Swelling of the legs after shunting
Coronary bypass surgery - heart surgery, in which one or moreblocked arteries are shunted with a vascular graft (shunt). This is done to restore normal blood flow in the arteries of the heart. Vascular grafts (shunts) are taken from the patients themselves - these are their own arteries and veins located in the chest wall (internal thoracic artery), in the leg (the large saphenous vein) and in the arm (radial artery). The shunts bypass the place where the coronary artery is blocked, and deliver oxygenated blood to the blocked area. The operation reduces the symptoms of angina and reduces the risk of heart attacks.
The whole operation lasts about 4 - 5 hours on average,depending on the number of arteries that need to be bypassed. After you fall asleep under anesthesia, surgeons secrete veins and prepare arteries for use as shunts.
There are several types of vasculartransplants (shunts), which are used to bypass the coronary arteries. The surgeon determines which kind of shunt you need. Most often for this, the internal thoracic artery (the so-called "mammaria") is used. The radial artery is another widely used arterial transplant (shunt).
If the radial artery is used in the form of a shunt,the patient in the postoperative period may need to take calcium channel blockers for several months after the operation. These drugs help keep the artery open. Sometimes after surgery, there is either numbness in the hand, or loss of sensitivity in the restricted area. But this is a fairly rare and rapidly occurring phenomenon.
After the shunting of the shunts is complete,the device of artificial circulation is turned off, the heart starts to beat independently and the circulation returns to normal mode. Before closing the chest with a special wire to the heart, temporary electrodes are attached for electrostimulation and drainages are installed. Then, the skin and subcutaneous tissue are sutured. Sometimes it is necessary to connect a pacemaker to the electrodes for electrostimulation of the heart, until it completely regains its own rhythm.
Patients are transferred to the intensive care unit for continuous monitoring on average for 2 days.
Before you leave the hospital after the operation, you will be told how to behave in the next 2-6 months.
If the stitch heals well and is dry, then you cantake a "quick" shower (no longer than 10 minutes). If the seams on the chest are not yet removed, stand with your back to the soul. You can take a bath, but do not sweat it, but wash faster.
Water should be warm - not hot and not cold. Extreme temperatures can cause fainting.
Wash the seam with ordinary soap, without perfumes and additives, andnot gel. Wet your hand or washcloth with soapy water and gently walk up the seam area up and down. Do not rub the seam with a washcloth until all the crusts come off and the wound completely heals. Do not lubricate it with any ointment, if there was no doctor's prescription.
Immediately consult a doctor if signs of infection have appeared: the wound separated from the wound, the edges of the wound parted, the stain red and swollen, the temperature rose above 38 ° C.
First time with active movement you willfeel discomfort in the muscles of the chest, in the area of the seam and chest. Itching, a feeling of stiffness in the area or a violation of sensitivity are normal after the operation. Anesthetic and anti-inflammatory drugs will be prescribed before discharge.
In addition to the painful sensations in your chest, you will feel discomfort for a time in the place where you took the vein for the shunts. Daily walks and moderate activity will help to cope with this.
Be sure to see a doctor if you have any stiffness in the sternum or snapping in the sternum during movement.After the operation on the legs for a while there will be a slight puffiness, especially if the vein for the shunts was taken from the foot. To combat it, use the following methods:
- During leisure, try to keep your foot high. When you lie down on a sofa or a bed, place a few pillows under your feet. It is also useful to lie on the floor, on some rug, and put your feet on the sofa. If you do this regularly, edema will decrease noticeably.
- If before surgery you are accustomed to sit on your leg, now is the time to give up this habit. And try to go out for walks every day, even if your legs ache and sweat.
- Use compression jersey.
But if the puffiness on the legs increases sharply and soreness appears, especially along with shortness of breath while walking, contact your doctor as soon as possible.
Your doctor will tell you how long it takes to takedrugs - at first or for life. Do not show unnecessary and dangerous initiatives, taking without a doctor's knowledge nutritional supplements or antibiotics in case of a cold. And strictly observe the dosage of already prescribed medications.
After returning home do not rush to immediately return to full load. You need to increase it gradually. You can do light work at home, but do not stand in one place for more than 15 minutes.
You can not lift weights more than 5 kilograms,pull or push heavy objects. You can raise your hand if you need something to get from the shelf or comb your hair. But you can not hold your hands too long.
At occurrence of even insignificant weariness there and then have a rest. Do not be zealous with walking on the stairs, it is enough to one descent and one rise.
Do not overexert yourself - distribute the load evenly for the whole day. Walk every day. Your doctor or rehabilitation instructor will explain in detail how much and how to walk after returning home.
The recovery period usually lasts 6-9 weeks. Return to work can only with the knowledge and permission of the doctor.
If you have a car, the doctor will say when youyou can again get behind the wheel. This will happen no sooner than your sternum begins to grow together and the reflexes are fully restored. This usually takes up to 9 weeks after the operation.
How to deal with sexual life after surgery ona heart? It is not forbidden. However, remember: the energy required for sexual intercourse is equal to the energy expended for climbing one or two flights of stairs or walking a distance of about 1 km at a fast pace. If such a load causes you fatigue and shortness of breath, then with sex you should not rush. And try to choose the positions with the least strain on the sternum, arms and chest. Be realistic - you will take time to return to a full and active sex life.
It is very important to have enough rest to avoidoverwork. Unfortunately, many patients after the operation are disturbed by sleep. Normal sleep will return in a few weeks. Consult your doctor if a lack of sleep affects your behavior or normal sleep is not restored.
After the operation, depression may well occuror nervous tension. Temporal decline of mood is a normal phenomenon, which will gradually come to naught when you are drawn into your ordinary life and work. Negative emotions can be associated with fatigue, even from a small load, which in the postoperative period is quite natural - because your body is restored.
