By John T Jones, Ph.D.
Heart disease is rampant in our country. The causes are mainly heredity, diet or other diseases. Smoking does not help the situation. Some can overcome the problems of heart disease by diet and exercise plus supervision of medications by trained physicians. For many of us however, we find ourselves in the hospital before any heart symptoms were noted by medical people and we undergo coronary bypass surgery.
Coronary bypass surgery occurs daily in the United States. The object of the process is to bypass blocked arteries with veins taken from the leg. The left internal mammary artery can be freed from the inside of the breast and used to bypass. The heart is stopped during the process and a heart-lung machine provides oxygenated blood to the heart. The process may be open-heart surgery or by other less intrusive techniques such as "Minimally Invasive" bypass surgery. The later depends on the availability of the procedure in your area. Also, if the process is not working correctly in the operating room, you my end up with conventional bypass surgery.
The length of hospital stay is usually less than a week and is similar by both procedures. The first time I had bypass surgery, my stay was one week. The second time which included aortic valve replacement, I was in the hospital for three weeks because of complications.
During the hospital stay and after the patient is in rehabilitation at home, training is given in diet, stress control along with physical recovery training. After my first heart surgery, I went through a 10-week period of physical and other training at a local hospital. After my second surgery, I was put on a tread mill in the hospital a few times to help regain my balance and strength. I was given no further activity after returning home. I was given some instruction in the hospital on dieting and life style.
Your surgery wounds will partly heal in the hospital. If you chest was opened, that will be your main concern. You need to learn how to prevent injury in that area. This means that you must learn to turn over in bed without straining your chest. Just standing up can be a problem. I suffered coughing after my first surgery and that did not help the situation. My chest wound did not heal properly and a large nuisance growth developed which was removed during my second surgery leaving a weak area which is now herniated. That is not all that common. My surgeon told me that those who have herniation in the chest area do not usually have painful repair surgery. I didn't either. I'm allowed to lift less than fifty pounds, I can still bring in the groceries and cut the lawn (which I don't) so I don't worry about it.
Your second concern is the wound in your leg or legs where the veins used in the procedure were extracted. You will have a long scar on the inside of your leg. Most people have little trouble with this. You may have pain near the ankle which is minor and does not seem to go away. It may only be tender to the touch. When my dear wife rubs my legs and feet everyday, she sometimes hits a tender spot.
Smoking and obesity are the two main things that you need to avoid after surgery. You should take medications as prescribed by your doctor. Vitamin E is now out of favor and should not be used as a supplement. You get plenty from your regular diet and the daily multivitamin you should be taking. Avoid all saturated fats and trans-fats. At least limit the saturated fats. B-vitamins are sometimes recommended. There are foods like olive oil, avocados, grapefruit, nuts, etc. that are good for the heart.
A procedure that occurs before bypass surgery is the angiogram. It determines which arteries are blocked. After the results of that are in, discuss your options with one or more doctors. You may be able to avoid bypass surgery so don't be too hasty in making the decision. By proper medication and eating like a rabbit plus exercise, you may be able to reverse the progression of heart disease which blocks the arteries. I did not make this decision. Two of my sons and my son-in-law are doctors and they made the decisions for me.
I felt completely relaxed before I went into surgery for the first bypass surgery and also before the second bypass surgery and aortic valve replacement. I remember everything that occurred before the first surgery including the work of the anesthesiologist and being wheeled into the operating room full of doctors, technicians and equipment. I have no recollection whatsoever prior to the second surgery.
Before the first surgery, I had a religious vision in the morning just as I was waking up. Another patient had a similar vision which he described to me when we were in rehabilitation. Our dreams seemed to be related to our religious affiliation. I don't know how common this phenomenon is. There was no vision before or after the second surgery.
After both surgeries, I woke up in Intensive Care, not the recovery room. I don't remember this after the second surgery. You are uncomfortable for a day or two and then you are up and around again. This did also did not occur after my second surgery. Complications kept me in intensive care for about three weeks. I also had horrible visions of war, etc., for weeks which my son said was due to the long surgery the second time around.
Other than removing any drain tubes and the external wires to the pacemaker, no other procedures are needed after surgery. The nurses will have to care for you for a few days but then you can handle things on your own.
I recovered rapidly after my first surgery and was home in one week. Unfortunately, I was told to take an antihistamine to which I became allergic. It was two months before I got back to work.
I was taught in the hospital how to regulate my diet but most of that training was again given to me after I got home. I was shown how much meat I could eat and how I needed all of the food groups and that I must chew my food. I was given 10 weeks of rehabilitation at the local hospital.
Staying away from work was the best thing I could do because of the stress situations.
My neighbor owned his own business, had bypass surgery and was back in the office in two weeks.
My friend here in Idaho had bypass a couple of months ago. He's a farmer and other than being unable to left much weight, he is back in the field.
Depression can set in after heart surgery. It usually disappears shortly thereafter. I had no such problem but I saw the symptoms in others.
After surgery, take your medications, watch your weight and don't smoke. If you are well enough, get some exercise. And keep a smile on your face even if you have to watch Three Stooges movies.
The thing that concerns me most is that heart disease is not always detected until a heart attack occurs. If you have a family with a history of heart trouble more careful monitoring is required. Talk to your doctor.
How long does bypass surgery last? You usually get a "guarantee" from your surgeon for 10 years. I went 12 years but I had to have a valve replaced or I would not have had the second bypass that soon. Of the three bypasses first given to me, only one had to be replaced the second time and that was a minor procedure because the technicians that did that part of the surgery could use the stubs of my old graphs. I know people who had bypass twenty years ago with no repeats.
My main problem has been avoiding obesity. I blame the computer.
Good health to you!
Fly Old Glory!
John T. Jones, Ph.D. (tjbooks@hotmail.com, a retired college professor and business executive, Former editor of an international engineering magazine. Writer, novelist and landscape painter. Tons of grandkids.
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