Heart Bypass - Normal recovery Vs Abnormal

[email hidden] (Nancy) wrote in message news:<[email hidden]>...

Quoted message said:

My father is a 75 year old man that has been a smoker for over 50
years and was diagnosed with diabetes 2 years ago. He is not on
insulin and controls the diabetes with medication and diet. On
October 27 my father had an aortic aneurysm repaired which involved
the aorta below the renal arteries down into the iliac arteries.
Post-op he ballooned with retained fluid and was put on Lasix to
reduce his water retention. On November 1, he was in great pain in
the chest and his blood values showed signs of being close to a heart
attack. On November 6 a cardiac catheterization was performed and a
blockage was found on his left descending coronary artery. On
November 14 he was to have angioplasty but they could not unblock the
artery and went directly to bypass surgery. He had a double involving
the left anterior descending and obtuse marginal coronary arteries.
On the second day post-op, the chest tube was removed but he still
showed fluid in his chest and another chest tube was put in for
another 24 hours.

I know he has been through a great deal and his body needs to repair
all this damaged tissue. I have been told by others that you will be
amazed by the change in your father. He will have so much more energy
but this is not happening. He seems to be in discomfort all the time
and sounds raspy. His main discomfort is where the chest tube was put
in and of course his chest. His throat is raspy from the endotracheal
tube (I think?) Am I asking for too much or is this a normal recovery
for a person with his history?

It is not usual.

Quoted message said:

He just doesn't seem to have the
energy to start walking around other than bathroom trips. What kind
of time line should I be looking at with regards to "normal
activities"?

Would suggest more frequent follow-ups with his cardiologist while he
is having symptoms.

Humbly,

Andrew
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Nancy said:

I have been told by others that you will be amazed by the change
in your father. He will have so much more energy but this is not
happening.

Even though he's 75, he probably seems (or will seem to be) more like
85 or 90 years old, both physically and from a personality point of
view, for several months after all these operations. You're going to
have to wait until 6 months go to get a really good feeling for the
degree to which he will return to his pre-operative personality,
state-of-mind, and physical capacity.

Quoted message said:

He seems to be in discomfort all the time and sounds raspy.
His main discomfort is where the chest tube was put in and
of course his chest. His throat is raspy from the endotracheal
tube (I think?)

This is quite common for someone that's been on a respirator. You'd
think that they'd have figured out how to build a more
"patient-friendly" trache tube by now, as well as take better care
when inserting it.

Quoted message said:

Am I asking for too much or is this a normal recovery for
a person with his history? He just doesn't seem to have the
energy to start walking around other than bathroom trips.
What kind of time line should I be looking at with regards
to "normal activities"?

Again, you've got to wait 6 months, and probably more like 9, for the
recovery to really set-in. You're just 1 week after having open-chest
surgery (was it beating-heart bypass or on-pump?). You have yet to
see him at his worst (both physically and psychologically). That will
probably happen in a few weeks and last a month or two. Look for
signs of depression, sadness, and tiredness.

They should be asking him to caugh and take deep breaths at this
point. Don't be surprised if he caughs up some wicked phlem - better
to get that out - that's the point of caughing.

Might be a good idea to get him on a diruetic to prevent fluid buildup
in the lungs. They probably have him on medication to reduce blood
pressure. This is sort-of a gut reaction by the MD's to reduce the
strain on the coronary arteries, but they tend to keep to BP reducers
going longer than they need to. After a month or two if he's still
overly tired a good part of that is probably the BP reduction drugs.

Myo Cardium <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

Again, you've got to wait 6 months, and probably more like 9, for the
recovery to really set-in. You're just 1 week after having open-chest
surgery (was it beating-heart bypass or on-pump?).

It was a beating heart bypass.

Quoted message said:

You have yet to
see him at his worst (both physically and psychologically). That will
probably happen in a few weeks and last a month or two. Look for
signs of depression, sadness, and tiredness.

He already is showing these signs. He was expecting to be in the
hospital for only a week and it is now a month. He exhibited these
signs after his aneurysm surgery and they seem to be worse. It's like
he has a fear of going home because he doesn't know if he can cope
with things like showering, getting out of a flat bed etc. On the
other hand, he desperately wants to get back to his house where the
heat is warmer and he can do things at his own pace.

Quoted message said:

Might be a good idea to get him on a diruetic to prevent fluid buildup
in the lungs. They probably have him on medication to reduce blood
pressure. This is sort-of a gut reaction by the MD's to reduce the
strain on the coronary arteries, but they tend to keep to BP reducers
going longer than they need to. After a month or two if he's still
overly tired a good part of that is probably the BP reduction drugs.

They have him on both of these drugs. He doesn't like the lasix as it
makes him get up too often in the night. He doesn't get a good nights
sleep because he is always waking up to go to the bathroom. I think
they have reduced his dosage because of his complaining. My father is
not a very good patient. If he doesn't want to do something, it's
like pulling teeth and dealing with a five year old.

Another concern I have is that he sometimes still feels the need to be
on oxygen. If he has been sitting up eating, then sits in a chair for
15 minutes, add a bathroom break and then he wants to lye down and
have the oxygen handy - "just in case" - he needs it. Should I be
looking into getting portable oxygen for when he goes home?

Thank you for your reply. Your message has been very informative.