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What care is needed after a bypass?

Dr OP Yadava
CEO & Chief Cardiac Surgeon,
National Heart Institute,
New Delhi

Q: I am 41 years old and have recently undergone a bypass surgery 57 days back. I went for my first review with the doctor and my blood report was as follows: serum creatinine: 0.98 mg/dl, cholesterol total: 179 mg/dl, triglycerides: 184 mg/dl (normal range is 34-150 mg/dl), HDL cholesterol: 30 mg/dl and LDL cholesterol: 113 mg/dl. Can you tell me the specific dos and don’ts on diet to bring down the triglycerides level? What is the diet advice to keep cholesterol levels within control keeping in mind HDL and LDL cholesterol levels? The doctor has cleared my chest incision. How long do I apply Betadine and Superiocin ointment after this? Can I undertake land travel now? Any dos and don’ts while travelling? Can I travel by air now? If yes, what are the dos and don’ts?

A:One has to avoid fried and fatty foods and excess oil during cooking. Here one must be careful of hidden fats as is found in various confectionery products like biscuits, cakes and pastries. Regular brisk walking for at least 20-30 minutes a day and consumption of 3-5 servings of fresh fruits daily also helps. One must also try to consume plenty of fibre and avoid simple carbohydrates and those foods, which lead to sudden and rapid increase in blood sugar levels (foods with high glycaemic index) like white bread, chapattis made of refined atta, rice etc. One should also consume less of dairy products and even what little one consumes should be made out of skimmed milk. Besides these, healthy practices including Yoga and stress relief measures like transcendental meditation etc. are very useful. Following bypass surgery usually statin group of drugs are prescribed to keep the blood cholesterol level to as low as is possible. However, I would not advise you to start any medication on your own but to seek a consultation with your treating cardiologist in this regard. No ointment or medication needs to be applied to the incision site until and unless, there is a discharge from the incision or if the incision is infected. Normally after 6-8 weeks of bypass surgery, it is perfectly safe to travel both by road/air. However, before you do so, you must get a clinical consultation with your cardiologist and take any specific advice from him. Also during the flight, you must carry your medications and make sure that you don’t miss any dose.