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What is Coronary Artery Bypass Surgery?

Coronary artery bypass surgery is a common procedure for reestablishing blood flow to heart muscle.  But before we get ahead of ourselves, it’s important to know that coronary artery disease is merely a fancy term for clogged plumbing in the arteries that deliver blood to your heart muscle (not to be confused with heart valve problems).

It’s possible to have up to a 75% blockage without any symptoms. Usually anything higher than this will tend to elicit symptoms (i.e., chest pain or tightness, shortness of breath) and may potentially require medical intervention to open the artery and reestablish blood flow. If left unchecked, it can result in a heart attack.

Quick Video About Bypass Surgery

If you’ve not yet had your operation and are curious to get a quick video tutorial about bypass surgery, this will fill you in on all the main elements of the procedure:

Common Treatments for Coronary Artery Disease

The two most common procedures are:

  • Percutaneous transluminal coronary angioplasty (PTCA), also referred to as percutaneous coronary intervention (PCI) in some countries; and
  • Coronary artery bypass surgery

PTCA For Clogged Cardiac Plumbing

PTCA entails inserting a catheter through the femoral artery in your groin, threading it up to the heart into the clogged coronary artery, and inflating a balloon to press the plaque up against the vessel wall to reestablish blood flow.It is often accompanied by placement of a supportive wire mesh called a stent. This option is usually suitable for individuals with mild arterial plaque in one or two vessels.

Coronary Artery Bypass Surgery for Heart Disease

If multiple vessels are blocked or the interventional cardiologist deems angioplasty too risky, then coronary artery bypass grafting may be required.

Coronary artery bypass surgery is an open-heart surgical procedure performed when the disease is too diffuse and widespread to accommodate a simple angioplasty procedure.

This operation generally entails the surgical removal of the saphenous vein from your leg and segments of it are then sewn from the aorta of your heart to the opposite side of the blocked arteries, effectively creating a bridge over the plaque.

In some instances, the internal mammary artery which feeds blood to the chest wall is detached and redirected to the other side of the blockage. Coronary artery bypass surgery is merely a more advanced plumbing job than its comparatively simpler angioplasty/stent cousin.

Newer technologies and surgical techniques are being developed which minimize the trauma to the body. Ask your surgeon which options are best for you.


Recovery Time After Bypass Surgery

As with heart valve repair or replacement, you can expect at least six to eight weeks of recovery time after coronary artery bypass surgery. While rest is important for healing, so is regular physical activity.

Regular aerobic exercise helps offset the deleterious effects of surgery and bed rest, such as muscle atrophy, muscle and joint stiffness, and balance and coordination.

Early mobilization should begin about one to two days after surgery including several short duration walks per day around the nurse’s station.

Most coronary artery bypass patients return home after a four to six day hospitalisation.

Resuming activities after bypass surgery

Returning to your activities of daily living (ADLs) can be a challenge upon release from the hospital. It’s normal to feel tired and exhausted as if you were run over by a bus. But rest assured this is expected and you will progressively regain your energy over the next couple months.

Before you get stuck into any heavy structured exercise, it’s important to work through your daily tasks as safely as possible to minimise any complications.

Overhead lifting

Overhead lifting after coronary artery bypass surgery can be a challenge. Your sternum is going to be sore and tender, so be careful when lifting your arms to shoulder height and above. You can place dishes in the cupboard or brush your teeth, but try to minimise how long your arms are in the elevated position. Avoid any heavy overhead lifting until you are cleared to do so by your doctor.

Climbing stairs and steps

Climbing stairs and steps after bypass surgery can be tiring, so you should assume a graduated approach. You may want to start with climbing one flight of stairs and see how you feel. If you become short of breath, then you should stop and rest. As you return to health and feel stronger, you can gradually increase the number of stairs and steps you climb, while reducing the number of rests you take.

Lifting during household chores

You can perform most domestic tasks after your surgery, but try not to lift much more than 2 to 4.5 kg (5 to 10 lbs)  during the first several weeks after discharge. You can prepare meals, wash cloths and dishes, do light cleaning, and go shopping.  Once you’ve received clearance from your doctor, you will be able to perform more heavy pushing and pulling activities that load the sternum.

Sex after coronary artery bypass surgery

One of the main concerns with sex after surgery is pressure on the sternum. You may need to experiment with different positions in order to find the one that least aggravates your incision site. You should speak with your doctor to discuss when is the best time to return to sex after your operation (usually a few weeks).

Return to driving

You can usually return to driving about a month after your surgery. You may feel groggy and tired due to the influence of your medications so it may not be advisable from a safety standpoint. Moreover, your sternum is going to be sore and turning the steering wheel might aggravate it.  There is nothing wrong with being a passenger, but you might want to try putting a soft pillow or cushion between the seatbelt and your chest. You might also opt to sit in the back seat since an airbag deployed during an accident could cause damage to your already weakened sternum.


Travel

Travel is fun but after bypass surgery it can be downright exhausting. Speak to your doctor about your impending trip and if it’s appropriate for you to take the trip or wait a bit longer. It is advisable to be geographically close to your doctor should you have any complications. Bottom line: you might need to hold off on your trip until you are deemed medically stable and feeling well enough to travel.

Going back to work

Going back to work can be both physically and mentally exhausting. It may take one to two months before you are fully able to engage in your regular duties. If you are performing a physical job that requires heavy lifting, you should speak with your doctor to determine the best time to return to work. If you work in an office setting, then it may be appropriate to return sooner.  No matter what your job, it may be advisable to start with a half-day and gradually work up to a full shift.

Healthy eating for coronary artery disease

For more information on diet for people with coronary artery disease, please read Gabby Maston’s article on the paleo diet vs. the Mediterranean diet.

Aerobic Activity Guidelines Post-Surgery

Obtain your surgeon or cardiologist’s approval before engaging in any vigorous exercise.

Low level walking during recovery is usually prescribed, but previously active individuals tend to overdo it with too much too soon.  Perform aerobic exercises that activate the large muscles of the lower body (i.e., legs and hips), are rhythmic in nature, and can be done continuously for an extended period of time.

Be sure to choose exercises you enjoy. You’re much more likely to stick with your program if it’s fun.

It is normal to feel quite tired the first few weeks after surgery, but this will go away in time—give yourself permission to be human.

Start off with multiple short-duration (i.e. three to five minutes) exercise sessions per day, gradually working up to longer durations fewer times per day.

Set a target of walking 45 to 60 minutes non-stop at a comfortable pace as you progress through the recovery period.

Use the following generic graduated exercise plan as a guide.  Notice the objective is to “ween” yourself from the shorter exercise bouts more times per day to the longer, continuous bouts less times per day.

exercise regimen cabg coronary artery bypass surgery

Exercise at least three days per week and as many as seven. Three days in the beginning should be more than enough.

Add extra days when you can comfortably perform three days without any ill effects or undue residual fatigue.

Because medications such as beta-blockers blunt your heart rate response to exercise, your pulse may not be considered an accurate marker of your exercise intensity. Even so, it’s still not a bad idea to keep tabs on your exercise heart rate so you know what your individual response is under the effects of your medication regime.

If you have a hard time finding your pulse, get yourself a heart rate monitor or a Fitbit (which also tracks your non-exercise movement habits). Click on each image to check out features and thousands of Amazon user reviews.

In this case, focus on a moderate to somewhat hard pace where you’re breathing just hard enough to perform the activity and carry on a conversation with an exercise partner. Exercise physiologists call this the talk test.


Aerobic Exercise Caution

  • Be sure to provide yourself with a 5 to 10 minute warm up and cool down phase before and after each session. It will help reduce your risk of injury or other post-surgery complications.
  • While in the early recovery phase, avoid overexerting yourself with strenuous/vigorous exercise (unless advised to do so by your cardiologist or surgeon). This can cause a sharp spike in your heart rate and blood pressure which might aggravate the bypass grafts.  Use the ol’ KISS acronym:  Keep It Slow and Steady.
  • Walk or cycle on level surfaces to establish your fitness foundation. You’ll be able to handle the hills in due time. If you find yourself huffing and puffing, that should be an indicator to ease up on the accelerator!
  • Limit your exposure to environmental stressors such as extreme cold, heat, or strong winds. Any of these can make your usual exercise pace seem much more difficult.
  • Pay attention to any signs or symptoms associated with exercise. If you experience chest pain or discomfort, slow down or stop exercising. If it does not resolve by itself or continues to get worse during rest, seek emergency medical attention.

Can I Go to the Gym After Coronary Artery Bypass Surgery?

If exercising at a gym, ask the staff what credentials or experience they have in working with heart patients. They should understand your condition as well as any medications you may be taking. They should also have an emergency response protocol in place (i.e. dial 911 (000, 111 in some countries), on-site defibrillator, etc).

Strength Training Guidelines Post-Surgery

While it may seem counter-intuitive to lift weights after bypass surgery, quite the opposite is true. If judiciously applied, resistance training can hasten your healing and recovery and help you get back to your regular way of life quickly and efficiently.

However, you shouldn’t lift much more than four to five kilos (10 pounds) during the first 4 to 6 weeks of recovery, or until clearance by your surgeon. After that, keep your progression slow to avoid any debilitating muscle soreness.

