My Heart Story: Surgery to Recovery – Part II

– The questions you were afraid to ask your doctor.

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What is a heart pillow?

The heart pillow was gifted by the hospital to be used after heart surgery. Unfortunately, the nurses there didn’t know its usefulness. They thought it was a goodie, a return gift. Heart pillows used after surgery are meant to give patients something to hold to their chest when they need to cough or sneeze or to try and help alleviate some pain. Since you cannot give tight hug to your dear ones for 8 to 10 weeks, this pillow keeps you in good humour till then. My wife gets teased, when she sees me squeezing the heart pillow tight to my heart.

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What Is Heart Bypass Surgery?

Heart bypass surgery is when a surgeon takes blood vessels from another part of your body to go around, or bypass, a blocked artery. The result is that more blood and oxygen can flow to your heart again.

Imagine you’re on a highway. An accident causes traffic to pile up ahead. Emergency crews redirect cars around (diversion) the congestion. Finally, you’re able to get back on the highway and the route is clear. Heart bypass surgery is similar.

It can help lower your risk for a heart attack and other problems. Once you recover, you’ll feel better and be able to get back to your regular activities.

In my case the surgery (making diversion) went on for 12 hours. But the doctors at the Asian Heart were highly communicative (video calls) to put my family at ease all the time. My son told me afterwards that my surgery took longer than anticipated by about four hours, which caused a bit of curiosity for him and his mom, my wife, who were in the waiting lounge.

Let us understand the procedure in laymen’s terms and the follow up actions.

What is Coronary Artery Bypass Grafting (CABG)?

Coronary artery bypass grafting (CABG) is the most common type of heart surgery done on adults today. During this surgery, a healthy artery or vein is grafted (attached) to a blocked coronary artery. This allows the grafted artery to “bypass” the blocked artery and bring fresh blood to the heart.

A coronary artery bypass graft may be necessary for people with coronary heart disease (CHD). Coronary heart disease occurs when the blood vessels that provide blood and oxygen to the heart muscle become narrow and hard. This is often called “hardening of the arteries.”

Hardening occurs when fatty material forms a plaque on the walls of the coronary arteries. This plaque narrows the arteries, making it difficult for blood to get through. When blood can’t flow properly to the heart, a heart attack may occur.

How was my open-heart surgery performed?

I was asleep the whole time. A breathing tube was pushed in my mouth. It’s attached to a ventilator, which will breathe for you during the procedure and right afterward.

Dr Ramakant Panda says, “Arterial grafts are considered superior conduits over vein grafts based on experience using the left internal mammary artery (LIMA) and artery from the arms to bypass the left anterior descending (LAD) coronary artery, over venous graft (veins from legs)”. Normal surgery takes from 3 to 6 hours. However, in my case it took nearly 12 hours. Why? I dare not question him.

Dr Tanay, a resident doctor present in the operation theatre and assistant to Dr Panda explained. It was done following these basic steps:

• I was given general anaesthesia. This ensured that I will be asleep and pain free through the whole surgery.
• The surgeon made an 8- to 10-inch cut in the chest.
• The surgeon cuts through all or part of the patient’s breastbone to expose the heart.
• Once the heart is visible, the patient may be connected to a heart-lung bypass machine. The machine moves blood away from the heart so that the surgeon can operate. But in my case since beating heart surgery was performed, I was not connected to the heart-lung bypass machine.
• The surgeon uses a healthy artery or vein to make a new path around the blocked artery. In my case the arterial graft was carried out.
• Left Internal Mammary Artery (LIMA) from my heart was taken out to bypass (replace) Left Anterior Descending Artery (LAD). The three small branches (obtuse marginals and posterior left ventricular) of Left Radial Artery (LRA) were bypassed by three grafts of arteries from left hand.
• The surgeon closed the breastbone with wire, leaving the wire inside the body.
• The original cut is stitched up. The stitches (sutures) were removed after 2 weeks.

What are the physical stresses and how to cope with?

Living with, and through, the physical effects of open-heart surgery can be daunting. Included are pain at the incision site, muscle pain, or throat pain. If you have chest tubes for drainage, those can also be uncomfortable.

