Heart Bypass - what to expect...!? - British Heart Fou...

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Heart Bypass - what to expect...!?

makmillar profile image
19 Replies

Hi everyone - new to the forum and looking for some advice for my hubby who is 59 and expecting to have a heart bypass operation in the near future, he had a small heart attack 27 Oct 17. We suspect it is a triple heart bypass that he needs and he is meeting the cardiac surgeon on 6 Mar 18.

We want to be as prepared as possible for the operation - currently renting a 3 story town house with lots of stairs. Options could be to move to a flat/bungalow before the operation or to move a bed downstairs or maybe just pay for him to be in a private hospital for a few weeks after the surgery?

Other than his heart (!) my hubby is fit and well his BMI is normal, he's been an Army Officer and done PT all his life until last few years - up to 3 years ago he was running 10km, he can still walk 8km in 80mins and will probably do so today. He's due to retire from the Army in April.

Here are a few of the questions we're struggling with:

- Are there any norms for how long after seeing the surgeon that you'd expect an operation?

- With a triple bypass I think they take a vein from the leg or arm to use as a heart artery (right/wrong)? How does that impact the leg/arm?!

- What happens immediately after the operation, does he go to intensive care for a few days?

- At what point would he be sent home from hospital?

- What happens in the next few weeks, can he walk and move around or are we looking at him being pretty motionless in bed needing someone to nurse him?

- If we went for the option of sending him to a private hospital for a few weeks then what sort of costs would we be looking at?

- At what point would you expect he could tackle stairs? Assuming we stay in our current home.

- What sort of rehabilitation would he be provided by the NHS and what else can we plan to do to support that?

- I've heard mention of three months for the full recovery - is that about right?

- At what point would he be ready to tackle a long haul flight?

Anything else that I've missed? Sorry for so many questions - it's quite stressful not understanding what we're getting into with this operation. I realise from reading the posts here that there is a great deal of variation between individuals based on things like level of fitness going into the operation, how many arteries are being bypassed, etc. but it would be good to hear from all of you to gather a picture.

Many thanks - we look forward to hearing from you.

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19 Replies
Fredders profile image
Fredders

Hi, can’t answer all your questions as I had aortic valve replacement, but can help with some.

Time between seeing surgeon and having op will depend on how urgent it is and which hospital your at. I had my op at Glenfields, Leicester and it was about three months.

Normally you go into intensive care for a day, depends on how you are, but they try to get you back on the ward asap.

I think the normal stay is about a week. I was in a bit longer this time because I ended up having to have a pacemaker fitted.

He won’t get the chance to lie around and be waited on! They have you out of bed almost as soon as you get moved to the ward and have you walking within a couple of days. Some hospitals check that you can manage stairs before they let you go home.

He will need someone with him for the first week home. My husband had the week off but then went back to work. You are encouraged to walk but make sure someone is with you if you go outside, at least for the first few weeks.

He should be offered cardiac rehab and I’ve heard that it can be helpful. I wasn’t offered it after either of my surgeries.

It takes about 12 weeks for the sternum to fuse completely, but everyone recovers at different rates so don’t be surprised to have aches and pains for several months. I went back to work after 3 months, but it does depend what you do, as you still have to be careful about lifting things etc. I am the same age as your husband and not particularly fit 😜

I’m sure someone else will be along to help with the specific bypass questions.

Hope this helps.

Wendy

MichaelJH profile image
MichaelJHHeart Star

I am awaiting a quadruple, have met my surgeon and done some research. With a triple I would expect veins to be harvested from both the leg and arm. They will be a bit sore but techniques have improved over the years. No long tem impact - remember they routinely remove varicose veins and people are not really affected by this. I was told I would be in ICU for 2 - 3 days and go home after 7 - 10 days. Remember these are best case scenarios and other events like wound infection can occur but are rare. He will be walking a few days after the op. I think moving a bed downstairs would be a good move - I do not think you really need the stress of a move just now. I am meeting the rehab team next week and if offered this would be a good idea for him.

