Wants to return to normal lifestyle as soon as possible. Unfortunately, this cannot be done if you are unable to drive. That’s why the question “when can I get behind the wheel?” is the most common one that doctors hear from their patients.
Let's figure out how long after endoprosthetics a person is able to drive a car.
What determines the time it takes to get back behind the wheel?
When you get behind the wheel again depends on many factors. Of greatest importance is the volume of surgical intervention and the speed of restoration of joint function. The type of car transmission and which leg you had surgery play a significant role.
It is natural that:
- After surgery performed abroad using a minimally invasive technique, you will be able to drive earlier. If you were operated on in state clinic According to the standard method, you will most likely have to wait 2-3 times longer.
- Recovery after hemiarthroplasty of the hip joint or unipolar knee replacement is faster than after a total replacement. It is logical that after a less traumatic operation you will be able to get behind the wheel faster.
- Surgery on the left leg makes it possible to return to driving sooner if the car has a manual transmission. The surgery on the right lower limb requires a long recovery.
- If the seat is low, it will be more difficult for you to get in and out of the car. Most likely, you will feel uncomfortable sitting behind the wheel. So if you are the owner of a sedan or sports car, get ready to wait longer for the owner of a jeep.
- Your muscle strength and reaction speed must be sufficient to cope with driving a car. Only an experienced doctor can tell whether you can drive.
- You should not take strong painkillers. This significantly impairs driving skills and slows down reactions. Moreover, driving after taking narcotic analgesics is illegal and dangerous. Fortunately, these drugs are given only in the first days after surgery.
Important! There is no clear guide to tell you when to return to driving. Only your attending physician can determine whether you are safe to drive after a thorough examination. The best time to ask his advice is during one of your routine checkups.
What is the most common time frame for returning to driving?
Some foreign authors believe that in certain situations a person can drive as early as 2 weeks after surgery. We are confident that this happens extremely rarely. Driving in such early period possible provided that the patient underwent unicondylar endoprosthetics using a minimally invasive technique. In this case, restoration of the joint and healing of the postoperative wound should occur surprisingly quickly. All this is possible only at a young age.
Fact! After a total knee replacement or hip joint most patients can return to driving within 6-8 weeks.
Table 1. Estimated time frame for returning to the wheel after different types endoprosthetics.
In 2011, doctors in Hong Kong conducted an interesting study in which 130 patients took part. The goal of the doctors’ work was to determine the timing of return to driving after total hip replacement. Researchers found that 81% of those operated on could return to driving in 6-8 weeks. Another 17% of patients can safely drive at 12 weeks. And only 3% of subjects cannot drive after this period.
People who have undergone endoprosthetics almost never complain that it has become more difficult for them to drive after surgery. Moreover, 38% of patients noted a subjective improvement in their driving skills.
Curious! For patients undergoing surgery in Russia under a quota, doctors allow them to drive only 2-3 months after surgery. The reason for a late return to driving is slow rehabilitation or its almost complete absence.
How to determine whether you can drive
Do not rush to get behind the wheel on your own, even if you think you are strong enough. Remember: you may be wrong! The only way to find out if you are fit to drive is to talk to your doctor. He should examine you, check muscle strength in the operated limb, and see how quickly you move your leg. Only after this the specialist is able to make a “verdict”.
Driving Precautions
If you decide to return to driving, please use extreme caution. Get in and out of the car carefully, being careful not to fall. Try not to make sudden movements that could cause dislocation. To make it more comfortable for you to sit, move your seat back. If you want to sit a little higher, place a folded blanket or firm pillow under you.
The rehabilitation process takes from 3 months to 1 year after surgery, depending on its complexity. After 6 months, patients are recommended to continue exercising on rehabilitation equipment under the supervision of a physical therapy doctor or instructor in order to prevent hernia recurrence intervertebral disc, for which a set of exercises is individually selected to create a muscle corset and improve blood circulation in problem areas.
The recovery period takes place under the supervision of a neurologist, who prescribes a course of drug therapy and recommends consultations with other specialists for more effective treatment.
Early rehabilitation period (from 1 to 3 months).
- Do not sit for 3-6 weeks after surgery (depending on the severity of the surgery).
- Do not make sudden and deep movements in the spine, bending forward, to the sides, twisting movements in lumbar region spine for 1-2 months after surgery.
- Do not drive or ride in public transport in a sitting position for 2-3 months after surgery (you can ride as a passenger, reclining, with the seat unfolded).
- Do not lift more than 3-5 kilograms for 3 months.
- For 3 months after the operation, you should not ride a bicycle or engage in team sports (football, volleyball, basketball, tennis, etc.).
- Periodically unload the spine (rest in a lying position for 20-30 minutes during the day).
- Wearing a postoperative corset no more than 3 hours a day.
- It is advisable not to smoke or drink alcohol during the entire rehabilitation period. Intimate life not contraindicated.
Rehabilitation:
As soon as the patient is allowed to walk, he should consult with a physical therapy doctor regarding the timing of the appointment and the complex of physical therapy, which depend on the volume and nature of the surgical intervention, as well as postoperative complications. A month after the uncomplicated operation, classes are indicated in the gym (not in the gym!) under the supervision of a physical therapy doctor, without deadlifts. Swimming on your stomach is beneficial.
A month after the operation, in uncomplicated cases, you can begin to work (the issue of timing and specific work performed is decided in each case individually with the attending physician).
Late rehabilitation period (3-6 months).
- It is not recommended to lift more than 5-8 kilograms, especially without warming up and warming up the back muscles, jumping from heights, long trips by car.
- When going outside in bad weather: wind, rain, low temperature, it is advisable to wear a warming belt on the lumbar area.
- Wearing a corset, especially long-term, is not recommended to avoid atrophy of the long back muscles.
Rehabilitation:
During this period, you can carefully, under the supervision of a physical therapy doctor, begin the formation of a muscle corset by doing exercises to strengthen the back muscles.
