Friday, February 3, 2023

Upper Back Pain After Open Heart Surgery

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How do you restart your exercise program after heart surgery?

Sternal wires removed 18 months post CABG, I am living proof…. not fun either, very sore for a few months after.

They do remove sternal wires.I had mine removed in 2009, 4 yrs after open heart due to the fact that I had broke them. They were coming through my skin. I was in pain all the time, had difficulty picking up my small children. My surgeon went in and removed them, I do have to be careful with one area. But I feel so much better.

I had wires and sternal-plating used. After 5 weeks one of the screws came loose. The pain had been subsiding but the screw changed that. I ended up adding Lidocaine patches to the Norco I was already on. Before I got to surgery more screws came loose so they took the entire upper plate out.

The bruising was actually worse with the second surgery. It’s been 8 days and there is still a strong pain on both sides of the incision but especially the left side. I’ve got hope by next week it will be more normal, when I have an appointment with the cardiac doctor. in the mean time it hurts to even take plates out of the cabinet!

If they cut horizontally ACROSS your chest, then they will have cut muscle and connective tissue which is going to take a lot longer to heal than the typical vertical only cut from top to bottom of the sternum.

The discomfort will pass with time.

Wow! What a story. You had some wonderful surgeons to deal with the ToF

It will strengthen the chest muscles and gently stretch them and the scar tissue.

Sternum Healing After Open Heart Surgery

To perform open heart surgery, a surgeon needs to cut through a persons sternum in a procedure known as a sternotomy. It is a major operation that involves a lengthy healing process that can take months.

In some cases , complete healing takes a year or more. However, this depends on the individual case. Older age and having other health conditions can affect healing time.

A person can help prevent complications by caring for their wound and gradually reintroducing physical activity according to the doctors instructions when they get home.

Read on to learn more about sternum healing after open heart surgery.

Full recovery following a sternotomy is possible, but it is a long process.

After surgery, the surgeon will use strong wire to hold the cut bones together, allowing new cells to grow. Over the course of months, the bones fuse back together.

Dont Take Your Meds As Prescribed

You may shrug off pain medication because you heard its addictive or it makes you constipated, nauseous, or woozy. But skimping on your medicine isnt smart.

Pain can sometimes interfere with your sleep, appetite, and ability to get around, Whiteson says. And that can make it harder for your body to heal. Ultimately, the goal is to get off medication, but not before youre ready.

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What Kinds Of Pain Can I Expect To Feel After Surgery

Every patient is unique, and you may or may not have the same type of pain another patient experiences. You may be surprised after surgery to feel pain in places besides the incision site, especially as you begin to move about. Please tell a member of your healthcare team about the pain you have after surgery, which can include:

  • Muscle pain: You may feel muscle pain in your neck, shoulders, back or chest. This is from lying on your back on the operating table and in the care unit.
  • Throat pain: Your throat may feel sore or scratchy from the endotracheal tube.
  • Pain from chest tubes: You may have some discomfort from the chest tubes that were placed in your chest to drain fluid, blood and air during heart surgery.
  • Incision pain: You may feel pressure or burning at the incision site

You May Feel Like Youre On An Emotional Roller Coaster

What To Expect After Open Heart Surgery

Recovering from open-heart surgery involves physical and emotional healing. The recovery process uses emotional and physical energy.

If you feel upset or emotional in the weeks after your operation, dont worry this is a normal reaction. Many patients report these feelings up to three months after the operation:

  • Mood swings that may include depression, fear, anxiety, loneliness, helplessness and anger

  • Crying easily for no apparent reason

  • Lack of energy or motivation

  • Getting easily frustrated

  • Having good days and bad days

  • Feeling more emotional or sentimental than normal

Even though you may feel drained physically and emotionally, its important to follow guidelines for good self-care:

  • Get dressed every day

  • Walk daily within your limits

  • Get plenty of rest

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The First 3 Months After Surgery

During the first 3 months after open heart surgery, it is safe to do easy chores around the house and yard, such as:

  • folding clothes
  • pruning flowers

Social activities, such as going to the movies and restaurants, are also safe as long as they do not involve a lot of physical effort.

A person should aim to some walking every day. Start with a short distance and try to walk up, little by little. Walking supports blood circulation and helps to reduce the risk of pneumonia and constipation.

It is also safe to use an indoor stationary bicycle at this stage, but only at a gentle pace.

A person can probably return to work after 13 months. However, this will depend on the type of work they do and how physically demanding it is.

To help manage pain, a person can sleep on their back. If they need to cough or take a deep breath, it can help to hold a pillow over the wound to support the sternum.

A person should ask their doctor when it will be safe for them to drive again.

