Physical Activity and Exercise
Regular physical activity is an important component of a healthy lifestyle, and has been shown to lower blood pressure. Because blood pressure control is important in patients who have suffered an aortic dissection, regular physical activity should be encourage. You can still perform activities after an aortic dissection, but we recommend patients work with their doctors to find the safest ways to do so.
Regular mild-moderate physical activity should be safe to perform with your doctor’s approval, such as:
- Walking
- Swimming, after any surgical incisions have healed
- Light jogging
- Biking, after one month post-dissection
- Dancing
- Sex
- Stair climbing
Aortic dissection patients should avoid any strenuous activities that can cause dangerous increases in blood pressure. Although little is known about exercise in dissection patients, heavy weightlifting should generally be avoided. Please consult with your doctor to determine what types and duration of activities are safe for you. Also, discuss with your doctor whether a cardiac rehab program is right for you.
Exercise should be fun and should fit into your lifestyle. Everyone is different. Some people will be able to walk long distances and others will not. Simply do as much as you can, within the guidelines listed above, as often as you can. Always begin slowly and gradually increase your activity level as tolerated.
The chart below lists the Metabolic equivalents, or METs, of different activities. METs describe the intensity of exercises, with the values based on how much each activity increases blood pressure. This information may help you find some mild to moderate exercises you would enjoy doing. For example, if your doctor recommends a walking program, you could also try slow aerobic dancing as the number of METs are similar. More information about activity after aortic dissection can be found here.
Pain Management
Unexplained pain, especially pain associated with aortic dissection such as sudden onset chest or back pain, should be taken very seriously. Any new pain could be an indicator of an aortic event.
Some dissection patients require open surgery. This surgery is an intensive procedure, requiring a sternotomy (cracking the sternum) or thoracotomy (entering the chest on the side through the ribs). It is normal to have some pain after surgery. You will experience soreness and muscle aches in your chest, back, shoulders, and legs. It will hurt when you cough and begin to move around. If you did not have an open surgical repair, pain can still occur at the site of stent graft insertion, or from the dissection itself.
Side Effects of Pain Medication
If you have open surgery to repair your aorta, you will be placed on pain medications. Taking your pain medication and practicing your physical therapy exercises will help decrease your discomfort. While in the hospital, the nurses will monitor your need for pain medication. You should ask for pain medication when you need it. After discharge, it is important to communicate with your doctor regarding your pain control and any new symptoms.
Side effects of pain medications include constipation, drowsiness, or nausea. If you experience constipation, a stool softener is recommended, as it can help alleviate some discomfort. It is important to avoid straining during a bowel movement, as this may also elevate the blood pressure.
Additional Strategies for Pain Control
Pain after dissection, especially with open surgery, is common.Surgical patients will be prescribed medication to deal with this pain.In addition to the medication, or after you are no longer being prescribed narcotics, you may decide to pursue alternative ways to control persistent pain.Speak with your doctor about whether strategies such as physical therapy or psychological and relaxation techniques may be helpful to you.Alert your provider if you have any pain that seems unusual or similar to the pain felt when you experienced your dissection.
Surgical Wound Care
While in the hospital, you will not be allowed to shower if you have an open wound from surgery. However, when you return home, you may shower. Do not take tub baths. We recommend that you stand with your back to the shower and allow the water to hit your back, shoulders and flow onto the surgical site. You may use soap and water. Additionally, once your doctor allows it, you may apply any type of cream or ointment to the scar.