STRESS
Stress is a normal part of life and not always bad. However, when you experience negative stress, it can make you feel anxious and can affect your whole body, especially if you have developed habits such as smoking, drinking, or eating to help you deal with your stress. There are ways to help minimize and handle the stress in your life.

Call Multifit, the cardiac rehabilitation program, to learn about the variety of programs that can help you manage your stress. To learn more about Kaiser Permanente classes or online programs to reduce stress or understand mind/body health, contact your Kaiser Permanente Health Education Center or Department or log onto www.kp.org/healthyliving.

Physical activity can reduce stress
Doing regular physical activity has many benefits. It can improve your body image, help reduce stress, make your heart stronger, and lower your blood pressure.

During the first 4 to 6 weeks after your surgery, you will receive specific instructions regarding activities to help you recover. Doing these activities – and avoiding others - can help your healing process.

After you have passed the 6 week mark, get in touch with Multifit, the cardiac rehabilitation program, to develop a regular exercise program that works for you.

DIET
What you eat can have a significant effect on your ability to maintain the health of your heart after surgery. Known dietary factors that contribute to heart disease include obesity and a diet high in cholesterol and saturated fats. So, in order to keep your "new" heart healthy, you need to decrease your fat intake and increase the carbohydrate and fiber content of your diet. These changes are not recommended for a limited time period after your surgery, but rather as long term changes in the way you eat.

For assistance making changes in your diet, call Multifit, the Kaiser Permanente cardiac rehabilitation program. You may also contact your Kaiser Permanente Health Education Center or Department for information about the cardiac nutrition classes offered or contact a Kaiser Permanente registered dietitian. You can also find information about heart health eating, a health encyclopedia, and other resources online at your physician’s Home Page at kp.org/mydoctor.