Life after CABG - Please Help

[Tcx38]

Hi, i am a 37 year old male who suffered a heart attack In Dec 2017. After 2 failed attempts for a stent I had a double CABG 3 weeks ago, where I also suffered 3 broken ribs during surgery. Since the CABG I’m still suffering with extreme chest pain and recently my left arm has start to hurt again like when I had angina, is this normal? 3 weeks on and the incision on my chest is still leaking and bleeding but I’m not to sure if this is normal either? I still feel so tired and in pain, please help.

[MichaelJH Heart Star]

I will post more later as on way out. Three months ago I had s quadruple bypass. Despite one cardiologist describing me as "hard" I needed tramadol for the first three weeks. The chest wound needs looking at (GP nurse and don't accept "We are very busy"). Also talk to your GP re arm pain - is it same side as broken ribs?

[Tcx38 in reply to MichaelJH]

Hi Michael, thank you for your response. At the moment I’m on codeine which doesn’t seem to work at all, the pain seems to be getting worse in my chest. Whilst in hospital I was on morphine where I felt comfortable but since being home, my pain seems to have got worse. I went to my surgery re chest wound 2 weeks after my operation and my GP wasn’t available and a nurse said they couldn’t help and to contact a district nurse, who refused to see me and advised to call 111. I called 111 who then advised to go to my local hospital. I spent the whole day there and as they do not deal with cardiac related issues 7 hours later advised to go to another hospital where I just gave up and I didn’t have the energy and felt faint due to low blood pressure so came home. I have finally got an appointment with my GP and I have managed to buy some waterproof plasters in the meanwhile.

The arm pain is my left arm and yes the same side as my broken ribs. When I suffered angina before my operation it wasn’t as bad as it is now and I’m worried the bypass has now been unsuccessful unless it’s normal to have this pain?

[MichaelJH Heart Star in reply to Tcx38]

Absolutely shattered so more tomorrow. I find both ibrufen and co-codamol ineffective - they also really mess up my digestion - which is why I requested tramadol. One thing to note is quite a few people cannot tolerate it but it works!

[Tcx38 in reply to MichaelJH]

Thank you. Whilst in hospital I was on morphine but when I got sent home I am now on codeine and paracetamol which really isn’t working, I think I should ask for something a little stronger?

[MichaelJH Heart Star in reply to Tcx38]

As I said I find tramadol a very effective pain killer. I had to request on discharge as it does not seem to be prescribed that often. It can become addictive and is a definite no-no with alcohol However, where there has been abuse I think careless repeat prescribing played a large part.

[Tcx38 in reply to MichaelJH]

I’ll see if I can get tramadol or morphine tablets as they seemed to help with the pain whilst in hospital, the codeine isn’t helping. Thank you for the advise

[Hidden in reply to Tcx38]

I am somewhat confused by your post - with the greatest respects, why are you asking us here to advise you on chest pains when you are only three weeks post triple heart bypass? Were you given no advice - booklets to read, advice on post operation? At three weeks it will hurt, especially in bed and getting up, coughing. sneezing etc. The whole process of having the breast bone "heal" is up to 12 weeks, so your process is still in its infancy. I was on Tramadol when I was discharged and that did not help at all. I went to the doctors as an emergency appointment (you should be insisting on an appointment) and was prescribed Oramorph - a liquid morphine and was on that for two, nearly three weeks which did wonders to aid my repair. Again, with a leaking chest, the doctors is the first stop and have to emphasise you are a new CABG that needs urgent assistance. You will be seen but have to disclose what and how bad the pain, feelings are. No point in discussing it with a nurse and receptionist. To help you with your knowledge have a look at this web page help pages that outline the recovery and prognosis as you heal. I assure you that after three months you will wonder what all the fuss was about - human nature dims the awful events in life and the despair and pain will soon become a distant memory, leaving you to celebrate your new found health and stamina. Keep at it, keep positive and thank your God you have made it.

[Hidden in reply to Hidden]

Just one more thing - pain or discomfort and tiredness are both issues with the process and you have to get used to it. I am six months past CABG and can still feel pain or discomfort, but usually its me being stupid and trying to do too much - like climbing a tree to prune it! Everyone is different, everyone needs to be kind to themselves but most of all everyone needs to remain positive - start whistling "Always look on the bright side of life! if nothing else it will make you smile....

