Heart bypass surgery is a coronary artery bypass graft, or CABG, in which a vein from the leg or the side of the chest wall is grafted into the cardiac artery network. Your physiotherapist will supervise a program of post-operative exercises to reduce the post-operative risks of chest infection, deep vein thrombosis or pulmonary embolus. She will include leg exercises that you can do while lying on your bed or sitting in a chair early in your recovery, and she will encourage you to walk as much as possible.
ICU Recovery
After surgery, you are transferred to the intensive care unit for monitoring for about 24 hours. After you wake up, a physiotherapist carries out passive exercises on your hips, knees and ankles, and supervises gentle resistance exercise such as encouraging you to push your foot against her hand, or pull it away from her grip. Your compression stockings are designed to provide extra support to the lower veins in your leg and to encourage venous return, and you should circle your feet and ankles, clockwise and counterclockwise, to help promote blood flow and reduce any edema.
Back on the Cardiac Ward
The physiotherapist helps you walk until you feel confident in doing this alone. It's natural to feel unsure initially, and you will feel extremely tired. Stretch your legs frequently while lying on your bed, alternately pointing your foot and stretching your ankle. Feel the pull in your leg muscles. Draw one knee up slowly, then down, repeat five times, and repeat with the other leg. Circle your feet and ankles five times clockwise, then counterclockwise. The more confidence and strength you gain each day, the more you will be motivated to walk as much as possible.
Exercising at Home
Even after a hospital stay of four to six weeks, you will feel exhausted upon returning home. Nap when you need to, but ramp up your daily walks without wearing yourself out. Build up by a few minutes each day until you are able to walk for an hour. Tell your doctor if you develop shortness of breath, pain, dizziness or nausea, and wait to be re-assessed before continuing with your walking schedule. Continue with your leg stretching exercises for flexibility and competent venous return, and continue wearing your compression stockings.
Building Up Your Exercise Schedule
Abstain from any intensive exercise such as resistance training at the gym or clambering up mountains until you are four to five months post-operative. In the meantime, build aerobic exercise into your week and be guided by your surgeon in what you include. Continue a daily schedule of general stretching, walking, leg and foot stretching and rest. Report any pain, breathlessness, dizziness or sleep disturbances to your surgeon. Don't overdo things.
Maintaining Good Exercise Habits
Dr. Steven Grover of McGill University says that many post-operative CABG patients lose impetus after nearly 12 months and drop their regular exercise schedules. Keep in regular contact with your doctor throughout the coming months so she can monitor your general and cardiovascular health. Talk through any concerns or lack of motivation. Depression can creep up on you, and this is understandable, given the life-changing effect on you and your family of cardiovascular illness and major surgery.
Long-term Cardiovascular Health
Commit to regular exercise, a healthy diet, regular rest and sleep, and a determination to stay as fit as possible. Work with your doctor. See yourself as part of the team that helps you maintain your physical and cardiovascular health, and take responsibility for monitoring your daily and weekly health and psychological wellness. Stress or anxiety management might be useful tools to add to your armory, together with a commitment to yourself not to allow work, stress or bad habits to lead to a deterioration in your general health and well-being.
References
- BUPA: Coronary Artery Bypass Graft (CABG)
- BUPA: Compression Stockings
- American Heart Journal: Aerobic Interval Training Versus Continuous Moderate Exercise After Coronary Artery Bypass Surgery
- Second Virtual Congress of Cardiology: Psychological Needs of Coronary Artery Bypass Surgery Patients
- Perspectives in Cardiology: After the Bypass: Keeping Your Patient Healthy
- American Heart Association: Resistance Exercise in Individuals With and Without Cardiovascular Disease
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