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The Heart Beat

with James Beckerman, MD, FACC

Heart disease can be prevented! Your personal choices have a big impact on your risk of heart attacks and strokes. Dr. James Beckerman is here to provide insights into how making small, livable lifestyle changes can have a real impact on your heart health.

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Thursday, May 13, 2010

The Road Home from Heart Surgery

Every time I do rounds in the cardiac surgery recovery unit, I am amazed. Room after room of people who, just a few hours previously, had their ribs split, their heart exposed to the circulating air of the operating room, and a human being’s hands replacing a heart valve or sewing healthy grafts on diseased coronary arteries. And there they lay, with tubes, drips and ventilators monitoring their every movement and supporting every breath. Even the ones who are awake are groggy, and it’s not surprising when they fall asleep while I’m talking or drift off in the middle of a sentence. This is heart surgery after all.

It’s the medical equivalent of being hit by a truck. It’s a hard thing to grasp when you are signing a consent form, but sometimes being hit by a truck is worth it. Every day, thousands of people’s hearts see more blood flow and oxygen from new blood vessels, and valve replacement or repair fixes drafts and leaks, and enables blood to travel where it needs to without being blocked by an obstruction. While we are able to do a lot of things these days without surgery, the OR still plays a very important role in extending life and improving its quality.

One of the greatest concerns people have is post-operative recovery. While it is easier to quantify and estimate the risks related to surgery (or any invasive procedure for that matter), it’s the time afterward that can be more difficult to predict. For a day or two after surgery, most people experience significant fatigue, but typically, this period is self-limited and once the body really starts to heal, the progression is miraculous. Patients stroll around the wards, days after surgery, with chest tubes, catheters and invasive monitors just a memory from the intensive care unit. We typically discharge cardiac surgery patients on post-operative day five – it’s a testament to just how resilient the human body can be.

But in all fairness, the real recovery then begins at home. We recommend that patients try to walk for twenty or thirty minutes each day, to help regain strength as well as improve lung function after surgery. It’s not uncommon for people to feel fatigue for several weeks, or even a month or two after surgery. We arrange for a follow-up visit with our cardiologists as well as the heart surgeon to touch base a few weeks after surgery, examine the incision site to make sure that everything is healing well, and to adjust any medications if necessary.

If you are going to have heart surgery, you definitely have questions – here are a few to help frame the discussion with your surgeon and cardiologist:

  • How many of these types of procedures have you done?
  • How would you estimate my risk of a complication as compared to other patients?
  • What type of valve replacement or repair do you recommend and why?
  • Where do you plan to obtain grafts (legs, arms, chest wall) for my bypass operation?
  • How soon can I travel after my surgery?
  • When do you anticipate that I can go back to work after surgery?
  • Do you recommend a cardiac rehabilitation program or physical therapy to help speed up my recovery?

It’s a long road, and not without its frustrations and challenges along the way. But it takes people where they want to be – and where they need to be in many cases. The surgeon and cardiologist are only part of the process – in my opinion the majority of the healing lies within the patients themselves.

- James Beckerman, MD, FACC

Have you been through heart surgery? Share your thoughts and help other people with their questions and concerns on the Heart Disease Exchange.

Posted by: James Beckerman, MD, FACC at 1:13 pm

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