Living With Heart Disease
Living With Heart Disease
Rose Marie Robertson, MD, FAHA, FACC, FESC (Chief Science Officer and Past President of the Board of American Heart Association) gives expert video advice on: How long will it take me to recover from heart surgery?; How else can I aid my recovery from a heart disease?; How should I exercise if I have a heart disease? and more...
How long will it take me to recover from heart surgery?
Recovery after heart surgery depends to a great extent on exactly what your particular surgical procedure was like. In the simplest case, for example, bypass surgery, patients are often in the hospital only 4 or 5 days after surgery. You may go home feeling clearly still somewhat sore in the chest, finding that you have to hug your chest with a pillow to be able to cough comfortably and still needing some pain medication. But in fact, you'll find that you progress remarkably rapidly and even if you've had a chest incision through the breastbone, which takes some time to heal, usually about 6 weeks for a bone to fully be healed. And you'll have some soreness there. You'll find that day by day you're gradually able to undertake more activity and feel comfortable doing it. You don't want to push beyond where you feel comfortable. An important thing for the family to realize, is that you shouldn't lift heavy things in those first days at home, but that you can't do damage to the bypass grafts. People often worry about doing something or tearing them loose or injuring the grafts. And in fact, your activity at home really cannot hurt the grafts. They're in there and they're very, very well protected.
What are the long-term results after a bypass graft surgery?
Bypass surgery has very good long-term results in that the arteries and veins that are used tend to stay open for many years and provide good blood flow to the heart. However, it's not quite as good as if you were born again with new arteries. You don't get to start back at childhood. The arteries and veins in your body have been exposed to the same influences that your own arteries and veins were and even if they don't have narrowings at the time they are put in, they are prone to close up over a period of years so it is very important to keep the risk factors under very good control after bypass surgery just as it is if you have any sort of coronary disease, any sort of procedure or no procedure at all. In particular, it is important to be certain that cholesterol and blood pressure are under good control, that smoking is cessed and that physical activity and maintaining lean body weight are controlled. It is also important to continue to take medications as your physician prescribes them.
How often will I need to follow up with my doctor after having heart surgery?
When you go home from the hospital after heart surgery, your surgeon will have given you an appointment or asked you to make an appointment to come back and see them in the office to be certain that everything is well with your recovery. Generally, one visit with your surgeon is all that is required, after that, you return to the care of your cardiologist and ultimately to your internist or family practitioner. The cardiologist will probably want to see you at intervals over the next several years and perhaps throughout the rest of your life. This is so that they can be certain that everything is being done that should be to reduce your risk, that your recovery is good and that you do all you can to prevent yourself from having any further events in the future.
How else can I aid my recovery from a heart disease?
In recovering from heart disease, for example, from a heart attack, it's important to work with your health care provider to make certain that you're including all aspects of things that will benefit you in terms of recovery. Cardiac rehabilitation, for example, where you have an increasing gradual exercise program, is an important facet of recovery. Along with that, often at the same place that cardiac rhabilitation is done, is counseling about how to think about heart disease, how to incorporate prevention into your life, how to fit those preventive aspects into a lifestyle and make it a kind of lifestyle you and your family can adopt. Those are all very important things to do, in addition to following the medication advice that your physician prescribes. It's important, as well, for certain, to be aware of the psychological effects of disease. It's common to become depressed after a heart attack, after a major life changing event, such as that. And it's important to talk about that with your physician or health care provider as well, because we can, in fact, provide assistance. It's also often helpful to talk to your spiritual counselor and get advice there. So it's really very useful to reach out to the people around you that you would normally reach out to in any life changing event and get the support that you need, from not only your health care professionals, but from your community as well.
Is it common to suffer from a second stroke?
