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British Heart Foundation
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Breathlessness after bypass

My 86-year-old dad had a triple bypass last year. It’s not been a success unfortunately. He had anaemia and a few transfusions and fluid on the lung which has been drained several times.

He’s pretty much housebound as going out brings on fits on breathlessness. With so little exercise and not much of a life, his appetite is non-existent. He had to give the operation a go. He knew the risks, but it’s sadly not paid off.

A GP came yesterday and said (o heard this second hand) he hasn’t much time left. I’m after more information obviously, but I don’t doubt what the GP said.

I’m curious what causes the breathlessness as it’s this which will finish him off. Has anyone else experienced this after heart surgery!

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Extreme breathlessness does not always follow heart surgery. I'm sure the Dr would explain what the heart is doing but it sounds like it is very weak and they have tried their best. My mum was 96 when in that situation and they decided to do nothing as she was not strong and anything they tried would benefit her maybe just one day with a lot of discomfort. So they cared for her and she suffered nothing and just slipt away a week later. I'm sorry if that is overly sad but it was right for her and I'm grateful that we , her children, had some say in her treatment. I hope you find the way to cope.

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Thanks. I think he has a while to go yet. I’ve not spoken to the GP yet, but I imagine the meaning was he’s unlikely to get better.

I’ll cope OK. To get to 86 and be healthy for most of that is a source of comfort. He’s not in pain as such, but his quality of life isn’t wonderful. It’s also “better” than he goes like this as opposed to suddenly or in pain.

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The lungs take quite a beating during open heart surgery, with many micro pockets of collapse. That's why breathing exercises and walking are so critically important to making a full and speedy recovery. Unless you reflate the lungs and get back into the habit of deep breathing there's likely to be problems with trapped fluids, which in turn is an open invitation to infection. Some GP's make it standard practise to inoculate heart patients against pneumonia

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Easy for me to say, but I think he could have made more effort with walking. I think he tried a few times and got very out of breath, and this took away his confidence. It would have been good to have a “personal trainer” to make him walk and push him to progress more. There was obviously a risk to have such an op at 85, but it’s a huge shame that the great efforts of the surgeon and hospital staff weren’t followed up with physio type activities.

He did attend some breathlessness workshops, but he really needed to build up stamina and confidence.

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Here is a discharge booklet for heart patients from Guy's Hospital that contains some good advice, you and your dad may find it useful.

guysandstthomas.nhs.uk/reso...

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Whilst mild anemia causes no symptoms more severe anemia can cause tiredness and breathlessness. Has this been fully addressed? As said the breathing exercises are very important - when I attended rehab a good number of people had not kept them up on leaving hospital.

Don't give up hope just yet. I know a lady whose family were told she would not come out of hospital alive. She has now been out eighteen months and says she is going to live to 100 to annoy the consultant!

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Hiya

I had breathless after my triple for about 8 weeks , first 4 weeks were the anti platelets med brillique or ticagrelor

The longer period was caused by the healing process and shear lack of good exercise for 3 months . I'm 48 and working as a gardener now and going to the gym for rehab I had my op in February.

Hope it gets easier for you and your dad .

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Cheers Deano, that’s a heartwarming (pun?) story I’m sure you never imagined in February (I assume Feb 2018).

Is the gym rehab your decision or advised by medical staff. I’m amazed my dad seems to have had no list of exercises to work to, even if it’s just walking every day,

Bear in mind he’s 86 so forcing someone that age to exercise requires professional assistance or I’d be kicking him out of bed myself 🙂

Glad you’re doing well.

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Hiya

No this was 2019 sorry , rehab at gym was part of my fast track recovery .

There were about 5 people 80+ in my ward I think it takes a lot out of everyone but at that age it's gonna take a lot more , slowly slowly catchy monkey I think is the way .

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Wow, that’s a speedy recovery. Well done.

So was the gym was part of your treatment plan from the medical team or was it of your own doing?

I ask because my dad had no exercise plan it seems.