A healthy lifestyle, quitting smoking, regular exercise in the gym, swimming, sauna, and limiting weight lifting significantly reduce the risk of developing intervertebral disc herniations.
To prevent back pain, you should avoid: stress, hypothermia, prolonged monotonous work in a forced position, heavy lifting, sudden movements on cold, unheated muscles, and the appearance of excess body weight.
In addition, at any stage of rehabilitation, acupuncture and physiotherapy can be included in the complex of rehabilitation measures.
Recommended set of exercises (one month after surgery)
- Initially, do 1 to 5 repetitions of the exercises 2 times a day, working up to 10 repetitions of each exercise 2 times a day.
- Perform the exercises smoothly and slowly, without sudden movements. If you feel discomfort or pain while doing this, then do not do this exercise for a while. If such sensations become persistent, you should consult a doctor.
- The intensity of the load depends on your well-being. As soon as pain appears, reduce the intensity of exercise.
Exercise 1. Lie on your back. Slowly bend your knees and press them to your chest, feeling the tension in your gluteal muscles. Relax your gluteal muscles. Keep your legs bent for 45-60 seconds, then slowly straighten them.
Exercise 2. Lie on your back, bend your knees, arms on the floor in different directions. Raise your pelvis above the floor and hold for 10-15 seconds. Increase the holding time to 60 seconds.
Exercise 3. Lie on your back, hands behind your head, legs bent at the knees. Turn your legs alternately, first to the right, then to left side touching the floor with your knee; the upper body remains horizontal. Hold your legs in the rotated position for up to 60 seconds.
Exercise 4. Lie on your back, bend your knees, cross your arms over your chest, press your chin to your chest. Tensing your muscles abdominals, bend forward and hold this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.
Exercise 5. Starting position on your hands and legs bent at the knees. Simultaneously left leg And right hand pull horizontally and lock in this position for 10 to 60 seconds. Repeat, raising your right arm and left leg.
Exercise 6. Starting position: lying on your stomach, arms bent in elbow joints, lie near the head. Straighten your arms and raise top part body and head up, bending in the lumbar region, while keeping your hips off the floor. Hold this position for 10 seconds. Get down on the floor and relax.
Exercise 7. Starting position: lying on your stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis from the floor. Slowly lower your leg and repeat with the other leg.
Exercise 8. Starting position: stand on one leg, the other straightened, place it on a chair. Leaning forward, bend the leg lying on the chair at the knee and hold this position for 30-45 seconds. Straighten up and return to the starting position.
Coronary heart disease is one of the most common pathologies today circulatory system. Unfortunately, the number of patients increases every year. As a result of illness coronary arteries Due to insufficient blood supply to the heart muscle, it is damaged. Many leading cardiologists and therapists in the world tried to combat this phenomenon with the help of pills. But nevertheless, coronary artery bypass grafting (CABG) still remains, albeit radical, but the most effective way fight against a disease that has proven its safety.
Rehabilitation after CABG: the first days
After coronary artery bypass surgery, the patient is placed in the ward intensive care or intensive care unit. Typically, the effect of some anesthetics continues for some time after the patient has woken up from anesthesia. Therefore, he is connected to a special apparatus that helps with the breathing function.
In order to avoid uncontrolled movements that could damage the sutures on the postoperative wound, pull out catheters or drains, or disconnect the IV, the patient is fixed using special devices. Electrodes are also connected to it, which record the state of health and allow medical personnel to control the frequency and rhythm of contractions of the heart muscle.
On the first day after this heart surgery, the following manipulations are performed:
- A blood test is taken from the patient;
- X-ray examinations are carried out;
- Electrocardiographic studies are performed.
Also on the first day the breathing tube is removed, but the gastric tube and drains are in chest remain. The patient is already breathing completely on his own.
Advice: at this point recovery stage It is important that the operated person stays warm. The patient is wrapped in a warm down or wool blanket, and to avoid stagnation of blood in the vessels lower limbs, wear special stockings.
To avoid complications, do not engage in physical activity without consulting your doctor.
On the first day, the patient needs peace and care from medical personnel who, among other things, will communicate with his relatives. The patient just lies down. During this period, he takes antibiotics, painkillers and sedatives. Within a few days there may be slight elevated temperature bodies. This is considered a normal reaction of the body to surgery. In addition, heavy sweating may occur.
As you can see, after coronary artery bypass surgery the patient needs third-party care. Regarding the recommended level physical activity, then in each individual case it has an individual character. At first, you are allowed to just sit and walk around the room. After some time, you are already allowed to leave the room. And only at the time of discharge the patient can walk along the corridor for a long time.
Advice: the patient is recommended to remain in a supine position for several hours, and it is necessary to change his position, turning from side to side. Lying on your back for long periods of time without physical activity increases the risk of developing congestive pneumonia due to the accumulation of excess fluid in the lungs.
When using the saphenous vein of the thigh as a graft, swelling of the lower leg may be observed in the corresponding leg. This happens even if the function of the replaced vein has been taken over by smaller blood vessels. This is the reason that the patient is recommended to wear support stockings made of elastic material for 4-6 weeks after surgery. In addition, when sitting, this leg must be raised slightly so as not to disrupt blood circulation. After a couple of months, the swelling resolves.
During the recovery process after surgery, patients are prohibited from lifting weights exceeding 5 kg and performing vigorous physical exercise.
Sutures from the leg are removed a week after the operation, and from the chest - immediately before discharge. Healing occurs within 90 days. The patient is not recommended to drive for 28 days after surgery to avoid possible damage to the sternum. Sexual activity can be carried out if the body is in a position that minimizes the load on the chest and shoulders. You can return to your workplace one and a half months after the operation, and if the work is sedentary, then even earlier.