What Is The Cause Of Back Pain In The Back After Aortic Valve Replacement

Answered by: Dr OP Yadava | CEO & Chief Cardiac Surgeon, National Heart Institute, New Delhi

Q: My husband underwent an open heart surgery 4 years ago, where his aortic valve was replaced with a mechanical one. He also had about 4 inches of aorta replaced due to enlargement. Since the surgery, he gets a pain in his back, lower part, on either side of the upper part and in the shoulder blade area. The pain is very intense and lasts from 5 to 10 minutes. Some are bad enough to make him feel like vomiting. He went back to the cardiologist, wore a heart monitor and got an MRI done. But there weren’t any problems. No doctor is able to explain the cause of this pain. They say that it might be due to the surgery. The pain comes at various times like during sleep, sitting, standing etc. He is taking Lipitor 10mg daily, Diovan 160 daily and Warfarin 7.5 mg daily. Please advise.

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Implications For Practice And Future Research

Additional study of the phenomenon should include what type of physical activity accounted for the daily energy expenditure, as well describing the type and intensity of exercise. Consideration should be given to evaluating other types of measurement devices, besides an accelerometer, which might be better suited to capture physical activity in the older population of cardiac patients. Future studies need to examine how these variables may differ between fatigued and non-fatigued patients. In addition, further examination of the predictors of fatigue following cardiac surgery and other cardiac events are needed. Additional study of the fatigue experience, including multiple dimensions of fatigue, following CABG surgery is warranted to determine which factors contribute to the presence and persistence of fatigue, as well as how to mitigate the effects of fatigue on functioning and physical activity. Another need is to determine if fatigue is more problematic for females versus male CABG surgical patients, when developing gender specific interventions to reduce fatigue. Assisting CABG surgical patients to recognize and interpret their perceptions of fatigue needs to be explored, as this may be useful in reducing the associated depressive and anxiety symptoms, which commonly occur after CABG surgery.

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Your Personality And Mood May Change After Open

Mother Receives Open-Heart Surgery While Giving Birth

After open-heart surgery, many people experience personality and mood changes. The most commonly experienced emotions are depression, fatigue and anxiety. These can be caused by being on bypass, anesthesia, or medication such as oxycontin. You may experience mood swings like crying or getting angry or easily frustrated.

I mostly experienced this after my second open heart surgery when I was a teenager and my third open-heart surgery. After both of them, I experienced depression, anxiety and PTSD. Before my second open heart surgery, I was more outgoing but afterward, my personality changed and I was quieter and self-reflective. I struggled with suicidal thoughts and mood swings. After my most recent surgery, I finally got the therapy I needed after years of not seeking help. If you are struggling, please find help, be open with your doctor and make sure you have someone to talk to.

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Muscle Injury Or Overuse

Sometimes chest and back pain may be due to injury or overuse of muscles. Injury can occur due to things like accidents or falls.

Overuse can also cause muscle pain. Repetitive motions that are used in day-to-day activities, work, or sports can also contribute to this. An example of a repetitive activity that may cause muscle pain in the chest and back is rowing.

Generally, pain from muscle injury or overuse may be worse when moving the affected area.

Upper Back Pain Causes

If the above symptoms sound familiar, theres a good chance you are being afflicted by upper back pain. Many patients are surprised to learn the broad spectrum of factors that can spur upper back complications. The following determinants can contribute to upper back pain:

  • Strained Muscles

The shoulder girdle is attached by large muscles to the scapula, or shoulder blade, and the back of the thoracic rib cage. These large upper back muscles are susceptible to irritation. When you over-stretch muscle tissue, damage often occurs. Tearing of the muscle and the disruption of small blood vessels can lead to tenderness, inflammation and swelling. Poor posture, a lack of exercise, a traumatic incident or improperly lifting heavy objects may induce harm.

Injured discs in the spinal column press against surrounding tissues and nerves, causing pain and other complications.

  • Fractured Vertebrae

A damaged vertebrae in the cervical or thoracic regions of the spine may hinder motion and incite intense discomfort.

Some serious bacterial infections, such as meningitis, can cause upper back pain.

Hormonal changes and vitamin deficiencies can cause osteoporosis, a condition in which the bones become brittle and fragile from tissue loss. Weak bones are more likely to fracture or become injured, straining corresponding tissues and ligaments.

  • Spinal Conditions, such as scoliosis

Certain complications, such as scoliosis, disrupt the structural integrity of the spine and cause pain.

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> > > 1 Unlikely Stretch Wipes Out Sciatica

Surgical interventions to correct spinal deformity include spinal fusion, which is a surgical procedure that uses bone graft to replace a disc. After undergoing surgery, your back will require physical therapy for three to six months. In addition to doctors and dentists, you can also see neurologists, physiatrists, and chiropractors. These specialists specialize in the brain and spinal cord disorders. They are often the best choice for patients seeking treatment for back pain.

Non-specific back pain is usually not diagnosed until the pain is long-term. There is no clear cause for non-specific back pain, but doctors should seek a diagnosis to treat the condition. It is important to visit a specialist for treatment in order to get the best treatment options. If the pain is chronic or has no specific cause, a doctor will perform diagnostic imaging to help identify the exact source of the pain. Further, they can perform MRIs to help diagnose underlying conditions.

