Life after bypass surgery: protecting your grafts

I tell every patient the same thing before discharge: the operation succeeded, and now the longer operation begins — yours. Bypass surgery restores blood flow around blockages, but it does not stop the disease that caused them. The same process that narrowed your coronary arteries can narrow your grafts. The good news: the habits that protect grafts are simple, inexpensive and entirely in your hands.

The first six weeks

Walk from day one — a little more each day, on flat ground, before meals or two hours after. Do your breathing exercises; they are as important as any medicine on your chart. Take medications exactly as written, and do not stop anything without asking. The breastbone takes about six weeks to knit: no heavy lifting, no driving until your surgeon clears you.

For the rest of your life

Five disciplines decide graft longevity: complete abstinence from tobacco; blood pressure kept at target; diabetes controlled and monitored; cholesterol treated seriously, usually with a statin; and forty-five minutes of brisk walking most days of the week. None of these is glamorous. Together they are more powerful than any operation I can perform.

The follow-up rhythm

See your cardiologist as scheduled even when you feel perfectly well — especially when you feel perfectly well. Silent changes are found in routine checks, not in emergencies. And any new chest discomfort, breathlessness or unusual fatigue deserves a call, not a wait.