Tips For Safe Exercise After Open Heart Surgery

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Exercise after open heart surgery
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What is open heart surgery?

Open heart surgery is a procedure commonly performed for coronary artery bypass grafting surgery (for treatment of blocked arteries after a heart attack or to prevent a heart attack) and/or heart valve surgery (repair or replacement).

In the case of coronary artery disease, open heart surgery is often advised when blockages are too diffuse for angioplasty and stenting or the arteries are too difficult to access via catheterisation.

heart

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Mitral and/or aortic valve repair or replacement are also common open heart surgery procedures and may stem from a case of childhood rheumatic fever, or perhaps valve damage associated with viral or bacterial endocarditis.

Update 14 January 2016: Latest article on exercise after heart valve surgery now live.

Other reasons for open heart surgery may stem from a congenital heart defect or a heart transplant.  No matter what the reason for your operation, the recovery time and subsequent exercise prescription are quite similar.

Recovery time after open heart surgery

Recovery time after cardiac bypass or heart valve surgery can last between six to eight weeks. Because each case is different, you should adhere to the specific guidelines provided by your surgeon or cardiologist. While bed rest is important, it is equally important that you perform low level activity during the recovery phase.

Practical activities such as walking, even at a slow pace, are important for staving off the negative effects of both the surgery and bed rest (i.e., muscle atrophy, muscle and joint stiffness, loss of balance and coordination).

It is quite common for a physical therapist to visit you immediately after open heart surgery to get you up on your feet for short duration walks around the hospital floor.

Most open-heart surgery patients are discharged from the hospital and return home between four and six days.

Resuming activities after open heart surgery

Remember that you’re going to be tired after your surgery. It may be frustrating at times not to be able to do everything you did before your surgery, but just relax and know that this is only temporary.

Before you get back to any heavy exercise, it’s important to get comfortable doing what are known as activities of daily living (ADLs). The following list can help guide you through

Overhead lifting

You can lift your arms over your head for light activities like putting dishes in the cupboard, but try to minimise 1) lifting heavy objects overhead and 2) having your arms overhead for extended periods of time.  You may find it’s not very comfortable anyway given your sternal incision, but try to work within your pain-free range of motion.

Climbing stairs and steps

You may climb stairs and steps after open heart surgery but you may need to take a graduated approach. Begin with a single flight of stairs and, if you find yourself short of breath, then stop and rest. As you start to feel stronger, gradually increase the number of stairs you climb and reduce breaks.

You might find stairs particularly difficult immediately after surgery since the operation is a trauma on the body and the medications that reduce heart rate and blood pressure might make you feel sluggish.

Lifting during household chores

Your sternum may remain sore for up to two months, maybe longer depending on your individual situation.  You can perform most domestic duties such as washing dishes, preparing meals, washing clothes, light cleaning, and shopping.  Try not to lift much more than 2 to 4.5 kg (5 to 10 lbs) during the initial recovery period until you receive clearance from your surgeon or cardiologist. Pay attention to pushing and pulling activities that jar your sternum and cause discomfort.

Sex after open heart surgery

You can resume sex after you’ve received clearance from your doctor (usually a few weeks). But remember, sex can be a stressor on your heart and also the sternum (depending on how adventurous you are). You may need to experiment with different positions that minimise pressure on your sternum, as this is likely to be uncomfortable at least during the first couple of months.

Return to driving

Driving can be dangerous immediately after your surgery since 1) you’re likely to be on a cocktail of medications that can affect your ability to operate a car and; 2) it’s not going to be very comfortable trying to turn a steering wheel while your sternum is still raw and tender. In fact, it might not be comfortable even as a passenger since the seat belt will place direct pressure on your sternum. You may wish to put a light pillow or cushion between your chest and the seat belt.  If necessary, sit in the back seat if your car has an air-bag. If these are deployed during an accident, it can potentially inflict damage to an already weakened sternum.

Travel

If you had a trip planned long before your surgery popped up in your schedule, speak to your doctor about your specific plans and get the nod before you board that plane to Mongolia. You’ll want to be geographically close to your medical management team should complications arise in the early days after your discharge. Remember that airplanes are pressurised to approximately 1800 to 2400 metres (6000 to 8000 feet) above sea level so this can place additional demands on your cardiovascular system. You might need to delay your travels until you are both medically stable and feeling physically strong enough for the trip.

Going back to work

Depending on your line of work, it may be advisable to take a month or two off to properly heal. You should speak with your surgeon and/or cardiologist to determine when is the best time to return to work. If you do a physical job, it may take a little longer to be able to perform heavy lifting, pushing, and pulling. If you’re doing an office job, then it maybe more appropriate to return sooner.

