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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for heart diseases and associated problems

Any advice & assistance you can share will be greatly valued by myself & my family!! Been married 41 yrs the day of his surgery!...can you imagine! My husband is 75yrs old ,always been healthy except for a mini stroke about 5yrs ago that passed with no damage-did weigh 218 & now weighs 190 after triple bypass June 16th 2011. Found after heat stroke on June5th. Had nuclear stress test showed lack of blood flow to part of heart resulting in Heart Cath thru wrist,which led to the triple bypass surgery due to 80%blockage on left side. Had bad irregular heart beat following Monday up to 145-150. Was regulated with meds-then needed 2bags of blood transfusion following day. Vitals became stable&he was starting to walk...feeling & looking better. Had severe allergic reaction to adhesive used with heart monitor&the surgery-was all over his neck&torso&hips. Allergist gave him oinment to put on &his body had a severe allergic reaction to it! Had to wash off in shower Saturday June25 &also June 26 at which time he fainted for a flash,collasped upon his knees with legs beneath him. I saved him from hurting his CABG or head.No nurse was present &should have been! Also never told him he couldn t take warm/hot shower due to blood rushing to feet&brain not getting enough! When they finally responded to my screams for help!!...they just stood around him &kept attempting to lift him up little then dropped his body weight back upon his squished legs&feet...over &over they did this for 6to7minutes till finally another heart patient s 50yr old son rescued my husband off the floor! He was conscious whole time except for intial momentary blackout &vitals were stable. However he complained of right foot hurting yet they had him walk on it atleast 5times after that! I said his ankle was really warm so something has to be going on in there! An xray was finally ordered next morning June 27th. The Cardiologists were furious with the negligance of this Sunday nursing staff however the damage was already done! The xray showed a severe break in his right ankle on right side-the smaller bone broke away from the ball &had separated &shifted plus ligaments on left side torn! The dropping of him over &over plus making him walk on it caused greater damage! He had ankle surgery July 1st...put pin & plate in &then had severe pain next day so needed morphine-which caused constipation, causing him then to have to drink citrate, which resulted in all day Sunday July3 &most of the 4th to have runny stools. This ended Monday afternoon accompanied by the most severe pain ever for next 24hrs or so in his lower right abdoman resulting in more morphine to ease the wrenching pain!His appendix was removed when he was 11 so a CT Scan was ordered which found kidney&gall bladder stones they feel were caused by the dehydrating effects from surgeries & meds& citrate! He s been thru so darn much &never took meds in his life except an occasional antibiotic for sinus infection &recently past 5yrs 10mg daily Lisinopril for maintenance purposes. So now he can t weight bear on right foot for 6weeks to 3months depending on how it heals...&he can t use his arms to push ,pull, lift, brace etc due to CABG for 8weeks or longer! Thus he can t use crutches so now instead of being home already &healing from triple bypass...walking being paramount in the well being of heart surgery patients...he is confined to bed in hospt-having to use lift to get him from chair to bed to toilet etc...&he once again had a fainting spell when on toilet in bathroom that was confining &had no circulation. He had finished having stool &was ready to be lifted off when he said he was feeling dizzy& it hit him fast. They got him in wheel chair when he was starting to pass out but he tried hard to remain conscious &did but it was scarey again! His vitals were ok again. The Doc-new one now down on TCC Unit(Transitional Care Center) where he can receive some kind of rehab therapy-cut back on some of his meds thinking could be causing this. I have noticed when he is up in wheelchair for an hour or more he gets tired easily & says he s starting to feel a little light headed. His BP has been recently 106 to 120 but tonight it was 95/58 at 4:30 pm. Is this too low?? He had just used the bedpan(cause they are afraid he ll get dizzy on toilet) about 30 minutes prior. So they didn t give him his blood pressure med. Then at 9pm BP was 114/62. This really concerns me& him that he gets so tired easily or can t stay up long & feels lightheadedness. He has gone to rehab 4times doing exercises to strengthen legs &only used the bicycle for the arms real slowly. An hr each session.They were making him use the sliding board by using his arms to scoot himself from chair to rehab table & back until today when a Cardio Rep said NO! Can t use his arms that way! I see how this is a strain for him &needs to lay down afterwards & u can see it in his eyes. Is all this just because he can t get up & walk like he should be doing-&his body just isn t use to being up & heart isn t use to pumping when body in upward position? &the low blood pressure is very concerning cause he could faint &be crippled for life or worse! This is a man who exercised & was basically healthy before all this! What exercises can he do with his arms now that won t hurt his CABG?! Will this tired dizziness ever leave him? When could he use crutches &be really safe in not damaging the CABG?! What is the remedy for the low BP? For I Know he has to take some BP meds rest of his life after bypass surgery-right? He s also afraid to eat too much cause he s confined to the darn bed due to one individual s lack of professionalism in caring for him! Which has changed his whole life now plus mine with this broken ankle plus how it is effecting the recovery process of his CABG! We should be home with our 19yr old son who is in Intell in the USAF &our daughter, 21, an Aerospace Med Tech in USAF overseas, is extremely concerned for her Dad s health as well! Please lend your professional advice as much as possible! It will be so deeply appreciated beyond words! Thankyou deeply!!
Thu, 23 Jan 2020
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Internal Medicine Specialist 's  Response
Hello Dr Faisal here,
I have read and understood your query, I will suggest you as if he is over weight? What about his BMI (height required).
In back ground of irregular heart beat, he needs 24 hour or 48 hour holter monitoring and defect needs to be worked upon if caught.
In future patient should be strictly checked for allergy, any new drug if started.
There is a very high chance of getting any arrhythmia after CABG surgery so patient should be vigilantly monitored for any syncope or collapse and ideally should not go to toilets for an initial 7 to 10 days. Or at best for initial 15 days.
Joints other than fractured ankle and other 3 limbs should undergo active or passive exercises as per convenience of patient.
Bed pan is good for him until and unless he is diagnosed for cause of his low bp and fainting spells.
Ideally a senior physiotherapist should be consulted but so far as I know he should use his biceps. And arm muscles. By pumping a tennis ball. Light weight exercises for his upper limbs for 15 minutes thrice a day at minimum.
His tiredness needs to be evaluated for any excess or deficiency of vitamins, minerals, thyroid or any blood count levels.
The recovery of bone and cartilage in chest cage takes almost 1 to 1.5 months to recover.he need to wear a belt post operatively.
Cause of low BP needs to be worked upon. I need list of medications which he is taking during his BP fluctuations,
Ideal weight for his body according to BMI needs to be calculated.
He should take enough healthy diet low in oil and ghee diet to maintain his weight at a fix. .
I understand that it’s a hard time for family, but your active coordination will help your patient and will be rewarded in a 2 to 3 months time.

