That unexpected event in your midlife might have come as a rude shock. An innocuous heartburn (which you had attributed to acidity) was proved to be due to an occluded coronary artery. Things moved at a pace which you did not fully comprehend, and here you are now recuperating from a bypass surgery!
Now what next?
Does it mean that, it is the end of all good things in life? Do you have to give up everything and stay put at home?
The answer is a loud, clear and resounding “NO”
Let me tell you a few things about bypass surgery that you probably didn’t know before:
1. Coronary artery disease causes an obstruction to the arterial blood flow to the heart, resulting in symptoms varying from breathlessness to incapacitating chest pain.
2. A bypass surgery fixes only the flow related issue. Namely, by using a graft, the blood flow can be significantly increased. However, the diseased artery continues to remain so and over course of time can worsen.
3. Bypass surgery is only a part of the therapy. You would need to continue medications, modify lifestyle and take up to healthful ways of living.
What is coronary bypass surgery?
Coronary bypass – also called CABG – is the single most common open-heart operation performed in most parts of the world. When a coronary artery is blocked, an alternate route of blood supply may be created surgically. Using a variety of conduits (leg veins or other arteries harvested from the patient’s own body) a connection is made between the major blood vessel of the body, the aorta and the blocked coronary artery, beyond the area of obstruction. In this way, even though nothing is done about the block itself, blood is provided to the heart via the “bypass“… hence the term, coronary bypass surgery.
Bypass surgery in progress
Post operative period
It is not uncommon to feel tired and exhausted during the first few weeks immediately after surgery. There may be some pain over the chest and the legs were veins were harvested. Backache, shoulder stiffness, loss of appetite and sleeplessness may also be present. One can resume walking as an exercise including climbing stairs immediately after discharge. Return to routine activities can be around 4th to 6th week. Activities requiring hard physical labour are best avoided for the first 3 months. Resuming passive sex is permitted after 6 weeks. Simple rule is, any activity that does not produce undue exertion, breathlessness or chest pain can be allowed.
Causes, risk factors and prevention
Causes for coronary artery disease include high blood pressure, diabetes, high blood cholesterol, smoking, obesity, and physical inactivity–all of which need to be addressed in the post-operative period. Although medical treatments for heart disease have come a long way, controlling risk factors remains the key to preventing illness and death from coronary artery disease. All patients should receive extensive training on how to modify these risk factors after a bypass operation.
Drugs used for coronary artery disease – beta-blockers and nitrates do not appreciably increase blood flow to the heart muscle. Instead, these drugs reduce the oxygen demand of the heart muscle. Aspirin reduces clot forming tendency and statins control cholesterol. All these may have to be continued.
Following a strict diet, exercise, taking all the medications the doctor has prescribed help the heart to heal and prevent another heart attack. Quitting smoking goes a long way. Loosing weight and walking 2 to 3 kms a day would make one feel better fit and more energetic.
To conclude cessation of smoking reduces mortality, controlling hypertension increases longevity, treating diabetes reduces morbidity, and having a bypass surgery done at the right time improves life’s quality!
Dr.T.Senthil Kumar, M.S.,M.Ch., F.I.A.C.S.,
Cardiovascular & Thoracic Surgeon.
Kauvery Heartcity, Trichy