Quadruple heart bypass - what to expect

[DiamondsAndRust]

Hello there all you wise Mumsnetters!

I posted on here recently about my dad's upcoming open-heart surgery. Basically he had been allocated a surgeon who he wasn't sure about, and who we couldn't find any information/statistics on. Having decided not to go with this particular surgeon, and to hold out for someone more experienced, he has since spoken to the doctor who originally did his angiogram, and they have advised him not to wait (several of his arteries are more than 90% blocked).

Upshot is that now he's reconciled to the original surgeon, and it looks like he'll be having the op next week! Also, somewhere along the line his triple heart bypass has been 'upgraded' to a quadruple one (in for a penny, in for a pound I guess!) This is all a bit short notice, as we were thinking in terms of months rather than days, and the whole process feels quite rushed. We're not sure what to expect afterwards in terms of his recovery - obviously it's major surgery, and we realise it will take months for him to be anywhere near back to normal.

I'd greatly appreciate any advice on how best to support my dad through this, and what to expect in terms of his recuperation from the surgery. My main concern is that he has never met his surgeon (and won't do until the day of his op) and no one seems to have sat down with him and discussed what will happen during the procedure and afterwards. I understand from what I've read online that memory loss and depression are fairly common side effects of open heart surgery, but no one seems to have explained this to him. Is there anything else we ought to know about the recovery process? My Mum in particular is understandably quite stressed out, and any solid tips/advice would be a great help to her.

Dad is 74 and, other than his heart condition (which has only ever manifested itself in terms of mild indigestion-style pain) seems in fairly good shape. He did, however, have a mild stroke 10 years ago, from which he made a full recovery, and I understand this elevates his risk slightly.

Hi, can only post from my experience with exDP.

Firstly don't be surprised at how early he might be discharged if everything goes well. It was 4 days from admission to discharge with us.

Getting home - chest is generally wired together so decent transport needed with easy access as no strength to manoeuvre themselves.

Leg wound - I didn't appreciate that his wound from where they stripped the vein would also be painful so be aware that he might be hurting and sensitive there.

Compression stockings - these were a bugger to get on and off and his mother couldn't manage.

Mood swings - bit out of it for a couple of days, bit weepy. Felt helpless and didn't want to be treated as an invalid but simply wasn't able to move himself in and out of bed and chairs due to the weakness in his chest. Got worse with the mood swings whilst physically getting better. Acted like a spoilt child and it was difficult to remind ourselves that this wasn't really him.

Longer term - depression lifted after about a month when he was less dependent. Getting to the gym for gentle exercise seemed to give him back his sense of being in control.

Bit morbid with his thoughts for a while. Told us he was fine but admits now that he has no recollection of his time in hospital or the months after.

6 months - pretty much in better health than when it started. Put us to shame with his fitness drives and enthusiasm for life.

Had I known all of the above, I would have made sure I had help around bed times, waking, sitting with him occasionally during the day but not to treat him as an invalid but simply as company. Would have learnt not to take mood swings so personally and would have been better prepared for his bleakness about not having control.

First few days were very scary. Felt that we had to watch his breathing and help with every attempt to move. Yes, to helping but only when needed or if he refuses to accept limitations. What else ? Lost his appetite for a while and slept for most of the first week. Needed to be prompted to keep mobile to lower risk of clots etc.

And I would know next time to make sure that the carer gets a break without feeling guilty. The fear of the operation, the fear of having someone home so soon after major surgery, the helplessness to deal with his moods all took a toll. Share the load and don't do it all yourself.

Phone dr if any concerns about him and if still not happy, take to hospital as they are happy to err on side of caution with recently discharged cardiac patients.

Don't be surprised if you just get discharged with a leaflet.

Good luck and hopefully he will make a full and fast recovery.

Thanks for much for that Blistory - it's extremely helpful! We haven't been told much at all by the hospital as yet, so you've helped to fill in some of the gaps. Funny how they don't seem to warn you about any of the emotional stuff (mood swings/depression) when it seems to be one of the main after-effects of the surgery.

Glad things worked out OK in the end for your exDP and thanks again for taking the time to reply!

My dad had a quadruple bypass and didn't get the emotional problems so its not inevitable

He saw it as a second chance but he had had a pretty major heart attack

The wound on his leg was much bigger than he thought and itched like crazy but he couldn't bend down to scratch it -probably for the best

Physically he said he felt as weak as a kitten and building up activity slowly but consistently is important, 50 yard strolls were fun!
We noticed that even while he was in recovery, he looked so much better, more colour in his face, we hadn't realised how ill he looked prior to surgery I don't think

When you collect him from hospital, take something to pad the seatbelt, a soft jumper etc is ideal

Long term, my dad really feels the cold in his chest so layers are a must however it really has given him a new lease on life, he's very active and at the end of the day, he wouldn't be here without the operation

You've mentioned a quadruple bypass and open heart surgery - which one is it? A bypass isn't open heart surgery - it's quite a routine operation, with the problems just being discomfort caused by opening the chest and the leg wound as Blistory has mentioned. Still scary if you don't know what to expect, of course, but it's as routine as having your appendix out.