In total, after coronary artery bypass grafting, rehabilitation takes up to 3 months. It involves gradually increasing the load while performing physical exercise which must be done three times a week for one hour. At the same time, patients receive recommendations on the lifestyle that needs to be followed after surgery to reduce the likelihood of progression coronary disease hearts. This includes quitting smoking, losing weight, special food, constant monitoring of blood cholesterol and blood pressure.
Diet after CABG
Even after discharge from the hospital, while at home, you must adhere to a certain diet, which will be prescribed by your doctor. This will significantly reduce the chances of developing heart and vascular disease. Some of the main foods whose consumption should be minimized are saturated fats and salt. After all, the operation performed does not guarantee that problems with the atria, ventricles, blood vessels and other components of the circulatory system will not appear in the future. The risks of this will increase significantly if you do not adhere to a certain diet and lead a carefree lifestyle (continue to smoke, drink alcohol and do not engage in recreational exercises).
It is necessary to strictly follow the diet and then you will not have to face again the problems that led to surgery. There will be no problems with transplanted veins replacing coronary arteries.
Advice: in addition to diet and exercise, you need to monitor your own weight, excess of which increases the load on the heart and, accordingly, increases the risk of recurrent disease.
Possible complications after CABG
Deep vein thrombosis
Despite the fact that this operation is successful in most cases, the following complications may occur during the recovery period:
- Thrombosis of blood vessels of the lower extremities, including deep veins;
- Bleeding;
- Wound infection;
- Formation of a keloid scar;
- Cerebrovascular accident;
- Myocardial infarction;
- Chronic pain in the incision area;
- Atrial fibrillation;
- Osteomyelitis of the sternum;
- Failure of seams.
Tip: Taking statins (drugs that lower blood cholesterol) before CABG significantly reduces the risk of scattered atrial contractions after surgery.
Still one of the most serious complications considered perioperative myocardial infarction. Complications after CABG may occur due to the following factors:
- Previous acute coronary syndrome;
- Unstable hemodynamics;
- Presence of severe angina;
- Atherosclerosis of the carotid arteries;
- Left ventricular dysfunction.
Those most at risk for complications in the postoperative period are women, the elderly, diabetics and patients with renal failure. Thorough examination atria, ventricles and other parts of the important body a person before surgery will also help reduce the risk of complications after CABG.
Rules of life after coronary artery bypass surgery
What lifestyle should you lead after coronary artery disease?
If bypass surgery was performed by professionals, immediately after it only lungs will remain discomfort in the chest and a little dizziness. It seems that everything is behind us, the most difficult trials have passed. But in fact, the operated person has a lot of work to do to positive effect operations were maintained as long as possible.
In the hospital
The very next day after bypass surgery, doctors warn: if you move little, complications are possible, for example, pneumonia. They should explain to you how to turn over in bed correctly, when you can sit up, and after how many days you are allowed to walk.
In the first days, you need to prepare yourself not to wait for the pain to return. Imagine that it never existed at all. Don’t be shy before the load, although you don’t need to perform “feats” either. Set realistic goals for yourself: for example, today and tomorrow I will walk 50 meters, next days– 75, then – 100. And then, as your health allows.
Before discharge
Statistics show: 60% of patients after bypass surgery are afraid of being left without constant medical supervision. Many believe that the heart may not be able to withstand it, remembering that the slightest load before the operation caused angina pectoris.
There is no need to be afraid. After bypass surgery, the number and severity of angina attacks decreases, fewer nitroglycerin tablets are required, and exercise tolerance improves. All this in medical language is called improving the quality of life. But the main objective surgery is an opportunity to delay the onset of myocardial infarction and increase life expectancy.
To find out how adapted a person is to life, tests with physical or medicinal stress are carried out some time after the operation. A bicycle ergometer or treadmill usually answers all questions, and based on the test results, the doctor can give the patient individual recommendations.
First weeks at home
Increasing physical activity is a prerequisite for normal rehabilitation. It is necessary to walk more and more lengths of the path every day; after some time, their length should be at least a kilometer (with feeling good). Try to climb the stairs - first one floor, then two, and so on as much as you can - without pain. An untrained heart works extremely uneconomically, wasting a lot of energy.
Gradual exercises can “teach” it to work correctly.
Spend at least 20-30 minutes a day exercising. It is advisable to avoid exercises that involve sudden movements, especially when it comes to hand movements. In general, you should try to strain the shoulder girdle as little as possible.
Future plans
More likely, old job, if it is associated with great physical and emotional stress, you will have to leave it: there is no need for unnecessary worries after the operation. But at the same time, you should not immediately register as disabled. Look for a “golden mean”, ask relatives, colleagues, doctors to help you with this. In addition to social importance psychological rehabilitation. The life of a person who has undergone bypass surgery should become calmer and more measured. Doctors advise: eat, move, speak, even think slowly. This will help avoid stress.
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Rules for rehabilitation after cardiac bypass surgery
In order to reduce the likelihood of complications after coronary artery bypass surgery and increase physical and social activity, cardiac rehabilitation is carried out. It includes therapeutic nutrition, dosed load regimen, preventive drug treatment and lifestyle recommendations for patients. These events are carried out at home and in specialized sanatoriums.
Is rehabilitation so important after cardiac bypass surgery?
After surgery, the symptoms of coronary heart disease in patients decrease, but the cause of its occurrence does not disappear. The condition of the vascular wall and the level of atherogenic fats in the blood do not change. This means that there remains a risk of narrowing of other branches of the coronary arteries and a deterioration in health with the return of previous symptoms.
In order to fully return to full life and not to worry about the risk of developing vascular crises, all patients need to complete the full course rehabilitation treatment. This will help maintain normal function of the new shunt and prevent it from closing.
And here's more about surgical treatment atrial fibrillation.
Goals of rehabilitation after vascular bypass surgery
Cardiac bypass surgery is a serious surgical procedure, so rehabilitation measures are aimed at different aspects of patients’ lives. The main tasks are as follows:
- Coronary artery bypass grafting
to prevent complications of the operation, to resume heart function in full;
What kind of rehabilitation is needed in the first days after surgery?