If you are really worried a care home for a few weeks would cost far less than a private hospital. I know two cases where guys did this they did not need acute hospital treatment but assistance with care, etc. - one had had a double THR after a serious accident.

I am sure others will tell you more. You can always ring the BHF nurses next week. How long a wait - how long is a piece of string?

stevejb1810 profile image
stevejb1810

Hi. Welcome to the BHF HealthUnlocked forum. I hope you'll find lots of help here, I know I have.

I am a 60 year old who had a triple bypass one day after my 60th - so I guess I'm well placed to answer most of your questions. So here goes:

Are there any norms for how long after seeing the surgeon that you'd expect an operation? Not that I am aware of. I was taken into hospital straight from my angiogram and had the op 8 days later, but I was an urgent case and from what I can gather, I was not typical. Some people wait a lot longer. Talk to your Cardiologist (actually, keep on their tail to get a firm date)

- With a triple bypass I think they take a vein from the leg or arm to use as a heart artery (right/wrong)? How does that impact the leg/arm?! Yes, that's accurate. I have a very long scar in my leg from harvesting a vein and of course the chest one as well. Sometimes, I believe the leg one might be replaced by one from an arm, but its not my experience. I had no issues with either scar - they healed really well. He won't be kneeling for a while (it'll feel very tight) but generally the scars, while not pretty, shouldn't be an issue.

- What happens immediately after the operation, does he go to intensive care for a few days? Few days!! - all things being equal he'll be out of theatre after about 6 hours and out of ICU about 8 hours later. Then to a high dependancy unit and then to a 'normal' ward (at least that was my experience at Basildon.

- At what point would he be sent home from hospital? Once he can manage stairs and opened his bowels (NHS is obsessed with the latter). All being well, 4-5 days

- What happens in the next few weeks, can he walk and move around or are we looking at him being pretty motionless in bed needing someone to nurse him? He'll start walking within about 8-12 hours of the op and will be walking before he leaves hospital. He will not be going anywhere fast however and will be exhausted very easily. You will need to be around for him for certainly the first week, but if you are physically able and have the time, you should not need any specialist nursing care (my wife was brilliant). He will definitely not be staying in bed (its very bad for you!!).

- If we went for the option of sending him to a private hospital for a few weeks then what sort of costs would we be looking at? No need to do this - he will not be an invalid. NHS is great!

- At what point would you expect he could tackle stairs? Assuming we stay in our current home. Before he leaves hospital he will have to be able to tackle stairs (see above) and he will certainly be OK at home, but don't expect him to walking up and down stairs at will for a few days. Advice I was given was upstairs once a day and down stairs once a day. I was OK within about 4 days of getting home to go up and down without too many issues.

- What sort of rehabilitation would he be provided by the NHS and what else can we plan to do to support that? You will see physiotherapists before you leave. They will tell you to walk and walk and walk and not lift anything much heavier than a half filled kettle for a few weeks (I was making tea (cuppa) from about 5 days after getting home and cooking a few days later). You should also be contacted by the Cardiac Rehab Team (usually direct to your home address rather than in hospital) - they run classes/training sessions and are definitely recommended.

- I've heard mention of three months for the full recovery - is that about right? No. It takes a lot longer to fully recover (about 12 months). I'm a golfer and was told no swinging of a club for 3 months. Having said this, he should be able to lead a normal life (driving etc.) from about 8 weeks. Full recovery is a slower process.

- At what point would he be ready to tackle a long haul flight? I managed a trip to China 3 months post op. However, I was told I could fly 2 weeks post op (be warned that you will not get travel insurance within 6 weeks of the op).

Other things: Have plenty of pillows avaiIable - he will have to sleep on his back to start with and having plenty of pillows helps (I had 4!). Have plenty of towels available (you will need three fresh ones a day at least - the nurses will explain why). You might want to use smaller towels as large ones might be too heavy (I now that sounds ridiculous but believe me, to start with showering is exhausting). Learn how to put compression socks on - you will grow to hate these. Coughing hurts - a lot - and sneezing is agony. Have a pillow available as he will need to hug it to his chest when coughing for the first couple of weeks. For the first week or so, don't make any plans to be anywhere early - it took my until about 11am to get up showered and dressed for the first few days!