Aerobic exercise after open heart surgery

Before taking up any exercise program after open heart surgery, it is advisable to discuss your plans for activity with your surgeon or cardiologist.

As mentioned above, low-level walking is advised in the immediate post-operative phase, but in order to advance to higher exercise intensities, you’d be well advised to partake in a structured cardiac rehabilitation program.  This will help you establish safe exercise intensity limits you can follow out on your own.

As a general rule, engage in aerobic exercises that work the large musculature of your lower body (i.e., your hips/legs), are rhythmic in nature, and can be performed over an extended period of time (i.e., 20+ minutes).

One of the main complaints about aerobic exercise is that it’s boring, so be sure to choose something you enjoy.  This will help improve your chances of sticking with it over the long-term!

If you feel exhausted after open heart surgery, then congratulations, you’re totally normal!  Any open heart procedure places significant stress on the body so give yourself permission to be human!

Begin with multiple (6-8) short duration exercise bouts of about 3-5 minutes each per day.  Then gradually work up to progressively longer duration bouts fewer times per day.  Aim to progress to 40-60 minutes non-stop at a comfortable pace as you advance through the recovery phase.

Sample exercise program after open heart surgery

The following is an illustration of a sample exercise plan which may serve as a rough guide (provided your surgical team agrees).  The aim is to wean yourself from shorter to longer exercise durations by minimizing how many exercise bouts you perform each day.

Recovery WeekMinutesTimes per Day
13-56-8
25-104-5
310-153-4
415-203
525-302
630-452
7601

 

Pay attention to how you feel as you progress from week to week. If you fatigue easily and feel shortness of breath, then you may need to lower your pace, reduce the duration of each exercise bout, or perhaps reduce the number of exercise bouts per day.

Effects of medications

Medications such as beta-blockers will reduce your heart rate response to a given exercise workload, so your pulse may not be an accurate indicator of how hard you’re working.  Even so, it’s still not a bad idea to keep tabs on your exercise heart rate so you know what your individual response is under the effects of your medication regime.

If you have a hard time finding your pulse, get yourself a heart rate monitor or a Fitbit (which also tracks your non-exercise movement habits). Click on each image to check out features and thousands of Amazon user reviews.

polar heart rate monitorfitbit

Other medications like diuretics and ACE inhibitors can lower your blood pressure before, during, and after exercise. This might make you feel a bit sluggish (along with a lowered heart rate), so give yourself permission to be human and just go with it. As you heal from your surgery and make healthy lifestyle changes, speak to your doctor about reducing the dosages or coming off the meds (as is medically prudent).

Also be aware of potential interactions between heart medications and dietary herbs and supplements. For example, “weight loss” and “detox” teas (such as Skinny Teatox) are loaded with diuretics and laxatives which can lower your blood volume by dehydration. This can leave you feeling dizzy and light-headed which can increase your chance of fainting.

Heart rate and blood pressure aside, gradually work up to a moderate to somewhat hard pace where you’re breathing just hard enough to perform the exercise but can still carry on a conversation with an exercise buddy.  In exercise physiologist parlance, this is known as “the talk test.”

Aerobic exercise precautions after open heart surgery

Perform a gradual 5 to 10 minute warm-up and cool down before and after each exercise session, respectively.  Obviously this is more relevant during the longer duration activities.  It will allow your body to gradually accommodate the high intensities and minimize the risk of adverse events.

  • Try to avoid over-exerting yourself immediately following open heart surgery.  Remember your heart is trying to heal itself, so any sharp rise in heart rate and blood pressure could plausibly aggravate the situation.  Stick to the KISS acronym: Keep It Slow and Steady!  If you have any questions about intensity, please discuss this with your heart surgeon or cardiologist.
  • Slowly establish your “fitness foundation.”  Walking and cycling are two common activities which most people can reasonably handle without any ill effects.  Initially stick to level surfaces, but in time you’ll be able to graduate to climbing hills.  If you find yourself short of breath and gasping for air, just ease up the pace a bit.
  • Watch out for environmental stressors such as cold, heat, or strong winds.  Any of these factors can make your exercise routine seem more difficult than usual.
  • Be vigilant of any exercise-induced signs or symptoms and report them to your doctor immediately.  For example, if you feel chest pain or discomfort, slow your pace or stop exercise altogether.  If the symptoms do not subside with cessation of exercise, or it gets worse during rest, then seek emergency medical care.