Always perform resistance movements with proper form and breathing technique. Always remember to exhale on the exertion (lifting) phase. As a rule, never hold your breath or strain during a lift. You may want to consult a qualified fitness professional for additional guidance on form and technique.

For general conditioning, work all major muscle groups from largest to smallest. You don’t want to pre-fatigue your small muscles first since they work as assisting muscles during larger movements.

For example, your triceps are assisting muscles during the chest press. If you work your triceps first, they’ll be too fatigued to assist during the chest exercise.

Begin with short duration sessions as this will allow your body to safely adapt. Start off with 15 to 20 minute sessions and work up from there. Marathon training sessions may leave you tired and sore and potentially discourage you from continuing with your regimen.

Use light resistance in the beginning. It is far better to use light weights and learn proper form up front than start off with heavy weights and sloppy form.

Begin with a weight that allows you to perform 10 to 15 repetitions. When you can do 15 without any undue fatigue, increase the weight by 3 to 5 percent.

Don’t overdo it. Perform resistance training two to three times per week. The in-between days are for proper recovery and recuperation.  After you receive final clearance from your surgeon and/or cardiologist, then you may progress to heavier weights and more sets and repetitions.


Strength Training Caution

  • As with aerobic training, obtain physician clearance before starting any strength training program.
  • Numbness in the chest area is normal. Coronary artery bypass surgery entails cutting nerves in your chest but the feeling usually returns within one year.
  • If signs or symptoms occur during resistance training, stop training immediately. If symptoms do not improve, or if they worsen during rest, seek immediate medical attention.

Take Home Message

While coronary artery bypass surgery can be very hard on the body, you will be served far better by engaging in regular physical activity during the recovery period.

The immediate post-surgery phase is the most difficult but after you break through the first two to three weeks, you’ll be amazed at how well you feel. The previously blocked arteries that were causing you shortness of breath and chest pain will no longer be limiting factors in your ability to carry out your daily tasks.

Most people who’ve had bypass surgery go on to live very fruitful and active lives, sometimes even better than before! But be forewarned, surgery is not a cure for artery disease.

If you previously lived an unhealthy lifestyle and return to your old ways, there is the possibility that your arteries will block up again, potentially leaving you in line for a follow-up coronary artery bypass procedure. In short, adopt healthy lifestyle changes and make it a part of your daily routine!

Be share your thoughts, experiences, or questions below in the comments section.

 

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Dr Bill Sukala is a Sydney-based health science communicator, clinical exercise physiologist, health writer, speaker, and media health commentator. He has published health articles in major publications around the world and has given invited lectures across five continents. Click here for more information or follow Bill on Facebook, Instagram, and Twitter.

105 Comments

  1. Dr Mohammad A Madni

    well, helping article.

    Reply
  2. Jeetender Prashad

    Hi,

    I had CABG 4 years back and now iam doing bench press with weights of 25 KGS a side 3 sets with 5 reps thrice a week, is it harmful in long run. At present I have no strain or fatigue.

    Please guide.

    Best Regards
    Jeetender

    Reply
    • Bill Sukala, PhD

      Hi Jeetender,
      Thanks for writing. If you’re four years out from your surgery and you’ve not had any adverse effects from your current regimen, than I can’t see any reason it would cause you long-term harm. In cardiac rehab, I frequently had our post CABG patients lifting weights. As long as you’re getting the all clear from your cardiologist, then you should be ok.

      Cheers,
      Bill

      Reply
  3. SURYAKUMAR

    I had CABG 6 years back , can i do skipping excercise , my doctor advised not to do , but i am doing 10 steps per day , i step is equal to 150Jumps within 20 minutes i am completing the 10 steps , i am comfortable , can i continue, do you recommened any more excercise

    Reply
    • Bill Sukala, PhD

      Hi there,
      Have you done any cardiac rehabilitation sessions? It would be very helpful for you to get professional guidance under an exercise physiologist to help you find the exercises that are right for you. Unfortunately, I cannot legally recommend specific exercises for you without being fully aware of your medical/surgical history. I would suggest you speak with your cardiologist and get a referral to either an exercise physiologist or physical therapist in your area. They would be best suited to evaluate your stepping exercise relative to your exercise capacity. Hope this helps:)

      Reply
  4. SURYAKUMAR

    HI,
    i forgotten to mention my age in earlier mail , my age is 41 years

    Reply
  5. Andrew

    I had 5x CABG 14 weeks ago. I am in a cardio rehab program with traditional treadmill, bikes etc, and I am doing well. I can walk 1.5 miles in less than 30 minutes, and I feel great. I am enormously grateful to my cardiologist and surgeons for taking the CABG route; but problem is that my cardiologist does not believe in resistance training and has forbidden it. What can I do to persuade him? The cardio rehab people think I can do it, but of course they won’t go against a Dr.’s advice (and I wouldn’t ask them to). What course of action do you suggest. And some gentle lawn mowing with my machine is a lot more intense than slinging some 15lb barbells.

    Reply
    • Bill Sukala, PhD

      Hi Andrew,
      Thank you for your comment. There is increasingly more information in the medical literature which shows that people who’ve had cardiac problems (and surgery) can safely perform resistance training. The main deciding factor is your risk stratification. Has your doctor told you you’re low, moderate, or high risk? You mention you’ve had CABGx5, but did not mention if you’ve had a heart attack as well. If not, then it’s safe to say you had a “plumbing problem” rather than a “heart problem.” In other words, a heart attack can sometimes result in damage to the heart muscle which can compromise your body’s ability to adapt to acute exercise (i.e. presence of wall motion abnormalities, possible arrythmias, etc). I should also mention that if you’re able to tolerate moderate to higher intensities on the treadmill without any ectopy on the ECG, then this is a favorable sign that you could likely handle some resistance exercise without any adverse events. In all fairness, bad things can happen to good people even if you do everything right, but based on my experience in cardiac rehab the likelihood of adverse events is reduced in those who can handle moderate to high intensity aerobic exercise.

      I would suggest having a look at this article from Circulation which discusses resistance exercise for cardiac patients:

      http://circ.ahajournals.org/content/101/7/828.full You should be able to download the PDF for free.

      I’d suggest discussing this with your cardiologist and cardiac rehabilitation team. I cannot reliably give you any specific advise since I’m not completely familiar with your medical history, but it is worth exploring provided you are low risk and able to handle a reasonably high intensity during aerobic exercise. Hope this helps.

      Yours in health,
      Dr. Bill

      Reply
  6. sunder

    I had CABGx2 12 weeks back and after 40 days joined duty.My company needs cardio tests so at 50th day i did stress test (thread mill test) i did for 9 mins and my heart rate reached around 158 so doctor stoped.My heart condition is normal.They said i can do normal excercise.Now iam going for swiming and daily i walk 3 to 4 km on thread mill at a speed 5.7km/hr .No discomfort i felt.Every day i climb nearly 50 steps (third floor) and drive my car.My eco report was perfect no damage to heart.My question is 3 to 4 km every day at 5.7km speed is enough or should i increase the speed??At this speed my heart rate is 130 as my age is 44 .

    Reply
    • Bill Sukala, PhD

      Thanks for your comment. It sounds like you had a relatively routine surgery and normal recovery. The fact that you have no damage to your heart muscle is a good thing. It just means you had a “plumbing problem.” If you are currently able to perform up to 4km each day at 5.7 km/h and are tolerating this well (no signs or symptoms), then it may be feasible to try a bit more speed. Try increasing your speed in 0.2 km/h increments and see how you tolerate this. Also, the fact that you are quite young works in your favor, as you are likely well conditioned in your periphery (legs) which will also decrease demands on the heart. Keep up the good work and thanks again for your comment.

      Reply
  7. RandyK

    I had quadruple bypass four months ago. In cardiac rehab, my weights were gradually increased. Is there a limit to how much I can ultimately work up to? Or can I work out the way I did ten years ago?

