7 Week Review after CABG

[Gribbin]

7 weeks since I had the CABG x 4... went in for a review with my consultant.

Soooo glad I had read up on here, and had the Cardio Rehab assessment beforehand, and had made notes of the questions a needed answers too. It was brutally efficient - yep your op was a success, you can do anything, and we'll discharge you to your GP!

What about... so I brought out my list, and fair enough they went through it with me:

1. I experience blackouts when I stand too quickly... This was attributed to me not drinking enough, and they would stop the Flurosemide, and half the Bisoprolol to 2.5mg/day.

2. GTN was withdrawn when I was discharged from hospital, and Cardio Rehab nurse was concerned. I have also had some angina/chest pain since, usually when I get stressed. No need for this, your problem has been fixed.

3. I have had a lot of anxiety, especially when thinking about my return to work, can I be referred for some counselling. Oh OK we will write to your GP for them to request this closer to your home.

4. I am experiencing 'brain fog' and find it hard to focus or concentrate, cannot complete a chapter in a book, takes ages to do puzzles, and fall asleep watching TV. This is fairly normal and should wear off.

5. Numbness on chest, wrist, leg. Pins and needles in hands when lying with arms bent. Very cold hands and feet at night. This is normal, change position - don't bend arms to allow better circulation. Otherwise these symptoms will reduce over time.

6. Can I drive, swim, fly, attend Rehab? Yes... you can now do anything.

7. Tiredness in addition to 'brain fog', usually in the afternoons. I walk briskly for 30-45mins with the dog every morning, warm up and get slightly breathless. Towards the end of the walk my legs and arms start to get heavy. I then keep busy up to lunch time, but usually zonk out and fall asleep for a few hours in the afternoon. This is normal, and will improve over time. Good to keep up with the exercise.

I am not sure if these are common, I got the feeling they were... I'm not sure if I should expect a letter to confirm all this... it has helped to put it in writing here, so I remember... Will my GP now let me know what my new medication regime will be?

I still feel like it is early days, physically I am improving day by day, but mentally I have highs and lows... because I had my HA at work I now associate work with this, and almost see it as a return to square one, if not a potential death sentence - this is my mind catastrophising things!?

Work have been supportive/quiet... and are looking towards Occupational Health as a route back to work, which I think is a good thing... I hope they have a better idea of what I am going through that I do ?

Thanks for reading all this... I think just putting some of this down has helped.

[Noodlesalad]

You have had major surgery and I think everything you have said is valid and understandable.Your doing amazingly well and you should give yourself a pat on the back. It's easy for people to say don't worry your doing fine but after major life changing surgery it's a big adjustment. You have to get used to the 'new you', and I am sure this will take time.

Sounds like you have an excellent cardiologist and I always think this person is highly qualified in what they do and have lots of experience and on balance you have to try and accept that the surgery you had has fixed your problem and you will in time feel so much better.

Onwards and upwards as they say.

[bagsypartime]

Hi Gribbin

Firstly i thought your post very well expressed.I had an 8wk check after cabgx2 and it was very similar.In effect we are good to got and back in the care of our GP.

A lot people get anziety after this op.I was elective so didn't have a heart attack but feel your mind is making this worse.I can understand the association work/HA but life goes on.

Most of the things you describe are minor.(unsure about continued chest pain, but the mind is a funny thing and plays tricks).

I wasn't happy with my recovery at 8wks, including as you say zonking out, being giddy when i stood up after sitting for a while, being giddy when i knelt down.

I think the replies that were given to your concerns were good ones.I don't think they were fobbing you off or dismissing your concerns.They were giving honest answers from dealing with a lot of people just like us.Your operation was a success.That's good.

They are now done with us- unless you get any heart related symptoms.This is a good thing.But you are thinking that it's scary.

You are doing all the right things and have a positive attitude.As time goes on your recovery will continue.You want those grafts to take and continual effort, as you are doing is the best guarantee of this.

What would you rather they said?Based on what you say we are really worried about you and had better have further monitoring? All of the things you have are in the normal range.Your improvement will continue.

I went back to work far too soon (5wks), and really struggled with giddiness and tiredness.My job is very physical and i was very weak.But i was a lot happier once i'd started work.After a couple of weeks i was even worse at work than when i started.My op was mar 1st so 20wks now and keep getting better and stronger.

What i'm trying to say is that you will continue to get better even if you have many doubts and sometimes go backwards.

.I'm always upbeat, but when i'm not i often use tricks.Your takeaway from the 7wk check was that you still had concerns, Mine was that i could now legitimately work, gym, get holiday insurance and drive.

Regards the GP as we've been 'fixed' so they can't do a lot.You got rehab, i never got that.They take charge of your meds but stick to NICE guidelines and your current prescription.