After the patient was transferred from intensive care unit in a regular ward, the main focus of recovery is to normalize breathing and prevent congestion in the lungs.
Above the area lungs lungs Vibromassage is performed using tapping movements. You need to change your position in bed as often as possible, and after the surgeon’s permission, lie on your side.
It is important to gradually increase motor activity. To do this, depending on how they feel, patients are advised to sit on a chair, then walk around the room or corridor. Shortly before discharge, all patients should independently climb stairs and walk on fresh air.
After arriving home: when to see a doctor urgently, scheduled visits
Usually, upon discharge, the doctor sets a date for the next scheduled consultation (in a month) in medical institution where it was held surgery. This takes into account the complexity and volume of bypass surgery, the presence of pathology in the patient, which can complicate the postoperative period. Within two weeks you need to visit your local doctor for further preventive monitoring.
If there are signs probable complications, then you need to contact a cardiac surgeon immediately. These include:
- signs of inflammation postoperative suture: redness, increased pain, discharge;
- increased body temperature;
- increasing weakness;
- labored breathing;
- sudden increase in body weight, swelling;
- attacks of tachycardia or interruptions in heart function;
- severe chest pain.
Life after cardiac bypass surgery
The patient must understand that the operation was performed in order to gradually normalize blood circulation and metabolic processes. This is only possible if you pay attention to your condition and switch to healthy image life: abandonment bad habits, increased physical activity and proper nutrition.
Diet for a healthy heart
The main factor in circulatory disorders during myocardial ischemia is excess cholesterol in the blood. Therefore, it is necessary to exclude animal fats, and add to the diet foods that can remove it from the body and prevent the formation of atherosclerotic plaques.
Prohibited products include:
- pork, lamb, offal (brains, kidneys, lungs), duck;
- most sausages, canned meat, semi-finished products, ready-made minced meat;
- fatty varieties of cheese, cottage cheese, sour cream and cream;
- butter, margarine, all store-bought sauces;
- fast food, chips, snacks;
- confectionery, sweets, White bread and baking, puff pastry;
- all fried foods.
The diet should be dominated by vegetables, preferably in the form of salads, fresh herbs, fruits, fish dishes, seafood, boiled beef or chicken without fat. It is better to prepare first courses vegetarian, and add meat or fish when serving. Dairy products should be low-fat and fresh. Fermented milk drinks are beneficial homemade. Recommended as a source of fat vegetable oil. Its daily norm is 2 tablespoons.
Very useful component diets are bran from oats, buckwheat or wheat. This food supplement will help normalize intestinal function and remove excess sugar and cholesterol from the body. They can be added starting with a teaspoon and then increased to 30 g per day.
To learn what foods are best to eat after heart surgery, watch this video:
Rules of nutrition and water balance
Dietary nutrition should be fractional - food is taken in small portions once a day. Between three main meals you need 2 or 3 snacks. For culinary processing, boiling in water, steaming, stewing and baking without oil is used. If you are overweight, your calorie intake must be reduced, and a fasting day is recommended once a week.
Steaming
An important rule is to limit table salt. Dishes are not allowed to be salted during preparation, and the entire amount of salt (3 - 5 g) is given to your hands. Liquids should also be taken in moderation - 1 - 1.2 liters per day. This volume does not include the first course. Coffee, strong tea, cocoa and chocolate are not recommended, as are sweet carbonated drinks and energy drinks. Absolute ban superimposed on alcohol.
Physical exercises in the postoperative period
The most accessible type of exercise after surgery is walking. It allows you to gradually increase the level of fitness of the body, it is easy to dose by changing the duration and pace. If possible, these should be walks in the fresh air, with a gradual increase in the distance traveled. In this case, it is important to control the heart rate - no more than beats per minute.
Special complexes can also be used therapeutic exercises, which at first do not put stress on the shoulder girdle. After complete healing of the sternum, you can swim, run, ride a bike, or dance. You should not choose sports that put stress on the chest - basketball, tennis, weight lifting, pull-ups or push-ups.
Is it possible to smoke?
Under the influence of nicotine, the following changes occur in the body:
- blood clotting increases, the risk of blood clots;
- coronary vessels spasm;
- the ability of red blood cells to carry oxygen to tissues decreases;
- Conduction in the heart muscle is impaired electrical impulses, arrhythmia occurs.
The influence of smoking on the progression of coronary disease manifests itself even with a minimum number of cigarettes smoked, which leads to the need complete refusal from this bad habit. If the patient ignores this recommendation, the success of the operation can be reduced to zero.
How to take medications after heart bypass surgery
Continues after bypass drug therapy, which is aimed at the following aspects:
- maintaining normal level blood pressure and heart rate;
- lowering blood cholesterol levels;
- preventing the formation of blood clots;
Intimate life: is it possible, how and from what moment
Return to full sexual relations depends on the patient's condition. Usually there are no contraindications to intimate contacts. In the first days after discharge, you should avoid excessively intense physical activity and choose positions that do not put pressure on the chest.
After 3 months, such restrictions are lifted, and the patient can only focus on own desires and needs.
When can I go to work, are there any restrictions?
If the view labor activity involves work without physical activity, you can return to it the day after the operation. This applies to office workers and intellectual workers. Other patients are advised to switch to lighter conditions. If this is not possible, it is necessary to either extend the rehabilitation period or undergo a work ability examination to determine the disability group.
Recovery in a sanatorium: is it worth going?
The best results can be obtained if recovery takes place in specialized cardiac sanatoriums. In this case, the patient is prescribed complex treatment and diet, physical activity that cannot be expertly carried out independently.
The great advantages are constant medical supervision, exposure to natural factors, psychological support. At sanatorium treatment It’s easier to acquire new useful skills for life, give up junk food, smoking, and drinking alcohol. There are special programs for this.
