Coronary Artery Bypass Surgery Safe Exercise Guidelines
Table of Contents + −
- What is Coronary Artery Bypass Surgery?
- Common Treatments for Coronary Artery Disease
- PTCA For Clogged Cardiac Plumbing
- Coronary Artery Bypass Surgery for Heart Disease
- Recovery Time After Bypass Surgery
- Resuming activities after bypass surgery
- Aerobic Activity Guidelines Post-Surgery
- Can I Go to the Gym After Coronary Artery Bypass Surgery?
- Strength Training Guidelines Post-Surgery
- Take Home Message
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.
If you're a visual learner, please check out this short video which will give you an overview of the procedure and what to expect.
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 mobilisation 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 at least three days per week and as many as seven. Three days in the beginning should be more than enough.
Graduated Post-CABG Surgery Exercise Regimen
| Recovery Week | Minutes | Times per day |
|---|---|---|
| 1 | 3 - 5 | 6 - 8 |
| 2 | 5 - 10 | 4 - 5 |
| 3 | 10 - 15 | 3 - 4 |
| 4 | 15 - 20 | 3 |
| 5 | 25 - 30 | 2 |
| 6 | 30 - 45 | 2 |
| 7+ | 60 | 1 |
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).
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!
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After five weeks, you should be pretty well functional and able to do most activities of daily living. If you were trying to do everything only one week out, then I'd say that's rushing it a bit.
I am in week 5.
Sometimes its harder than others. Get plenty of sleep and water too.
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
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
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:)
i forgotten to mention my age in earlier mail , my age is 41 years
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
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
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
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
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.
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
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
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
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
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
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.
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.
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
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
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
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
Here’s a quick link to an article I just wrote on exercise after angioplasty and stent. I hope you find it helpful: https://drbillsukala.com/exercise-after-angioplasty-stent/
Do u allow your patients to holiday and if so when
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.
Best of luck in the marathon! Let me know how you go with this! Kind regards, Bill
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
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
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
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
Best regards
Thore Nyborg
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
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 :)
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
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
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
because I am not nearest to doctor. pl. advise me immediately
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.
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. https://www.woundcarecenters.org/article/living-with-wounds/how-diabetes-affects-wound-healing
Kind regards,
Bill
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
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
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
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
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
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
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
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.
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
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.
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
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: https://drbillsukala.com/paleo-diet-heart-attack/ It gives a lot of general information which you might find helpful.
Kind regards
Bill
I underwent CABG on 2o may 14. I started walking as advised. Now after six months,I walk 5 KMs in one hour@ 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
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
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.
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
Very interesting and informative articles
Thanks for such kind efforts
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
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
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
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
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?
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
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
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
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
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
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 !
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
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?
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
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 .
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
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
My question is about the leg they harvested the vein from. I’m 5 weeks out from a triple bypass and I had to apply some meds to my dog and got down on the floor and had a hard time getting back up. It was painful in my leg. It feels warm to me but maybe I’m imagining it? What is the length of time before you can perform floor exercises after bypass?
Since you're only just a little over a month post-op, remember it takes time for these things to heal. Having a little bit of post-op pain in your leg is going to be par for the course and it's really just a question of patience. By 8 to 10 weeks you should probably be feeling much better. As you progress through the healing process, you may consider slowly trying out different activities and self-monitor for any pain. In short, if something hurts (as in, "ouch! It feels like a knife in my leg") then back off and give it some more time. I don't think there is any definitive answer though because it often depends on the individual. Some people go through the recovery phase quite easily and others have a bit more of a rough course. I would strongly suggest speaking to your cardiologist or surgeon (or one of their practice nurses) to discuss your individual concerns, as they will be most familiar with your entire medical history. But bottom line, bear in mind that you are still reasonably fresh out of your surgery and it is going to take a little time for your leg and sternum to heal up. Hope this helps. Kind regards, Bill
It's not sexy and doesn't sell diet books or infomercial ab blasters, but the simple answer is ultimately eating more fruits/veggies and moving more. On the diet side, there is a lot of evidence that a mediterranean style of eating is beneficial to both losing/maintaining body weight and also improving heart health. I would suggest consulting a university-qualified Accredited Practising Dietitian in your area to get solid, evidence-based information on nutrition. As of this writing, the nutrition field is a cesspool of misinformation (particularly on social media), so for that reason I think it's imperative to get reliable information and put that into action. On the exercise / physical activity side of things, depending on how comfortable you feel with exercise, you might even consider working with a university-qualified exercise physiologist with experience working with cardiac patients. If you have had a stress test done and the results were normal, then that is good reassurance to help you minimise risk. If you have any specific questions though, it's always best to speak to your cardiologist for advice relevant to your particular medical history. Hope this helps, kind regards, Bill
I'm 42 years old and 14 weeks out from triple vessel CABG. As my physician advised me to walk more than an hour after the 6 week mark, I took to walking and improved gradually to now about 10 km per day in two sessions. I always wondered about not feeling out of breath or having high heart rates after these walking sessions. Now I understand it could be because of the effect of medicines. I'm worried whether I could've aggravated my grafts due to the amount of walking I'm doing. Kindly advise me whether it's okay for me to continue with the amount of walking I'm doing or if I should cut down on it. Thank you so much for the wonderful help you have been providing with your kind advices for people like me.