[wiltsgirl]

Hi, I had a triple in March and my drain wounds were a bit weepy. From what you have said I wound insist on seeing your GP and if not got to A & E. Do you have the number of the ward you were discharged from? They may be able to suggest something. I wouldn;t say no for an answer. if you are in significant pain and wound issues they have to listen to you. Best of luck x

[Tcx38 in reply to wiltsgirl]

Hi, thank you. I went to A&E at my local hospital but after a day of waiting around they then suggested to go to a cardiac hospital but it was less then 2 weeks since my operation and I was tired and wanted to go home. I called the ward I was on and they just said we have no beds even though I didn’t even mention anything about beds. I’ve now got an appointment with my GP week after next, hopefully she’ll be able to guide me on what to do. I didn’t realise the after care was so poor after a CABG, it’s like your left to get on with it with no help at all. Thank you for your help and hope you are feeling better x

[wiltsgirl in reply to Tcx38]

Oh my goodness I think you have had rubbish after care. I guess it depends on where you are (post code lottery). I was told to see my GP as soon as I could when I came out of hospital, which I did within a week, she wanted to see me two weeks later and then at a month. Inbween this I was also seeing the nurses for changes of dressing and to trim stiches where needed. I also saw my surgeon after 6 weeks to check on my progress, I also had an ECG and chest x-ray. Also you should be invited to cardiac rehab, I started mine after 6 weeks for 6 weeks. I think you need to make a nuisance of yourself and get the right care. It must be so frustrating for you. Best of luck x

[Tcx38 in reply to wiltsgirl]

Haha, very true, I understand everyone is stretched but it’s only now been 3 weeks since my operation, I would have hoped they’ll be some kind of support for me. My dressing was taken off 2 days after my operation whilst in hospital and not replaced so I’ve had to go and buy my own where it leaks and I change it daily myself. Sounds like you’ve got great support after your CABG. Can I ask, did you suffer any angina or pain in your left arm after your surgery and also how long did the chest pain last for? 3 weeks on and I’m still in so much pain when I sleep, move and cough, I thought in time I’d get better but seems the pain is getting worse. I will have to start kicking up a fuss, but I’m sure my GP will help as she’s really good when I can get an appointment with her x

[wiltsgirl in reply to Tcx38]

Hi, I remember it being hard to sleep and slept sat up for a few weeks and could only lay on my left side. My right is still sore some 6 months later. Did they take any arteries from your arm? They tried for me but were unable to harvest, so I have a lovely large scar but no benefit. It can sometimes be sore now. As for your wounds, mine were uncovered in hospital and I did not cover them back up at all apart from the drain one which took about 5 weeks to heal properly. The scars need air to heal I understand but I think you should get it checked out anyway. I was told I could shower with the wounds exposed as long as I used a separate towel to dry the wounds to ensure there was no infection. Are you taking any pain killers? I took codeine only at night as it then meant I could sleep as pain free as possible. Other than that its paracetamol. I found that each week I would improve and by 6 weeks things were a lot better. 6 months on I still expeience soreness in my chest, they used mammory arteries, and I have been told it can take up to 2 years to be 'normal' so its a slow process. I still hold my chest when I sneeze as it reassures me. You are still only very early on, take it easy and don't be so hard on yourself. I found I had to take ownership a bit and called up the rehab nurses to get booked on the course. Best of luck, if you need anything just message me xx

[Tcx38 in reply to wiltsgirl]

Hello, I’ve been sleeping on my back which I find really uncomfortable as when I sleep on either side the pain is unbearable. No they took an artery from my leg and that seems to be healing fine and the other was a mammoth artery, but it’s just the incision on my chest that leaks. Omg I’m so sorry to hear that they couldn’t harvest an artery and only found out when they opened your arm. Sounds like you got a lot of good information before you left hospital, no one told me about using different towels, I was just told if I have any issues to contact my GP or call 999. I’m on codeine at the moment but whilst I was in hospital they gave me morphine which I guess really helped with the pain then. I seem to be taking 8 codeine a day at the moment but it’s not making any difference to the pain. My chest still really hurts when I move, cough, sleep, it’s so sore. I’m guessing the morphine covered the pain in the hospital so I felt fine but when I got home and came of the morphine and got given codeine and paracetamol the pain started, I might try and ask for something a little more stronger. Your right, I should call cardiac rehab and see what’s happening too. Thank you for all your advice and hope your recovery is going well x