Exercising at the gym after open heart surgery

After you complete your cardiac rehabilitation, you may be cleared to participate in a self-guided exercise program at your local gym. But before you dive into it, it may be advisable to find out if the staff is qualified and equipped to work with cardiac patients.  Ask if there are any trainers with experience working with people with heart problems.  Ask if they have all the relevant emergency protocols in place (i.e., dial 911 [or 000, 111 in some countries] and perhaps an on-site automated external defibrillator (AED).

Strength training (weight lifting) after open heart surgery

Strength training is now recognised as an integral part of any post- open heart surgery recovery plan.  It can be safely administered in properly risk stratified cardiac patients who are stable and medically-managed.

While weight lifting might seem counter-intuitive after an open heart procedure, quite the opposite is true.  Where surgery and bed-rest can lead to muscle atrophy and wasting, resistance training is a great way to offset these negative health effects and promote healing.

It may be advisable to start off with lighter weights of not much more than 4.5 kilos (10 pounds) during the first 4 to 6 weeks of recovery or until receiving the go-ahead from your surgeon or cardiologist.

After that, progress at a slow and steady pace (ideally with guidance from an exercise physiologist or physical therapist) to minimize delayed onset muscle soreness.

Carry out your strength training regimen with proper lifting and breathing technique.  Exhale on the exertion (lifting) phase of the movement.   Or as a general rule, do not hold your breath or strain during a lift.

For an overall body workout, target all major muscle groups from largest to smallest.  For example, you can start off with large compound movements such as body weight squats or lunges, then move on to back exercises like a bent-over row or seated row, then a chest press, and finally an overhead press, biceps curl, triceps extension, and then core (abdominal) exercises.  This is a very basic generic routine, but will certainly get you moving in the right direction.

Start your resistance training routine by performing short duration sessions of approximately 15 to 20 minutes. See how your body tolerates this and then progress from there.  Be careful not to overdo it, as a marathon training session may leave you sore and potentially discourage you from continuing with your exercise program.

As mentioned above, start off with light resistance so you can focus first on form and then progress to heavier weights. Start with a weight that allows you to perform 10 to 15 repetitions.  When you can easily get to 15 without any undue fatigue, then consider increasing your weight by 3 to 5 percent (general rule). Seek specific advice from your cardiologist or surgeon for when you can bump up your weights.

You can perform weight training 2 to 3 times per week.  The days in between are to allow for recovery (i.e., your muscles grow stronger).

Strength training precautions for open heart surgery

  • As with aerobic training, obtain physician clearance before starting any strength training program.
  • Numbness in the chest area is normal after open heart surgery. The surgery entails cutting nerves in your chest but the feeling usually returns within one year.
  • If signs or symptoms occur during resistance training, stop training immediately. If symptoms do not improve, or if they worsen during rest, seek immediate medical attention.

Take home message

Properly prescribed structured exercise is an important step in the recovery process after open heart surgery.  Exercise, along with rest, a healthy diet, and medications can help you progress through your recovery in the most efficient manner possible.

While the immediate post-surgery, post-discharge period can be daunting, start off slow and ease yourself towards longer durations for your aerobic activity and heavier weights in your resistance training program.

Be aware of how you’re feeling during exercise and watch out for any signs and symptoms which might indicate complications.

If your open heart surgery procedure was a result of coronary artery disease, then it is particularly important that you maintain a healthy lifestyle to minimise the chances of your arteries reoccluding (blocking up again).

Be share your thoughts, experiences, or questions below in the comments section, or get my daily health updates by liking my Facebook page (click below). Thanks for visiting.

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103 COMMENTS

  1. Hey Doc. GREAT article and GREAT advise. I’m 61. Male. 12 weeks out from aortic valve replacement. Pig tissue. Before surgery I used an exercise bar called a BULLWORKER. Excellent isometric workout for total body especially my bad lumbar. Basic idea is to hold the pushes and pulls for 10 seconds each body part. What’s the deal on hard isometric exercises with a tissue valve? This thing has been like an old friend for many years. Hate to be unable to use it anymore. Thanx Doc. ‘Preciate your time and experience. -Bill

    • Hi Bill, Thanks for your message. Glad to hear you’re on the other side of the surgery and getting back into the swing of things. Before I answer, I should preface my comments by saying I cannot give specific advice due to legal reasons (i.e., I’m not familiar with every aspect of your health history, etc).

      In your situation, you’ve had a valve replacement instead of bypass surgery. In my experience, those who’ve had valve repair/replacement WITHOUT coronary artery disease (blockages in the blood vessels) generally tend to do quite well with getting back into their old routine and, all things considered, can be quite durable. I would suggest talking to your cardiologist and see about arranging a stress test on the treadmill. If you’re able to tolerate a reasonably high workload (high intensity), then it is likely any stress on your body imposed by the “bullworker” would be less than this. But again, only your medical management team can give you specific advice.