Chance to travel after surgery
You are allowed to drive a car a month after bypass surgery, provided there is a consistent improvement in your well-being.
All long-distance trips, especially flights, must be coordinated with your doctor. They are not recommended in the first months. This is especially true for sudden changes in climatic conditions, time zones, and travel to high mountain areas.
Before a long business trip or vacation, it is advisable to undergo a cardiac examination.
Disability after cardiac bypass surgery
Direction to pass medical examination issued by a cardiologist at your place of residence. Medical commission analyzes the patient’s documentation: discharge from the department, laboratory and instrumental studies, and also examines the patient, after which the disability group can be determined.
Most often, after vascular bypass surgery, patients receive temporary disability for one year, and then it is reconfirmed or removed. Approximately one percent of the total number of operated patients require such restrictions on work activity.
And here you can read more about the rules of life after installing a pacemaker.
Which patients can qualify for a disability group?
The first group is defined for patients who, due to frequent attacks of angina pectoris and manifestations of heart failure, require outside help.
Ischemic disease with daily attacks and insufficient functioning of the heart class suggest assignment to the second group. The second and third groups can be workers, but with limited loads. The third group is given when moderate violations conditions of the heart muscle that interfere with normal work activities.
Thus, we can conclude that after cardiac bypass surgery, patients can return to a full life. The result of rehabilitation will depend on the patient himself - how much he can give up bad habits and change his lifestyle.
Useful video
ABOUT rehabilitation period after coronary artery bypass surgery, watch this video:
After surgical interventions on the heart or great vessels. . The most common ones include: Is it possible to perform bypass surgery without coronary angiography?
bruises at the sites of vascular catheterization. After surgery, the patient stays in the hospital for 2 to 4 days. . In this situation, when surgery is required open heart(installation of an artificial valve or bypass surgery), then it.
embolism of blood vessels of the heart, lungs or brain with the development of a heart attack or stroke. After bypass surgery and postoperative recovery pain is relieved and the ability to move improves.
Thin tubes (called catheters) through blood vessels (usually femoral vein or artery) advance to the chambers of the heart. . Duration of rehabilitation after radiofrequency ablation usually occupies the heart.
damage to tissue or blood vessels near the heart. Recovery after surgery. Rehabilitation after installation of a pacemaker usually lasts from a week to a month.
We will publish information soon.
After bypass surgery, when can you drive?
Coronary artery bypass surgery- heart surgery in which one or more blocked arteries are bypassed using a vascular graft (shunt). This is done to restore normal blood flow in the arteries of the heart. Vascular grafts (shunts) are taken from the patients themselves - these are their own arteries and veins located in the chest wall (internal thoracic artery), in the leg (great saphenous vein) and in the arm (radial artery). Shunts bypass the area where the coronary artery is blocked and deliver oxygenated blood to the blocked area. The surgery reduces the symptoms of angina and reduces the risk of heart attacks.
How is the operation performed?
The entire operation lasts about an hour on average, depending on the number of arteries that need to be bypassed. After you fall asleep under anesthesia, surgeons isolate the veins and prepare the arteries for use as bypasses.
There are several types of vascular grafts (shunts) that are used to bypass coronary arteries. The surgeon will determine which type of shunt is right for you. Most often, the internal mammary artery (the so-called “mammary”) is used for this purpose. The radial artery is another commonly used arterial graft (shunt).
If the radial artery is used as a shunt, the patient may need to take blockers during the postoperative period calcium channels for several months after surgery. These medications help keep the artery open. Sometimes after surgery there is either numbness in the hand or loss of sensation in a limited area. But this is a rather rare and quickly passing phenomenon.
After the suturing of the shunts is completed, the heart-lung machine is turned off, the heart begins to beat on its own and blood circulation returns to normal. Before closing the chest, temporary electrodes for electrical stimulation are sutured to the heart using a special wire and drains are installed. Then the skin and subcutaneous tissue are sutured. Sometimes it is necessary to connect a pacemaker to electrodes to pace the heart until it completely restores its own rhythm.
Patients are transferred to the intensive care unit for continuous observation for an average of 2 days.
Before you leave the hospital after surgery, you will be told what to do for the next 2-6 months.
If the seam heals well and is dry, then you can take a “quick” shower (no longer than 10 minutes). If the stitches on your chest have not yet been removed, stand with your back to the shower. You can also take a bath, but don’t bask in it, but wash quickly.
The water should be warm - not hot and not cold. Extreme temperatures can cause fainting.
Wash the seam with regular soap, without fragrances or additives, and not with gel. Wet your hand or washcloth with soapy water and gently work your way up and down the seam area. Do not rub the seam with a washcloth until all the crusts come off and the wound is completely healed. Do not lubricate it with any ointments unless directed by a doctor.
Consult a doctor immediately if signs of infection appear: discharge from the wound has increased, the edges of the wound have separated, the suture has become red and swollen, the temperature has risen above 38 °C.
At first, when actively moving, you will feel discomfort in the chest muscles, in the suture area and in the chest. Itching, stiffness in the area, or loss of sensation are normal after surgery. Before discharge, you will be prescribed painkillers and anti-inflammatory medications.
Besides painful sensations in the chest you will feel discomfort for some time in the place where the vein for the shunts was taken from. Daily walks and moderate activity will help cope with this.
Be sure to consult a doctor if you experience mobility in the sternum or clicking sound in the sternum when moving.
After surgery, there will be some swelling in your legs for a while, especially if the vein for the shunts was taken from your leg. To deal with it, use the following methods:
- While resting, try to keep your leg elevated. When you lie down on the sofa or bed, place several pillows under your feet. It is also useful to lie on the floor, on some rug, and put your feet on the sofa. If you do this regularly, the swelling will noticeably decrease.
- If you were used to sitting cross-legged before surgery, now is the time to give up this habit. And try to go for walks every day, even if your legs ache and swell.
