Sunday, April 14, 2024

Chest Pain 1 Year After Bypass Surgery

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Pain and Physical Function After Bariatric Surgery

He was very muscular 6’2″ 260lbs the nurse that had to revive him and give him chest compressions for 8min said this man has the thickest chest he ever had to work on. I am wondering if maybe his chest thickness or being muscular might have something to do with it.. He has went to cardio rehab and he still Exercises a lot more cardio now then before but still lifts but a lot lighter weight then before. He is not lazy my sone and him cut and stacked 2 triaxel loads of wood dr said he can do all he was doing before this happened. Ooh and before he had his bypass he was to have carpal tunnel surgery on both wrist. Keep falling asleep wakes him up at night he has had back surgery in the past he has just been miserable.My heart breaks for him not used to seeing him like this he is getting very down. Any suggestions would be greatly appreciated.

Thank you for your response.. Does scar tissue go away on its own? How can you find out if he has excessive scar tissue?He has a strenuous job he is in maintenance at work laying down on the floor using tools leaning over trying to fix the machines. He was off work for about 4 months (and they did not want to give him even that much time off. Made him feel like he was trying to use the short term disability more then he shoul have.. He works a lot and is a very proud man. You see the dr gave him a 100% clear so no one is taking at easy on him.

Chronic Post Sternotomy Pain: The Role Of Sternal Wire Removala Review

Elsayed Elmistekawy1, Ahmed Attia2

University of Ottawa Heart Institute , Cardiac Surgery Department, Saud Albabtain Cardiac Center, Dammam , Saudi Arabia

Contributions: Conception and design: E Elmistekawy Administrative support: None Provision of study materials or patients: None Collection and assembly of data: Both authors Data analysis and interpretation: None Manuscript writing: Both authors Final approval of manuscript: Both authors.

Correspondence to:

Abstract: Millions of patients worldwide undergo cardiac surgery via median sternotomy. Many of those patients suffer from chronic pain. Late pain after median sternotomy usually considered insignificant however recently chronic postoperative pain has been considered as an annoying problem and gaining more attention in order to understand the nature and management of it. In this review we will shed some lights on the incidence, etiology and management of chronic postoperative pain after cardiac surgery with a focus on the role of sternal wires removal as a management option for chronic post sternotomy pain.

Keywords: Sternotomy pain sternal wires

Received: 16 February 2020 Accepted: 06 March 2020 Published: 25 September 2020.

doi: 10.21037/amj.2020.03.06

Helping Your Loved Ones In Managing Their Emotions During Bypass Surgery Recovery Period

The caregiver can help their loved ones in managing their emotions during bypass surgery recovery period. Feeling sad or cold after a surgery is a common symptom, but it should pass after a few weeks. The person who is taking care of the patient should encourage their loved one to:

There are a few precautions for bypass surgery that can be taken to reduce the risk of getting heart problems in the future.

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Chest Pain After Open Heart By Pass Surgery

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What Happens After This Procedure

First Successful âOff Pumpâ?, âBeating Heartâ? Coronary Artery Bypass ...

After surgery, people who undergo CABG go to the hospitals intensive care unit . Staying in the intensive care unit is necessary because ICU staff have specialized training and experience that is better suited for people with specialized needs like those whove just undergone CABG.

Once a person is stable and a doctor feels theyre ready, they can transfer to a regular medical-surgical room in the hospital for the remainder of their stay. The average hospital stay for CABG is between 8 and 12 days .

After leaving the hospital, most people who have CABG will also complete a cardiac rehabilitation program. Often called cardiac rehab, these programs help you recover and rebuild your strength after intensive cardiac procedures or events like heart attacks. Cardiac rehab programs include specially trained and highly qualified staff. They usually include nurses, exercise physiologists, nutritionists and dietitians, counselors and behavioral health specialists and doctors.

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Causes Of Chest Pain After Bypass Surgery

During the bypass surgery, the surgeon has to incise the chest to reach the heart. In majority of cases a cut is made through the breastbone which is repaired with wire and metal plates after the surgery is over.

In most cases chest pain after bypass is due to trauma to muscles and bones of the chest. The pain is typically located near the incised area of the breastbone. It may be mild to moderate, boring and burning pain. Few medical conditions which may arise after the surgery may also cause pain in chest.

Myocardial ischemia sometimes occurs when the graft becomes occluded. It can give rise to pain similar to angina pain before the surgery was performed. Certain post operative complications such as pericarditis, pulmonary embolism, aortic dissection, pneumonia, and gastritis are few other causes for pain in chest after the bypass.

Management Of Chest Pain After Bypass

Patient should always report of pain in chest even if it is minor after bypass surgery. While in most cases, pain is due to manipulation of muscles, nerves and incising of the breastbone, there is high index of suspicion of myocardial ischemia even though it is rare after the bypass surgery. If the EKG and hemodynamics are stable and normal, doctors usually prescribe pain killers for pain management.

