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What are my limitations after heart bypass surgery?
Exercise and resumption of daily activity following surgery should be carefully directed by your primary physician. In general, however, you may resume self-care and household activities as tolerated, being careful not lift objects heavier than 20 pounds for the first six weeks. Any exercise program should be carried out in a controlled setting initially immediately following bypass surgery, preferably in conjunction with a "cardiac rehabilitation program". I advise my own patients that walking or running alone does pose some risk, and that working out in a healthcare facility or exercise club, or walking or jogging with a companion provides an element of safety. Most health clubs and many individuals are trained to administer CPR in an emergency situation.
Following bypass surgery, the patient should exercise either by walking or using a stationary bicycle to achieve a heart rate equal to the resting pulse plus 20 beats per minute. Increase the time gradually to 30 minutes per session over a period of weeks, exercising three to five days a week. Avoid extremes in temperature and terrain.
One of the most frequent concerns of patients following coronary artery bypass surgery is the leg incisions from where the vessels were "harvested" for the bypass. It should be noted that it may take several months for these leg wounds to fully heal, and the patient should be given written instructions from either the physician or "cardiac rehab team" as to how to manage the leg incision.
Another common concern is pain control. Due to the nature of the surgery, itself, most patients experience more pain after bypass surgery than those who have undergone a general surgical procedure. The patient should clearly understand how to differentiate between pain from the incision and possible pain coming from low blood supply to the heart muscle following bypass. If there is any concern, the patient should contact the physician's office.
At about four weeks following bypass surgery, your physician should obtain a maximum exercise stress test to determine your progress. Sexual activity may be resumed once you are able to go up and down two flights of stairs without resting.
At about three months following bypass surgery, if your exercise stress test was unremarkable, there should be very few limitations on activity, and an exercise program of increased physical activity is considered important. However, it should be noted that a patient's greatest risk of having a heart attack or sudden death following bypass surgery may be during heavy exercise and, again, such activity should be carried out in a supervised environment.
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