Coronary Artery Bypass Graft Surgery: Self-Care for Recovery
What are my responsibilities during my recovery from bypass surgery?
You have several responsibilities while you are recovering from coronary artery bypass graft (CABG) surgery, including:
Everyone heals at a different rate. But following your doctor's orders can help you achieve a fast and comfortable recovery.
Settling in at home
It may be worthwhile to keep all of your medical information together and handy during your recovery, including:
Caring for your wounds
A major aspect of your recovery is caring for the incision (sternotomy) made to open your chest during CABG surgery. Because it is so important that this incision heals properly, many limitations are placed upon you during your recovery. You also need to take care of the skin around your arm or leg incisions. All of your incisions need to be taken care of so that they can heal quickly and without infection. To do this, you need to:
Your surgeon may cut through your chest bone, or sternum, to perform your CABG surgery. Unlike other bones in your body, your sternum cannot be placed in a cast while it heals. Instead, your surgeon wraps heavy wire around it to hold the edges together. The sternum can heal properly only if the ends are held together constantly for several weeks. Therefore, you should not engage in strenuous activities that could shift the two edges apart during the first 4 to 6 weeks of your recovery.
Two activities that can shift the edges of your sternum apart and so should be avoided are:
Your arm or leg
Your arm or leg incision may be swollen and painful. This results not only from the incision that cut through your skin and muscle but also from losing a blood vessel in your arm or leg that would normally circulate blood in the area of the incision. It will take a little time for your arm or leg to adjust to the missing vessel and for your incision to heal.
To help your arm or leg recover faster and more comfortably, you can:
Taking your medicines
You may need to take medicines after your CABG surgery. Your doctor or nurse will give you written instructions for taking your medicines before you leave the hospital. These new medicines may be in addition to or instead of the medicines you were taking before your surgery. Make sure that your doctor or nurse explains very clearly to you what medicines you should be taking.
You need to know:
You need to do the following:
One of the medicines you may be prescribed after CABG surgery is an anticoagulant, such as warfarin (Coumadin, for example). This medicine helps prevent blood clots. You will likely need regular blood tests to check how the blood thinner is working. If you are having home health care, your home health nurse may take your blood test. If you do not have home health care, you will go to your doctor's office, a lab, or the hospital for your blood test.
When you take warfarin, you need to take extra steps to avoid bleeding problems.
For more information, see the topic:
Watching your weight
It is important to watch your weight very closely after your surgery. A sudden increase in your weight is often a sign of fluid retention. This fluid retention can point to a problem, such as worsening heart function and kidney failure.
To monitor your weight, you should:
Improving your heart and lung functions
While you are recovering from your CABG surgery, you will need to work on increasing your physical activity or exercising. You need to become more physically active, because you need to restore your full lung function. You also need to improve the blood circulation throughout your body. This will help your body heal properly.
If you do not exercise, you risk developing blood clots within the blood vessels of your legs. This is a painful condition that can cause several complications, including blockage of a blood vessel.
Walking is an excellent exercise after CABG surgery. Walking is safe and someone else can easily walk with you. Your leg will be sore if your surgeon removed blood vessels from your leg to use during your surgery. Despite this pain, it is important to your recovery that you continue to walk.
Attending cardiac rehabilitation
Based on your health and rate of recovery, your doctor will recommend that you enroll in a cardiac rehabilitation (rehab) program to help you recondition and strengthen your heart. Usually, the program will start 4 to 6 weeks after your surgery. This type of cardiac rehab program is known as a phase II program. (A phase I program refers to any rehab steps you begin right after your CABG surgery).
In the phase II program, a specially trained nurse will help you improve your heart's strength and overall health in sessions of supervised exercise using a treadmill or a bike. In addition, you will also receive education about healthy eating and lifestyle habits each week. For more information, see the topic Cardiac Rehabilitation.
Some tips for exercising after CABG
Work with your doctor and rehabilitation specialist to develop a rehabilitation plan. The following is a general guideline for increasing your exercise:
Although you may be weak, tired, or experiencing chest soreness as a result of your surgery, many people with coronary artery disease (CAD) can work their way back up to normal activity levels by participating in a structured cardiac rehabilitation program or by working with their doctor to develop a home exercise program.
Making changes in your lifestyle
Your doctor probably told you that certain aspects of your lifestyle (such as smoking, an unhealthy diet, or high stress) make your cardiac health worse. Now that you have had your diseased arteries repaired with open-heart surgery, you want to be sure that your CAD does not get worse. In particular, it is important to keep your new bypass grafts healthy. Your doctors, nurses, or rehabilitation team members can help you take steps to quit smoking, start eating a heart-healthy diet, and reduce the stress in your life.
Resuming sexual activity
You will be able to resume sexual activity after you recover from surgery. But several factors may discourage you from resuming sexual activity.
Professional counseling may help you to understand and deal with your fears.
When you and your partner decide to start having sex again, it might be helpful to keep in mind the following:
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