Hope I have answered your query. Let me know if I can assist you further.

Take Care
Regards.
Dr. FAISAL BACHA, MEDICAL SPECIALIST (FCPS INTERNAL MEDICINE)
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Suggest treatment for heart diseases and associated problems

Hello Dr Faisal here, I have read and understood your query, I will suggest you as if he is over weight? What about his BMI (height required). In back ground of irregular heart beat, he needs 24 hour or 48 hour holter monitoring and defect needs to be worked upon if caught. In future patient should be strictly checked for allergy, any new drug if started. There is a very high chance of getting any arrhythmia after CABG surgery so patient should be vigilantly monitored for any syncope or collapse and ideally should not go to toilets for an initial 7 to 10 days. Or at best for initial 15 days. Joints other than fractured ankle and other 3 limbs should undergo active or passive exercises as per convenience of patient. Bed pan is good for him until and unless he is diagnosed for cause of his low bp and fainting spells. Ideally a senior physiotherapist should be consulted but so far as I know he should use his biceps. And arm muscles. By pumping a tennis ball. Light weight exercises for his upper limbs for 15 minutes thrice a day at minimum. His tiredness needs to be evaluated for any excess or deficiency of vitamins, minerals, thyroid or any blood count levels. The recovery of bone and cartilage in chest cage takes almost 1 to 1.5 months to recover.he need to wear a belt post operatively. Cause of low BP needs to be worked upon. I need list of medications which he is taking during his BP fluctuations, Ideal weight for his body according to BMI needs to be calculated. He should take enough healthy diet low in oil and ghee diet to maintain his weight at a fix. . I understand that it’s a hard time for family, but your active coordination will help your patient and will be rewarded in a 2 to 3 months time. Hope I have answered your query. Let me know if I can assist you further. Take Care Regards. Dr. FAISAL BACHA, MEDICAL SPECIALIST (FCPS INTERNAL MEDICINE)