Coronary Artery Bypass (CABG) Surgery

Three coronary artery bypass grafts, a LIMA to...

Three coronary artery bypass grafts, a LIMA to LAD and two saphenous vein grafts – one to the right coronary artery (RCA) system and one to the obtuse marginal (OM) system. (Photo credit: Wikipedia)

Your doctor has recommended that you have coronary artery bypass surgery. But what does that actually mean?

Your heart is located in the center of your chest. It is surrounded by your rib cage and protected by your breastbone. Your heart’s job is to keep blood continually circulating throughout your body.
The vessels that supply the body with oxygen-rich blood are called arteries.

The vessels that return blood to the heart are called veins.
Like any other muscle in the body, the heart depends on a steady supply of oxygen rich blood. The arteries that carry this blood supply to the heart muscle are called coronary arteries.

Sometimes, these blood vessels can narrow or become blocked by deposits of fat, cholesterol and other substances collectively known as plaque.
Over time, plaque deposits can narrow the vessels so much that normal blood flow is restricted. In some cases, the coronary artery becomes so narrow that the heart muscle itself is in danger.

Coronary bypass surgery attempts to correct this serious problem. In order to restore normal blood flow, the surgeon removes a portion of a blood vessel from the patient’s leg or chest, most probably the left internal mammary artery and the saphenous vein.

Your doctor uses one or both of these vessels to bypass the old, diseased coronary artery and to build a new pathway for blood to reach the heart muscle. These transplanted vessels are called grafts and depending on your condition, your doctor may need to perform more than one coronary artery bypass graft.

Of course, operating on the heart is a complex and delicate process and in the case of bypass surgery, your doctor will most likely need to stop your heart before installing the graft.

During the time that your heart is not beating, a special machine, called a heart-lung machine, will take over the job of circulating and oxygenating your blood.

By using this machine, your doctor is able to repair the heart without interfering with the blood flow to the rest of the body.

Following surgery, your heart will be restarted and you will be disconnected from the heart-lung machine

Monday – Four Weeks Post-Op

This is the first of the timeline posts that I’m actually writing more or less as they happen!

day-mon

Last Monday, Feb 18 was the first visit with the cardiologist.  Getting there was a bit of a problem but the appointment itself went smoothly.

We got into the inner sanctum and a very nice nurse named Lisa took down DH’s info.  It worked out well that we hadn’t finished all the paperwork since she had lots of info fron the hospital, anyway.

She took DH’s blood pressure and oxygen levels (both good), then took the bags of meds and vitamins away for cataloging.

The doctor came in and asked some of the same questions as everyone else about how he was eating, sleeping, exercise, swelling, pain.  He listened to DH’s heart and lungs and everything sounded good.  He checked the legs for swelling…none.

We made 2 more appointments – one for a low-stress treadmill next week and one with him for three months out.  There’s also bloodwork to be done before the treadmill. After passing the treadmill test, DH can start rehab.  Yea!

When we got home, there was a call from the PCP’s lab.  DH called back but had just missed them.

day-tues
DH slept in the bed and out of the recliner for several hours last night.  Another step forward!

DH finally got through to the PCP’s lab and the cholesterol numbers were excellent.  Hooray!  Other numbers such as liver enzymes were good, too.

day-wed
DH did some work today, with several naps in between. I got the car taken care of. He got the disher unloaded and reloaded – with resting afterwards.

He decided to start off the night sleeping in bed and made it until about 4:00 am. He said that there was no pain but he would be more comfortable in the recliner.
day-thurs
DH spent most of the morning working (at home) on a proposal, then most of the afternoon napping.  Most of the pain seems gone – hooray! Evening there was a short meeting with a nap before and after.  Then, dinner and another nap before bed.

He started out for about an hour in bed, then back to the recliner for the rest of the night.

He doesn’t seem to cough nearly as much. Hooray!

day-fri

Friday through Sunday – lots of napping, trying to sleep or nap in the bed but usually winding up in the recliner.

day-sun

 

It was a nice day so we took the dog outside for a very short walk…followed by more napping.  DH is looking forward to the treadmill test on Wednesday so he can start the rehab soon.

Heart Disease Risk Factors

From the National Heart, Lung, and Blood Institute (NHLBI)

Heart Attack Risk Factors address the two types of risk factors associated with heart attacks, factors that a person can control and factors they cannot. Knowing the risk factors is so important because having just one risk factor doubles a person’s chance of developing heart disease.

This video is presented by the NIH’s National Heart, Lung, and Blood Institute

 

Monday – 3 Weeks Post-op

I’ve decided to do a sort of timeline in case anyone is interested.  This is all from memory so future posts should be more accurate.

Week Zero, January 28, 2013 was the actual CABG surgery.  The hospital experience  can be found here.

DH came home on Thursday of that week and the first visiting nurse arrived on Saturday. Luckily, DS was able to stay until Sunday and he was a big help.

DH wasn’t allowed to lift any more than 5 pounds, so couldn’t raise himself out of bed.  He slept on a recliner in the living room and either DS or I slept on the sofa in case he needed any meds or help during the night.

Week One, February 4, 2013, one week from surgery.

The visiting nurse came twice and is pleased with wound healing.  Blood pressure is sometimes low.  The nurse thought he should have more fluids.  One lobe of the lung isn’t working to capacity and she wants more use of the incentive spirometers.  DH has two types from the hospital – the traditional one and one that our dog thinks looks like a dog toy that she should have.

incentive spirometer

Week Two, February 11, 2013 two weeks from surgery.  DH continues to lose weight.  He’s still sleeping in the recliner and I’m still on the sofa but there is much less getting up at night.

The Oxycodone is down to half pills much less often than prescribed.

The first (and only) visit to the surgeon’s office this week.  We saw her nurse practitioner who was very impressed with how DH is doing as was his PCP.  The nurse practitioner was so pleased, she said we don’t have to go back unless there are any problems.

The PCP ran blood tests, glucose, liver enzymes, cholesterol and others.

We saw the visiting nurse twice.  She thought DH was doing so well that she discharged him on Thursday.

DH made a few phone calls this week, worked a little, had a visitor on Sunday.

Week Three, February 18, 2013, three weeks from surgery

DH slept in the bed for half the night last night and seems to be doing ok.  He still took a half Oxycodone this morning.

We see the cardiologist this afternoon.  That report will be in the Week Four post. I imagine that we’ll be talking about rehab at this appointment.

Weeks Four and Beyond will have their own posts.