    Reply
    • Bill Sukala, PhD

      Thanks for your comment Randy. Without knowing the details of your medical history, I can’t give you specific advice. However, I have seen some impressive improvements after CABG surgery. Your best bet is to consult your cardiac rehab exercise physiologist and get specific home exercise guidelines for your situation. If you progress through your weight regimen slowly to allow proper adaptations, then I’m sure you’ll be fine. Keep us posted on how you get along with everything. Cheers

      Reply
  8. Larry Chmiel

    Dr. Sukala,
    In June of 2008, I had open heart surgery – triple by-pass.
    In December of 2008, a Pacemaker/Defibrillator was implanted in my upper left side of my chest.
    Before the surgery, I did lift weights to keep in shape and would like to go back to some weight lifting as my muscles became weak since my surgery.
    I get different messages from my doctors, cardiologist, family, etc. regarding weight training.
    Some tell me not to do Bench Presses, Overhead Presses, or Chin Ups because of the stretching and what it may do to the leads from the P/D to the heart.
    My cardiologist tells me to weight train and don’t worry about the leads and do cardio to help with weight loss. I am 6’2″ at 260 pounds.
    What should be the restrictions when one has an implanted P/D?
    Thank You,
    Larry

    Reply
    • Bill Sukala, PhD

      Hi Larry, Thanks for your comment. I can certainly understand your frustration with getting conflicting messages. In my experience, I’m less concerned about individuals with a pacemaker/defibrillator. Provided the settings can detect the difference between a malignant arrhythmia and a normal rise in heart rate with exercise, I can’t see this being a major cause for concern. Without my being familiar with your specific medical history, I am unable to give specific advice. But your cardiologist did give you the green light so that is a good sign. I would say that if you’re doing reasonably controlled movements and nothing too aggressive or jerky, it’s unlikely that you’re going to cause any damage to your ICD. I think with bench press, overheads, and chin-ups, you should be ok, but it would also be wise to start out with low resistance and see if you experience any discomfort or get the feeling that it might cause problems with your ICD (i.e., bar touching the device). I would suggest making sure you know the heart rate limits for your device and try to work within them to minimize any chance of getting an unnecessary shock. Regarding weight loss, I agree it would be wise to include cardio. Try to work on increasing your duration (time during exercise) to maximize your calorie burn. Over time, work up on the intensity side of things to further enhance your energy expenditure. Obviously diet is a part of it as well, so if you can consult a dietitian and get some specific guidance for your situation, that would also be a step in the right direction. You may also find that with weight loss, the reduced overall gravitational load on your body may reduce stress on the heart and, consequently, the risk of arrhythmias. Every little bit helps, so work on developing and maintaining a healthy lifestyle! Cheers, Bill

      Reply
  9. Nupur

    My father have undergone 5X CABG, in Dec’2011. He is right now 66 years old. We take a lot of care for his food nad his walks. He is managing well. Hence, we decided to go for a hill station nearby with prior consent from our cardiologist. But there he had to walk up and down the stairs several times..in gaps. He tried his level best not to exert. But after returning back, he seems to be quite lethargic. He doesnot complain but I can make out the difference. What could be the reason? What do you suggest me to to do? Can we take him for further trips or CABG patients should be confined to one place?

    Reply
    • Bill Sukala, PhD

      Hi Nupur,
      Thank you for your post. I am unable to provide advice for specific conditions because I am not familiar with your father’s complete medical history. However, it would be wise to discuss this fatigue with your father’s cardiologist. It is not uncommon to be quite tired and lethargic after open heart surgery, but at this point, it is about 7 months post-op. While light to moderate exercise is generally well-tolerated in most people after surgery, any ongoing undue fatigue could possibly be related to other underlying medical issues. I would strongly suggest that you contact his cardiologist and explore your options. IF there is a cardiac rehabilitation program with exercise physiologists, you should discuss what exercise options might work for him. Sorry I cannot provide specifics (legally) but hopefully you get some resolve in all this. Kind regards

      Reply
      • cheryl

        Is it safe to ride a zero turn lawnmower cutting grass for two to five hours on a bumpy terrain after 5x bypass surgery? Also had ablation on heart at same time of bypass.

        Reply
        • cheryl

          Additional information is the surgery and ablation are 9 weeks out post surgery.

          Reply
  10. Bijay

    Hi,

    I’m 26 years old and had a bypass surgery at the age of 6 years. I do not get any difficulty in my doing daily routine but I do not feel a body growth like as a 26 years old guy should have. So I decided to join a Gym. will it be okay to join a Gym for me. Please advise..

    Thanks,
    Bijay

    Reply
  11. MILTON

    I have had an operation for aortic valve replacement, got a mechanical valve now. I have already completed a year, is it ok if i exercise on the tread mill at speed of 6

    Reply
    • Bill Sukala, PhD

      Hi Milton,
      You will need to discuss this with your doctor, as I cannot give specific advice to anyone without being familiar with your medical history. I would suggest meeting with an exercise physiologist in your area that has experience working with people after heart surgeries. However, I will say I have worked with a lot of valve replacement patients who were able to tolerate reasonably high workloads. Best wishes.

      Reply
  12. glen

    Firstly thanks for the opportunity to ask a question. I had 99% blockage in 3 places in my Lad 6 months ago. It was a complete surprise as I had been training hard only the night before albeit with some pain. I had 3 stents and no need for cabg as the blockage was soft. Fortunately, there was no damage to my heart. I had a heart ct scan 18 months before the blockage that showed it was 100% clear. Firstly, can the blockage happen so quickly assuming the prior scan was accurate? I have psoriatic arthritis during the last 3 years (had no major illness before it) and also on prednisone to manage it. There is a view that either the arthritis and/or the steroids caused the blockage (as I have no apparent predisposition for heart problems – ie no high bp, no diabetes, never smoked, no majorly overweight, no family history etc). Have u witnessed this occurring in others in similar conditions ie due to arthritis so quickly?

    And I had been back at the gym about 6 months before I had pain and the heart opp and then went back albeit slowly a week after the opp and have now exceeded even my fitness both cardio (can u for 90 minutes at speeds of up to 9m/hr during intervals) and heavy weights – than was able to do when I was young (now 44). I did a stress test at week 7 post opp for 25+ minutes with max heart of 185 with no pain. My cardiologist said go for it with no limits on future cardio and weights. Do u have the same view? Any another words of advice? Thanks

    Reply
    • Bill Sukala, PhD

      Hi Glen, Thanks for your comment. While I can’t legally give specific advice without knowing your medical history, if you tolerated a reasonably high intensity on your treadmill test and you have physician approval, then you will likely be able to tolerate most submaximal workloads during your regular exercise sessions. Hope this helps. Best wishes.

      Reply
      • glen

        thanks for your reply. also re: Have u witnessed this occurring in others in similar conditions ie due to arthritis so quickly?

        Reply
        • Bill Sukala, PhD

          Hi Glen,
          I cannot say I’ve seen this as a direct cause and effect situation. Human health is affected by so many variables that each person needs to be evaluated as an individual with all genetic, environmental, and lifestyle factors taken into consideration. However, there may be some link between immunosuppression therapy and coronary artery disease, but it may be dose-dependent. I would suggest speaking to your cardiologist for more specific information on your medications and your situation. Best wishes

          Reply
  13. glen

    thanks for your comments. much appreciated. really love the site. take care.

    Reply
  14. William Siong

    Hi Dr Bill, thanks to your article which is useful to me although I’ve gone through my CABGx3 for 4 months by now.

    Still experiencing soreness on the chest as 1 of the Chest Vein was use for the Bypass.

    Nevertheless, many good tips for me to remember on my route to recovery.

    Cheers,
    William Siong

    Reply
  15. Larry Chmiel

    Dr. Sukala,
    First of all thank you for responging to my inquiry regarding weight training with a pacemaker/defribulaor.
    Why do you recommend working up to 60 minutes a day for aerobic training. Is this the length of time required to make the heart stronger? Or is this for weight loss?
    Thank you,
    Larry

    Reply
    • Bill Sukala,PhD

      Hi Larry,
      The particular duration of exercise is going to vary from person to person depending on individual fitness levels, impact of medications, etc. Sixty minutes is adequate time to both strengthen the heart and provide weight loss benefits (which will also help lighten the load on the ticker). Irrespective of what recommendations you read, it still depends on you. Adjust your workout variables accordingly based on how often you work out (frequency), how hard (intensity), how long (duration), and what kinds of exercise you do (type). Hope this helps.
      Cheers
      Bill

      Reply
  16. Akila

    Is there a specific standardized walking schedule for patients after CABG

    Reply
    • Dr Bill Sukala

      Hi Akila,
      Please check about midway down the article. There is a basic exercise schedule which you can adapt to fit your needs. Once you’re past the initial healing and have clearance from your doctor, and provided you don’t have any ongoing complications, you should be able to work up to an hour or more of walking on most or all days of the week.

      Reply
  17. Air Commodore Dr HSR Arora

    Dear Dr Bill Sukala,
    Interesting & informative reading.I run a Cardio-Pulmonary Rehabilitation Centre with Apollo Life Centre
    located with Apollo Hospital Jubilee Hills Film Nagar Hyderabad Telangana India.The Centre has team constituting Medical,Physiotherapist/Dietician/Psychologist/Yoga Expert for holistic condition of Heart Cases.We start for cardiac cases 6-7 day post surgery in open heart surgery,2-3 day for all post angioplasty -stents, acute heart attacks.2- 3 day after Ac CHF stabilised. 2 day after ICD,Pace Maker.All kinds of Chronic Pulmonary cases.We work with state of the art of Technology i.e. Telemetry Monitoring , Medical TM,Top X, Ergo cycle, Incentive Spiro., Static Ex.We also undertake conditioning of Diabetes,HTN, Cancers,People on Dialysis,Depression ,Post Stroke,Obesity,Metabolic Syndrome, Geriatric Care, ANC,Meno & Andropause cases. Condition people for adventure activity.
    This is the only such facility which work on evidence based internationally acclaimed protocol. Ensures quality & safety of patients.
    Kindly do visit.

    Reply
    • Dr Bill Sukala

      I’d love to come visit! Thanks for making me aware of your facility. It sounds incredible!