While back pain is a common ailment, it can also be caused by something else. Many people experience sciatica or other pain in the leg, and a slipped disc could be the cause. Other types of back pain may be more acute, such as a herniated disc. For nonspecific back pain, a doctor may need to perform radiological imaging to diagnose the exact cause of the pain.

Pots: A Little Known Cause Of Extreme Fatigue

Scoliosis post surgery scar

Everyone knows what being tired feels like at the end of a long day. But some people experience fatigue so severe and so seemingly random that its hard to describe. If that sounds familiar, there could be more going on than daily stress.

While there are many causes of fatigue, one of them is frequently missed and misdiagnosed: postural orthostatic tachycardia syndrome . Physical medicine and neuromuscular specialist Tae Chung, M.D., answers questions about POTS and extreme fatigue as one of its symptoms.

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Pregabalin Effect On Acute And Chronic Pain After Cardiac Surgery

Menelaos KaranikolasAcademic Editor: Received

Abstract

Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75mg, and Group 3 received oral pregabalin 150mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively. Results. Patients receiving pregabalin required fewer morphine boluses and had lower pain scores at 8 hours and 3 months and lower morphine consumption at 8 hours and 24 hours . Percentage of patients with sleep disturbances or requiring analgesics was lower in the pregabalin group and even lower with higher pregabalin dose 3 months after surgery. Preoperative oral pregabalin 75 or 150mg reduces postoperative morphine requirements and acute and chronic pain after cardiac surgery.

1. Introduction

Approaches used in an attempt to reduce pain after cardiac surgery include local anesthetic infiltration of the sternotomy and chest tube insertion sites , parasternal block , thoracic epidural analgesia , and analgesic medications, including intravenous opioids , intrathecal opioids , and paracetamol, diclofenac, and gabapentin by different routes .

2. Methods

2.1. Statistical Analysis

3. Results

4. Discussion

What Happens To The Bone After Open Heart Surgery

Although this compromise in the blood supply to the fractured bone is essential for surgery, it is a violation of the third principle of fracture management and likely affects the healing time of bones and soft tissues. This necessary breach may make adherence to the remaining three principles of fracture management more important.

How long does it take for a heart transplant to work?

Expect a gradual recovery. It can take up to six weeks before you start to feel better and up to six months to feel the full benefits of surgery. However, the outlook is good for many people, and transplants can work for many years. How long does it take for the pericardium to heal after open heart surgery?

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Reasons To Call Your Doctor

If you feel any of these symptoms, report them to your doctor or nurse:

  • Palpitations or a heart rate greater than 120 beats per minute when you are at rest, or a change from a regular to an irregular pulse.
  • Increased fatigue or shortness of breath at rest.
  • Temperature greater than 101 degrees more than one time, or chills for 24 hours.
  • Excessive redness, swelling, soreness or drainage from any wound site.
  • Swelling in your ankles and hands with a weight gain of two or more pounds in one day or five pounds in one week.
  • Abnormal pain or other symptoms that do not go away with your medication.
  • Pain in the calf of your leg.

Pathophysiology Of Acute Pain

Recovering from Open Heart Surgery

Postoperative pain mechanisms are complex, but generally speaking, in addition to the nociceptive stimulus from direct tissue trauma, an inflammatory response leads to peripheral and central sensitization in pain experience. Most of the pain after sternotomy occurs because of tissular damage in the skin, subcutaneous tissue, bone, and cartilage.11 Mazzeffi M, Khelemsky Y. Poststernotomy pain: a clinical review. J Cardiothorac Vasc Anesth. 2011 25:1163-78.

The intercostal nerves that arise from the thoracic nerve roots innervate the sternum, ribs, and the adjacent subcutaneous tissue. The main thoracic nerves that supply the sternum range from T2 to T6. The parietal pleura is also densely innervated by pain fibers that can be activated by both mechanical and chemical stimulation. In contrast, visceral pleura has no significant sensory innervation. Pericardium is innervated by sensory fibers from the vagus and phrenic nerves and sympathetic trunk.11 Mazzeffi M, Khelemsky Y. Poststernotomy pain: a clinical review. J Cardiothorac Vasc Anesth. 2011 25:1163-78.

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Caring For The Wound At Home

Before a person leaves hospital, a health professional will typically remove a persons surgical dressings. At home, once the wound is clean and dry, it is safe to use the shower, or take a short bath, as long as a person takes care not to push or pull too hard getting in or out.

However, a person should avoid using fragranced soaps, creams, or powders, which may irritate the wound. They should also avoid rubbing the wound too vigorously when drying after washing. No matter how itchy the wound may feel, they should avoid scratching or picking, as this can lead to infection.

Doctors recommend that a person eases their way back into everyday activities gently. The key is to start small and take plenty of breaks. Rest when tired, and do not try to push through fatigue or pain.

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