Q: My 68 years old mother-in-law is going to be operated for blockage in her heart. What is bypass surgery and suggest some tips for recovery also?

A:Bypass surgery is a surgical intervention to restore blood supply to the heart. The term is quite akin to the colloquially used bypass in reference to the motorways. If one has to go to Jaipur and Gurgaon is a bottleneck so we create a separate path on the outskirts of Gurgaon so that the traffic doesn’t have to enter the city and can flow smoothly. Similarly when an artery gets blocked, we create an alternative pathway for the blood flow around the blockage and this operation is called bypass surgery. Here alternative conduits are taken from inside the chest (Internal Mammary Artery) or from the hand (Radial Arteries) or from the leg (Long Saphenous Vein) and one end of them is connected to the aorta and the other to the arteries of the heart beyond the block, so that the blood flow can be restored to the muscles of the heart. As for your query on tips for recovery, I think most of these things will be told to you by your operating surgeon and the nurses looking after you, but essentially common complications, which can be to some extent obviated by the patient’s cooperation, are:

• Chest infection – to prevent this, one must do deep breathing exercises and steam inhalation to keep the lungs clear.
• Deep vein thrombosis or blood clots forming in the legs - This can be avoided by early mobilization and walking, and even when, one is in the bed, to keep moving the ankle joints and the knee joints as much as possible.
• Infective complications – these are also reduced by the above two measures as also by taking prophylactic antibiotics, which your surgeon obviously will advise.
• Quite often, when the vein is harvested from the legs, some degree of swelling develops in the legs and that can be prevented by calf muscle exercises and by elevation of the foot end of the bed at the night time.
• If the leg vein is harvested, one may have to wear stockings or a crepe bandage to prevent swelling of the legs.
• Some of the symptoms are best left untreated and should not be paid any need.

They are: - Lack of sleep - Lack of concentration - Lack of appetite - Excess gas formation - Lethargy and pain - Constipation - Mild low-grade fever etc These symptoms should be ignored and nature will take care over the next 4-6 weeks. One can have bath after 72 hours of the surgery and in fact, it is desirable to bath daily. However, before the first bath, you must take clearance from your treating doctor.