As a physiotherapist on a surgical ward, we spend most of our time convincing patients that getting out of bed, no matter how painful it is, will actually make a difference!! So when faced with a patient who wont stop walking 3 days post 4x CABG, i was lost on what to do. She has an interesting social history and is a carer for both her son and husband. This patient has just had open heart surgery and cant wait to get home so she can help out.
In terms of cardio problems, her SpO2 remains stable however she gets SOB post walking. Her chest is clear, she does ALL her breathing exercises, she does ALL her UL and LL exercises and she walks around as much as she can. The problem is.... she wont stop!!!
She has an anxious personality and is continuously on the move. I am currently trying limitation stratergies with her to minimise the work she is doing. I have told her to walk only 4-5 times a day and only do her breathing exercises 4 times a day. She is NOT to try ANY lifting of carer duties for the first 3 months. We are CONSTANTLY reminding her that she is to put herself first. If she is unwell and requires more surgery, it will take longer for her to recover completely. She is a hard patient to monitor because all the usual tricks don't apply.
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Well, what strategies have you implemented so far?
I would consider educating her the fine lines between overexercising and under exercising. U can also explain to her that strenuous activity sometimes may cause adverse effects rather than positive effects. I suppose you'll hav to word it carefully so she doesn't kick into underdrive and become one of those or the majority of those patients who doesn't do their exercises. Good luck!
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