Dr Arvind Kohli
Each individual patient responds to surgery differentialy and recovery from each specific surgical procedure, whether a coronary artery bypass for clogged arteries or a valve repair/replacement for a narrow or leaky valve, is somewhat different as well. Despite these differences, however, some generalizations can be made.
After surgery it’s normal to have ….
Not have much appetite: It takes several weeks for appetite to return. Many patients notice that their sense of taste is diminished or almost absent. It will return. Some patients even complain of nausea at the smell of food for a week or two after surgery.
To Have some swelling, especially if there is an incision in leg :
That leg will tend to swell more for some time. Elevating the legs will help.
Have difficulty sleeping at night : it is difficult to fall asleep, or patient may find that he wakes up at 2 or 3 am and cannot fall back to sleep. This will improve. Taking a pain pill before bed sometimes helps.
Have problems with constipation. Patient may use a laxative and add more fruits, fiber and juiice in the diet.
Have mood swings and feel depressed: Patient may have good days and bad days. This will get better, with counselling and family support.
Cardiac rehabilitation :
Cardiac rehabilitation is a way for people who have had bypass, valve replacement, transplant, or other cardiac surgical procedures to get going again. A team of physicians, nurses, exercise physiologists and nutritionists will help patient feel well again by leading him through a rehab program designed to fit patients needs. There are four phases of cardiac rehabilitation :
phase 1
Phase 1 begins early after a cardiac event, while patient is still in the hospital. This phase usually includes light supervised exercise such as walking the halls and stair climbing. Additional education is provided to hospital nurses and physical therapists. One can ask the hospital staff about risk factors, diet, medication instruction, sexual activity, exercise and normal life at home.
PHASE II
Phase II is the early outpatient phase of cardiac rehabilitation. This phase usually requires a physician referral and involves telemetry monitoring. Entrance into the program is usually two to six weeks after discharge from the hospital. Most programs meet for one hour three or more times per week for 12 weeks. Phase II aims to return you to normal active life. With improved functional capacity and endurance and assist in making optimal social and psychological adjustments.
PHASE III
Phase III is a continuation of the Phase II program. As a general rule, Phase III programs include participants who were discharged from the hospital six to 14 weeks earlier.
The goals of Phase III are to provide an ongoing exercise program, To Offer support necessary to make lifestyle changes and to achieve the desired goal, such as, independent lifestyle or return to work and to prevent progression of heart disease The program offers monitoring of heart rhythm, rate and blood pressure before, during and after exercise. Records of your exercise routines are required. These routines generally occur three or more times per week.
Phase IV is a wellness program for those who have completed any of the other phases and is meant to continue working on improving lifestyle changes
Diet :
Doctor will probably recommend that you follow a low fat, no added-salt diet after discharge. This may reduce risk of a heart attack in the future and risk for requiring angioplasty or surgery again. One should try to have less than 30 percent of calories from fat. One should try to control weight and eat less saturated fat and cholesterol.
Medicines :
Take the medicine exactly as prescribed by the doctor. It is important to keep a current list of medicines, dosages, and times to be taken in wallet or purse. One should not take other medication without telling doctor.
Role of Yoga after surgery
There are quite a few asanas and pranayams which will help immensely. The Shavasan asna is highly recommended as it relaxes the body and mind, helping patients develop a positive outlook. The Yastikasana involves the stretching of hands and legs which improves circulation to the heart. Abdominal breathing, alternate nostril breathing, equal breathing are techniques that will help improve oxygenation of blood, enhancing healing and increasing the efficiency of heart. However pranayam, (Holding your breath) should be avoided as it can be counter productive, placing strain on the heart.
(The author is Cardiac Surgeon SSH, Jammu)
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