Will my fluid restriction change?
While on LVAD therapy, some patients are still encouraged to limit fluid intake to two liters a day. Other patients may need to drink a lot of fluid to avoid dehydration. Your medical team will discuss your fluid needs.
How do I take care of the equipment and the driveline coming out of my abdomen?
We will provide you with all the equipment you need to safely run your LVAD. We will also teach you how to care for the “driveline exit site.” This is the open area where the driveline (electrical cord attached to the LVAD pump) comes out of your abdomen. It must always be covered with a dressing and this dressing needs to be changed weekly once your wound heals. If you do not take good care of the site, it can cause a dangerous infection. If you get this wet with shower water, it has a high risk of infection.
How will the LVAD affect my daily routine?
LVAD therapy will come with changes and you will have to adjust to a “new normal.” It will take some time to get used to having a device that is always connected to you. You will also have to make adjustments to many of your daily activities, because you will now need a constant power source and will have to carry the LVAD equipment. You will also have to be very careful to protect your driveline exit site from getting tugged or soiled, which can lead to infection.
The goal of the LVAD is an improved quality of life. Over time and as you recover from surgery, you will notice you are less short of breath and have more energy.
Will I be able to shower or take a bath?
If you submerge yourself in water, you could stop your pump and this can be fatal. Your driveline is your lifeline, and infections are very serious and often lead to the need for repeat LVAD surgery, which carries a high risk of death.
This means no bathtubs, hot tubs and swimming while you’re undergoing LVAD therapy. While many programs allow showering, we do not recommend taking a traditional shower. Even chlorinated water has bacteria in it. Some patients will take a modified shower, using a handheld shower spray, avoiding any water exposure to the chest and abdominal areas. That is safe with proper education and good technique, including wrapping of the driveline and equipment protection.
Saunas are also discouraged.
How about intimacy?
Intimacy is important for everyone and just because you have an LVAD, it doesn’t mean you can’t continue to enjoy intimacy with your partner. We recommend you wait 6-8 weeks after surgery before having sex. Talk to your physician if you want to resume sexual activity. You will have to figure out how to comfortably manage your equipment and avoid anything that may pull on your driveline exit site.
If you are taking any drugs to improve your sexual performance, you will need to discuss resuming these medications with your physician. Some of these medications can affect your heart and it may not be safe for you take them.
Can I get pregnant?
You should work to prevent pregnancy while undergoing LVAD therapy, because there is no safe way to manage your blood thinner medications when pregnant. Please discuss appropriate birth control options with your physician.
Can I exercise or engage in other recreational activities?
Yes. We encourage all our patients to exercise and be as active as tolerated. You will first work with physical and occupational therapists in the hospital and then at home with home care. You will then be enrolled in an outpatient cardiac rehab program to build strength.
Avoid exercising in very hot and humid or cold weather. Exercising inside or in a more comfortable temperature is recommended for your safety.
Many patients return to other activities they enjoyed prior to LVAD, such as singing, playing an instrument, biking, golfing and hunting. However, you should avoid all contact sports such as basketball, hockey and football.
Remember that you just had a big surgery and you will still feel quite tired after getting home. This is normal. You will build your strength and feel stronger with time.
What about driving or sitting in the front seat of a vehicle?
You can be a passenger in a car. However, you will need to wait at least 90 days after surgery before you can sit in the front seat of the car due to the risk of airbag injury. Discuss this with your physician before you decide to sit in the passenger seat.
Whether you wish to drive a personal car or truck is up to you and your insurance provider. If you have completed rehab, are off narcotic medications, and have had no device alarms or impairments to memory, you may be able to drive a personal vehicle after three months. However, the laws of the state you live in, not your doctor, decide whether or not you have the right to drive.
The State of Michigan does not have clear laws regarding driving while undergoing LVAD therapy. State law prohibits operating a motor vehicle if you have an episode that “contributes to loss of consciousness, blackout, seizure, a fainting spell, syncope, or any other impairment of the level of consciousness” or an experience that impacts driving judgment. So if you pass out or have a dangerous heart rhythm abnormality, your doctor may be required to advise you to not operate a vehicle for at least six months.
Can I operate a commercial vehicle or fly a plane?
It is unlikely that you will be able to operate a commercial vehicle or plane while undergoing LVAD therapy.
Can I travel?
Many people travel while on LVAD support. In general, we advise waiting six months before you make your first trip that is more than 1-2 hours from home. We advise waiting one year for distant and/or international travel or cruises.
If you want to travel, please call your assigned LVAD coordinator or talk to your physician to discuss where you are going so we can identify if LVAD centers are nearby should emergencies arise. Prior to traveling, your LVAD coordinator will also need to provide you with tips on how to travel with an LVAD, including that of airport security. We will also give you emergency contact information for an LVAD-trained hospital that is close to where you are traveling.
Can I work?
You may be able to go back to work, but it will depend on the type of activities you perform. In some cases, you may be required to modify what you can and cannot do at your job. Talk to your physician about the possibility of returning to work, and they will clear you for work if and when you are ready.