I hope that answers your questions and a few more besides and I hope I haven't scared you. There should be no need to move house. He will be knackered for a few days but as he is fit now, he should make a rapid recovery (I think and hope you will be pleasantly surprised).

If there is anything else you need to know, please do not hesitate to ask.

Good luck

Steve

chrsfrm profile image
chrsfrm in reply tostevejb1810

Steve, very comprehensive and it mirrors my experience.....except I contracted MRSA so was in hospital for 5 weeks......but that is far from the norm. Plenty of reassurance there for Makmillar.

Moose45 profile image
Moose45 in reply tostevejb1810

Hi Steve, that’s really helpful to me too. Do you know what caused the cough, it seems to be the most debilitating aspect post op. No chest infection, blood pressure great, oxygen says brilliant. Just a constant tickle dry cough, it’s exhausting. Thanks

Billypil profile image
Billypil

Hi makmillar, I guess we are all different. Many things change how we react to various surgeries. I would like to reassure you a little however. I am not getting on a bit, born Dec.1934. I had my first lot of bypass surgery in Feb 1981. I was told my need was urgent for a triple bypass. I had no trouble during surgery and recovered quite quickly. (All my British Ancestry lol.) What I found was that it is essential to follow the instructions from the surgeon with respect to looking after yourself and exercising correctly, even though it may be a little uncomfortable. My surgery was one of those where your chest is opened up, but now-a-days it seems that they are doing much with smaller incisions. I managed well enough, but because I am one of those people with CAD and get Thromboses a bit too easy I had a TIA later that year, but since that time I believe the after care has improved considerably and this is much more unlikely. Intensive care is now reduced also.

That lasted me until October 1997, when I needed a second lot of surgery for a repeat performance for a Quadruple bypass set of Coronary Artery Bypasses (CABGs pronounced Cabbages.) As I said I have severe Coronary Artery Disease, but I was helped twice with CABGs and getting along OK for my age. Since then I was advised that I may have problems in future but in 2006 I had a Stent inserted in a coronary Artery.

Recovery time will vary with the individual and what the surgeon thinks, but don't worry too much in advance as you will probably find that all will go well. I didn't get the rehab either, but make sure that he takes up the offer if suggested, because any trauma does take a bit of time to recover. I still think that we can help ourselves as much as the doctors, by following advice, doing the right exercise after surgery and maybe being careful with the diet and simply as much as possible lead a normal life, but make a reasonable attempt to avoid a lot of stress.

The veins in my legs were too bad to use once they saw what they were like, so I had my legs to heal and my arms as well, but that wasn't too bad & they healed well. I have not had a problem with Cholesterol but if he does watch the diet and don't overdo things. Just take care of one another and you will be together for a long time.

MichaelJH profile image
MichaelJHHeart Star

First a thank you to Stevejb1810 for a very comprehensive reply.

A friend never went home after a angiogram (this was done when there was an issue with a stress teat for a medical but he had no symptoms) and had a bypass three days later. Whilst he was driving after about six weeks and working p/t from home a couple of weeks later it did take time. Particular issues were tiredness and an uncomfortable leg scar (while it healed). Once these were past he returned to summer evening and weekend cycling. His bypass was a decade ago and a colleague's father had one in his fifties and is still reasonably active and with it in his nineties.

Charlie0007 profile image
Charlie0007

i had a triple back in November and most things have been covered but just want to add one thing, not knowing where you live might depend on how they do it. mine was done at the Brompton in Lomdon and there provided the leg vein is ok, the vein was removed through key hole and i only had 2 small scars at my groin and 2 below the knee, which reduced the leg scar issue to not really a problem. the leg feels a bit numb in places as does the the chest.

i also had a meeting before the operation with a specialist cardiac nurse who talked my wife and i through it all and was able to answer any questions.

hope this helps

Charlie

Charlie0007 profile image
Charlie0007

just one other thought, i went into hospital expecting to come out feeling like i had been hit by a bus but i was very pleasantly surprised. the leg was heavily bruised but to be expected but the chest no bruising, not real pain unless you cough or sneeze, what ever you do don't try and block the sneeze it adds pressure and hurts like hell.

i came out actually feeling better than when i went in, i hope you husband is as pleasantly surprised too.

anything else you know where we all are and get your husband to join the group, i has been a huge support to many of us.

