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Question:
What happens if a person doesn't follow a healthy lifestyle after heart surgery?
My husband had double bypass open heart surgery 2 years ago. He has gained roughly 40 pounds since. Has been on Lipitor and blood pressure medication along with Paxil and Depakot. He does not exercise much at all (2 week binge every 6 months on average) and eats all the wrong things. In the last 2 weeks he has become extremely tired (used to sleep 5-6 hours and is now sleeping approximately 10 hours). He has not had a stress test in over 1 year and tells me his cardiologist says he doesn't need to see him back. Should I be concerned about a potential heart attack right now? I'm already scared and haven't been able to find answers to what if a person doesn't follow a healthy lifestyle after heart surgery, and early signs of heart condition getting worse.
submitted by Paula from Michigan, on 11/5/09
Answer:
by Texas Heart Institute cardiologist, Michael J. Mihalick, MD
Dear Paula: I think you should be very concerned, but unfortunately, other than trying to motivate your husband, your options are limited. He is the only one that can fix the situation. Having said that, there may be several things that can be done:
1) The Paxil is quite likely contributing to his weight gain. The Lipitor may be contributing to his fatigue. If he is taking them, beta blockers could be aggravating the depression.
2) He is probably depressed and may need to see a psychiatrist to confirm this and if so put him on a drug that will help without the tendency to cause weight gain.
3) He should have a complete blood panel, including (in my opinion) a fasting glucose and a hemoglobin A1-C that will screen him for diabetes, a thyroid panel, lipid profile, and a HSCRP (high sensitivity C reactive protein). These tests will help assess his particular risk for future events.
4) A stress perfusion scan (preferably using treadmill stress) will be important to establish a new baseline and determine his exercise capacity . . . important if he enrolls in a rehab program.
5) Enrolling in a "Phase 2" cardiac rehab program will get him started and actually move him along faster than a self-supervised program. He will meet others with similar issues who may be better or worse off that he is, and he won't feel isolated. Exercise will benefit him physically and mentally.
6) Losing 5% of his current weight (by any method) will decrease his chances of getting diabetes by 60% over the next 5 years. After acheiving this goal, he should attempt to get his waist size below 40 inches. Once this has been accomplished, losing more weight will be much easier.
7) If you can afford it, a nutritionist may be very helpful to both of you. Otherwise, following the 'Omega Diet' and using books like 'Eat This, Not That' can be very helpful.
8) As far as changing medication is concerned, that will have to be done by his physician. He may feel better on Crestor since it is metabolized differently than Lipitor; whether or not he can get off of a beta blocker will need to be addressed by his cardiologist.
Unfortuately your husband's situation is not uncommon. All studies have shown that those patients who take care of themselves by not smoking, exericising, and losing excess weight do much better that those who don't. I have been in practice long enough to see individuals who thought they would die early from heart disease live well into their 80's and beyond. I wish you and your husband the best.
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Updated November 2009