      Reply
  18. Jason

    Weight lifting after LAD stent

    I had 1 medicated stent placed in my LAD a couple of weeks ago (90% blockage). I didn’t have a heart attack, I just felt sharp shooting pain up into my the back of my neck with some pain upon breathing in after breakfast on a non workout day). This is what sent me in to the ER prior to my intervention. No other blockages and my weight, bloodwork and blood pressure are all normal (this is most likely a family history condition and/or stress). I am 39 years old. I have been an avid weight lifter for the past 2-3 years and am eager to get back to it. I don’t do heavy squats or heavy deadlifts just some basic upper, arm, shoulder, and leg work (a little over body weight… 160 pounds or 80-90 pounds per arm). In your experience, are there any concerns and/or suggestions in going back to the gym. Obviously I know I should start slow and listen to my body and of course get clearance from my Doctor. I am just looking for more information as there is little available.

    Thanks so much for your time

    Reply
    • Dr Bill Sukala

      Hi Jason
      Thank you very much for your comment. You have a number of things going in your favour. First off, you are still young and your blood work, blood pressure, and body weight are all within normal limits (as you mention). You are also a pretty active guy, so presumably you already have some level of physical conditioning. It’s much easier for active people to get back into their routine than someone who is exercising for the first time after 30+ years of inactivity.

      I think the biggest thing you need to pay attention to at this point is that you are still pretty fresh in recovery. As a general rule, I’d suggest to give it at least a good four (4) weeks post stent before you consider doing anything more strenuous. You must remember that, even if you feel great, there IS still healing happening on the inside (even if you can’t feel it). That stent will take a little time to settle in so you want to be sure you’re not doing anything excessively strenuous which might cause a sharp rise in blood pressure and heart rate.

      Once you’re about 4 weeks post op, you should get back in to see your cardiologist for a check up and, as you’re aware, get his/her permission to get back into your routine. Clearly I cannot give you any specific advice since I know nothing about the details of your condition. If you have a cardiac rehab at your hospital, perhaps they can put you on a telemetry monitor while you get back into your routine. The sessions might be covered by your insurance depending on your level of coverage.

      Bottom line: make sure you’ve given yourself sufficient time to heal (at least 4 weeks). Get your doc’s approval to start exercising. And, if feasible, do at least six (6) cardiac rehab sessions supervised by cardiac nurses and exercise physiologists to see how your heart is looking on the monitor. If you go six sessions and your heart looks nice and stable with no arrhythmias and drastically high spikes in heart rate and blood pressure, then you could say with reasonable confidence you’ll be fine. Hope this helps.

      Cheers
      Bill

      Reply
  19. Sudarshan

    Hello Dr Sukala
    I had a angioplasty 6 yrs back for a RCA block. Didnt have an MI. 10 days back i underwent a CABG FOR A 3 blocks. Im 49 yrs old now. Blood parameters normal. LV function normal, but strong family history
    I used to lift weights and take supplements like Whey Protien and BCAA.
    Could that have been responsible for such a early block. And can i get back to lifting wts and taking supplements

    Reply
    • Dr Bill Sukala

      Hi Sudarshan,
      I can’t say for sure that whey protein and BCAAs were responsible for your blocked arteries since coronary artery disease can have multiple causes. If you have a strong family history of heart disease then that would likely play a greater role than dietary supplements. If you’re only 10 days out of a CABG x 3 then you’re probably going to want to wait at least two to three months before you’re doing any strenuous exercise. Your best bet is to speak to your cardiologist and/or surgeon to see what they recommend in your case. Everyone is different and so I cannot give any specific exercise recommendations to anyone over the internet, particularly without knowing your full medical history. Kind regards

      Reply
  20. Sudarshan

    Thank you for the response. One last question . We r booked to travel to Spain for a holiday ( not hectic) 6 weeks from today . That’s about 7-8 weeks from the CABG.
    Do u allow your patients to holiday and if so when

    Reply
    • Dr Bill Sukala

      Hi Sudarshan, You would need to discuss your travel plans with your cardiologist and get his/her approval. However, in my experience, depending on the patient’s individual condition, I have seen cardiologists grant permission for travel. Please remember I am an exercise physiologist and not a cardiologist so neither I, nor any other health professional, should be giving you specific health advice over the internet. As I said, best to discuss your particular circumstances with your cardiologist. Kind regards

      Reply
  21. Ava Анастасия James

    I had quadruple bypass on April 22, 2013 and now I am going to run the Victoria Marathon. I am making sure to take my Blood thinner (probably an extra dose if there is a possibility of being a little dehydrated), and anti-cholesterol. I am doing the over 5:30:00 and making sure I am staying well hydrated as that may have contributed to the problem that created having to have quadruple bypass. My doctor said it was O’Kay to run the Marathon, but one more question I didn’t ask him was “Could a short period of Dehydration caused by running long distance be a danger factor to create the same problem again?”. Maybe some of you on this list may know the answer to this complex question, as that is really only a short period of dehydration.

    Reply
    • Dr Bill Sukala

      Thank you for your comment. Without knowing anything about your medical history, I cannot give any specific recommendations. If you had a quadruple bypass, then you likely had multiple lesions in a few arteries which made it too complicated to put stents in all of the affected arteries.

      Becoming dehydrated could plausibly make your blood more viscous due to a lower blood volume, but I can’t say this would necessarily cause a blocked artery. Plus the fact that you are taking blood thinners (and probably other meds for your HR and BP) will help keep things under control. Whether or not you had heart problems or the surgery, if you’re running a marathon, it is in your best interest to remain well-hydrated throughout the race.

      If you need a more detailed consultation, I am now providing these via my website at http://consultations.drbillsukala.com.au I would need more comprehensive information from you which would include your medical history, surgical reports, and discharge summary.

      Best of luck in the marathon! Let me know how you go with this! Kind regards, Bill

      Reply
  22. Pete

    Hi, I’m Peter, I had a Ross Procedure – open heart surgery – done about 8 years ago. I’m 46 now, I’m fit, run the beach in Coogee, do body weight exercizes and swim lots.

    I’ve always wanted to know: Can I do pull ups and chin ups, or would that freak my sternum out too much.

    I’d love to take my body weight exercises to the next level, and do that, but I wonder if it’s safe for the little wires still stringing my Sternum together.

    I would love a straight answer, man, I’ve been searching google for ages trying to get a definitive answer.

    cheers

    Pete

    Reply
    • Dr Bill Sukala

      G’day Pete,
      So you’re in Coogee eh? We’re neighbours then! Strictly speaking about your sternum, if your surgery was 8 years ago, the sternum should be well healed and stable now. In my experience, most patients I work with that have had any open heart procedure (and notwithstanding any complications) tend to resume most activities that stress the sternum within a year. Without knowing all the specifics of your medical history, provided it was that long ago, you had no complications, and you’re as active as you are, then you might try gently easing into more strenuous exercises. If you tolerate that well, then gradually bump up the intensity a bit. If we’re talking about pull ups, then perhaps you might try a weight-assisted pull up so you’re not taking on your body’s full gravitational load, then progress in a safe and systematic way. I would also suggest speaking to your cardiologist or practice nurse about your particular situation and see if they have any specific cautions for you. You sound like a very fit guy so that will lend support to your case. Hope this helps.

      Cheers
      Bill

      Reply
  23. jose thomas

    doctor my name is jose who lives in dallas,tx.i have a question about lifting the weight.i did my cabg 7 months ago.i have lot of lifting in my work site,which is less than 25 kg.frequently i have to do 8 hrs a day ,40 hrs a week.im doing ,is there any problem to do that?please advise.

    Reply
    • Dr Bill Sukala

      Hi Jose,
      Thank you for your comment. If you’re 7 months post-op then, assuming you’ve had a normal recovery with no complications or other special considerations (i.e. other health issues), then you should be able to resume most of your previous activities by now. HOWEVER, having said that, ultimately the final green light must be given by your doctor. A lot of people come to these articles looking for clearance, but as I’m sure you can appreciate, I cannot give specific advice over the internet without actually knowing your entire medical history. Hope this helps. Kind regards, Bill

      Reply
  24. Rajni

    Hi there,
    My father had a heart bypass of 3 arteries in October 2015 (silent attack, no chest pain). One graft was taken from chest itself. He is healing well but he is still feeling wound like pain in the chest area while touching. During our 1 month checkup post-operation, his X-ray and blood tests were normal, but what could be the reason for wound like pain and tightness?
    He has started walking a lot and is on healthy diet. He hasn’t started lifting any weights though. When can he drive the Two Wheeler (scooter) again?
    He is 67 years old.
    How much weight he can lift and would driving a scooter cause any harm?
    Your response would be much appreciated.
    Thanks

    Reply
    • Dr Bill Sukala

      Hi Rajni, Thank you for your comment. It’s difficult to say exactly why your father is still experiencing pain in the chest, but I would encourage you to discuss this with the cardiologist. Remember that any open heart surgery procedure is a trauma on the body and it does take time to get back to normal and for odd pains to go away. It could be something related to a damaged or pinched nerve. The sternum itself will take significantly longer to heal up so your father will have to be patient in this regard. As for when he can drive the two-wheeler again, this will be up to his cardiologist to give him approval. Generally the recommendations for lifting weight are to not lift much over 5kg during the recovery period and minimising overhead lifting. In my experience, most people tend to feel reasonably well after 4 to 6 months of recovery, but this will vary from person to person. As I’m sure you can understand, I cannot provide any specific medical advice on my website, but I think your father should discuss his concerns with his cardiologist to get answers related to his specific condition. Hope this helps. Kind regards, Bill

      Reply
  25. Thore Nyborg

    Hello Doc, my name is Thore and is from Norway . Had a quadruple bypass for exactly 2 years ago due to serious plumbing problems. I am now 51 yrs. Changed lifestyle totally , extremely fit. Weightlifting , 4 x 4 on treadmill 3 times a week with 15 ° uphill running. My resting puls is 38. Only one thing really bugs me, confuses me , and lies as a big black cloud over my head (existense). I sometimes comes across experts saying that vein grafts has a “sell by date,” only lasts for 7 to 10 years. My heart doc just says forget it, just keep on running up the hills and continue the vegetarian lifestyle and you’ll be fine. But I just cant stop thinking of this. and i dont dare go on the Google 🙂 do you have any knowledge on this ?