Thinking about it this is not actually true.You and i, were not sent back to out GP, we were referred back to our local hospital.You will get a phone call from them and the nurse will go through everything you said in your post.She will ask you how you are handling your meds and what exercise you are doing and lots of other questions.And only then will she give you back to your GP.She will suggest you take a blood test at your surgery and what panels to ask for and afterwards make an Doc appt to see if your meds need adjusting.

[Gribbin in reply to bagsypartime]

I really appreciate the feedback, it's good to get points if view from others that have been through a similar experience. It's hard to imagine how many of us pass through these incredibly skilled hands, both in surgery and on the wards... they know what they're doing, and they have a very specific focus, so once that is done we have to move on.

Moving on means change, and that's not always popular... possibly a reason why I was looking for problems?

I am looking forward to Cardio rehab, for the professional support as well as meeting others in the same boat. It was reassuring talking with others on the ward while in hospital.

I feel like things are progressing 👍😊

[ChoochSiesta]

I am 18 months on. I have no real issues now. However, I rarely get through a day without an afternoon doze, usually 30 minutes. Could be just 2.5mg beta blockers? Still get chest and leg twinges but they aren't heart related. Left side of chest still numb but who cares, minor inconvenience.

[Gail1967]

I def think the physical recovery is much more straight forward than the mental/emotional one. I was in body ready to go back to work a few weeks post my cabg x 4 but my head took a lot longer to catch up!! Just take it slow & time helps it all to sync again

[CyclingTime]

I'm slightly concerned about the "yes you can do anything".That normally happens after 12 weeks and not 7 so I would say be careful for a while yet with heavy lifting etc .

[MountainGoat52]

My first thought was "7 weeks!". I would have thought that this was the kind of review you'd be getting at 12 or 13 weeks, after all your sternum won't have fully healed yet and you won't be able to do anything as they suggest. I wasn't discharged to the care of my GP until 13 weeks post op and was told I needed consent from my GP to start driving again. From experience I don't see this is a process that can be fast tracked. 😯

[Wooodsie]

Well done Gribbin, and thanks for the in depth post. My op was a couple of years back and at 6 weeks I took "you can't undo what we've done" literally and have lived a normal life ever since. My one regret was not asking the questions you asked, and I'm sure many others would like the answers too. So thank you 👏👏

[LadyZ13]

I'm so glad you took your questions and got answers. Your experience was fairly similar to mine - surgeon saw my case as all done, all brilliant, off you trot now, back on the horse etc. Whereas I'm still sore, wound hurts, and my heart is in abnormal rhythm, exacerbated by stress and activities. I'm 7 weeks post OHS.

He put these in a note to my consultant back at my local hospital and as a result I was put on a holter the following week to look at the atrial flutter/ fibrillation and hope to hear back from them before too long about how they plan to address this.

We're living in recover every minute of every day and there are lots of little niggles and worried along the way. Reassurance from others does help, but it's also important to have a medical team that you can turn to!

Wishing you all the best with your recovery .

[Rogo23]

Reads rather like my "end of term report" although I didn't have the dizzyness on standing.And the brain fog at least for me disappeared, the numbness in the chest also has basically gone, it's still not quite as it was pre cabg, but considering what they do to the sternum I am pleasantly surprised at it.

Likewise the tiredness passes, you have had the equivalent of a car crash, some highly qualified looney with a saw and sharp knife has assaulted you,of course you want to zonk out in the daytime, my advice give in to it. Your body has a good idea about what is good for it, listen to it I did and five months after the bypass was laying Indian sandstone flags on a patio.

Gtn well I think that the surgeon's regard it as a bit of a insult to their talents, sort of " I have just spent many hours rebuilding his hart he doesn't need it " ask your GP a red bottle will be forthcoming.

You will get better,in fact it is likely you will improve on your condition in the months pre bypass,if you take it carefully during this convalescent phase. Do the miles eat the salad get well.

Dan 👍

[Samazeuilh2]

I had CABG in late December 2022, i.e. just over six months ago. Here are a few comments for comparative purposes.

“1. I experience blackouts when I stand too quickly... This was attributed to me not drinking enough, and they would stop the Flurosemide, and half the Bisoprolol to 2.5mg/day.”

I haven’t blacked out, but sometimes feel dizzy momentarily when standing-it always passes in about 10 seconds. There doesn’t seem to be any pattern to this-sometimes it happens, sometimes not. I was, like you, advised to drink more water and be careful when standing up.

“2. GTN was withdrawn when I was discharged from hospital, and Cardio Rehab nurse was concerned. I have also had some angina/chest pain since, usually when I get stressed. No need for this, your problem has been fixed.”

I have had this on a few occasions when stressed , but they said they don’t think it’s angina. I would get an opinion on this from a cardiologist.

