LIFESTYLE MANAGEMENT AFTER CARDIAC SURGERY

DR I S VIRDI

MBBS, MS, MCh, FRCS (Edin), FRCS (C/th), FRACSSenior Consultant & Chief of CTVS

Max Healthcare

• Undergraduate & General Surgical Post Graduate studies-G M C-Patiala(1980)

• M.Ch in Cardiothoracic Surgery –P GI M ER, Chandigarh, in 1983 • British Heart Foundation Fellow in Cardiothoracic Surgery• FRCS from Edinburgh University• FRCS in Cardiothoracic Surgery from the Inter Collegiate Board. • Due to turbulent times in 1986 went to Sydney, Australia• Fellowship of the Royal Australasian College of Surgeons -St. Vincent’s

Hospital Sydney. • Apollo Hospital, Delhi in 1995 2000 heart operations and about 200 major thoracic procedures – 6years • Returned back to Australia in 2002 Senior Consultant Cardiothoracic Surgeon and Adjunct Associate Professor at the James Cook University - 5 years • Returned back as Chief Cardiothoracic and Vascular Surgeon of Max Hospital

New Delhi

• Main interest pertain to adult heart and lung surgery• also has trained for neonatal heart surgery • transplantation of thoracic organs – both heart and lungs. • Coronary Artery Surgery• Valvular Heart Disease – reparative procedures for the mitral valve• Surgery on the aortic root, thoracic aortic dissections and

aneurysms• Thoracic malignancies• Major research interest myocardial preservation - James Cook

University developing a new Cardioplegic solution for arrested heart surgery and pharmacological stabilization for Beating heart surgery

• Published in several Peer reviewed Journals• Trained more than a dozen cardiothoracic surgeons who are now

running successful cardiac surgical programmes of their own.

• Cardiac surgery is one of the most significant events in an individual life.

• Aim - return to a good quality life as quickly as possible.

• Lifestyle changes – Alter old habits to

minimize recurrence of future cardiac events

LIFESTYLE CHANGES

• Exercise

• Diet

• Stress Management

• Weight Control

• Achieved through a planned rehabilitation programme

Rehabilitation programme

• Educate about Cardiac risk factors

• How to manage them– psycho social issues– stress and depression– returning to work, sports and leisure activities– improving fitness in the short and long term– healthy eating– FINALLY - remaining motivated.

CARDIAC RISK FACTORS

• Smoking• Physical inactivity• High blood cholesterol• Excess weight• High blood pressure• Diabetes• Stress• Male gender• Family history

HOME EXERCISE PROGRAM

• Range of movement exercises to reduce stiffness in joints

• Posture correction• Breathing exercises to

improve the lung function• Progressive walking

program– Over a period of six

weeks the patient gradually progresses to a 30min moderate paced or brisk walk.

• All these improve fitness in the long term

• Initially under the guidance of a cardiac physiotherapist

• In consultation with the surgeon - individualized for each patient

• Tennis, Swimming or Golf encouraged after 3 months of surgery.

DIET MANAGEMENT

• Directed towards– Weight control– Reduction of cholesterol

levels.

• Individualized as per the patient’s diagnosis.– Diabetes– Renal dysfunction– Any other additional

medical condition– Diet has to be modified

further.

HEALTHY DIET• A well balanced diet

– rich in nutrients– low in fat.

• Specific:– Low-sodium diet– Limited fluid intake– High Protein Diet

• Unspecific:– Fat and Cholesterol– Simple carbohydrates– Reduce weight if patient is obese– No smoking– No alcohol

HEALTHY DIET

• It will make you feel much better• Help you live a longer life

• Challenging to learn new ways of cooking and eating

• Learn a few different habits– Grocery shopping– Cooking

STRESS MANAGEMENT

• Recognize what causes stress and how the body reacts to it

• Tips to managing stress– deep breathing– positive and realistic thinking– taking time out– maintaining good social support– nurturing a hobby– learning to relax– cutting down on stimulants like coffee, tea etc– FINALLY practicing stress management regularly

CONCLUSION

• Help in feeling better– Emotionally– Physically– With less stress– more confidence.

• Take control of your health– Reducing the risk of further heart problems– Help in living longer