Thanks 17 - the seatbelt tip is something I hadn't thought of so really useful advice there. I'm hoping we'll have the same thoughts as you about Dad's improved condition after the op, but it all feels a bit weird at the moment as he wasn't even aware he had a heart condition until he was told he needed the bypass - outwardly he seems very fit (in fact the cardiac nurse was confused about why he was the when he went for his consultation!)

Fortyplus - The operation is definitely a quadruple bypass, but I thought the two were interchangeable? CABG is listed under open heart surgery on many of the websites I've looked at (they seem to include anything that involves cutting through the chest wall) and the term has also been used by several of the doctors we've spoken to. Confusing! Anyway, it's been difficult to get a handle on things - some people (health professionals and people we've spoken to who have had it done) seem to think it's just 'routine plumbing' and fairly straightforward, while others emphasise how major the procedure is (anything that involves stopping your heart seems fairly major to me!), and imply that it will knock everyone for six. Range of different experiences I suppose.

Thanks again for responses so far!

My lovely dad had a quadruple bypass more than ten years ago now, and has been in good health since. He has had some unexpected long-term effects - he stopped liking some food/drink he formerly liked (not a health thing, just really can't stand the taste) and also had to switch to driving an automatic as he couldn't cope with gear changes, as the muscles in his chest never quite got back to normal. He didn't have the major emotional issues, but he is a very quiet and understated sort of person, so he might have hidden some of it well.

It is both routine, and scary - I know what you mean. Routine in that lots of them happen every day and survival rates are excellent, but a huge upheaval and worry for patient and family.

Your dad should be given every opportunity to ask questions when he is admitted. It's good to write things down because it's very easy to forget. Just to warn you, sometimes it's the registrar who will go through the consent process so it's quite possible he still won't have met the consultant. Hopefully not, but possible. However, the registrar is a senior doctor in his/ own right.

The nurses will be the best people for recovery advice, but actually, the advice you've received on here is probably more comprehensive than any you'll get in hospital.

Don't think anyone has mentioned possible injections for blood clot prevention. He might need these.

And...the hated stockings...he will need help. The easiest way to get them on is to turn inside out, pinch the heel area of the stocking and slide ove the foot and into place then gradually ease the leg of the stocking up over his leg. Bit hard to explain! They have to be correctly fitted to be properly effective.

Matildathecat (and others!) Re. the stockings: We're confused about this too! Dad is especially vulnerable to blood clots, given his previous stroke history. He's been on anti-clotting drugs ever since, which he has to stop taking 5 days before he's admitted. I'm pretty sure he will need the anti-clotting injections, given his medical history. However, he was also told by the cardiac nurse that he couldn't have the anti-DVT stockings because they would interfere with the vein they were taking from his leg. My Mum queried this, and they said something about Dad having to tell the nurses/registrar himself when he was admitted. This seems odd to me - I thought taking a vein from the leg was fairly normal?

Responses have been fab so far - knew Mumsnetters would come up with the goods! Unfortunately we've been receiving such mixed messages from the various health professionals we've encountered that things were getting very muddled. Part of the problem seems to be that (so far) we haven't managed to speak to the same person more than once due to staff holiday/sickness/chronic understaffing.

Maybe also think about the support your mum will need in the first few weeks home. Make sure she has a freezer full of food, and even better get some people to bring around fresh home cooked food. She may also want people to come around and sit with your dad so she can get shopping done, and maybe have some me time.

Yes, Buggedoff, we've thought about this - luckily I only live a mile or so away, so can pop in easily, and DP and I will be looking after their dog for a while as well. Good point about the freezer thing, especially as Mum doesn't enjoy cooking at the best of times!

Have PM'd you

I had a quad bypass 5 years ago,and did not have to wear the stockings,things might have changed since then but at the time they were not recommended unless there were other health issues,I think it was to do with the leg the vien had been taken from.

DiamondsAndRust - I forgot to mention that my dad (who had already had 2 heart attacks) had a triple bypass and lived another 18 years. When he did eventually die it wasn't because of his heart

Thats good to hear fortyplus I am five years on and still feel great

heronsfly that's brilliant!

Also - my dad's op was in 1987 so I'm sure techniques have improved even further by now

Lovely to hear your stories heronsfly and fortyplus - all very reassuring. Glad you're doing so well heronsfly, and that the op made such a difference to your dad fortyplus.