LOOKING AHEAD AFTER BYPASS
By Dr. Kesava Dev
Till not long ago, having a bypass surgery meant being a semi invalid for at least a month, followed by a long convalescence period and a somewhat scared existence, wondering when the time bomb will go off.

Fast track recovery
Patients can take comfort from the fact that many things have changed. Now the accent is on a fast track recovery, with early return to work and productive life. With younger patients being affected, it is essential that patients get back to work so that their jobs and income do not suffer.

Role of the surgeon
Surgeons try to improve the early recovery and the long-term results of their operations in various ways, thus benefiting patients. It goes without saying that good technique and excellent post-operative care contribute in large measure to the recovery of patients. There are also several techniques, which help.

'Beating heart surgery' or 'Off Pump Surgery' is one technique by which surgeons improve early recovery, especially in high-risk cases. 'Multiple Arterial Grafting' is a technique to improve the long-term patency of grafts. 'Sternum sparing approaches' in some patients will enable them to get back to full activity in a short time. Finally, the development of Robotics and Endoscopic approaches will in future make bypass surgery truly 'minimally invasive'.

The initial days
The first few days after the surgery should see a gradual return to normal activity. Patients should be initiated into a programme of graded, increasing activity, initially with walking and some simple stretching and relaxing movements. Before leaving the hospital almost all patients should be able to comfortably climb a flight of stairs. Even after being discharged it is important to remain active and ambulant. It is important to eat reasonably well during this period to get over the initial feeling of weakness after the operation.In addition to cardiac drugs, painkillers are to be taken to prevent wound discomfort for a couple of weeks.

Driving can be resumed after 6 to 8 weeks. Lifting of heavier weights should be avoided for the first three months, by which time the bones would have healed and would be able to take any load.

By far the most important thing is to be occupied in doing some work or activity. People who are mentally occupied recover the soonest and with the least difficulty.

Later life: If you have had or are about to undergo a bypass surgery, there is no doubt that you need and deserve tender loving care (TLC). But what you really need is another type of TLC namely 'Total Lifestyle Change.' This will not only make you feel better, but also retard and possibly halt the relentless progression of the disease called atherosclerosis which is the cause of arterial blocks.