Charlie

Berylsmum profile image
Berylsmum

Hi makmillar

Just reading your existing replies....we are all very individual in our recoveries. I stayed in hospital following my 2nd M.I. & waited 3 weeks to have my triple bypass op. They took my vein from my leg, with no problems thereafter. I was 2 days on CICU then back to the ward & out within a week. All this @ Blackpool Victoria Cardiac Unit which was excellent. I was lucky enough to rehab @ my daughter's for a few weeks & she could accommodate me downstairs. I did need help with showering, especially hair washing but our exercise was for her to walk me to her next door neighbour's gate on the 1st day then increase it to one house along as the days went on. By they time I went home to my flat, I could manage most things on my own. Just couldn't use my existing bath which has now been replaced by a walk in shower.

Local Rehab team contacted me within two weeks, local cardiologist adjusted my medication & consultant @ Blackpool discharged me within 3 months after 1 follow up appointment there.

5 & a half years later, with only slight adjustment to my medication, I'm told I'm doing well.

I wish you both the very best & a happy & healthy future.

Phil-52 profile image
Phil-52

Hi Makmillar, Like all the others on here pre op waiting times and recovery differs from patient to patient. It took 3 months for me to be called in for my quad bypass and my cardiologist said it was urgent. Those 3 months play with your mind. when I woke after the op I had been placed in an intensive care ward. I remember some sort of moving mattress that i thought was wonderful but that may have been down to the drug related lucid dreams :) I only spent the day in intensive care before being released to the recovery ward. I was released around ten days after my op which was a bit longer because I had dipped in and out of AF (irregular heart beat) and they wanted to keep an eye on me. It was a bank holiday weekend when I did get released (Sunday) but I needed daily blood tests back at the hospital as I had just gone on to warfarin. The Tuesday was awkward as everyone had gone back to work so rather than bother people I caught the bus to go back to the hospital. my long winded point is , I thoroughly enjoyed my first post op taste of independence and even though i only strolled at my sedate pace I found it easy enough. I was back at working in the building trade within three months. And I ran Birmingham 10 k race 12 months to the date of release after. The chest takes time to heal and lifting a kettle (half full) took two hands but as long as you remember each day will be a little better than the last, things will be fine. I would suggest staying put in your town house. Before the hospital would release me the gave me a stair test which consisted of walking up and down the hospital stairs to see if i was mobile enough. I would suggest you also take advantage of cardio rehab as soon as they give you the go ahead. They recommend you keep up the activities

Hope this helps and feel free to ask any questions. I know any one of us would be willing to help

good luck

Phil

makmillar profile image
makmillar

Oh my goodness! Thanks so much for all of your very kind and full responses. We read them all in detail, it's wonderful to have such reassurance and to hear that you're all doing so well post op.

We will see how things go on the 6th March!

marypw profile image
marypw

Hello makmillar; just a few words from a CABG patient's wife!

Do make sure you look after yourself as well. The process is physically and emotionally stressful for a partner. It's very distressing to see your previously strong and fit spouse in pain and struggle to lift a glass of water. You will be up at 4am, getting drinks, pain medication, hot water bottles, extra pillows or just being there when things are tough.

The surgery day is something else on the anxiety scale, so try to have friends round or do something to distract you. I did manic knitting. You will be so happy when you get the phone call to say he's safely sleeping in ITU!

Hospital food can really vary so if it's grim, take in food parcels - dried fruit, nuts, even flapjacks. Try and eat properly yourself as well - I was hopeless at that and lived on toast and apples.

Do get support if necessary, from friends, relatives, your GP or a counsellor. All the focus is rightly on the patient, but you can just get to feel that you're only there to make tea for visitors!