- Use compression stockings.
But if the swelling in your legs increases sharply and pain appears, especially along with shortness of breath when moving, consult a doctor as soon as possible.
Your doctor will tell you how long you need to take the medicine - initially or for life. Do not take unnecessary and dangerous initiatives by taking without your doctor’s knowledge. nutritional supplements or antibiotics in case of a cold. And strictly follow the dosage of the medications already prescribed.
After returning home, do not rush to immediately return to full exercise. It needs to be increased gradually. You can do light housework, but don't stand in one place for more than 15 minutes.
You cannot lift weights exceeding 5 kilograms, pull or push heavy objects. You can raise your hands if you need to get something from a shelf or comb your hair. But you can't keep your hands up for too long.
If you feel even slightly tired, rest immediately. Don't bother walking up the stairs; one descent and one ascent is enough.
Don't overexert yourself - distribute the load evenly throughout the day. Walk daily. Your doctor or rehabilitation instructor will explain in detail how much and how to walk after returning home.
The recovery period usually lasts 6-9 weeks. You can return to work only with the knowledge and permission of your doctor.
If you have a car, your doctor will tell you when you can drive again. This will not happen until your sternum begins to heal and your reflexes are fully restored. This usually takes up to 9 weeks after surgery.
What to do with sex life after heart surgery? It is not prohibited. However, remember: the energy required for sexual intercourse is equal to the energy spent climbing one or two flights of stairs or walking about 1 km at a brisk pace. If such a load causes you fatigue and shortness of breath, then you should not rush into sex. And try to choose positions with the least amount of stress on your sternum, arms and chest. Be realistic - it will take time for you to return to a full and active sex life.
It is very important to get enough rest to avoid overwork. Unfortunately, many patients experience sleep disturbances after surgery. Normal sleep patterns will return within a few weeks. Contact your doctor if your sleep deprivation is affecting your behavior or if your sleep patterns are not returning to normal.
After surgery, you may experience depression or nervous tension. Temporary low mood is normal and will gradually subside as you get back into your regular life and work. Negative emotions may be associated with fatigue even from a small load, which is quite natural in the postoperative period - after all, your body is recovering.
However, if the depressed mood does not weaken every day, but only intensifies, consult a doctor. Many patients are upset because after surgery they feel memory loss and sometimes a decrease in intelligence. This is normal after heart surgery. The entire body, including the brain, experiences severe stress during surgery. Everything will be restored over time, don't worry. You should not torture yourself if at first it seems to you that you need to immediately restore your previous form. Avoid mental overexertion.
Immediately after discharge from the hospital, you should contact a cardiologist at your place of residence. You need to do this even if nothing bothers you. A specialist will monitor your recovery progress. He will determine the time when you can start work.
Stop smoking. Monitor your cholesterol levels, blood pressure and weight.
After surgery, you will have decreased appetite for some time. This is another reason to eat more often, but in smaller portions. Everything will be back to normal in a few weeks. No special diet is required, but to avoid gaining weight due to decreased activity excess weight, you need to adhere to some rules.
Eat slowly and chew your food well. Almost everyone eats too quickly and ends up eating more than they need. If you eat slowly and diligently and chew for a long time, then much less food will end up in your stomach. After all, it takes about 20 minutes for your brain to signal to your stomach that you are no longer hungry. The signal to stop eating depends on the amount of nutrients in the blood, and not on the volume of food in the stomach.
If food is poorly chewed, it will be poorly digested. And in this form it does not represent any value, turning into waste, adding toxins to an already overloaded digestive system
The longer and more thoroughly food is chewed, the better it is digested and the more nutrients enter the body as a result. In addition, special digestive enzymes are released along with saliva, which serve to break down food, as a result of which the stomach and intestines will work with less stress.
Our mood also depends on the “speed” of a snack. If we eat hastily, and also experience mental stress due to some extraneous reasons, the digestion process will never proceed properly. Various emotions, such as anger, fear and grief, greatly affect the digestion process. So if you are experiencing mental stress or any negative emotions, it is better to abstain from food altogether. Always try to ensure that meals take place in a calm, pleasant atmosphere and at the same time you would have good mood- this is especially important after your surgery.
If you experience any discomfort in your stomach or intestines, try eating an apple or a slice of orange. Has a good effect green tea, especially with the addition of mint. A slow walk after eating also helps a lot.
Eat a little less than you need. We must eat exactly as much as the body requires, and not an ounce more - otherwise all the excess will remain in the body in the form of fat, which is completely undesirable after your operation.
IN modern world people eat a lot, but at the same time their body constantly lacks important nutrients. Products from the “Top Twenty” make our body the most in the best possible way can digest and assimilate, but moderation must be observed with them.
Laboratory studies on animals showed that animals that received less food had better resistance to all kinds of diseases and a longer life expectancy than those that overfed. This does not mean that you need to constantly undereat or give up all culinary preferences. You just need to eat in strictly required quantities and according to energy expenditure.
The reason for overeating is also that in the modern diet according to the principle “ fast food“includes foods that are mostly deprived of the nutrients necessary for the body: vitamins, mineral compounds and enzymes. And when cells are deprived of these nutrients, they signal the need for additional food. So overeating is a direct consequence of not getting the necessary nutrients.
In addition, overeating forces the digestive system to work under enormous strain, which requires the body to expend increased energy. As a result, a person feels tired for several hours after eating.
Once you switch to proper nutrition, you will very soon notice how little food you actually need to feel normal. And then after eating you will experience a feeling of satisfaction, not discomfort. And for several hours after eating, you will not feel hungry, which will allow you to give up habitual but unnecessary snacks.
Diversify your diet. Eating a variety of different foods will ensure that you get everything you need nutrients, including vitamins and mineral salts, which will help your body recover faster after surgery.
