What to Expect After Coronary Bypass Surgery
By Stephanie Trelogan
If someone's doctor informs him that his coronary arteries (the arteries that provide blood flow to the heart) are severely blocked, he may need to undergo coronary bypass surgery. Also known as coronary artery bypass grafting, this surgical procedure diverts blood flow around a section of blocked or diseased artery. According to the American Heart Association, more than half a million of these operations are performed every year. Bypass surgery is a major operation: The surgeon usually makes an incision along the breastbone (sternum), spreads the rib cage, stops the heart, and uses a heart-lung machine to circulate the blood during the operation.
In some cases, the surgeon may remove a section of a long vein from the leg and use it as a bypass graft.In this procedure, one end of the leg vein is grafted to the aorta (the large artery leaving the heart), and the other end is grafted to the coronary artery past the blockage. Alternatively, the surgeon may detach one or both of the internal mammary arteries (arteries that branch from the aorta) from the chest wall and attach the open end directly to the coronary artery downstream of the blockage.
Recovery from coronary bypass surgery depends on a number of things, including what type of bypass was done, the patient's physical condition before the operation, and whether he complies with his doctor's recommendations following surgery. A general timetable may help you plan for the future, but remember that there's no set schedule for recovery. Whether the patient experiences some or all of the following issues, here are some practical tips to help you both.
What you can expect:He may experience swollen legs for a few weeks after the operation. If the surgeon removed veins from his leg, the blood flow returning to the heart may be slower, causing fluid to accumulate in the ankles and lower legs. The swelling can be extremely uncomfortable.
What you can do:
- While he's resting on the bed or couch, place several pillows under his legs to raise his feet higher than his heart. Do this for an hour at a time, at least three times a day.
- Remind him not to sit in one position for a long time or cross his legs, which can impair blood flow.
- Once the doctor gives the OK, encourage him to walk as much as possible. Even short jaunts around the house or yard can help promote circulation.
- Ask the doctor if elastic support stockings might be helpful. You can buy these at any medical supply store and even at some drugstores.
- Notify the doctor if swelling worsens significantly or persists even with regular activity and elevation of the legs. Fluid buildup in the legs is a symptom of heart failure.
What you can expect: As part of the healing process, a lump may develop at the top of the incision. This is a seroma, a pocket of fluid that sometimes forms after surgery or traumatic injury. Typically, the lump will disappear in about six weeks, although it may take as long as several months.
What you can do: A lump and some discomfort are normal, but notify the doctor if there's increased tenderness, redness, or swelling, drainage from the incision, or a persistent fever.
What you can expect: Insomnia and fragmented sleep are common complaints after heart surgery. Normal sleep can be disrupted by pain, stress, or anxiety. He may find it difficult to fall asleep, or he may wake in the middle of the night and not be able to drift off again.
What you can do:
- Minimize pain and discomfort at night. Arrange pillows to help him find the most comfortable sleeping position. If he has been prescribed pain medication, have him take it 30 minutes before bedtime.
- Keep him busy so he won't nap too much during the day, but not so busy that he gets overly tired
- Eliminate caffeine in the late afternoon and evening.
- Play relaxing music.
What you can expect: It's normal for a person to feel fearful after heart surgery. He may be worried that the surgery wasn't successful or that he won't recover. He may be afraid that he'll develop future complications like heart failure.
What you can do:
- Let him talk about his fears. Don't brush off his concerns; keeping his feelings bottled up will make him feel worse. If it's difficult for you to hear his worries, help him find a support group or online community
- Encourage him to keep a journal. Sometimes just writing about negative feelings can defuse them.
- Remind him — and yourself — that his anxiety is most likely temporary. As recovery progresses, he's probably going to feel more like himself again.
- Encourage him to get back into a normal routine as soon as possible. Getting dressed first thing in the morning, going for a walk outside, resuming favorite hobbies, and socializing with family and friends are all excellent ways to relieve fear and anxiety.
- If his anxiety persists for more than four weeks, talk to his doctor. He may need counseling or antidepressant treatment.
http://www.caring.com/articles/coronary-bypass-surgery-recovery
http://www.caring.com/articles/physical-issues-after-bypass-surgery
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