BUT always remember that cardiac surgery in this country is world class and he will be really well looked after. As your husband is otherwise healthy, with lots of hard work, determination and support from you, he will come out the other side feeling fitter and healthier than for years.

Zimmies profile image
Zimmies

Hi, obviously times will vary slightly depending on the area. I was diagnosed with an angiogram at my local hospital early January 2017. I was told I needed a quadruple bypass. It was a shock because like your hubby I am reasonably fit, non smoker, and good BMI. It took 3 weeks to see my surgeon at the regional heart hospital. I made a list of the questions I wanted to ask and with my wife we had a very frank discussion with the surgeon. The main thing I learnt from that meeting is that although it is a major operation it also a routine operation! I then went through a series of tests (X-Ray's, ecg's, etc) and meetings with the nursing staff, past patients etc. all of which gave me more information and confidence. The preparation before surgery was excellent. I waited 11 weeks from the initial meeting with the surgeon until the operation.

I went in on the Wednesday at 2pm. My chest, both inner legs and arms were shaved because at this stage the nurses don't know where the veins are going to be taken from. I went to theatre at 1pm on the following day. My wife tells me I taken into ICU at 5pm. I woke at 1am on the Friday morning with no pain or discomfort and drifted in and out of sleep until I was moved onto a ward at 6am on the Friday. I was encouraged to get out of bed about 9am and sit in a chair. The two chest drains were removed about lunch time and I can honestly say in the whole process that was the most uncomfortable and it lasts about 30 seconds! The advice I would give is a) do not lie in bed (apparently sitting in the chair increases your oxygen intake) b) get walking (or shuffling as my wife called it) I was walking from Saturday morning, and c) cough! the nurses actually wanted to check what I coughed up (I held a rolled up towel to my chest as I coughed). My catheter was removed on Saturday lunchtime. You are constantly monitored.day and night. I was told on Sunday morning that I would be going home on the Monday. I had partial paralysis of my left arm which is fairly common and within 3 months had full use of my arm. Apart from the chest scar I have 4 scars on my inner left leg and two very small scars where the chest drains were removed.

You are not allowed to lift anything or put any weight on your arms (eg you cannot push up on your arms when leaving a chair) for 6 weeks. You cannot drive until you are given the OK by the hospital. You then are given a chest X-ray and if the sternum has knitted then you given the OK. The only part of the recovery I did not like was wearing compression stockings for 6 weeks which given everything that you go through is pretty minor. I was contacted by my local cardiac nursing team and offered 12 sessions which is a mixture of light circuit training, info sessions and BP monitoring.

I am now about 10 months post op. My leg scars have just about disappeared and my chest scar is not so prominent. I get minor pains in my left chest which is nerve damage correcting itself. I am now hill walking twice and week and on the treadmill daily. Prior to the op I was breathless after walking 100 metres on the level so for me the op has given me my life back.

I hope this is useful and I would recommend you go on the BHF website because it is full of useful info.

Haribocat profile image
Haribocat

My mum is due home tmrw 10 days post triple. She got herself onto the 'short notice' list as she was o/wise well, took about 3 months. Fortunately she doesn't really remember the first 48h (even tho we were talking to her), and spent a bit longer on HDU due to rhythm issues (needed pacing and remained in bed) which resolved themselves on day 5. Once on the normal ward it's moved quite quickly. All 3 vessels appear to be from the one leg, but she's a small lady. I found it scary seeing her on the unit with the ventilator but it's not for long. I also have found it stressful supporting my mum's journey (and absorbing her anxiety) but wouldn't have had it any other way. Will let u know how we get on x

Rupertthedog profile image
Rupertthedog

Hi there, i had a quad bypass and mech aortic valve.Most people are in about 5-7 days.They usually get you up and down stairs before they let you go home and then you must walk a few yards extending the distance 2 - 3 times a day.The scar on the leg is from top to ankle,i have some nerve damage from that.The worst bit is the breastbone ,after 2 years still feel the clips that wire it up.A big must is being near to a cushion,in case you sneeze,that is painfull.Mine took 12 months to heal.Everyone has a slightly different breastbone,so some heal quicker.Depending where you live cardiac rehab exercise classes start after several weeks,mine took 3 months.I think you have to push yourself and with support from family.I hope this helps and good luck.I am 67 and still working.