In any of those circumstances, it's important to realize that having had one event does mean you're at higher risk than the next person who hasn't had those symptoms. You're at higher risk to have a second event. Now, we can do a great deal to prevent a second event and to be sure you don't have it if we look at all the risk factors for stroke, and make sure we control each one as perfectly as possible. So that includes all the risk factors for atherosclerosis, like high blood pressure, high cholesterol being obese or overweight, being physically inactive, having out of control diabetes. And it includes the risk factors specific to stroke such as: atrial fibrillation, or sickle-cell disease, or other heart defects that make you prone to have clots that we can control those as well, but if we do all that we can to control those, we can reduce your chances tremendouly of ever having a second event.
How will heart disease impact my children?
Heart disease will impact your children. The predispositon for heart disease is inherited in many cases, not in all, but in many, so it's important to think about your children if you have heart disease. Your children share the same environment that you do, but they also share your genes. They're not carbon copies, you certainly know that. But, in fact, they do have some of the same genetic predispositions to high blood pressure, to high cholesterol, and whether those will develop fully in them or not is something you can't know at this time. If you've already demonstrated that you have coronary artery disease, it's important to make sure that your children have the best chance to avoid it. And so it's important to model to them a healthy lifestyle in terms of diet and exercise, and it's important to model to them as well the benefit of having a health care provider who helps you manage your risk factors. So modeling a good relationship with that health care provider is quite important. It's important to be certain that your children don't already have problems that might lead them to have coronary artery disease, and you'll want to talk to your doctor about whether your particular problems are likely to be inherited. You also want to be certain that if you look around your family and see, for example, a family of people who are overweight and obese, that you're talking, not just about a genetic predispostion, but perhaps an environment in which food is provided to an extent that's excessive or exercise is too little, and you may want to correct those risk factors as well for your children.
How will heart disease impact my sex life?
In general, people who have had a heart attack can engage in sex life again after the heart attack just as they could before. Many patients with stroke can also. And in fact, the American Heart Association has brochures and pamphlets to give you advice on that. And you can call our 1-888-my-heart number to get advice about that and to get information you can read at home. Generally after a heart attack, by the time that your exercise ability is such that you can climb two flights of stairs without being short of breath or having chest pain, it's fine to engage in sexual activity with your usual partner, and you shouldn't be afraid of sexual activity at that time.
How will heart disease impact my partner?
Heart disease like many other conditions, affects the whole family. And it's important to realize that your partner will be affected by your heart disease just as you are. In many cases, partners feel guilty for not having provided a healthy lifestyle or circumstances in which you could have avoided heart disease. Partners often are worried about you. Partners often feel that you are more fragile than in fact you are. And it's important to let your partner, as well as yourself, have a good relationship with your health care provider, so that all of those issues can be talked out, and everyone can be comfortable about what your activities are and what your lifestyle changes may need to be. It's particularly important that you take responsibility for your health care and lifestyle and not count on your partner to do that. For a partner to be put in the circumstance of nagging you to do things, it'll almost never work. Partners often feel like they need to do that if they see you slipping off to get that extra piece of pie or not exercising. Your partner may feel that they are guilty if they don't remind you to do that. But, you know, grown ups don't like to be told what to do. You won't want to be told what to do and your partner will be in an awkward position if they try to do that. Hopefully your physician will give your partner advice about leaving the decisions to you. They are, after all, your decisions. You're the one in control and in charge of your life. The partner can be a support, can be a help, but don't count on them to make decisions for you.
Can heart disease be cured?
There are some forms of heart disease that can be essentially cured. Some heart rhythm problems, for example, after a procedure, may never come back again and you may never have any effects from them for the rest of your life. Some operations that can be done, particularly with children with congenital heart defects, will leave them without really any residual over the course of their lives. On the other hand, the great majority of heart disease, particularly coronary artery disease, arthrosclerosis effecting the heart and valvular heart disease, will have some effect on you for a long period of time and perhaps forever. The fact that we can't cure it - that is, we can't make it absolutely go away - doesn't mean that you can't live a perfectly happy and content life with heart disease and that you can't control all the symptoms that you might have from it. Although the heart disease may not be cured, you can in many cases be free of symptoms, doing everything you want to do, and able to go on with your life as if it had been cured. It's important to realize that continuing to engage in prevention of heart disease is critical to making that happen.