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All coronary bypass surgery in Saskatoon Health Region is performed
at Royal University Hospital in Saskatoon.
What is Coronary Bypass?
The surgeon takes a blood vessel form another part of your body
(usually a vein from your leg or an artery from your chest) and
bypasses the narrowed or blocked coronary artery. This bypass is
also called a graft. One or more grafts may be used depending on
the number of arteries that are blocked.
The Day Before Surgery
- You will have a x-ray, E.C.G. (heart tracing) and some blood
work done prior to your surgery.
- You will have a physical examination by the doctor who works
with your cardiac surgeon.
- These tests and questions ensure a better diagnosis, better
all round care and help to make a plan for your own needs and
progress.
- The physiotherapist will visit you and teach you to do proper
breathing, coughing and leg exercises. These exercises are very
important in your recovery. The staff nurse will provide you
with a videotape about these exercises before your surgery.
- A nurse is also available to go over the teaching program for
cardiac surgical patients. You will have an opportunity to ask
questions and discuss concerns.
- The anaesthetist (the doctor who puts you to sleep for surgery)
will visit you in the afternoon before your surgery.
Preparation Before Surgery
- You will take a bath or shower the evening before and the
morning of your surgery using a special soap to ensure your skin
is very clean.
- You will be offered an evening sleeping pill.
- An enema may be given in the evening.
- You will be allowed to eat and drink until midnight the evening
before your surgery. Usually nothing by mouth is allowed after
midnight or early morning depending on the time of your surgery.
The Day of Surgery
- You will receive a hospital gown to wear to the operating
room. All jewellery, make-up, finger nail polish and prosthesis
must be removed before going to the operating room.
- You will be given some medication the morning of your surgery.
This will help you relax. You will be asked to stay in bed following
this medication.
- Nasal oxygen will be started. (A tube with oxygen is put in
your nose).
- You will be taken to the “holding area” (a waiting
area) by stretcher. It is near the operating room. A nurse will
greet you there, check your name band and put on E.C.G. patches
and a blood pressure cuff in preparation for monitoring.
- The anaesthetist who visited you will start an intravenous
in a vein in your arm and give you some medication to put you
to sleep.
After Surgery
After your surgery you will be taken to the surgical intensive
care unit on the ground floor next to the operating room. A nurse
will be with you at all times. You will stay in the intensive care
unit for about 24 hours. You will have some tubes and machines
connected to you to help your recovery. They include:
- A tube in your mouth to help your breathing for the first
little while. It is connected to a respirator. It is usually
removed a few hours after your surgery and replaced with an oxygen
mask. The oxygen mask will be replaced with nasal oxygen.
- Intravenous into the vein for fluids for approximately 24 hours.
- E.C.G. patches on the outside of your chest to read the heart
beat.
- A tube to your bladder to drain your urine. This is in place
for about 48 hours.
This sounds like a lot of equipment, but it is necessary and it
is not long before it is all removed.
After the breathing tube has been removed you have to do deep
breathing and coughing exercises. The physiotherapist and nurse
will help you and support your chest while you do the exercises.
You must do the exercises every two to three hours for about three
to four days in order to prevent pneumonia.
The morning after surgery you will usually be sitting up on the
edge of the bed and begin taking fluids like juice, milk or water.
Your family can visit you in the intensive care unit for short
periods of time.
Unit 6000
Once you leave the intensive care unit you will be transferred
to unit 6000 on the 6 th floor of the hospital. Your care will
continue, but you will become more independent. You may have oxygen
and an IV for medications, but you will require less intensive
care.
Approximately two days after your surgery you will be sitting
up in a chair and going for short walks. Your activity will gradually
increase. Within four to five days after surgery you will be able
to walk the length of the hall, two to three times a day.
For the first week after surgery it is normal to have less of
an appetite. You will be going home approximately five to six days
after surgery.
Before Going Home
- You will receive a medication prescription from your doctor
on your day of discharge.
- A pharmacist or nurse will review your medications with you
and give you an information sheet about your medications.
- A dietitian will teach you about a low cholesterol diet and
give you an information booklet to take home with you.
- You will receive videotape about your recovery at home that
covers care of incisions, activity and diet.
- The Tri-Hospital Cardiac Rehab Program Nurse Educator will
visit you to discuss future activities and lifestyle modifications.
Education and exercise classes at the Saskatoon Field House are
available after you go home. You can take an active role to prevent
further coronary artery disease.
- An appointment card will be given to you to see your surgeon/cardiologist
six weeks after you are discharged from the hospital.
Guidelines to Follow After Cardiac Surgery
General Guidelines for the First Six to Eight Weeks
Your strength and energy will gradually return if you gradually
increase your activity and exercise and follow a well-balanced
diet. Remember to stop and rest when you get tired.
- Avoid extreme hot or cold temperatures and windy weather
- Avoid exercise that requires extreme exertion or encourages
breath holding such as pushing or pulling heavy objects (shoveling
snow, lawn mowing, vacuuming) and exercise bikes with tension
- Avoid constipation
- Avoid lifting or carrying packages over 20 pounds (groceries,
laundry, furniture)
- Avoid exercising for one hour after a heavy meal
Use a regular exercise routine. Select an exercise program that
is suitable for you and choose activities you enjoy.
Specific Guidelines for the First Week at Home
- Stair climbing as tolerated
- Rise at your usual time in the morning, dress and be up most
of the day
- Carry on the same activity level reached in the hospital and
rest when tired
- Walk 10 to 15 minutes, two to three times a day
Specific Guidelines for the Second Week at Home
- Assist in light duties around the house – dusting, dishes,
folding laundry
- Increase exercise/walking to 20 minutes one or two times a
day
- Outdoor walking is good, unless it is very windy or cold. If
available, walk in a shopping mall.
- It is appropriate to resume sexual activity when you feel ready.
A good guideline to use is when you are able to climb two flights
of stairs without stopping.
Specific Guidelines for the Third Through the Sixth Week
at Home
- Increase your walking and/or exercise time to 30 minutes one
or two times a day
- Driving a car may be resumed after about four weeks, unless
otherwise advised
- Continue resting after meals
Consult Your Physician About the Following
- Resumption of work, part-time or full-time
- Participating in sports, social activities like golfing, bowling,
curling, etc.
- An exercise program for body conditioning, if you are not already
participating in one
Diet
It is very important to follow a well-balanced diet. Refer to
the diet instructions you were given before you were discharged
from the hospital. You may have alcohol in moderation (one to two
drinks per week), unless you are taking medications that require
you to refrain from drinking alcohol. Discuss your diet with your
physician. Your appetite may take a while to come back to what
it was before your surgery.
Personal Hygiene
Shower or sponge bath and avoid extremes in water temperature.
It you have a leg incision, showering for a few weeks is safer
and easier than getting out of a tub. Keep your incisions clean
with mild unscented soap. If there is any increase in redness,
swelling or tenderness notify your family doctor.
Smoking
Smoking is extremely dangerous to your heart and lungs. It should
NEVER be resumed. To resume smoking increases the chances of your
heart disease progressing. Nicotine causes your heart rate and
blood pressure to rise, increasing the workload on your heart and
stress on your lungs.
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