What to Expect After Having Coronary Artery Bypass Graft Surgery as a Senior?

What to Expect After Having Coronary Artery Bypass Graft Surgery as a Senior?

According to the CDC (2021), coronary artery disease is the most common form of heart disease. Approximately 1 in 4 deaths in the United States are a result of heart disease.

So, it shouldn’t be surprising that one of the most common surgical procedures is a coronary artery bypass graft surgery (CABG). We are going to discuss in detail what a CABG is and what the procedure and recovery aspects entail.

What is a CABG and Why Is it Performed in the Hospital?

A coronary artery bypass graft (CABG) surgery is a major heart operation that improves blood flow.

In coronary artery disease, arterial flow is blocked by plaque build-up with constricts blood flow to the heart.

Plaque is commonly made up of fat, cholesterol, and/or calcium deposits and severe enough blockage can cause angina, shortness of breath and heart attacks.

During a CABG, the surgeon connects (or grafts) a healthy vein or artery to a blocked vein or artery so that blood flow can bypass the blockage and restore blood flow to the heart.

A CABG is performed when other treatment options and lifestyle changes aren’t effective.

What to Expect Post – Operatively in the Hospital After Having a CABG?

As mentioned previously, a CABG is a major surgical procedure which means patient should expect a strict recovery regimen to prevent complications.

After the patient leaves the operating room, the patient is admitted into inpatient care where they are closely monitored.

Inpatient services will include medication management, pain management, 24/7 medical care, and eventually rehabilitation services (i.e. physical and occupational therapy) once the patient is safe and appropriate to move out of bed.

What Are The Precautions After Having a CABG?

In order to access the heart, the surgeon will have to cut through the skin and the breastbone.

Another consideration are small venous incisions in other portions of your body where the surgeon had to extract a healthy vein or artery for the grafted bypass.

After completing surgery, patients will be expected to follow strict movement and sternal precautions for up to 4 to 6 weeks after discharge:

  • No lifting any objects greater than 7 to 10 lbs (varies depending on the surgeon)
  • No reaching backwards or twisting of the torso
  • Avoid letting anyone pull on your arms to help move you around.
  • No driving until permitted by your doctor
  • Have 24/7 help for at least the first 1 to 2 weeks post-op.
  • Follow your medication regimen and monitor your heart rate and blood pressure regularly
  • Take it slow but move around regularly to promote blood flow.
  • Avoid activities that require movement or reaching above shoulder height.
  • Shower if permitted by the doctor, but do not soak or bathe to avoid infection. 

What You Will Be Expected to Do When You See Physical Therapy and Occupational Therapy in the Hospital Post-Operatively?

Physical therapy and occupational therapy services are available in inpatient care within a matter of hours after surgery.

Both therapies will encourage the patient to participate in activities out-of-bed in a reasonable timeframe and when anesthesia effects wear off.

For inpatient rehabilitation, therapists will want to make sure that the patient can perform bare minimum activities before discharging from the hospital.

This includes walking a few steps with a walker, performing toileting tasks, and transferring in and out of bed safely.

Once the patient discharges home, the doctor may recommend in-home health and rehabilitation or outpatient cardiac-related rehabilitation to promote healing and recovery.

In that case, therapists will follow safety recommendations set forth by the patient’s doctor in order to help the patient move around their home with as little help as possible and in a safe manner.

After a few weeks, the patient may go in for follow-up appointments where the doctor will dismiss certain precautions (i.e. lifting and movement) so that therapy can proceed with upgraded exercises and tasks.

If You Are Not Able to Perform FADL’s Independently in the Hospital. Expect to Be Discharged to Either Acute Rehab or a Skilled Nursing Facility to Complete Your Rehabilitation

The recovery process will not look the same for every patient because some seniors will be going into surgery with comorbidity conditions that complicate recovery.

If a patient is unable to complete a certain set of basic activities in inpatient care before discharge, then the doctor may recommend that the patient transfer to transitional care or a skilled nursing facility for an extended rehabilitation stay.

This only happens if the medical team concludes that discharging the patient home would be unsafe.

What to Expect if You Are Able to Be Discharged Home?

If the medical team approves discharge for home, then expect a continuation of care through an in-home health agency.

Your doctor will talk to you prior to hospital discharge if you qualify for in-home health services and will have everything set up and scheduled before you arrive back home.

In-home services may include some or all of the following: nursing care, respiratory care (if supplemental oxygen is needed), and rehabilitation services (occupational therapy, physical therapy, and occasionally speech therapy).

Will You Need to Go to Cardiac Rehab as an Outpatient After Your CABG? What it Will Consist of and What to Expect?

When your doctor approves it, a senior patient may qualify to participate in outpatient cardiac rehabilitation services.

This is where the patient leaves the home and receives therapy services (physical and/or occupational) in an outpatient clinic a few times per week.

Therapy intervention will address overall strength, endurance, functional activity participation, and adaptations to cardiac precautions to promote full recovery from surgery.

 What Lifestyle Habits Should a Patient Adopt Post-Operatively After a Coronary Bypass Graft Procedure?

Your doctor may suggest making some serious changes to your lifestyle to prevent future surgeries, heart complications, hospitalizations, and death.

Recommendations may include alcohol and smoking cessation, limiting fat and sugar intake, increasing fruit and vegetable intake, participating in a regular exercise regimen, and the list goes on.

Each lifestyle change will depend on the individual and what the doctor may suggest to aid recovery.

A CABG is a major procedure that comes with a long recovery but provides patients with better cardiac outcomes that can completely revamp their quality of life.

Do your research and take proactive steps to ease your recovery and to prevent unnecessarily medical roadblocks so you can get back to your life as soon as possible.

Author: Samuel

Samuel is a physical therapist with over 20 years medical experience. He has extensive knowledge in functional rehabilitation in the acute care hospital and in-home care settings. He has spent most of his career helping seniors transition from hospital or rehab care to living independently at home. In his free time he likes to travel and read autobiographies.

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