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I should have added that I think it’s more of a mental thing. My dad doesn’t want to do anything, not even go out in a car as a passenger. To me, that’s a vicious circle of boredom and being self defeatist. My mother isn’t overly well, and I think they get each other down. Not much to look forward to when the only highlight is sons coming to visit 🙂

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Hi CocoNutWater,

Sorry to read of your dad’s problems. How unwell was he before his operation? My husband who is 70 had a quadruple bypass a year ago and is only just getting back to feeling better and wanting to do things. He lost his appetite and did not want to eat. He was anaemic but we eventually discovered that he was also deficient in vitamin B12, folate and vitamin D3. Correcting those has helped and his appetite is returning. He also retained fluid and was very breathless for a while but so far Furusemide water tablets have helped with that.

It is a very long road but hopefully your dad and you will be able to enjoy some good times together this summer.

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He was pretty OK but had angina and had had “minor” heart attacks. I say minor as it not doing anything about it - most people would have dialled 999 but I notice older people don’t like to make a fuss (unbelievable).

Being harsh on my dad, I don’t know how anyone can expect to recover from a bypass without exercise. I reckon five minutes a day walking might have been all it took. He was chosen for the op based on the criteria which means someone else wasn’t chosen or pushed back. I don’t think he feels that sense of duty, for want of a better word, to make the effort. Anyone with that mindset who doesn’t even want to go out for a trip in the car isn’t likely to recover I guess.

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My Dad had surgery at 93 to drain a clot on his brain that was causing stroke like symptoms after a fall. Although he made a fantastic recovery and is now able to drive again he has developed the mindset that ‘I’m past my best before date’ and he won’t plan anything as his number could be called any day - he says he is tired!

My hubby enjoys going out in the car but he doesn’t walk far - his balance isn’t the best. He had a small stroke after his heart surgery and as part of his rehab was taught by the OT and Physio how to safely and easily get in the car - that made it a much less tiring operation.

Have you any local support groups that could maybe help with encouraging your parents?

It’s a long road and I feel the surgeons often underestimate the impact on a persons life and the expected recovery time.

Your dad is maybe also anxious about your mum and the future for either of them without the other.

Best wishes.

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I’d find it quite demotivating for a surgeon to spend 7 or so tiring hours to perform a perfect bypass only for that patient to not have decent aftercare. My dad had no sort of exercise plan. He religiously takes a mountain of tablets at the right times each day as a doctor has told him to do so. If a doctor said walk a few minutes a day, he probably would.

Yes, it’s difficult for older people to care for each other. They both seem to have retreated into their own self-centred sick world. Neither of them has much appetite, but rather than cook something appetising for each other, they’ll make their own sandwich or whatever.

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Maybe the mountain of tablets is partly to blame for how he feels! Bob is on Ramipril, Atenolol, edoxaban (an anti-coagulant), a PPI to protect his stomach, metformin for his diabetes a diuretic and folic acid and Vit D3. All of these are low doses. He also takes a statin and has vit B12 injections every 12 weeks ( to correct a defiocaused by both the PPI and metformin)

I there someone who could cook a meal a couple of times a week for your parents? It can be soul destroying if you feel unwell yourself trying to think what to get as a meal for someone who doesn’t really want to eat (I have spent times it tears wondering what to give Bob and I am generally fit and healthy!) Alternatively what about a company such as Wiltshire Farm Foods that does frozen meals, delivered to their freezer and that would just need to be microwaved. Do they have a home help/Carers that can heat the meal and serve it for them.

Is there a local heart nurse that you could speak to about support services, have you contacted the hospital where his surgery was done about ongoing support?

Don’t be cross with your Dad, he probably still feels as if he has been hit by a train and if he is anything like Bob he won’t want to feel like he does! Was his surgery ‘planned’ or did it happen quite quickly?

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Mmm we tried carers who come and microwave an evening meal. It didn’t work out well as the person would come as early as 4pm. They’re fussy about eating too now! You’ve probably guessed I live a few (2) hours away but visit every 2 weekends now and cook a fair bit.

Yes, I’ll try again with the heart nurse and some exercise.

