According to the American Heart Association, 552,000 people had open heart surgery in the United States in 2006. Chances are, you know someone who has gone through it.

Open heart surgery refers to either heart valve surgery - replacement or repair - or bypass grafting of a blocked vessel in the heart. The goal of bypass surgery is to restore oxygen supply to the heart in order to achieve efficient circulation of blood throughout the body to provide oxygen to vital organs. If the surgery is not an emergency, there is extensive pre-operative examination and education. But what happens right after surgery?

Right after surgery, recovery occurs in the Intensive Care Unit. Patients are brought in their beds to their ICU rooms from the operating room by the anesthesiologist and operating room staff. They report the patient's medical history and the details of the procedure to a critical care registered nurse.

The patient is attached to sophisticated monitoring equipment that allows the nurse to monitor vital signs and heart function. Blood is sent to the laboratory for immediate processing and a temporary pacemaker is either in use or available as backup.

A respiratory therapist wakes the patient gradually from anesthesia and sedation while there is still a breathing tube in place. Once patients are awake enough and able to breathe on their own, the breathing tube is removed. Many patients do not remember much of this process.

Next we deal with postoperative pain, diet, activity and lung exercise. Pain control is of utmost importance and pain medicine can be administered either intravenously or by mouth. The patient may begin to take ice chips and sips of water, and is encouraged to cough and breathe deeply to avoid lung complications that can occur due to his or her immobility. Within six hours of removal of the breathing tube, the patient is helped to stand with a nurse on either side to prevent dislodgement of the drainage tubes and IV lines that come with this type of surgery.

That night, the patient stays in the ICU under the supervision of a nurse with specific training in the special needs of an open heart surgery patient. There are protocols in place to keep the patient stable. Any variance in the patient's progress can be reported to the surgeon immediately.

With morning rounds the next day, the patient transfers to the cardiac floor. The patient is prepped for transfer by removing the chest drains and invasive monitoring devices, ensuring that pain is controlled, food is tolerated and all lab work is within normal limits.

Next, the patient transfers to the telemetry unit. Wireless medical telemetry is used to monitor cardiac signals over a distance via radio frequency communications between a transmitter worn by the patient and a central monitoring station. This is typically two days after surgery, and the patient is up and walking, eating on his or her own, and making fast progress. Many team members work together to make sure all issues and potential issues are addressed with the patient before discharge.

However, once the patient is out of the hospital, there is still more to recovery. Read more next week about the next chapter in a patient's recovery after heart surgery.

Nicole Marks and Carrie Stensrud are registered nurses in St. Patrick Hospital's Intensive Care Unit.