To reduce the incidence of pain, patient should stay active during the recovery period at home. Avoid sitting for long time in one place. Walking is a good exercise although in the beginning it may be slow. It helps the heart to lungs to get strengthen. Patient should also perform light household activities such as folding clothes, climbing slowly few staircases etc.

After few months patient should increase the intensity of activities. Avoid lifting any heavy objects, and exposure to extreme cold and hot weather. Avoid driving for 2 months after the surgery as it may aggravate pain. Sexual activity should be restrained for 2 months after the surgery.

Wear loose clothing and a brace around the chest as suggested by the physician. Wearing surgical bra helps to relieve pain in women. It helps to reduce the discomfort that is felt at the incision site due to the weight of breasts while lying down.

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Adopt Healthy Lifestyle As A Precaution For Bypass Surgery

Some of the precautions for bypass surgery that can be taken to help reduce the risk of any further health problems post bypass surgery are described below:

  • Healthy Diet as a Precaution for Bypass Surgery

    Choose a healthy diet as a precaution for bypass surgery. Chances of getting another heart problem post bypass surgery increases if a healthy diet is not taken. The diet should be low in fat, high in fiber and omega-3 that is a fatty acid that can help reduce cholesterol levels. A few types of food you should avoid are:

  • Sausages and fatty cuts of meat.
  • Pushing a lawn mower as a precaution for bypass surgery.
  • One should start exercising at a level which keeps them comfortable, if it is difficult to cove 150 minutes a week. Gradually the duration and intensity should be increased as your stamina and fitness starts to improve.

  • Lose Weight as a Precaution for Bypass Surgery

    One should always have a check on his or her body weight. It is very important to lose weight if a person is overweight or obese as a precaution for bypass surgery. It will reduce the future health problems of a person who has a healthy weight. Healthy diet and regular exercises can help you reduce weight. It is easier to shed those extra kilos from your body by following a weight loss program, like NHS weight loss plan.

  • Both the sexes are advised to not consume alcohol more than 14 units in a week.
  • Drinking should be taken in small amount at a time.
  • Risk Factors Of Chronic Post Sternotomy Pain

    Open Heart Surgery: What to Expect (English CC)

    In their study Laura van Gulik and colleague found that non-elective surgery, re-sternotomy shortly after the original surgery, severe pain on the third postoperative day, and female gender are independent predictors for the development of chronic thoracic pain . Allergy to the wire used for sternum closure, younger age, and the use of the IMA can be also considered risk factors . It has been suggested that the severity of acute postoperative pain and greater need for analgesics during the rst few days after surgery may predict future chronic pain. That reflects the importance of management of the acute postoperative pain for the purpose of disrupting the possible peripheral and central neural processes responsible for the transition to a chronic pain .

    Excessive sternal retraction can result in a trauma to muscles, bones, tendons and ligaments beside its effects on the brachial plexus. A local inammatory component will usually follow the surgery, in addition to a general inammatory response due to cardiopulmonary bypass .

    Preoperative anxiety, depression and catastrophizing , are associated with higher rates of chronic post sternotomy pain .

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    What Is The Recovery Time

    Most people who have CABG will need several weeks to fully recover from this procedure. During that time, your provider will likely have you avoiding any strenuous activities or situations that might put too much stress on your heart and incisions.

    Your healthcare provider is the best person to tell you how long it will probably take you to recover and what you should expect. Theyll also tell you when you can start resuming your regular activities like work, exercising, driving, etc.

    Can My Sternum Wires Cause Chest Pain Two Years After Heart Valve Surgery Asks Jake

    By Adam Pick on August 23, 2011

    I just received a very interesting question from Jake about chest pain, sternum wires and heart valve surgery.

    Jake writes to me, Dear Adam Its been 2 years since my aortic valve replacement operation. While my heart is doing great, I still have a very sensitive incision. There are spots along my sternum that, if I press on, cause a shot of pain. My chest also hurts if I twist in odd ways. Is it possible that the sternum wires are causing this discomfort. If so, can I get them taken out? Is that a big procedure? Thanks! Jake

    While I have my own thoughts on this topic, I wanted to provide Jake an expert opinion. That said, I contacted Dr. Lishan Aklog, the Chief of Cardiovascualr Surgery at St. Josephs Medical Center in Phoenix, Arizona, to learn more.

    So you know, Dr. Lishan Aklog has performed over 2,000 cardiac procedures of which more than 60% involved heart valve treatment. Dr. Aklog specializes in mitral valve repair with minimally invasive approaches.

    Dr. Aklog continues, If the bone is fully healed then the pain can simply be related to one or more of your wires. These can be removed. It does require surgery, usually a brief general anesthetic, but it is not a big procedure and most patients go home the same day or the next.

    Thanks to Jake for his question and a special thanks to Dr. Lishan Aklog for sharing his clinical work with our patient and caregiver community!

    Keep on tickin!

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    Management Of Chronic Post Sternotomy Pain

    It is essential to rule out important causes of chronic anterior wall pain such as myocardial ischemia, and mediastinitis in every cardiac surgery patient presenting with chest pain.