“3. I have had a lot of anxiety, especially when thinking about my return to work, can I be referred for some counselling. Oh OK we will write to your GP for them to request this closer to your home.”

I’m retired so I haven’t had to face this. I guess a lot depends on your occupation, employer etc..

“4. I am experiencing 'brain fog' and find it hard to focus or concentrate, cannot complete a chapter in a book, takes ages to do puzzles, and fall asleep watching TV. This is fairly normal and should wear off.”

I didn’t get this. I would monitor it and report back if it doesn’t improve after another month.

“5. Numbness on chest, wrist, leg. Pins and needles in hands when lying with arms bent. Very cold hands and feet at night. This is normal, change position - don't bend arms to allow better circulation. Otherwise these symptoms will reduce over time.”

I initially had very cold feet at night and even when out walking even when the weather was only moderately cold, but not since about early June. Pins and needles on a few occasions but not recently. So, yes, these should improve.

“6. Can I drive, swim, fly, attend Rehab? Yes... you can now do anything.”

I was told the same.

“7. Tiredness in addition to 'brain fog', usually in the afternoons. I walk briskly for 30-45mins with the dog every morning, warm up and get slightly breathless. Towards the end of the walk my legs and arms start to get heavy. I then keep busy up to lunch time, but usually zonk out and fall asleep for a few hours in the afternoon. This is normal, and will improve over time. Good to keep up with the exercise.”

I still feel tired in a “sleepy” way now and again. This tends to diminish with regular exercise and occurs if I haven’t exercised for a few days.

“I still feel like it is early days, physically I am improving day by day, but mentally I have highs and lows... because I had my HA at work I now associate work with this, and almost see it as a return to square one, if not a potential death sentence - this is my mind catastrophising things!?”

You seem to be doing g well. It is early days. Shortly after my OP I travelled by taxi and discovered the driver had had a bypass years ago. He told me that he couldn’t even get out of bed for about six weeks after the OP. Good luck!

[Gribbin]

Thanks for your comments and support.Someone recently told me the phrase - The viewpoint from the bed often differs from that at the end of the bed.

This is where we have do look in to ourselves, and that's not always easy.

Maybe I have just been a model patient... discharged from hospital on day 4, and signed off to my GP at 7 weeks. I've never considered myself a model example... I'll take it as a pat on the back, and Keep buggering on!

Don't get me wrong about some of my relatively trivial questions, just reassuring myself nothing is out of order...a bit of discomfort and numbness is a small price to pay for the life I now have to enjoy for many years... even if that is now more salad based😂

[momander]

Wow!!! First of all congratulations!! Secondly, you are so lucky to have actually seen someone face to face after only 7 weeks!! I had to wait 12 weeks then I was advised my surgeon wouldn't be phoning but a member of his surgical team would. It was awful and sould destroying. The person had no interest in me whatsoever and merely told me I was discharged from them to my local hospital and GP. I had questions to ask but I wasn't given the chance to ask them!! I'm so glad you had a better experience than me. The physical recovery has been surprisingly good but the emotional recovery had been the worst!! I know everyone is different, but the constant tears and low moods have been so hard to deal with. Health anxiety too, as you are more aware of your own mortality now. I met a lady on Tuesday at my cardio rehab class and she had a bypass in 2001!! So 22 years isn't bad going!! Just take it easy and slow and don't rush things or go back to work too soon. You have no need to be a hero or prove anything to anyone, ( I kinda went down that road )Baby steps all the way. Best getting there safely than making yourself poorly. I wss told " your heart is fixed but remember it is still healing" I've always remembered that. I Was also reminded to be careful of twisting or turning as it takes approx a whole year for the sternum to heal!! I'm 7 months on now and it is still considered early days by my cardiologist!! I'm only just able to lie in my own bed!! Still propped up a wee bit. It all takes time. I wish you every luck in your recovery and your new life too. If you want to chat over anything I will be happy to help if I can. I wasn't given any info at all on discharge so had to find things out as I went along. The BHF nurses are great and so are CHSS. Take care. X

[Gribbin in reply to momander]

Hi Momander... thanks for your support... yes I think I have been lucky: right place at the right time when I had my HA; excellent response through A&E; quick referrals through the system, and transfer to the surgical hospital, and excellent treatment/care/aftercare.

I am looking forward to the Cardio rehab... I feel like a passenger up until this point... once I start Cardio rehab I hope to have a bit more input and feedback, as well as the chance to compare notes with others at different stages of their recovery.

[momander in reply to Gribbin]

I think it depends what hospital you had your op in!? It's a post code and bed availability thing. I've heard good and bad stories about hospitals!! I'm just so very grateful that I was kept in and that i had my operation. I feel better than I have for years . I've stopped smoking and drinking and overhauled my diet too. I wouldn't have done any of that had I not had 3 heart attacks!!!