Thank you for your comment. Without being involved in your medical care and not knowing your entire medical history, I couldn't really tell you exactly what to do. However, you should probably bring up these issues with your cardiologist. As long as you are deemed medically stable and have been released by your doctor to participate in moderate intensity exercise, it sounds like the exercise you're doing should be reasonable. If you are 14 weeks post-surgery, then it is highly unlikely you're going to do any damage to the bypass grafts. Based on your IP address, you appear to be based around Mumbai, India. If there is a cardiac rehabilitation program near you, then this would be a good step in the right direction to get some supervised exercise while on a telemetry device. This way they can monitor you at different intensity levels and see if there are any abnormalities on the ECG (hopefully not). I hope this helps give you a little bit more direction. Kind regards, Bill
Just started limited speed work (200's, 300's, and 400's) this week at 75-80 second 400 pace.
As a 72 year old competitive track middle distance runner, I can't find any information on any negative impact of speed work and middle distance racing (800 to 5k) on my bypasses.
Lots of info related to the marathon, but not track races. My cardiologist is up in the air about it. Is there any good data on this topic? My only issue to date is sore left chest where grafts were pulled from, but does not hurt during speed work, which I find strange.
Thanks for your comment. I've changed your last name to your initial to protect your privacy.
First off, kudos to you for all your hard work and dedication to your sport. Based on what you've written, you seem to have gone down the safe path during your recovery. This is important because most people I've seen who've had problems were the ones who tried to be superman and go back to what they were doing too soon. There is healing happening on the inside and a lot of people, when they start feeling better, go out and redline it before they should be.
I don't think there's a lot of research specifically on track racing after bypass surgery mainly because most people getting bypasses are older and tend to be physically inactive (definitely not elite athletes).
However, on that note, I've worked with quite a few people who were high-level athletes. The common protocol is for you to 1) get through the healing process; 2) talk to your cardiologist and organise a high-intensity treadmill stress test; 3) evaluate the results with your cardiologist and then determine if it is prudent to go back to training/competing at high intensities.
The reality is, whether you're had a bypass or not, there are ALWAYS risks associated with exercise. But the question is, do the benefits outweigh the risks or vice versa. Remember that if you've already had the bypass, then it's a case of "better the devil you know than the one you don't know." To be honest, I'm more worried about the person with lots of obvious risk factors than I am the person who's already been diagnosed and had an intervention (i.e., angiplasty/stent/CABG surgery).
The bottom line is this: if your cardiologist deems you medically stable and there are no abnormalities in your heart rate, blood pressure, ECG with high intensity exercise, no signs or symptoms, then you would likely be ok to get back to your training and competing. Weigh out the risks versus benefits and then make a decision with your doctor.
I hope this helps clarify things a bit.
Kind regards,
Bill
advice. Things seem to be returning to normal, and I will be taking a
stress test on the tread mill next week. As a university researcher, I intend
to do more research on any studies related to track/anaerobic training and
racing, and perhaps do my own study if there is little information available.
Hope to be racing by late December when our indoor track season begins.
Thanks again, Harold.
Staying safe at home, But no real direction was given. Very isolated. However, your guide has been more information than I have gotten in four weeks Thank you.
Glad to hear that you're ok and coming through the recovery in the age of the coronavirus. Thanks for the kind words. I'm happy that it was able to help you along in your recovery process. Cheers, Bill
Good day to you, I underwent CABG surgery last March 12, 2020. After that, all chest pain I experienced was gone. Last July 12, my Tmt test result was normal. I was doing brisk walking and light jogging for about 500 meters. Last week, I started feeling chest pain and went to the hospital. There is a little change on my ecg and I was admitted to the ICU for close monitoring. Blood tests and 2D echo were normal and I did a tmt test again. But tmt test have changes and discharge me from the hospital yesterday. I asked my cardiologist for some changes in my tmt result. He said changes were normal during the tmt test. But sometime chest pain still there. Can I have your advice. Thanks
Thank you for your comment and apologies for the late reply. Comments sometimes land in my spam folder so I have to manually approve them.