    The management of chronic post sternotomy pain requires a multidisciplinary approach that starts first with preventive measures that involves intensive perioperative psychological, medical, physical therapy, and second utilizing pharmacological and non-pharmacological measures aimed at preventing and treating the factors that increase the risk of chronic post stereotomy pain and associated negative consequences .

    The surgical therapy includes sternal wire removal which may be an effective treatment for pain in a subgroup of patients. If the pain persists after wire removal, referral to a chronic pain management specialist is recommended.

    Activities During Bypass Surgery Recovery Period

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    The patient has to be careful while choosing the activities during bypass surgery recovery period, he or she cannot do whatever they want and have to be very careful in performing certain activities. There are a few things recommended by the team of doctor and nurses taking care of you in the hospital and they will ask you to avoid during the first few weeks after the bypass surgery. In the beginning days after you have undergone the bypass surgery you will be allowed to do some light and easy things like cooking, walking short distances, playing board games & carrying light objects. After a longer period of the bypass surgery you might be able to do a bit tougher jobs like driving, vacuuming, carrying medium weight objects, carrying babies and shearing the lawn.

    If your job is not physically challenging then you might get back to your job in 6 to 8 weeks. Getting back to your job also depends on the complications that you may or may not have faced. Also if your job involves a lot of time involved in lifting and standing it is recommended to take off for a longer period of time or till the time you are perfectly fit for it. Taking rest is the most important key to bypass surgery recovery period. Also it is recommended that you take up all the activities slowly to get time for relaxing.

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    Major Side Effects Of Having Bypass Surgery

    There are side effects from all kinds of surgery. Bypass surgery may also make you experience some of the side effects after you have been discharged from the hospital.

    These side effects of during the bypass surgery recovery period may include:

  • Constipation, muscle or back pain is a side effect during the bypass surgery recovery period.
  • Having mood swings or feeling sad is another side effect of bypass surgery recovery period.
  • Difficulty in sleeping and getting tired.
  • Pins & needles or swelling at the point where the blood vessel graft was taken off.
  • Another side effect during bypass surgery recovery period is partial or complete loss of appetite.
  • One should be prepared that bypass surgery recovery period or the healing time following a bypass surgery will take weeks rather than just days. It is fine if you feel low or if you are having bad and good days after the bypass surgery. Side effects which are natural after the surgery will be temporary and will disappear in 4 to 6 weeks. Complete bypass surgery recovery period generally takes a month or so depending on the health conditions before the bypass surgery. Sometimes we feel that the ways things are going are wrong and that is when one should consult his or her doctor again.

    If you are experiencing these problems after the surgery and during the bypass surgery recovery period please seek advice from your general physician as soon as possible:

    What Is This Procedure

    Coronary artery bypass grafting is a surgery that restores blood flow to areas of your heart that arent getting enough blood. This surgery can improve your heart function and how you feel, especially when youve just had a heart attack or theres an increased risk for you to have one in the near future.

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    Helping Loved Ones During Bypass Surgery Recovery Period

    Helping a loved one during bypass surgery recovery period is a crucial time for the caregiver. At the time of discharge the doctor hands him or her and the person responsible for his or her care is handed a set of instructions on how to deal with bypass surgery recovery period symptoms. This also includes tips on what to do for the patients emotional and physical well-being.

    Chest Pain On Various Occasions During 15 Years

    Before and After Your Heart Surgery

    The high recovery rate from chest pain continued throughout the 15-year follow-up after CABG. However, the percentage of patients reporting chest pain increased slightly over time, from 44% after 5 years to 50% after 15 years . A higher percentage of chest pain was reported in most situations, with the exception of chest pain at rest, at night and after dinner, when no significant change was found.

    Chest pain on various occasions prior to and five, 10 and 15 years after the operation.

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    One Year After Heart Attack Chest Pain Remains For Many

    About 20% of heart attack patients experience angina one year after the major cardiac event, according to researchers who have published a new study in the June 23 issue of Archives of Internal Medicine.

    In both inpatient and outpatient settings, a primary goal of care after myocardial infarction , commonly known as heart attack, is to the episodic chest pain known as angina. There has been little or no research up to this point focusing on the prevalence and treatment of chest pain that occurs one year after MI. Author Thomas M. Maddox, M.D., S.M. and colleagues note that, By identifying these factors, a more complete understanding of those patients who are at the greatest risk for angina after myocardial infarction can occur. In order to treat remaining chest pain and improve a patients ability to exercise among other health-related quality of life outcomes, it is crucial for doctors to identifying this population who suffers the greatest angina risk.

    The study consisted of 1,957 patients who were selected from January 2003 to June 2004. Researchers asked patient to fill out surveys that included questions about chest pain occurring one year after MI hospitalization, sociodemographic information, and details about clinical and lifestyle factors.

    Angina one year after MI hospitalization was reported by almost 20% of patients . Daily chest pain was reported by 1.2% , weekly chest pain by 3% , and chest pain less than once a week by 15.6% .

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