Pre-op

Eating healthy to prepare for op
Eating healthy to prepare for op

It is 3 days to my coronary artery bypass graft (CABG – pronounced “cabbage”) surgery on 22 September. There are several things which I have to do to prepare for this.

The first is to stop taking anti-coagulent medication. In my case, this would be the drug called plavix. Doc wanted me to be on aspirin but as it turned out, I am allergic to that drug. (I am also allergic to naproxen, another painkiller.) So, plavix was recommended instead.

Here, I would like to explain that it is very important that you note your allergies. So that in time such as this, you are able to tell your doc straight away about them.

When they asked me for my allergies, all I could say was Synflex, which I later found out was known as naproxen, its medical name. When they asked if I was also allergic to aspirin, which I am told is a “cousin” of naproxen, I was unable to say for sure since I had not taken aspirin for a very very long time.

Bisoprolol
Bisoprolol

This was why the doc had to put me through a “aspirin challenge”, to ascertain if I was allergic to the drug. Aspirin is the drug prescribed to those who undergo angioplasty and bypass. And since it is a common drug, it is also cheaper. Cost is an issue for many heart patients since they would have to take it for life after an op.

Unfortunately, I can’t take aspirin and will have to stick to plavix.

Anyway, a week before the op, you are asked to stop aspirin or plavix, because these are blood thinners and they may cause excessive bleeding or blood loss during surgery.

ferrous gluconate
ferrous gluconate

I was also given bisoprolol fumarate, a drug to slow down my heart rate; and atovarstatin, the anti-cholesterol drug. The doctors at the polyclinic which I had been seeing prescribed just 10mg of atovarstatin. The docs at NHCS upped this to 40mg.

And also, there are ferrous gluconate (or iron pills), and prednisolone.

What I noticed in the week during which I was taking these drugs was that I felt a lot lighter in the chest. I was telling the lady (my partner) that my heart feels so light I hardly feel it at all. And it felt good. Very good, in fact. There wasn’t that tightness I felt all the time before these medications.

And since I stopped them – the bisoprolol, prednisolone (to manage my allergic reactions to aspirin then) and plavix – the tightness in my chest has returned.

Here, I should also mention that I have been prescribed Glyceryl Trinitrate.  It is for the treatment of chest pains, but I am advised to take it only when necessary, such as when the pain is acute. I am supposed to put one under the tongue and let it dissolve slowly. (I have to carry this medicine with me all the time. It is sort of an emergency drug, I suppose.)

Glyceryl Trinitrate
Glyceryl Trinitrate

Ok, back to pre-op preps.

The other thing which I need to do is to bathe with prescribed bath and shampoo gels. I’ve to do this for 3 consecutive days before surgery. The purpose is to kill germs on my body so that there are no complications from contamination during surgery.

Hospital-prescribed bath & shampoo gels
Hospital-prescribed bath & shampoo gels

The last thing to do before I am wheeled into the operating room is to fast. I will be admitted a day before surgery day, so I guess the nurses will make sure I am starved (!) the day before the surgery.

I have also been eating healthy, giving up coffee, for example, and eating hawker food. My breakfast is oats and fruits, and meals are home cooked. And I take the prescribed medications faithfully.

And a few days ago, I had to return to the hospital for further pre-op tests, to make sure I was all good to go. For example, they did another test on my left arm, where they would be harvesting a vein from, to make sure the vein is good for such a purpose.

And more blood tests, which all came back great.

Blood test results
Blood test results

Other than these, the rest are in the hands of the nurses, doctors and the other medical professionals. I would imagine there would be at least 10 people involved in the operation itself on Thursday. I don’t think I will get to see all of them before the op because I would be knocked out by the anesthesiologist even before I enter the operating room.

So, am I anxious or nervous, or worried?

Yes, I am anxious – not for the surgery itself but for the post-op management, the pain and the potential unexpected eventualities.

I am not worried about the operation although as the day itself nears, I suspect my nerves will jangle a little.

Not to scare anyone but they are going to open up my chest. (By the way, the op is often referred to as “open heart surgery”, but that’s a misnomer. The heart is not opened. The chest is. So, the more accurate description is “open chest surgery”.)

They will open the chest by separating the breastbone, and prying apart the rib cage to have access to the heart. And after they have done this, they will stop my heart, hooking it up with the heart-lung machine to breathe for me. By this time, they would have already harvested the required veins from my leg (called the saphenous vein), and in my arm. (They might take another from my chest as well.)

And once the op is over, they will close my my chest and hold the breasbone together with metal pins or clips which will remain there forever. And then they will sew me up.

Here is a short video of the procedure:

I will not know a thing as I will be under general anesthesia even before I am wheeled into the operating room.  Which is why I said I am more anxious about post-op than pre-op or the op itself.

But I take courage in knowing that once this harder part is over, I will be a better man in more ways than one. I am in fact looking forward to doing the things I have planned – such as getting back to exercising, taking up yoga once again (and doing it seriously this time round, and putting my yoga teacher certification to good use), getting back to regular jogging and swimming, and yes, achieving my goal of doing something I have never done in my life – running in a marathon – within 2 years after my op.

After I wrote the original article about my bypass operation, I received many messages of thanks, and well wishes, with some giving me valuable suggestions about health and how I can change my habits. They are very much appreciated indeed. I am a little overwhelmed especially by strangers who have sent me their well wishes.

Thank you all so much. Your thoughts do help. 😉

I will spend the next 2 days, taking quiet time for myself. Maybe do a little meditation, before the op.

I am sharing my experience so that if you, my reader, are going through the same thing, or know anyone who is, may find the information useful. My aim is also to dispel the fears we may have about medical treatments. There are a lot of half-truths and inaccurate info out there which may have caused you to worry unnecessarily.

I hope my sharing will help clear up some of these things.

Here is something to read, from the Singapore Heart Foundation website.

*Special thanks to Tay Hung Yong for sharing this info with me.*

shf1

shf2

 

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