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The Bounce-Back after Heart Surgery

Dr Sreedevi Yadavalli with Dr Vijay Dikshit

(Continued...)
 
Even so, given Dr Dikshit’s wealth of experience, what factors influenced post operative recovery for most patients – including those who are not surgeons themselves, we probed. As a heart surgeon, what factors does he think play an important role in post operative recovery?
 
Would he respond to some of the random factors we came up with, in terms of indicating how they had a bearing on patient recovery, and indicate the degree of “illness symptoms” his patients came up with, following surgery?

Time in the course of illness – would patients with prolonged illness take longer to recover after surgery?
Delayed and neglected cases take longer in post recovery phase. Such cases also have more chances of running complications. For optimal recovery, surgery must be done at the appropriate stage – neither too early, nor too late. For surgeons, a lot depends on in what condition we get to receive a patient.

Co morbidity – does the existence of other illnesses, along with a heart condition, strongly relate to post operative illness symptoms?
Yes, they do. For instance, associated illnesses, especially diabetes, which among Indians comprises nearly half of those with cardiac illness, makes it that much more difficult during recovery. Added to this, if the patient were to be a smoker or prone to excessive consumption of alcohol, or even subject to the sheer stress of urban living, then we are looking at longer recovery periods.

Gender – is this a significant discriminator for recovery?
Yes this is, but not in the way we learn of in textbooks. Let me explain. Textbooks tell us that women may tend to run more complications than men, but my experience is different.

Women do tend to neglect themselves more and come in late for treatment. I have often encountered women who were obese and had me wondering about their recovery, but have ended up surprising me with their rate of recovery.
I have certainly found women patients more resilient, and less complaining.

Obesity – We know that obese and overweight patients run a higher risk for heart disease, but are they slower to recover as well?
Almost invariably. Actually, whenever I see an obese patient due for surgery, I begin worrying.

Diet – Are vegetarians likely to recover faster than non-vegetarians?
Let me surprise you – the answer is ‘no’!
Yes, I know that vegetarian is supposed to be a better diet, and I am a vegetarian too. But as a surgeon, I’ve found that the higher protein content in non-vegetarian diet makes such patients recover faster from surgery.

In fact for a major surgery, if I know the patient is vegetarian, this factor weighs at the back of my mind, particularly if extensive surgery may be required. But for non-vegetarians - and I mean those who take meat as part of their daily diet - things are a little more reassuring. Why, I have operated on patients from Africa and the Gulf, who take a predominantly non-vegetarian diet, and have seen them recover in record time to depart happily for their respective countries.

Family support – Does the presence of a caring family and friends’ circle indicate better recovery?
Family support is certainly a very important factor for recovery. Though in rare cases, there is another extreme to it in terms of too many caring family members giving varied “dos and don’ts” directives to the patient to end up eroding the patient’s self-confidence and inducing nervousness. Maybe he would recover faster if left alone! But yes, overall, the love and care of family plays a vital role in the recovery phase.

Attitude towards procedure – would a cooperative and optimistic patient fare better at recovery?
Yes, most certainly. I have instances where family members request me not to talk about the details of the procedure to the patient, for they fear the patient’s non-cooperation. But I always make it a point to explain the procedure to the patient who is to undergo it. I also detail post recovery expectations. This is because I find willing patients more confident at recovery, so the patient has to be told all.

Is there any other point that makes a crucial differentiator for post operative recovery?
Yes, it is faith and trust – in the Almighty, in the hospital, and in the doctor – in that order.
 
Dr Vijay Dikshit is Chief Cardio-Thoracic Surgeon, Apollo Health City, Hyderabad.
 
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