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Dr. Andrew Rynne

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Information on exercise post Open Heart Surgery - what is the possibilities ?

Information on exercise post Open Heart Surgery - what is possible? My father had a very difficult time deciding to go ahead with his triple heart by pass as my mother (his wife of 44 years) had been admitted into a hospice after battling melanoma cancer for 8 years. On the morning my father was taken away for surgergy my mother passed away. My father awoke from surgery to be informed Mum had passed. He has always been a very fit man his whole life and is continuing to exercise however the complexity of his situation has meant that he is often lacking energy probably suffering a little depression not that he would ever say that. He also suffered a virus and infection in the lung which delayed his recovery further. He is desperate to find a book that gives you a guide on how far you can push exercise after open heart surgery as he is keen to get back into it but does not feel his body is up for it which I believe is more psychological than physical. Does anyone have any books they could recommend on this subject???
Fri, 18 Dec 2009
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Firstly, I should point out that almost half of cardiac patients will suffer from some degree of depression after their index event, whether it is a heart attack or surgury. Its a normal grief process for coming to terms with the realization of their mortality. If thsi depression lasts more than six months, it should be considered pathological and needs medical help. But keep in mind he may also be grieving for your recently departed mother as well. In the meantime your reassurance will help. Talking to other cardiac patients will help. Help him talk it out by simply making sure you are there with him at least several times a week. Have some of his older buddies come by and hang out for a while. What he needs to say will come out eventually. As for cardiac rehab, you failed to mention how long post surgery he is and whether or not his sternum has fully healed yet or not? Information on cardiac rehab is available from your cardiologist, or CCU nurse educator. There is a cost associated wit this, so some patients elect not to go through a formal program. Understanding recovery time is slightly longer on your own, he can excercise at home. But the advantage of patient contact, access to psych and dietician will be less if you go the trip on your own. For excercise portion, the recovery is divided in to several phases. Phase one is walking aorund in the hall after bypass. generally it lasts a week or so. Phase two is somewhere between week 2-6 with gradual increase of walking distance. Some places do this on a treadmill with heart monitoring equipment. Some places simply tell you to start walking at home. Try to get a total of an hour a day, split into 5-10minute shifts, as you can tolerate it. Make sure deep breathing excercises done to minimize risk of lung infections. Phase three rehab is after the 6-8week period. By this point the sternum is fairly well healed and you aren't clutching the signature pillow to your chest anymore. At this point you start doing 10-20minute stretches in the treadmill. Followed by mild arm excercises without weights. As the weeks roll by the time and intensity on the treadmill is gradually increased. Also small weights 1-2lbs is added and scaled up slowly to 5-10lbs depending on your strength and conditioning. This coninues over a three month period. Eventually you are back to a normal pace of excercise. Maintenance is doing an hour of aerobic excercise daily at a stretch. This is either walking, cycling, swimming etc. you need a daily regimen of moderate excercise using major muscle groups to stay fit and healthy. As you see, there is a lot of wigle room here. I didn't even go into the Karvonen formula for figuring out resting heart rate reserve etc.. Its best to leave it to a professional. But if money is an issue, work out a deal where he goes once a week or sofor supervised excercise. And follow the regimen at home in between. This will be cheaper since less "face time" is needed. As long as he is disciplined, it should suffice.
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