I'm sorry to hear you were having chest pain after your CABG surgery. Sometimes it's possible to have nerve pain that is related to the surgery itself rather than your coronary arteries.
If you have had further tests that came back normal, then it is possible that you are still experiencing pain from the sternal incision. I have seen this quite often and it's not entirely uncommon. But the good news is that these sorts of things do tend to resolve on their own over the course of 6 to 12 months after the operation.
I often say that any open heart surgery is like a controlled train crash. It is a trauma to the body and it is going to take some time to recover. Now that you are about 6 months post surgery, you should start to begin to feel more back to normal again.
The smartest thing for you to do right now is to keep in close contact with your cardiologist or whichever doctor is managing your post-operative care. If you feel any of these little aches and pains, it is wise to bring them to their attention and keep on top of it. More than likely, the pain will be due to the incision, but it's always smart to check and be sure.
If you are experiencing chest pain a couple years or more after your surgery, then there is a remote possibility that one of the grafts could have a blockage but, again, it's important to get things checked out just to be on the safe side.
I hope this helps. Feel free to leave a message again if you have further questions.
Kind regards
Bill
First off, thanks for all the great advice and counsel you offer to all who write. Just reading through has provided lots of info ( and comfort) for those of us traveling the journey of recovery.
I'm 4 weeks out of a CABG x 5. Everything has gone well, with the exception of a PE event about a week after surgery. Slowed recovery a bit but now on track again.
I am a long time race car driver and now participate in vintage racing. Assuming a full recovery , do you have any thoughts about returning to racing. Main concern is being tightly restrained with racing harness and the occasional possibility of a racing incident (crash) and the effect on the sternum.
I am in otherwise good health and at 68 was lucky to have the intervention before there was damage.
Thanks.
Thanks for taking the time to leave a comment. Sometimes those little hiccups occur during recovery and I'm happy to hear you're doing well and on the up and up.
Moving forward, as you will see me mention in most of my responses, the most important thing is working closely with your medical management team to get specific recommendations for your unique circumstances (based on your full medical history etc).
I think once your sternum fully heals (about 6 to 12 months and beyond), that will probably not be an issue. Otherwise, it would be good to discuss with your doctors the effects any meds might have on your driving abilities, response times, or any impact on your blood pressure. Also, depending on how fast you're driving, I wonder if that might also impact your circulation (plus being tightly strapped in).
Bottom line: I'd talk to your cardiologist and perhaps even see about getting a treadmill stress test done before you go back to racing (just as a safety precaution). The thing to remember is that you are just trying to minimise risk. There are always going to be risks in everything you do, but if you can sort of preempt those risks by covering your bases in advance, then you at least give yourself and others some peace of mind.
Hope this helps and best wishes to you in your racing endeavours!
Cheers
Bill
I am post CABG (now 4 months). I am a (long time) Strength and Conditioning Coach. So I know my way round exercise pretty well.
Your comment about previous high level of activity is spot on! I was always a high achiever and always competitive.
Mentally it’s been tough. Even though 4 months post, I’m frustrated because I was achieving less than just prior to surgery.
I have been bike riding, slowly biting off chunks of a long hill.
My Surgeon just chewed me out! Saying I should have been at 120bpm. My previous max was 173-176… guess I’ve been close!
Kindest regards, Clive Rodell (.com)
I have a quadruple CABG 6 weeks ago and I have maintained a solid regular walking regime at pace over that time period. Is it possible to know when it may be appropriate to include some short jog or running with a view to returning to the routine exercise level I undertook prior to the surgery - twenty minute slow jog on 5 to 6 days a week ? Any view greatly accepted. (PS. Levels of pain/discomfort since surgery have reduced excepting some variable frequency of pain on one side of one's neck)
If you're 6 weeks post-op and you're already tolerating that level of exercise, provided there are no objections from your doc and/or are given full clearance to return to exercise, you would likely be safe to introduce a little more intensity into your workout.
Regarding the pain, it's not unusual to have a bit of residual discomfort after open heart surgery. It's definitely a stress on the body so, heart healing aside, it takes a while for the sternum to heal and the pain to subside.
Hope this helps!
Kind regards,
Bill
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