Keep-it-ticking profile image
Keep-it-ticking

Had a quad 4 years ago, the biggest problem I had was constipation because of the pain relief given in hospital. I would advise getting some form of laxative and get him taking that soonest. Exercise as directed but do keep the exercise.

jeffmorgan profile image
jeffmorgan

Hi this is my first time to write anything here, I am 57 but just to say that I experienced a heart attack last year, end of October totally out of the blue, and ended up with a quadruple bypass just over 2 weeks later, I was admitted to Poole general, then transferred to Bournemouth where I had an Angiogram where I was informed that stents were not a viable option, I was then transferred to Southampton and was operated on the Monday and out on the Saturday! They went into my left leg but had issues with the vein so ended up taken from my right leg, a couple o nice scars but not too bad. Had a couple of days in intensive care then transferred back to the normal ward on the Thursday I think and then home on the Saturday.

So the whole thing took only 6 days.

They had me out of bed by the Wednesday morning I think sat in the chair, they like to have you up and out fairly quickly as long as you are progressing well.

I didn’t know how tough it would be walking around as I was always into my jogging and gym and considered myself a fairly fit person. Walking out of the hospital I just took it easy and slowly but the first challenge was the stairs at home on the Saturday evening going to bed, I actually had to stop for a breather just over half way up!!! My wife was then more than worried but over the coming days I did do more than was recommended as far as walking was concerned. And think this got me more active quicker than would be normal. I wouldn’t sit in a chair all day but after the first week we did start taking gentle walks around the block and then going slightly further afield. The stairs I just took carefully each time, going up and coming down, stop for a minute if needs be before moving on.

You do get a booklet with how you should proceed in the days, weeks and months after surgery. So it is really how your Husband feels when taking a walk as to how far he can go, bearing in mind where ever he walks he has to return.. and he should just listen to his body, when it tells him to take a rest. Have a rest. And when he feels like move on again. If he is fit as you say then he will want to move and won’t just sit around all day. He just needs to take things easy and not rush but rest plenty. There is also an 8 week rehabilitation course of one day a week which is very good just to get you back into the swing of things, this comes after 12 weeks post surgery.

One critical point which should not be missed is that he cannot lift through his arms, lift himself out of bed, chair or lift any weight heavier than a half kettle. This is so there is no undue stress on the sternum and that bit is very important. I did find that difficult when out with my wife and not being able to help carry anything, I felt like people were looking at me and questioning why I was letting my wife struggle with things.

For me getting back to work was the main focus, As I work on cruise ships I had to be in a good position to convince my company I was fit before I could re-apply for a sea going medical certificate. This I did finally manage late March and obtained my certificate which only last 6 months instead of the normal 2 years but at least I had one and was back on board early April. So from operation to back at work just over 5 months. And that is mainly because ship board regulations are a lot stricter than working ashore and there are time frames afforded various illnesses.

My company has very kindly given me only 5 weeks on board, instead of the normal 4 months as its quite full on from the time I walk up the gangway until I’m walking back down at the end of my contract. I’m just about finished this 5 weeks and have felt tired especially as I’m on my feet most of the day. I do have a problem with my legs swelling towards the evening but are usually back to normal by morning. Anyway looking forward to getting home and resting up.

I also flew back to join my ship in Madeira which was around 4 hours and I was fine with it. So depends on what you class as a long haul and if in doubt ask your doctor or the cardiac nurses taking the rehabilitation course who are a great source of information.

Well the above is a bit long winded but the more you write the more you remember and could go on for longer… but the essence is take it easy and don’t rush things and listen to your body.

Oh and watch the sneezing.. make sure you have your pillow handy as that is painful for a while.

Hope the above helps a little.

Jeff

DavidOverton profile image
DavidOverton

Hi Makmillar, I thought I would check in and see how things are going? Hopefully you and your other half are getting over the worst of it, although the heat might have been a bit of an issue over the last few weeks. Always like to hear an update!

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