A good way to create variety is to change the color of the foods you eat. It is also useful to eat several types of vegetables and fruits at one time - if you have foods of various colors and shades on your plate, you will create the effect of diversity. The bright color of a fruit or vegetable indicates its high nutritional value.
Don't skip another meal. It is better to never skip breakfast. Skipping breakfast will impact your mood, energy levels, and mental performance throughout the day. Usually a person who has not had time to have breakfast likes to take a coffee break while satisfying his hunger with cakes, buns and sweets. Anyone who skips breakfast overeats at lunch, and as a result, struggles with sleepiness and fatigue the rest of the day. You can't skip lunch either. Because when it’s time for dinner, those who missed lunch are ready to gobble up everything and with great speed. In addition, if you skip lunch, by the end of the day your blood sugar levels drop significantly, and with it your vitality drops.
Food should be taken at certain hours. If you eat whenever you have to, you will either end up having to eat when your body doesn’t yet need food, or you will start eating when hunger becomes unbearable. As a result, you will eat much more than you need to feel full. And if the meal hours are always the same, everything will arrive in the right quantities and on time.
This does not mean that you need to eat 3 times a day. Sometimes it’s better to eat 5-6 times, but little by little, rather than 1-2 times, but to satiety.
Always eat in moderation. In your post-surgery diet, moderation is key. Any excesses are unacceptable. Don't become a fanatic and limit yourself to just one product category. Even if you love fruits and vegetables, this doesn't mean you have to be a strict vegetarian. After all, all categories are important food products. All kinds of accidental breakdowns and violations are acceptable, unless, of course, they are of a regular nature and do not turn into a habit over time.
If you decide to make any changes to your diet, do it gradually. Give your body time to adapt to them.
If you deviate from the system from time to time proper nutrition, don't panic. All is not lost. Just try to get back to her as quickly as possible.
Salary at interview
Housing provided, social package
Salary at interview
Accommodation is not provided
Salary at interview
Salary at interview
Accommodation is not provided
Salary cut
Housing is provided, a one-time payment of rubles. according to the Zemsky Doctor program
Salary at interview
Housing not provided, work in rural areas
- Treatment of bunions (Hallux Valgus)
What is the difference between a free operation (based on a quota) and a paid one?
The operation itself is no different. For all the operations that I perform, I use modern medical equipment, the best imported implants, high-quality consumables, necessary medications, and I use conduction anesthesia (a type of local one - two injections are given in the foot).
U free operation there are only two differences:
1. According to the quota, only one foot can be operated on per operation.
If you want to operate on both legs at once, they will need to be operated on in different days. Moreover, the second foot can be operated on no earlier than in 2 weeks
2. If you are operated on under a quota, then you do not have postoperative management
Included in price paid operations I always include post-operative care. This way I can monitor how you feel, how the bone is healing and overall healing, and the restoration of joint mobility. Thanks to this, I can prevent possible postoperative complications. This always leads to excellent results and satisfied patients.
Postoperative care can be purchased separately.
Why does swelling last so long after surgery and when does it subside?
Indeed, swelling can last from 3 to 6 months. The degree (volume) of swelling and the time it lasts are influenced by 4 factors. Here they are:
1. The experience of the surgeon and the invasiveness of the intervention - when the doctor has performed thousands of operations, he already knows what to do and keeps everything under control, the operation time is reduced, accordingly, it will be easier to undergo rehabilitation and the result will be better
2. Equipment and instruments that the surgeon uses during the operation - the use of high-quality instruments reduces trauma and operation time
3. Conditions of the patient’s venous system
4. The patient’s compliance with the doctor’s recommendations for the postoperative and recovery period
Very rarely severe swelling maybe for some other reason.
Of course, swelling is not something we all expect, but only forced by-effect. Therefore, there is a natural desire to reduce it as quickly as possible in order to fully enjoy healthy and beautiful legs.
How can you reduce it? To do this, simply follow your doctor’s recommendations, use compression stockings, do lymphatic drainage and physical therapy. And the result will not be long in coming.
Can I wear heels after surgery?
We only live once, why deny yourself the pleasure of showing off your beautiful legs? That's why I allow my patients to wear high-heeled shoes. This is only possible after full period recovery - 4-6 months. You can wear beautiful shoes to go to the theater, restaurant or some kind of celebration for a couple of hours.
It is advisable not to wear high-heeled shoes all the time. This may lead to major changes even completely healthy legs. ⠀
⠀1. When you wear high heels, the distribution of body weight between your toes and heel is disrupted - the center of gravity shifts and your body leans forward. This leads to an imbalance in the entire body. And first of all, the spine suffers from this, especially the lumbar region. ⠀
⠀2. Chronically wearing high heels can cause significant changes in Achilles tendon length in less than 6 months. Why is this happening? As soon as you put on your shoes, your Achilles contracts. This increases the tension at the site of its attachment to the heel bone. This can lead to inflammation called tendinitis. ⠀
3. When you put on narrow shoes, you squeeze your toes. And they take an unnatural position. This leads to ingrown toenails, calluses and blisters, tendon disease, painful growths and swollen feet.
4. When you stand or walk in your shoes, your foot is inclined, which greatly increases the pressure on the plantar part of your foot. The higher the heel, the greater the pressure. An 8-centimeter heel increases blood pressure by 76%. This leads to swollen fingers, bunions, calluses and neuromas. ⠀
5. When you wear heels, your body is unstable. The most frequent injuries Girls who wear such shoes have sprained ligaments and broken ankles. But they actually meet severe injuries, for example, a fracture of the calcaneus. ⠀
Of course, you decide how often and for how long you wear high-heeled shoes. I would recommend doing this no more than 3 hours a day. And do foot exercises and massage every day
Who can undergo surgery for free (under quota) and what is needed for this?
I can operate for free on almost all residents of Russia due to the fact that the quotas are federal. Unfortunately, there is one exception - patients with Moscow registration are not covered by the quota. Quota operations are performed in Moscow, at the Medical Center in Kolomenskoye (ZAO MCC).