    Best regards

    Thore Nyborg

    Reply
    • Dr Bill Sukala

      Dear Thore,
      Thank you very much for taking the time to leave a comment. You are a wise man for not going and scouring google looking for answers. Sometimes it can be downright terrifying! The duration of how long a saphenous vein graft lasts for can vary from person to person. There are generalities, but I don’t think it’s fair to rely solely on this since it’s not the same for everyone. I will tell you one thing that will likely put you at ease: People who do an EXCELLENT job at taking care of themselves after surgery tend to have fewer complications and are less likely to need a repeat operation. I have had patients at my hospital who had bypass surgery in the 1980s and have never had to have another operation. There are sometimes people with a very strong propensity towards coronary artery disease where even if they do everything right, they can still have another artery or vein clog up on them. Best thing you can do is keep up with your exercise and healthy diet (as you’re already doing) and pay attention to any signs or symptoms that something isn’t right. For the most part, not many people just drop dead of heart attacks. Usually people have symptoms but ignore them and that’s when bad things happen to good people. Just make sure you look both ways before crossing the street, stop at stop signs, wear a parachute when you go skydiving, etc. There are plenty of things that can kill you, but plugged up saphenous veins need not be one of them! Keep smiling! Kind regards, Bill

      Reply
  26. Thore Nyborg

    Hahaha fantastic answered, thanks a lot ill bear this in mind.
    PS. I was the die hard hypocondriac , spending a fortune on check ups, especially heart tests during many years …….and guess what…..I finally was right. Lucky me. Never ever felt fysically better in my life than i feel now. Again thank you and have a nice week 🙂

    Reply
    • Dr Bill Sukala

      Cheers Thore, I know what you mean. Sometimes we can be our own worst enemies! I know it’s not easy and I can certainly empathise from my own personal experience too (for different reasons) but sometimes it’s best to just deal with what is rather than worry about something that may never actually happen at all! Best wishes, Bill

      Reply
  27. Mike

    Hello doc. I had a quadruple bypass on 12/18/2015. I’m 51 diabetic going to cardiac rehab. I used to ride a bike 50 miles 3 times a week with a challenging mile long hill. I always pushed pretty hard, heart rate as high as 180 on the hills and average rate was 145. Will this be possible this summer? Most of the ride is flat there’s about 1.5 miles of hills heart rate between 150 to 180.

    Reply
    • Dr Bill Sukala

      Hi Mike,
      Thanks for taking the time to leave a comment. Whilst I can’t give you any resolute yes or no to your question (since I’m not familiar with your entire medical history and this is just the internet), I would recommend having a talk with your cardiac rehab team and cardiologist regarding your specific exercise goals. Remember that you are only a couple months post-op so your sternum will still likely have a fair bit of healing to do. Provided there are no complications from your surgery or other conditions (like diabetes), then with proper training, you may be able to tolerate your previous exercise routine again. If you’re taking a cocktail of medications that affect your heart rate, then I wouldn’t be too focused on your target heart rates of 150 to 180. I’m assuming these heart rates were achieved before your surgery when you were not taking any medications. Again, your best bet is to work closely with your cardiac rehab team and get specific recommendations for your individual level of health and fitness. Hope this helps. Kind regards, Bill

      Reply
  28. mani

    Hi sir.. onaug 22nd 2015 my mother had cabg
    Can she lift a weights and can she sit down on the floor. And she is diabetic .how can i care after my mothers’ health

    Reply
    • Dr Bill Sukala

      Hi Mani,
      Thank you for leaving a comment. Without knowing any details of your mother’s health and surgical history, I couldn’t give you any specific information. I would suggest speaking to her cardiologist for specific information regarding what she should or shouldn’t do.

      I will say that if she is diabetic, then it’s going to be very important to try and keep her blood sugar under control, as this can contribute to an increased risk of blockages in her arteries. If she’s already had cabg surgery, then it’s important she make lifestyle changes that include healthy eating and exercise so it reduces her risk of any future blockages in the same or other arteries.

      As she is about 6 months post operation, is she currently able to walk around the neighbourhood on a flat surface? If she’s able to tolerate this at a low level, then this is a step in the right direction. My article contains general information on this, but as I said, it is not specific to any one individual. I would recommend speaking to her cardiologist or the team at a local cardiac rehab (if available) to get specific recommendations and guidelines for her situation.

      Kind regards
      Bill

      Reply
  29. Buddhadebchatterjee

    After CABG in the year 2013 month of december,24th after that 24hrs Holter monitorin had been done on 09.03.2016 and the result written below 1. average heart rate was 63,2. minimum heart rate was 47 a5 03:32., 3. mmaxim8um heart rate was 110 at 22:51,4. pause grater than 2.5seconds were 0 5. ventricular ectopy was 8. 6. V. pairs were 0.7. ventricular Biggeminy events were0. 8Supraveentricular ectopy was 3. 9. SV-Runs were 0.10. Supraventricular Bigeminy events were0. 11. Supraventricular Trigeminy events were0.m12. Total A-fib(Flu) were0. 13. ST episode minutes trtaled 0. 14. 24Hrs. Holter Monitoring shows fEW SVPCS and FEW VPCS Noted . NO sinus pause seen. This report is good or Not? It will necessary for inform doctor immediately
    because I am not nearest to doctor. pl. advise me immediately

    Reply
    • Dr Bill Sukala

      You’ll need to have this information interpreted by the doctor that ordered the Holter monitor. I cannot legally give you any advice because I am an exercise physiologist, not a cardiologist. Furthermore, no doctor is going to give you advice over the internet. Sorry I can’t be of further help.

      Reply
  30. M.B.Mujahid

    Hello! Dr. Bill. I am from Pakistan.I went under open heart surgery on 23rd December,2015. After surgery I made a reasonable recovery in hospital. But after returning from hospital I could not make recovery as it should be due to some uncongenial conditions like death of my friends after one another. I have to used painkillers and paracetamol tab regularly. Then my wound got septic and I have to take antibiotics. use of these medicines my stomach went out of order. I could not eat for some days but today I am feeling slight well.
    Today I have a chance to see your tips about this surgery. I got a lot of from your tips and thank for all it. I would like to receive some special tips for myself. I face a problem these days, as if I do not take pain killers I feel some pain in my breastbone (Sternum). Almost 11 weeks have passed. Should I use pain killers twice or not. I am 57 years old and diabetic patient.

    Reply
    • Dr Bill Sukala

      Thank you for your comment M.B. I’m sorry to hear you’ve had a rough time after your surgery and I am hopeful things will start to settle down for you now.

      Regarding your use of painkillers, unfortunately I cannot legally give you any recommendations on what medications you should or should not be taking, but would strongly recommend that you discuss this with your cardiologist, surgeon, or general practitioner.

      You should also be aware that diabetes can affect your wound healing time. You can review this article here to learn more about how you can give yourself the best shot and healing and recovering as quickly as possible. http://www.woundcarecenters.org/article/living-with-wounds/how-diabetes-affects-wound-healing

      Kind regards,
      Bill

      Reply
  31. mani

    hi sir. i am nagamani. my mother had the cabg (left aterty on aug 22nd). her blood sugar level maintains as 220 mg/dl. and b.p. as130. now the problem is her legs are swelling for some period of time and doing walking its getting normal.. what is the reason for it? i have read in the internet it is common after cabg. is it true or any problem with her health again like kidney or any other….? i am taking tension about my mother.. i am preparing for my exams but i cant concentrate…please reply for my question as early as possible….it’s my humble request….

    Reply
    • Dr Bill Sukala

      Hi Mani
      I can’t say exactly why she is experiencing swelling in her legs. There could be many reasons for this. I would suggest speaking to her doctor who will be more familiar with her individual condition. kind regards, Bill

      Reply
  32. Sandra Bowring

    What a great site Dr Bill. Thank you. My husband had CABG X 6, just four weeks ago, and it’s all been very interesting reading.

    Reply
    • Dr Bill Sukala

      Thanks Sandra! I always appreciate kind feedback. Feel free to drop in and ask questions if any. Kind regards

      Reply
  33. Brian Linley

    I had by-pass surgery a month ago. I used to do 6 miles a day on treadmill. When can I resume exercising and at what level. No post surgery complications so far.

