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WHAT DO YOU THINK IF YOU ARE TOLD THAT YOU SHOULD HAVE CORONARY BYPASS SURGERY?

PROF. DR. HÜSEYİN OKUTAN

In the modern age, taking the current form of daily life conditions, prolonged life expectancy increased the frequency of coronary heart disease. We definitely have coronary heart disease in ourselves, a close relative or at least one acquaintance. Some of these patients came face to face with the issue of having coronary bypass surgery. It is correct to divide patients who should have coronary bypass surgery into two groups. The first group of patients are those with cardiac angioma due to their complaints and coronary bypass surgery is recommended. This patient group has time to get detailed information about the proposed surgery and to choose the center where the surgery will be performed, and therefore the physician to be operated.

The second group of patients were those who were admitted to the hospital with a sudden heart attack and were treated urgently. When coronary bypass surgery is recommended after cardiac angiography for these patients, the patient and family have a more limited time to think and decide. Preparing the patient and the family for surgery is very important in terms of being aware of the process and returning the patient to his former life after surgery. The surgeon who performs the operation due to intense daily functioning may not be able to allocate enough time for the patient to be operated on. For this reason, a patient profile, which does not have enough information about the disease, and who has concerns and fears about the surgery it will undergo, is formed. Ideally, in both patient groups, the physician should give sufficient time to the patient and explain his / her condition by answering his questions, if any. A patient with this chance would be better prepared psychologically for surgery. In addition, it should be clarified about when the patient can walk in the post-operative period, whether one of his physical activities will be restricted, whether there will be a change in lifestyle.

The operation of the patient, whose surgery is recommended, can vary from a few hours to a few days. Since this period is different for each patient, this period should be used correctly. Patients who do not have any additional problems are carried out within the first 24 hours after surgery and begin to be fed orally. Often the patient is taken to the room from the intensive care unit within a day or two. The patient, who can move freely in his room, is discharged to the 5th day home when there is no additional problem. It would be correct to call the patient's 6-week period after surgery as the preparation period for resting and returning to his routine life. During this period, heavy exercises and physical activities that will harm wound healing are not recommended. Postoperative medical checks can be done at week 1, week 2, month 1, month 3 and month 6, depending on the physician's will. In patients who have had coronary bypass surgery, even if everything goes well, it is appropriate to perform a check at least twice a year. In our next meeting, we will cover the daily life, changes in our lifestyle, and exercise plan after coronary bypass surgery. What should be the daily life after coronary bypass surgery? Regardless of age, a person who has undergone coronary bypass surgery may have to make some changes in his daily life. It is the boiling process of the breast bone, which is known as the 6-week early sternum after the surgery and is known by the public as the board of faith. In this period, in order not to put a heavy load on the breastbone; lying down, lifting heavy loads, and heavy exercise are not recommended. It would be correct to call this period the recovery period after coronary bypass surgery and preparation for life after surgery. If there is no special and mandatory situation in this period; we do not follow a heavy diet. We also recommend walking as an exercise. If there is no problem in wound healing of the patient 6 weeks after coronary bypass surgery, routine life can be started before surgery. During this period, it is necessary to make different recommendations for each patient. First of all, the patient's heart functions, namely the power of contraction, should be taken into consideration after the operation. This is a lucky situation if the heart's contraction functions have been operated without impairment. There is no need to go to exercise restriction in these patients. However, if there is a decrease in contraction power or if the entire problem cannot be corrected by surgery; heavy exercise is not recommended. For this reason, a patient who has surgery should ask the doctor if his condition causes a deterioration in heart function. Another question should ask if he has a heavy job or if he can exercise hard. To explain this issue as an example, when the contraction functions of the heart are intact, when all the narrowed or blocked vessels are bypassed, after the recovery period, the patient can even do heavy work such as construction work, shepherd, factory work. However, if the heart attack has caused serious damage to the pumping power of the heart, these patients are not allowed to do such heavy professions. Briefly, postoperative profession practices, how much the patients' heart functions are protected and performed