The operation itself is completely free for you. It includes conduction anesthesia, necessary medications and materials from the best manufacturers. Travel expenses, foot x-rays, preoperative tests, postoperative Baruk shoes, consultation fees, and postoperative care are NOT covered. The patient pays for all this independently.
In order for me to sign you up for surgery under a quota, an initial consultation is required. You can come to my appointment in St. Petersburg on weekdays. I also accept appointments in other cities; the appointment schedule appears on the website in advance. The cost of admission is 2000 rubles.
In addition, I can give an official opinion on radiographs of your feet and schedule you for surgery online via Skype or WhatsApp. The cost of this service is 1500 rubles.
After this, you just need to come to the clinic on the day of the operation with your passport, compulsory medical insurance policy and SNILS. And, of course, with the results of the necessary tests.
Is it worth operating on both feet at once, or is it better to operate on one at a time?
There is no clear answer to this question. It's best to make this decision based on your individual situation.
The first two weeks after surgery must be followed bed rest. Therefore, when you have children, it is very difficult to give them enough attention during this period. Not everyone has the opportunity to benefit from the help of their relatives.
One of my patients has two small children. At that time, the eldest was 4 years old, and the youngest was 1.5 years old. Realizing that after the operation she would have to cope with caring for the children herself, she decided to operate on one foot first, and after a month and a half on the second. Both operations were successful, the patient was very pleased with the result.
According to her, she decided to operate on her legs one at a time, because small children need a lot of attention, you need to be constantly nearby, they are constantly on the move. But the first time after surgery there are many restrictions on movement and your legs get tired quickly.
Another example. The patient also has two children. At the same time, there was good support from relatives: grandmothers helped with caring for their grandchildren. Therefore, my patient decided to have both feet operated on at once, so as not to have to undergo repeated rehabilitation in a few months.
When two weeks passed after the operation, she began to take care of the children on her own. Therefore, she didn’t really have time for rehabilitation. And yet, after the recovery period, everything is fine: the feet have healed perfectly, the range of motion of the fingers has been restored. According to her, it was difficult even with the help. Nevertheless, she is very pleased with the result.
A completely different situation is work. Not everyone has the opportunity to take sick leave for a month. Some of my patients go to work after the first two weeks wearing special post-operative shoes. This is only possible if the work does not involve stress on the legs. In this case, it is more convenient to operate on one foot at a time.
And of course, you need to take into account the fact that surgery is always stressful for the body. And if you have the opportunity and desire to operate on both feet at once, then it is better to do so so as not to experience this stress twice.
Can the bunion come back after surgery?
Yes, sometimes this is possible - when the operation was performed poorly: undercorrection, non-compliance with technology, etc. Therefore, it is best to be very careful when choosing the surgeon who will operate on you.
In addition, if you have problems in the middle and/or hindfoot, this can lead to overload of the medial ray of the foot (it is formed by the bones of the first toe). Because of this, over time hallux valgus the first toe may develop again. But this happens really rarely.
According to statistics, 85% of operated patients are satisfied with the result of the operation - these are the results of observations 15-20 years after the operation. As you can see, the long-term results are very good.
Of course, no one can give a 100% guarantee in medicine. However, with a well-performed operation, with correct execution exercises during recovery, subject to the required regimen after surgery and throughout the entire rehabilitation, with proper selection and correct wearing of shoes, you can minimize the possibility of the return of a bunion.
How long is the recovery period after surgery?
Recovery after surgery to remove a bone lasts from 4 to 6 months. Conventionally, it can be divided into 4 stages:
- first two weeks
- third and fourth weeks
- fifth and sixth weeks
- from the seventh week until the end of the entire rehabilitation (4-6 months)
How are the first two weeks after surgery?
During this period, it is necessary to observe maximum home, bed rest. In this case, you need to position yourself so that your leg is raised above the level of your heart. You can place pillows or a soft cushion under your leg.
Why is it important? When you lower your leg down, you will feel blood flow and heaviness in your legs. This causes severe discomfort and pain.
In addition, the leg will swell more. As you know, when you lower your leg down, the blood flows downward due to gravity and the work of the heart. In addition to the heart, the work of muscles and valves helps it flow upward. And after the operation, the muscles do not work well. Because of this, swelling forms. From the third week, exercises will begin, and with large swelling it will be difficult to develop your fingers.
In addition, during this period you can only walk short distances within the house: to the toilet, bath or kitchen. This can only be done in special post-operative Baruk shoes, because during this period you can only step on the heel.
- Other
What tests are needed to perform the operation?
Tests valid for 2 weeks:
General analysis blood + ESR
- General urine analysis
- Blood coagulogram (INR, fibrinogen, duration of bleeding)
- ECG – electrocardiogram
Tests valid for 5 weeks:
Blood biochemistry (glucose, urea, creatinine, total bilirubin, AST, ALT)
Tests valid for 3 months:
HBS-Ag – test for hepatitis B
- HCV – test for hepatitis C
- RW – test for syphilis
- HIV – AIDS test
Tests valid for 6 months:
Fluorography (or x-ray) of the chest
Tests that can be taken at any time:
Blood type and Rh factor
All tests must be taken in the morning on an empty stomach.
After you pass all the tests, you need to get a conclusion from your therapist that there are no contraindications for planned surgery.
What's the next step after you've booked your surgery?
The next step after you have booked your surgery is to take the necessary tests. Each analysis has an expiration date. Some can be done up to three months in advance, and some can be done up to 2 weeks before surgery. This is very important, please pay attention to this when you perform them.
Is it possible to replace a series of analyzes with similar ones?
This is not worth doing. The list has been approved by hospitals: these are the studies that are necessary so that you can be approved for surgery. If you replace one analysis with another, they may differ, even if it does not seem so at first glance. Each study has a lot of subtleties and nuances.
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