    Reply
    • Dr Bill Sukala

      Hi Brian,
      Thanks for writing. Without knowing anything about your full medical history, I honestly couldn’t give any specific answers. Moreover, the only one who can legally answer this question would be your cardiologist/surgeon. If you’re only a month out of surgery, I would expect they’d have recommended you attend a cardiac rehab program in order to safely progress you back to exercise. I provided some general guidelines in my article, but any specifics would have to be directed by your doctor or cardiac rehab team.
      Kind regards,
      Bill

      Reply
  34. Taryn Parker

    Hi Dr. Sukala –
    I am 41 years old and had double bypass Aprill 11, 2016. I am in a wonderful cardiac rehab program and progressing well. I am an ER nurse and I have not as of yet returned to work because we have a requirement of being able to push pull and lift 50lbs, I just started lifting my 31 lb 2 1/2 yr old about a week and a half ago and it is a little challenging because I do experience a lot of puling and pain on my sternum. My goal is to return to work the end of August – does that sound feasible to you? I also had a post op wound infection at the base of my incision which I was treated for with clindamycin and vancomycin it has healed but where I had the infection it feels very swollen and there is a hard lump in the area. I also have two other hard lumps on my sternum above where I had the infection and they also are hard. They tend to get bigger throughout the day then after awaking in the morning return to their normal grape like size. They are tender to touch. Have you ever had anyone have anything like this? Sorry I’m so wordy and asking so many questions, but its been hard to get answers from my dr’s one says its scar tissue and the other says its keloids – being a nurse what I have does not feel like either. To me it almost feels like growths on my bone, maybe I’m crazy. Thank you in advance for your help!
    Taryn

    Reply
    • Dr Bill Sukala

      Hi Taryn,
      Thanks for your comment. As I tell many other people posting to my website with questions, be aware I am a clinical exercise physiologist and not a cardiologist. So legally I can’t give any specific medical advice. I am a cardiac rehabilitation guy though so I have seen people arriving to the clinic with scar tissue and adhesions. The way you described it sounds consistent with what I’ve seen in patients I’v worked with and would tend to agree with the docs. One thing i will say is that remember that open heart surgery is really rough on the body. I call it something of a “controlled car wreck.” There’s still a lot of healing happening on the inside, so you probably won’t feel quite right for a while. Most people do OK after a few months but that sternum can be a tricky one in some people. Bottom line: i don’t think you’re crazy and I’m certain you’re not hallucinating anything, but perhaps it would be worthwhile discussing this in more depth with your docs and see if you can get further work-up to see what it might be. Keep me posted on how you go. Thanks, Bill

      Reply
  35. C Rodrigo

    Dear Dr Bill
    Many thanks for your very informative articles. I had a CABG operation (4 grafts) on 07/06/16 and I was engaged in some sports activities like swimming and badminton prior to it. I really want to resume those and would also like to start walking/running on the treadmill. I would like to know when can i start my driving. I shall be grateful if i can have some of your comments.
    C. Rodrigo

    Reply
    • Dr Bill Sukala

      Hi C,
      Thank you for your kind words and comment. If your surgery was only a few weeks ago then you’re still in the early recovery stage. Whilst I cannot give any specific recommendations or medical advice, I can tell you a few things to discuss with your cardiologist.
      1) Get medical clearance for exercise from your doctor.
      2) Ask if there are any particular restrictions on your ability to exercise (other health conditions, medications, etc).
      3) If safe to exercise, perhaps consider a cardiac rehabilitation program. This will be the safest way to get in shape.
      4) If no cardiac rehab is available, then ask about exercise limits from your doc (if he can do a treadmill stress test on you, then that would be a good idea).
      5) If you’re able to tolerate a high workload on the treadmill, then the doctor may give you clearance to return to swimming, badminton, and walking/running on the treadmill.
      6) Regarding when you can drive again, that is going to be between you and your doctor. The main limitation is that having a seatbelt across your chest is not going to be very comfortable due to the incision. If you’re on medications that can alter your level of consciousness, then the doctor might put further restrictions on you.

      In the meantime, you should have been prescribed low-level walking similar to the recommendations in my article. Have a look at what I’ve put in this article and discuss with your doctor to work on a plan to get you active again. Hope this helps.

      Kind regards,
      Bill

      Reply
  36. C.Rodrigo

    Dear Dr Sukala
    Many thanks for you time replying me sir amids your buzy shedule. We do not find any cardiac rehabilitation programes. When i ask about the excises and their limits , the general answer i get is only brisk walking until six months ( any patient). I think it is a very safe answer. But i think your website gives lot of information for so many patients.
    Thank you very much for your hard work. Wish you good health
    Cheers
    C.Rodrigo

    Reply
  37. sean

    i had a triple bypass just over 1 month ago and still have a numb and agonising painful thumb and first three fingers that also covers half my left hand. the surgeons at st vincent’s in vic, say it is because i have had an operation, none of them can answer if or when the pain will go away, also my left leg is still swollen to twice its size, again surgeons at st vincent’s just shrug. it sounds very much like the surgeons followed a step by step picture book to do the operation and have no other knowledge. if i knew about the agony i am now going through i would have not had this surgery and i would have been happy with my ‘spray’ to relieve a small amount of discomfort. a total hip replacement provides some pain for upto 3 weeks, but a bypass is giving me 1 month of agony where no painkiller helps yes i have already been in an ambulance and hospital and was given a number of shots of morphine which did not help…… either the surgeons could not follow the pictures or i had a butcher or two working on me. what can i do to reduce swelling in my left leg and hand, stop agonising pain in my hand fingers, relief the strong pain in the upper right of my chest? the scar on my left arm is nearly healed, the scar on my left leg is far from healed and still sticks out by about 1/2 cm.

    i am happy that many other posters have claimed success, i just want some answers and to warn others that not all bypass surgeries are as good as the brochure claims.
    out of the 12 surgeries i have had, i will never have bypass again, i will also encourage everyone else too think twice then again before thinking about a bypass.

    please help me get away from agony, i am waiting on the day where i can be relieved to say i am in server pain, that would be bliss.

    Reply
    • Dr Bill Sukala

      Hi Sean,
      I’m very sorry to hear you have a lot of pain after your bypass surgery. I’ll say a few things to you. First: pain sucks, but it’s quite common to feel bad for the first few weeks to a month after your open heart surgery. However, what you describe seems to be a bit more extreme than what most experience. Second, by the two month mark after your surgery, you “should” be feeling better with less pain. Having said all that, if you’re still experiencing severe pain, I would suggest asking for a referral to a pain clinic who may be able to help you with some strategies for reducing your discomfort. I think it’s also important to get more information on WHY you’re having this pain. I can’t say for sure, but perhaps there was some nerve damage which might explain the pain radiating down into your hand. I think this would be worth discussing with your surgeon and/or cardiologist and, as I said above, possibly asking for a referral to a pain clinic. Please stop back and keep everyone updated on how you get on through your recovery. Others might find your words of wisdom helpful if they should find themselves in the same situation as you. Kind regards, Bill

      Reply
      • sean

        as of now i have very little pain, pain clinics are not worth the time, talking to cardiologists is a waste of time as they all say the same thing they shrug shoulders and say “you have had surgery”. i have been to my local hospital for rehab, wel it would be ok for those who have done absolutely nothing since their surgery, as i was told rehab would not really benefit me as i am fitter than those attending the clinic for 3+ months. my left thumb and first two fingers are still numb i can use them but i need to look to see what they are doing, lyrica helps. swelling in my left leg still has not subsided cardiologists say “you have had surgery it will take time” when i ask roughly how long they say “dont know”. in my experience cardiologists and heart surgeons know nothing about after surgery care, did they learn nothing while being taught? i know more about after surgery conditions than the specialists do.

        Reply
        • sean

          update.
          after about 6 months.
          shoulder pain has gone.
          still have lots of pain in the left hand and two fingers and thumb.
          now i am getting pain in the left wrist where they cut the artery out.
          left leg is still very swollen.
          heart is working fine with no problems.

          Reply
  38. Ravindra Kumar

    Dear Doctor,
    I have under gone CABG surgery on 03.08 .2016- No heart attack- treated for triple vessel blockage.
    i have reported back to duty after two months on 03.10.2016 with out any complication.
    iam walking for 30-45 minutes per day
    Please guide me further, how i should go further with respect to excerise & diet

    Please guide me
    Regards
    Ravindra kumar

    Reply
    • Dr Bill Sukala

      Hi Ravindra,
      Thank you for your comment. I’m unable to provide any specific advice beyond what I’ve included in my article, but if by chance you happen to have access to a cardiac rehabilitation program in your hospital, I think that would be a step in the right direction. Here is a link to an article on my site written by Gabrielle Maston, a dietitian and exercise physiologist: http://www.drbillsukala.com.au/nutrition/paleo-diet-heart-attack/ It gives a lot of general information which you might find helpful.