Despite the discomfort, post-surgical pain usually disappears after 6 – 8 weeks. However, other kinds of problems can linger? How to cope with them, continue reading.

How much should I walk after heart surgery?

Most patients should be capable of walking at least 1 to 2 kms per day at one month after surgery. As you recover from heart surgery, walking represents the best form of exercise for you. When I felt tired, took rest for 4 to 5 minutes but continued. You need to stretch a bit every day.

How long do chest muscles hurt after open heart surgery?

Your chest, shoulders, and upper back may ache. The incision in your chest and the area where the healthy artery / vein was taken may be sore or swollen. These symptoms usually get better after 4 to 6 weeks. You will probably be able to do many of your usual activities after 4 to 6 weeks.

What is a heart pillow?

The heart pillow was gifted by the hospital to be used after heart surgery. Unfortunately, the nurses there didn’t know its usefulness. They thought it was a goodie, a return gift. Heart pillows used after surgery are meant to give patients something to hold to their chest when they need to cough or sneeze or to try and help alleviate some pain. Since you cannot give tight hug to your dear ones for 8 to 10 weeks, this pillow keeps you in good humour till then. My wife gets teased, when she sees me squeezing the heart pillow tight to my heart.

What are the do’s and don’ts after open heart surgery?

Stop if you feel short of breath, dizzy, or any pain in your chest. Do not do any activity or exercise that causes pulling or pain across your chest, such as using a rowing machine or weight lifting. Keep your incision areas protected from the sun to avoid sunburn.

Why is chest belt/brace used after heart surgery?

The device is intended to support patients’ chest and so, during an activity or upon coughing, it stabilises the chest cavity and immobilizing the chest wound. Patients wear chest belt for 6 to 8 weeks. Dr Vijay DeSilva says, “We recommend you wear your chest belt from the time it’s put on in the ICU throughout your hospital stay. You can then adjust chest belt to fit over your street clothes and continue to wear it as needed for about 6 to 8 weeks after you are at home”.

How long does it take for the breastbone to heal after open heart surgery?

Dr Tanay says, “If you have had open heart surgery and the surgeon divided your sternum, it will be about 80% healed after six to eight weeks. By that time, you’ll generally be strong enough to get back to normal activities such as driving”.

How long do chest muscles hurt after open heart surgery?

Your chest, shoulders, and upper back may ache. The incision in your chest and the area where the healthy vein was taken may be sore or swollen. These symptoms usually get better after 4 to 6 weeks. You will probably be able to do many of your usual activities after 4 to 6 weeks. The incision in chest feels as if the strip is cemented. The sensation around this area gets better as time passes.

How do we know the patient is under depression?

Patients who experience depression for more than several weeks after open-heart surgery may have something more than a typical, post-surgical mood change. One way to tell is if a person has difficulty in doing simple, daily tasks, like making their bed, getting and staying properly dressed, or keeping a routine. If an individual was instructed to do certain tasks after the surgery such as exercise, are they doing them? Has the person withdrawn from contact with others, or mentioned suicide?

What are the options for healthy sleeping positions?

If you’re dealing with a heart condition, you may want to avoid sleeping on your left side. It’s thought that sleeping on this side may reposition your heart in your chest and change its electrical activity. It’s still not clear if this effect is large enough to be of concern.

Since I have right shoulder issue, found it convenient to sleep on my left side after 2^nd week of surgery, that is discharge. It was perfectly okey, with no side effects. In hospital I always slept on my back, with chest up.

Gratitude

Grateful to the Asian Heart Institute and its medical and non-medical staff for taking great professional care, both during pre-operative and post operative time. This hospital is run very professionally, and their billing system is very transparent, though on higher side. But I guess, to maintain the highest standard in medical care and hygiene along with well trained staff, one pays willingly, considering the value for money.

Epilogue

Even though it’s your heart that’s undergoing the surgery, your entire body will go through a lot during this process, too. You’ll need time to recover and regain your strength. By taking your recovery one day at a time, you’ll heal faster and feel better before you know it.