[wiltsgirl in reply to Tcx38]

I think you need to speak to someone to manage the pain. Maybe I was lucky in that I didn't take any pain killers quite soon after the Op. You do not have to put up with any pain that can be treated. Hope things improve for you soon. Take care and keep in touch xx

[Tcx38 in reply to wiltsgirl]

Thank you. I have an appointment with my GP next week, hopefully she can review my medication and prescribe something stronger x

[Twobells in reply to Tcx38]

The support is not always there. I too had this issue last year after my triple bypass. Rehab did not help me at all. What I needed was support in coping what I had been through. The suppot never came. I now have PTSD. I became an emergency, blue twoed and emergency bypass. Once I was dischargednobody apart from this site gave a damn. In the endI managed to see a GP atmy practice, thank goodnes for her, I now see her regularly justkeepingon top of things. Its tough to come to terms with. I have positive days, but I still have severe flashbacks aboutwhat happened. Eventually got some counselling which helped me open up a bit. Its a long road to travel, but just take one day at a time. I eventually jpined a local gymand got their help when I explained my condition.

Yournot alone, some of us just plod along, take pressure of yourself and recver inyour own time. You have been through one of the biggest op you can have and it ismind boggling to come to terms with it.

Take are Fran

[Philippa_BHF]

Hi Tcx38,

It sounds like you are having a really bad time and that things aren't going to plan according to plan with your recovery. Rather than my giving you a long winded reply with my nurse hat on,please give our heart helpline a ring on 0300-330-3311 today, where one of the cardiac nurses can talk you through things and give you some much needed medical advice!

I really hope you feel better soon,

Take care,

Philippa

[Tcx38 in reply to Philippa_BHF]

Thank you, I will do

[dave1957]

Hi sorry to hear that you have felt so rough and with the bad aftercare that you have received since being discharged from hospital. I too was young like you when I had my heart attack and triple bypass at 36 yrs old in 1993. I also had problems with ongoing pain and scar issues on leaving hospital but back then it seems the aftercare was so much better than you are receiving now. With my scar it was weeping and was healing like thick rope (Carioid I think its called) and had to have it cut out and re-stitched followed by many steroid injections which seemed to calm it down. I found that as time passed most of the pain and uncomfortableness receded, as for the tiredness this is very normal. This is a scary time for all going through this as I found out but that was 25 years ago for meso there is hope, and I hope you get the help you do need to get through your post op issues.

[Tcx38 in reply to dave1957]

Thank you. I’m glad you got the support you needed and hopefully I’ll grt there too. Hope the scar has now settled, luckily mine not like a thick rope but it’s just weeping and bleeding a lot. Thank you.

[El-Tel1990 in reply to dave1957]

Hi Dave,I read one of your replies on this forum. You had your bypass in 1993. Have you had any major events since then?

Regards

El-Tel

[Hidden]

After a mild heart attack on 26 May and failed stent operation because of severe cardiac blockages, I had my CABG on 8 June. Because the incidents were so quick, I had little time to soak in all of the information I was bombarded with, however I took the time to read as much as I could and retain the info - very difficult to grasp everything so you will have missed that 4 to six weeks is a very sore time where the slightest movement can bring on waves of pain and getting my walking quota was something I dreaded. However, even if you cannot see the end of the tunnel yet - the pain actually does recede very slowly every day. It is good you are young but youth is not guaranteed to make the transition to painless any different than everyone else. They do say that the older one gets, the better they deal with pain - who knows. What I can say is that everyone is different - everyone and all you read is a guide because we have varying needs and expectations. There are thousands of these operations done a year and everyone get through them and upon looking back I was so sore and even now get a bruised feeling in the sternum but my donor leg still stings at time.

As for your pain and leaks - Contact the hospital or hospital ward you were in before release. You will have the number in the paperwork you were given when discharged. Having said that the reason is that your family doctor cannot possibly intervene in another surgeons work - purely due to who is responsible - get in tough with the hospital, When you get there, also talk about your pain management. It is questionable how you could be discharged with a weeping wound, but thats another matter.