However, if a depressed mood every daydoes not weaken, but only intensifies, consult a doctor. Many patients get frustrated because they feel worse memory after surgery, and sometimes a decrease in intelligence. This is normal after cardiac surgery. The whole organism, including the brain, experiences severe stress during the operation. Over time, everything will be restored, do not be discouraged. You should not torture yourself, if at first you think that you need to immediately restore the old form. Avoid mental strain.
Immediately after discharge from the hospital, you mustaddress to the cardiologist on a residence. You need to do this even if nothing disturbs you. The specialist will monitor the progress of your recovery. He will determine the time when you can start working.
Refuse from smoking. Watch for cholesterol, blood pressure and weight.
After the operation, you will be reduced for a whileappetite. This is an additional reason to eat more often, but in smaller portions. Everything will go back to normal in a few weeks. A special diet is not required, but because of the reduced activity not gain weight, you need to adhere to some rules.
Eat slowly and chew your food well. Almost everyone eats too fast and inThe result eats more than he needs. If there is a slow and diligent and long chew, then much less food will enter your stomach. After all, in order for the brain to signal the stomach that you are no longer hungry, it takes about 20 minutes. The signal to stop eating depends on the amount of nutrients in the blood, and not on the amount of food in the stomach.
If the food is badly chewed, it will be baddigest. And in this form it does not represent any value, turning into waste, adding toxins and an already overloaded digestive system
The longer and more thoroughly the food is chewed, theit is better to digest and the more nutrients that result in the body. In addition, along with saliva, special digestive enzymes are released that serve to break down food, as a result of which the stomach and intestines will work with less stress.
From the "speed" of the snack depends on our mood. If we eat hastily, and still experience mental stress due to some extraneous reasons, the process of digestion will never proceed properly. Strongly influenced by the process of digestion are various emotions, such as anger, fear and grief. So if you are experiencing mental stress or some negative emotions, it is better to refrain from eating altogether. Always try to make sure that the meal takes place in a calm, pleasant atmosphere and you will have a good mood - this is especially important after your operation.
If you experience discomfort in the stomachor the intestines, try to eat an apple or a piece of orange. A good effect is provided by green tea, especially with the addition of mint. And the slow walk after eating is also great.
Eat a little less than you need. We should eat just as much as the body needs, and not a gram more - otherwise all the excess will remain in the body in the form of fat, which after your operation is completely undesirable.
In today's world people eat a lot, and their bodyat the same time, constantly receives less important nutrients. Products from the "Top Twenty" our body can digest and assimilate in the best way, but with them it is necessary to observe moderation.
Laboratory studies in animals have shown,that animals who received food less than normal had better resistance to all sorts of diseases and longer life expectancy than those who overeated. This does not mean that you need to constantly be malnourished or give up all culinary attachments. Simply need to eat in strictly necessary quantities and, accordingly, energy expenditure.
The reason for overeating is also that ina modern diet on the principle of "fast food" includes foods that are for the most part deprived of the necessary nutrients for the body: vitamins, mineral compounds and enzymes. And when the cells lose these nutrients, they signal the need for additional portions of food. So overeating is a direct consequence of a shortage of essential nutrients.
In addition, overeating causes the digestive systemsystem to work with a huge voltage, which requires the body to increase energy consumption. As a result, for several hours after eating, a person feels tired.
As soon as you switch to proper nutrition, youvery soon notice how little food is actually required for normal health. And then after a meal you will feel a sense of satisfaction, not discomfort. And within a few hours after eating, you will not feel hungry, which will allow you to give up the usual but unnecessary snacks.
Diversify your diet. Consumption of many different foodsIs a guarantee that you will receive all the necessary nutrients, including vitamins and mineral salts, which will help your body recover more quickly after the operation.
A good way to create a variety is to changethe colors of the foods you eat. It is also useful to eat several kinds of vegetables and fruits at once - if you have products of different colors and shades on the plate, you will create the effect of diversity. The bright color of a fruit or vegetable speaks of its high nutritional value.
Do not skip the next meal. Breakfast is best never to miss. If you refuse breakfast, during the day it will affect your mood, energy reserve and mental abilities. Usually a person who does not have time to have breakfast likes to take a break for coffee, while satisfying the hunger with cakes, rolls and sweets. He who skips breakfast, overeat at dinner, and as a result, the rest of the day struggling with drowsiness and a sense of fatigue. You can not skip dinner. Because when it's time for dinner, the missed dinner is ready to swallow everything and at great speed. In addition, if you miss lunch, by the end of the day the blood sugar level drops significantly, and with it your vital tone also falls.
Food should be taken at certain times. If you eat, when you have to, it will leador to what you will have to eat when the body does not need food, or you will start eating when the onset of hunger becomes intolerable. As a result, you will eat much more than you need for saturation. And if the hours of the meal are always the same, everything will come in the right quantities and on time.
This does not mean that you must eat 3 times a day. Sometimes it is better to eat 5-6 times, but little by little, not 1-2 times, but before dumping.
Always be moderate in food. In your postoperative diet moderation -key moment. Any excesses are inadmissible. Do not become a fanatic and limit yourself to only one category of products. Even if you are very fond of fruits and vegetables, this does not mean that you must adhere to strict vegetarianism. After all, all categories of food are important. All sorts of random disruptions and violations are permissible, unless, of course, they are of a regular nature and do not become a habit with time.
If you decide to make some changes in your diet, do it gradually. Give the body time to adjust to them.
If you from time to time will deviate from the system of proper nutrition, do not panic. Not everything is lost yet. Just try to get back to her as soon as possible.
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