His arteries were pretty much clogged up. He had angina and a few “minor” heart attacks. Incredibly he had these at home and didn’t call 999 or do anything to make a fuss! His surgery was therefore not especially rushed.

I have to be a bit cross (not to his face) as he doesn’t want to do anything, not even go out in the car. He must be bored beyond belief. And then there’s napping whenever he feels like and then complaining he can’t sleep at night :) There’s no purpose or anything to look forward to.

We’ll keep trying.

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You may find that as the weather warms up they will feel better - Bob struggles to breathe when it’s cold and also feels the cold.

Heart attacks don’t always show up in the way we expect them to. When Bob had his first one he thought it was a chest infection as his neck ached and he felt it was hard to breathe ( our daughter had a chest infection at the time with similar symptoms so he thought that was the problem) he also had a few episodes where he felt a bit off but nothing that a sit and a cuppa didn’t sort ( these were little heart attacks but we didn’t realise)

Did your parents have any hobbies or things that they enjoyed doing before your dad became unwell?

In this area there is a community minibus service that does trips for ‘less mobile ‘ folk - they have several helpers and collect you from your door, they go to some of the shopping centres or a garden centre and then have lunch somewhere and back home and help to carry the shopping - something like that might be a help.

My dad is a member of a local ‘ramblers’ group and still goes out with them but often doesn’t walk far - just goes for the company and the bus ride! He set himself a target to be fit enough to lead a walk that he was scheduled for about 4 months after his surgery and managed that. Something to aim for always helps.

Best wishes to you all - it does seem to take a year to start and be better when you are older.

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Thanks Janma, my Dad’s actually making an effort now! You might be right about the weather. Tomorrow, I’m taking him out in the car “on an errand” with a little picnic chair and we’ll do some walking. I’m expecting this to be a bit unpleasant as he will get very breathless, but I’ll be ecstatic with a couple of minutes. His mindset has changed it seems, and he’s giving it a try.

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That's great news! Sunshine is wonderful! It's a year yesterday since Bob came home from hospital and we still have ups and downs!

I took my dad out for a run to see the daffodils on Friday, he kept yawning and said he was tired at home, but he was fine when we were out - I opened all the house windows when we got back and gave the air a refresh. That might be worth a try at your parents too!

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The daffodil run sounded a great idea. Well done!

My mum isn’t helping. She gets anxiety attacks and spreads this to my dad. She also says (behind my back) that I’m a bully with my dad. I’m not there to be popular :)

My mum’s negativity has definitely hindered my dads recovery, but it now looks like he’s helping himself.

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Your mum is probably struggling too. I have days where I don't know what to do for the best and I get anxious. I changed from drinking ordinary tea to drinking decaf and that has made a big difference to my 'wound up' levels!

Enjoy your trip out.

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Thanks Janma, I only see my dad every 2 or 3 weekends, but my mum has to deal with it all the time, as you do. Fortunately, my dad’s mindset seems to have changed, and now he seems to want to get better! He walked today and although he got tired a lot and sat down, I would call this fatigue as opposed to breathlessness. If he can keep up this positivity, I’m sure he has more of a chance than if moping about at home.

Hope you’re doing well as you’ve clearly had a tiring time of it lately, and I hope you have help.

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I’m pleased your trip out went well, I was thinking about you today. We had a drive out and a short walk too, and then called in on some friends. This weather is fabulous and makes you want to do something. I hope your Dad continues to improve and get his fitness back and his appetite!

Jane

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Thanks Jane, it’s not easy as you know. I’ve spent the last few months either blaming my dad for not making more effort or my mum for being negative/anxious. When I say blaming, I mean internally or whinging to my wife. I’m sure you get negative feelings too, but it sounds like you do a great job.

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You are doing a good job too and your Dad and Mum will appreciate the support that you are giving them, even if they don’t always show it!

You will also have been ‘shaken up’ by your Dad’s illness and operation - our parents have always been there and we don’t register that they are getting older! Parents are also very good at covering up and glossing over things, which can make us feel guilty that we hadn’t noticed or done more about something sooner - don’t feel guilty, do what you can and enjoy the time you can spend with them!

Jane

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