      Kind regards
      Bill

      Reply
  39. Colonel Rajive Sood, Veteran

    DEAR Dr BILL.
    I underwent CABG on 2o may 14. I started walking as advised. Now after six months,I walk 5 KMs in one [email protected] of one Km in 12 minutes in the morning and five KMs in 70 minutes in the evening which involves one km uphill gradient of about 20 degrees. I dont feel uncomfortable though a bit tired in the legs only.
    I am 61 yrs, weigh 71 KGs and am 165 cms tall, an ex army officer.
    My lipid profile before procedure was normal,ecg and echo normal too. However TMT was positive with depressions.
    I am more of a vegetarian, always had healthy diet,very moderate drinker,appx one glass of beer over roasted fish is my indulgence. Moderate smoker earlier but absolutely none post CABG.
    Please advise if I am doing OK and can commence jogging now.
    RegARDS

    Reply
    • Dr Bill Sukala

      Hello Colonel,
      Thank you for your comment. I can’t provide any specific advice here since that would be illegal, but it sounds like you’re on the right track if you’re now doing 5km of walking. I would recommend discussing this with your cardiologist who is most familiar with your medical history and ask him if it’s advisable to start jogging. You might ask him to perform a treadmill stress test to determine how well your heart functions at higher intensities. If no problems on the ECG, then it may be advisable to progress to higher workloads (i.e., jogging). Hope this helps. Kind regards, Bill

      Reply
  40. satye raj

    Dear Dr Bill Sukala,

    I have already had a CABG surgery 2 years back.Im 34 years old now and i can feel shortness in breathing,sweating and at work while working at work.Im a farm supervisor.

    Please advise of the possible reasons and what should i do now as im getting worried.

    Reply
    • Dr Bill Sukala

      Hi Satye,
      Thank you for leaving a comment. I would strongly advise you to make an appointment with your cardiologist for further evaluation. This is the safest and most effective way to ensure your heart and your previous bypass grafts are ok. I’m sorry I cannot provide any specific medical advice here.
      Kind regards
      Bill

      Reply
  41. Jagdish M

    Hello, Sir

    Very interesting and informative articles
    Thanks for such kind efforts

    Reply
  42. Mushtaq Ahmed

    Hi
    My name is Mushtaq. I am from Pakistan. I am 66 and I had my CABG on Nov.22, 2016 (5 months and 11 days back from today). All is well. My incision scar is extended type i.e. some keloid formated on the lower portion of 4 inches. I feel some ‘streching and little pain ( sometimes pinning) that last just few seconds of streching.This ‘streching’ happens while I am sitting and make an upright position or stand-up. Otherwise, there is no pain. Please advise……..Many thanks.
    My another problem is of “restlessness” feeling at chest area which is quiet disturbing. Just to brief you: before CABG, I was taking 1/2 tablet of Telmisartan 20 mg. Now after CABG I am taking also Metoprolol 25mg 1 x 0 x 1, Ascard (aspirin) 75 mg 1 x 0 x 0 and Rusuvastatin 10mg (on alternate days. My present Blood pressure is + – 115 / 70. It sometimes increases to 120-130 / 80 – 87. I do not know the reason for it. But when does it happens I also feel discomfort, while before CABG my BP remained somewhere around 130-140 / 80-90.
    Sir, I need your your great advice on it. Please please do reply and do not ignore my humble request. Please answer on my personal e-mail as I am very slow on computer.
    PLS advise, how much of weight I can pick as I am planning a trip to out of city. Please also let me have the information of: “maximum BP count in order, not to be in tension, and how can I avoid this “restlesness
    feeliing ” which is, in turn, creates negative thinking.
    Please ignore my wrong English writing, if any’.
    very eagerly and sincerely looking forward for your answer,
    Mushtaq

    Reply
    • Dr Bill Sukala

      Hi Mushtaq,
      Thanks for your comment. Sorry for the late response, as I’ve only just seen this now. It looks like we have two issues here: 1) you’re having discomfort around your sternal incision site; and 2) you’re concerned about your blood pressure response when you lift weights.

      1. Discomfort around your chest incision scar
      It is not uncommon to have discomfort at the incision site after cardiac bypass surgery. Everyone responds a little bit differently but some people do experience a bit more itching. In most cases, this will resolve over time, but if it remains problematic, I would suggest speaking to your doctor who may have suggestions specific to your case.

      2. Blood pressure and weight lifting
      Looking at the blood pressure numbers you’ve provided, if these are resting blood pressure numbers, then they’re quite good. Exercise will increase your blood pressure, which is a normal and expected response. I would suggest you speak to your doctor regarding upper blood pressure limits for exercise. If you’re doing moderate intensity activity for both aerobic and weight training, the chances are your blood pressure will remain in a normal range (possibly increase to 140 or 150 / 70 – 80. To help put your mind at ease, remember that blood pressure changes throughout the day and is not a fixed number. It just floats around a certain range which can vary from one person to another. In your case, your numbers are quite normal and healthy and definitely not too high (plus you’re on a number of medications).

      The bottom line: I would suggest speaking to your cardiologist for specific guidelines on upper limits for blood pressure during exercise, and also discuss your concerns about the discomfort you’re experiencing in your sternal incision site. Hope this helps.

      Kind regards,
      Bill

      Reply
  43. Venkat sada

    Hi my name is shiv
    Had CABG in 2014 after a heart attack. Currently iam on beta blockers and statin. I am 60 years old. Going for quarterly checks. My last echo test done a year ago gives a result of 58 percent ejection fraction. I do walking and sometimes jogging and sometimes spot jumping alternately for one hour in total. I use Fitbit to monitor my heart beats. I let my heart beat go up to 120 and maintain at that level. My resting heart rate is around 55 beats per minute. While I am not engaged in exercise it beats at around 65 to 75. I don’t feel tired. I take care not to exceed my jogging or spot jumping 30 minutes at a time. Am I doing alright or do I need to go slow. I read your article and feel very confident now. It is an eye opener. Thank you

    Reply
    • Dr Bill Sukala

      Hi Shiv,
      Thanks for your comment. The first thing I’ll point out is that your ejection fraction is quite good at 58%. That means that you either had no real damage to your heart muscle or very little damage. Based on the information you’ve provided, it sounds like you’re right on track and doing well. Provided that you are not experiencing any signs or symptoms like shortness of breath or any new bouts of chest pain, then it sounds like you’re having a very normal and uneventful recovery. Bearing in mind that your surgery was back in 2014, if you were going to have complications, you’d have had them long ago. I think as long as you are keeping on top of monitoring your heart rate and any signs and symptoms, you’ll be fine. Keep up the good work. Kind regards, Bill

      Reply
  44. kish

    Hello Dr Bill Sukala,
    I had a CABG four weeks ago since three of my arteries were blocked but the surgery was performed on two arteries.
    Every alternate days, I walk gently without stressing myself a distance of 2.7km which takes me about 40 mins and then rest before returning back home. So, basically I am walking 5.4 km in about 80mins. Sometimes, I get pain in the chest similar to pins and needles. Not sure if this is due to the wound.
    My question is, am I overdoing the walking exercises or should I slow down?

    Reply
    • Dr Bill Sukala

      Hi Kish,
      I can’t give any specific guidelines or information here, but it would be worth discussing this with your cardiologist. It’s not uncommon after open heart surgery to have some discomfort around the chest at the incision site, but only your doctor can give you specific advice relative to your situation.

      One way to tell if the pins and needles are related to the heart or your wound is, when you feel these symptoms, stop and see if it goes away. Then when you start up again, does it come back? Is it predictable? Can you induce the pins/needles with exercise and then make the pins/needles go away when you stop? If so, then that possibly “could” be related to your heart.

      However, if the pins/needles are happening in your chest even when you’re just sitting at rest and seems to have no connection to your exercise, then it “might” be related to the wound going through it’s healing phase (perhaps the shirt rubbing against it?).

      Bottom line: I can’t say for sure, but I would strongly encourage you to speak to your cardiologist and make sure that he/she knows what’s going on. That’s the best way to stay safe. Hope this is helpful.

      Kind regards
      Bill

      Reply
  45. Kish

    Dear Dr Bill Sukala,
    Thank you for your guidance regarding my issue. One more thing which seems to be bothering me is the distance which I am walking. Someone told me that walking 5 km is too much when I am in my 4th week post surgery. This has alarmed me and I have actually stopped walking for the past one day.
    Kish

    Reply
    • Dr Bill Sukala

      Hi Kish,
      When they say 5 km is too much, my question is “too much for what?” If you are currently tolerating that level of exercise then it may be appropriate for you (low to moderate intensity is best in the early recovery stages). Again, the more important concern is speaking to your doctor about those pins and needle feelings you’re having in your chest. Cheers, Bill

      Reply
  46. Kish

    Thank you Dr Bill Sukala for your advice.

    Reply
    • Dr Bill Sukala

      Good luck Kish. Feel free to come back to this page and leave another comment, as it may help others in a similar situation to yours. Kind regards, Bill

      Reply
  47. Anna

    Dear Dr. Sukala,
    Thak you for this article. I know we are talking about coronary artery bypass here, but I have been unable to find resources for my question. Maybe you have an answer or else can redirect me. My father underwent 2 surgeries over little more than 2 months between July and September, on the same spot. He had a clogging in his calf area, in addition, an artery was damaged and had to insert a bypass. After a few weeks, something was causing him pain so went back and had a second surgery, which apparently only cleaned the bypass. He seems to be recovering now. Doctors told him to walk 1000 steps a day and do just that. They did not want to hear anything else. He is now walking about 5 km a day, sometimes more. But he also decided that he will start exercising even though the doctors are saying that walking is good enough. He was told not to bend his knee more than the 90 degrees of the seating position since the repetition of such movement would damage the bypass. He had not exercised for decades, now that he is retired and 67 years old, he wants to do it. What type of exercise would you say would be safe? elliptical? or maybe lightweights in the shape of barbells or dumbells? T-RX? short step-ups? Are there resources you recommend me to look at? Thank you so very much in advance.
    Cheers,
    Anna

    Reply
    • Dr Bill Sukala

      Hi Anna,
      Thanks for taking the time to write a comment. What you’re talking about here is called peripheral arterial disease (PAD). The same way people get clogged arteries, so too can people get clogs in the arterial network in other parts of the body (legs, arms, etc).