I have been on Tramadol for years for another injury to my arms and it was not until I was prescribed Oromorph, a Morphine based pain killer that my recuperation truly began, so I can understand your concerns. The hospital should sort that one out - but if not, then go to your GP since this area is aftercare and that they can deal with.

Because you have presumably had a triple heart bypass graft, the surgeon needs to farm two points of your body to obtain the vein/artery to make the bypass. The first I believe if from the inner chest wall of the left side of your chest. There are less nerves inside the body, but there are nerves and my chest on the outside is quite numb in an area about the size of a side plate and I get pains in that area but I know it is muscular, its deep and on the left but I know it is not angina. Having said that I do not know what you are describing is angina - and again you could bring that up when you get an appointment at the hospital. Furthermore, I hear people have concerns trying to get to see a GP at your local surgery. Just say that you have undergone triple heart surgery and need to see a doctor urgently - I guarantee you will be seen the same day - I was and again it raised the question of blame should anything go wrong.....so depend on that.

Finally, both my leg and chest wound had leaky spots but they were where the underlying stitches laid close to the surface - in fact, I had four small pieces actually come out of the skin where they were surgically cut off or pulled out by the family GP - again this is quite normal where the are was just wiped clean with an antiseptic and left to heal naturally.

Reading between the lines I could guess that you are not getting much support at home - are you alone during the day? For it could be your anxiety levels have been pumped up because of lack of knowledge or just a need for guidance. I have no idea. Go get the appointment with the hospital, they might even deal with it over the phone and then send you to the GP for stronger pain killers. If you are still concerned, then please message me or any of the others "here" and we can advise you - from our own knowledge since we are not experts. Hope this helps you and trust me give it another three weeks and you will wonder what the fuss was about.

[Tcx38]

Hi, thank you for your email, it’ll be 4 weeks tomorrow since my surgery so I’m still in that very uncomfortable stage. Looking back I think it’s better to have less time to digest what is happening as I’m a worrier and had a bit to much time on my hands to think about things. Twice I lived in hope that a stent would work, but after 2 failed attempts a CABG was the only option. As you can relate, at the age of 37 I’d never thought it’ll happen to me.

As for the leak on my chest, I have now contacted the hospital who said it’s normal and to just put waterproof plasters in there, not sure if I fully agree but I have to trust the experts. I have an appointment with my GP who I’ll get a second opinion on. I understand my GP can not intervene but least I can get her opinion. I’ve also just had my 6 week hospital appointment through, where as you say I will be more tough and talk through all my pain and concerns.

When I see my GP next week I will also talk to her about the pain as he codeine isn’t making the pain any better.

My GP is great it’s the staff that work on reception that have no sense of urgency. Last time I was there asking to see the doctor they had a young boy on reception who just pulled a face. A senior member of staff then intervened but she stated to call a district nurse, I did explain I had a bypass under 2 weeks ago but there was no comprehension or urgency.

I’m not alone in the day but when it comes to this we’re all a bit lost on what is right and what isn’t, I’ve also learnt Google is full of varied answers, but this site is great.

Thank you for all the information and he positive thoughts, fingers crossed things will start to get better soon. Hopefully I’ll be invited to cardiac rehab at some point too.

[Blockage]

Just read this in relation to my own worries post CABG where care (other than BHF) is limited / non-existent. How are things 2 years on?

[Smudgebuttonjessie]

Hi, sorry for long reply, I thought i was reading my own story for a minute then. I had x2 CABG 9 weeks ago, i started getting the ‘angina’ type episodes again after 2 weeks and they we’re getting worse, i went to A&E after experiencing a really bad ‘angina’ type episode, they did chest x-rays, CT angiogram, echocardiogram and bloods, they ruled out the critical stuff like PE, pericarditis etc, my results were abnormal and were sent for review at an MDT meeting to discuss findings, the consultant said i had DRESSLER’s SYNDROME, this is a form of pericarditis which occurs after chest trauma or surgery, it’s quite rare and not much literature about it, the medical teams have to look it too.

I’m not saying that’s what you have but making you aware of complications as you shouldn’t get angina after surgery.

Make sure you go to A&E and keep getting checked