      While I can’t give any specific advice here since that would be both illegal and unethical, I can give you some suggestions which your father might like to discuss with this docs. First, it would be helpful for for him to find out from his docs how long his recovery is to last. Once he is given the all clear, then it will be a question of whether or not those same restrictions apply. The elliptical trainer might be a good option provided it does not cause any undue stress around the surgical area (and is cleared by his docs). Regarding resistance training, I don’t think the particular type of resistance matters (machines, dumbbells/barbells, or TRX), but it will come down to him 1) having clearance from his docs, and 2) making sure that what he’s doing does not aggravate the surgical site and result in any complications.

      Considering that he is already walking 5 km per day, it sounds like he’s got a reasonable level of fitness. This is something that your father could bring to the attention of the docs and say “hey, look, I’m tolerating this well with no signs or symptoms, so could I do these other forms of exercise or work at higher intensities?”

      Also consider that it may be worthwhile asking his docs to check out his coronary arteries too. If he’s had arterial disease in his legs, then it’s “possible” there could be something in his coronary arteries as well. Perhaps the docs already checked that out, but before your dad goes and really starts pushing up the intensity, it might be good to know that his heart is not a concern (peace of mind is a great thing!).

      Hope this is helpful for you. Feel free to write another comment if you have further questions.
      Kind regards,
      Bill

      Reply
  48. Mike M

    Great article! One of the best I read on line.
    I am 64 years old and had 5 valve bypass surgery. It has been 7 weeks since I left hospital.
    I still have soreness around sternum
    I am now driving , little more soreness after doing so
    I have 3 sessions of cardiac rehab done also causes some more soreness
    Starting back to work this week , kinda nervous about making it all day.

    Anyway ,everybody says I am dong great ,my cardiologist said see you in 6 months !

    Main thing that agravates me is the soreness around the sternum, Its like a nagging toothache
    Is there anything I can do to relieve some of this pain. I dont like taking pain killers !
    What can I do to accelerate the healing process if anything ?

    Once again great article! Written with common sense and very direct and to the point !

    Reply
    • Dr Bill Sukala

      Hi Mike,
      I appreciate your taking the time to leave a comment. One thing I can tell you with absolute certainty is that the sternum can take a bit of time to heal up. Remember, they’re cutting through bone so open heart surgery is kinda like a controlled car wreck with broken bones. It’s a trauma and that stuff doesn’t heal fast! You telling me you’re a bit sore is actually more normal par for the course than anything out of the ordinary. I’m no cozy buddy to the pharmaceutical industry but in this early stage of healing, a light dose of a pain killer might help you get through those rough patches. I’d recommend speaking to your doc to see which pain killers might be best suited for you. I would also recommend speaking to a clinical exercise physiologist or physiotherapist to see if you can get some appropriate chest stretches to help relieve some of that chest and shoulder girdle tightness. Bottom line is that it’ll take some time to ride out the early healing phase and then things will start to snap back to normal. If you feel pain after several months, then I’d suggest having a talk with your doc to see what’s going on. Thanks again for the comment and feel free to report back as you progress through the healing. PS, I deleted your last name to protect your privacy. Cheers

      Reply
  49. Curt Howard

    Dr. Bill,
    I was in moderately good shape, reasonable diet 59 year old male 6’3″ 280 (former athlete) and had 3 way CABG 10 weeks ago. I was walking in the hospital the next day with little or no issues. I can walk briskly(3.4/3.5 mph) for several miles now without a problem. However, I find that when I do my MaxTrainer (Bowflex-Stirstepper with handles) my legs get fatigued fairly quickly and I believe prematurely. I do the machine in increments of 3 minutes or so briefly resting in between. Are the beta blockers keeping my heart rate in check restricting the recovery of my legs?

    Reply
    • Dr Bill Sukala

      Hi Curt,
      It’s tough to say exactly what’s going on but beta blockers can sometimes be the culprit. Would suggest you speak to your doc who will be most familiar with your medical history. Also consider that your surgery wasn’t that long ago and healing completely can take a bit of time (which can leave you feeling pretty tired at times). Definitely have a talk with your doc but remember to give yourself permission to be human. I know from experience that many athletes have a hard time because they’re used to pushing hard. Surgery kind of clips your wings for a little while! Hang in there and feel free to stop back here and leave another comment, as your experience may help other readers as well. Cheers, Bill

      Reply
  50. A.g.ashok

    Dear Dr. Bill
    Thanks for your article.
    I had cabg in 2011. Now i m 62. Recent check says my heart ejection fraction is 42% . Doctor said all perfect. I take all my previous excercises as earlier. No strain or pain. Thanks to God. When I run in tread mill my heart beat sometimes shows.180 . And still no problem at all. Am I ok doctor? Whether I can trust treadmill? My life is as good as normal.
    Please advise. God bless you .

    Reply
    • Dr Bill Sukala

      Hi A.G., Thanks for your comment. I can’t give you any specific advice since I’m not fully aware of your entire medical history, but if you have been cleared by your doctor for exercise then that is a good step forward. A heart rate of 180 seems quite high to me. Are you sure this is an accurate number? How are you determining your heart rate? Are you using a heart rate monitor? Does your treadmill have a heart rate monitor? Or are you checking your heart rate manually? If the number is accurate and you are completely without symptoms, then it may be ok. To be safe, always a good idea to discuss these matters with your cardiologist. Kind regards, Bill

      Reply
  51. Louisa

    Hello Doctor, My dad is 67 years old and he had CABG four days ago. He had 4 arteries blocked which were replaced by nerves in his leg. He is really weak and tired and is in pain. He is still struggling to talk properly and his walking is weak as well. He feels sick all the time in the stomach and has a metallic taste in his mouth my question is, Is this all normal after bypass surgery? He’s not eating either and is on a lot of medications.

    Reply
    • Dr Bill Sukala

      Hi Louisa,
      Open heart surgery is hard on the body. In many ways, it’s sort of like a controlled car wreck and it takes time to heal. If he is only four days post-op, then it is still VERY early days. In fact, many people are just being discharged from the hospital at about day four. I would recommend speaking to your dad’s doctor and/or nurse just to get their input since they will be most familiar with his specific medical history. I can tell you with reasonable confidence that, once he gets past the first month or so, then the recovery will get a bit easier. It is important that he’s eating well and getting up to do regular walks. While he does need his rest and recovery, it’s also very important that he’s up on his feet and gravity bearing. Even if he’s walking at a snail’s pace, it doesn’t matter. As for the medications, while I admit I’m not a fan of pumping people full of meds, after a major surgery like this, the meds are actually a necessary evil to help control his heart rate and blood pressure (which will help him through the recovery). Talk to his docs and ask them if he’ll be able to work down onto lower doses over time. Hope this helps put you at ease. Kind regards, Bill

      Reply
  52. Ravi

    Dr. Bill …… My name is Ravi. Iam 45 years male and had CABG exactly a year back. I request your advice on jogging / running. Currently, I can walk with no issues at a speed of 6km/hr for 1 hr daily. I want to start jogging at slow pace may be max 10 Km / hr …… but everyone is threatening me that I should not jog / run after CABG as it increases the exertion……. my doc says “no issues in hog but also says why do you want run , just walk” …….. I am confused. Can you advicecwhere a person after CABG can jog / run . Is it harmful if it does the same.

    Reply
    • Dr Bill Sukala

      Hi Ravi,
      Thanks for taking the time to leave a comment. First and foremost, if you are medically stable and your doc has given you clearance to resume regular physical activity, then you should be able to tolerate higher workloads. I would suggest asking your cardiologist for a treadmill stress test to push you to exhaustion. If your heart remains in sinus rhythm the entire time without any potentially dangerous arrhythmias, and you tolerate the exercise well (subjectively), then there should be no medical reason why you can’t do 10km/h. Moreover, you are still young and if the CABG was a success, then your heart muscle should be getting plenty of oxygen.

      Bottom line: I cannot legally give you any medical advice over the internet since I am not fully aware of your entire medical history. Only your doctor can give you the final green light. BUT I can say with reasonable confidence that, in medically stable people who have had bypass surgery, exercising at higher intensities should not pose a problem (unless there is a specific medical reason that would prohibit you from doing so). Talk to your doc, get a stress test and, if that’s all clear, then you should be ok to push to the higher intensities. And remember to gradually work up to the higher intensities rather than just going out and pushing super hard on the first day.

      Hope this helps give you some direction.
      kind regards,
      Bill

      Reply

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