      The bottom line is that you just need to make sure that you’ve got the following boxes ticked:
      1) medically stable.
      2) no underlying issues such as high blood pressure, malignant arrhythmias, coronary artery disease or other issues which may be worsened with exercise.
      3) attend cardiac rehab with an exercise physiologist and cardiac nurse while on the monitors to make sure you’re responding normally.

      If you’ve got the all clear on the above, then you’re likely going to be fine with getting back into your exercise program. Hope this helps.

      Best wishes,
      Bill

  2. Hello, Thank you for all this wonderful information. I am 36. female. 8 weeks after mitral valve replacement, tissue. I have been off work for about 1 year. I lift 50lb bags on my job and I was having a problem finding out what I was able to do after surgery to get me back to lifting like that in a 8 hour shift. I finally found it and I thank you so much. My incision is not completely healed yet but getting better now that they gave me an antibiotic. I just don’t want to screw anything up in there with the wires and all, lifting weights. Thanks so much

  3. Hey Doc. Very happy to report that I’ve been back to my old workout for over a month now. Started out easy. Chest muscles were a little sore at first. Just massaged them out. Feel like I’m really back in the saddle again. BIG thanx for your advice. -Bill

  4. Dr. Sukala,

    I had a cabg performed on two arteries one month ago and am recoverying ahead of schedule. I am where I need to be in recovery at this point in time.

    I am up to 45 – 60 minutes of treadmill 5 times a week at a walking pace. I feel great and the future looks good for me.

    I am 57 year old male,slim frame, 173lbs. and have been body building for 37 years. My plan is to resume my presurgery lifestyle asap. In your opinion, what time frame do you think it may be safe to continue with bench press exercises?

    I do plan on starting light and increasing as my recovery will allow. I have been getting conflicting information regarding this issue. I have told by the Cardiologist not to train at all, or to wait up to a year before doing chest exercises again. From your experience in the gym, what is you opinion regarding chest exercised post cabg surgery?

    Sincerely,

    Robert

    • Hi Robert,
      Thanks for your comment. You’re clearly doing very well in your recovery. Your cardiovascular fitness looks like it’s coming along in leaps and bounds. However, as for your bench press you’ll need to remember that your sternum will need to heal up well and get stronger. This can take a while, perhaps a good 6 months plus. A year out and it should be reasonably strong. I can’t legally give you any specific advice as I’m not fully aware of your medical history, but I do think you should see if you can find a qualified masters degree level exercise physiologist. Then have him/her work with your cardiologist or cardiac rehab team to work you back up to the heavier weights. Bottom line: be cautious and prudent in your approach and don’t do too much too soon. Hope this helps.
      Kind regards,
      Bill

  5. Hi Doc
    greetings from India

    I am 45 yrs old. My medical history is as follows:
    Single vessel angioplasty(LAD) 2005
    Emergency CABG for stent block 2010 July
    Last Tread mill test in jan 2013- normal
    Ejection fraction 45%
    Presently on Atorvastatin,aspirin, clopidrogel, cardevilol
    Presently i do a brisk walk of 6 kilometers in an hour as the only form of exercise. I dont have any cardiac rehab in my country so i built my own program reading all the websites here.
    Now i would like to know:
    1. is this exercise good enough?
    2. my upper limb & chest muscles got wasted after the CABG and i want to get them better. Plz tell me how?

    Thanks & Best wishes
    Rakesh

    • Hi Rakesh,
      Whilst I cannot give specific medical advice on this site for legal reasons, you should be aware that walking is a very common exercise prescribed for people after having heart surgery. It is a very functional exercise, but you must be sure to pay attention to and get immediate medical attention for any signs or symptoms which may arise. As for your muscles, resistance training (weight lifting) is indicated for people who are medically stable. However, with your ejection fraction being 45%, it may be advisable to discuss this with your cardiologist to make sure there are no specific reasons for which weight lifting might be unsafe. Your best bet is to err on the side of caution and make sure you’re exercising at a moderate level. But again, do have a talk with your cardiologist to work together in creating an exercise regimen that is right for you. Kind regards, Bill

  6. Had 3xCABG 8 months ago, feel slight pain in left elbow after been on treadmill for over 5 minutes and goes away after finishing treadmill, any advice

  7. Hi Doc,
    I’m a heart bypass triple surgery last year july,but now I want to go back on my routine in the gym. Am I allowed to go back again and make myself be comfortable as a body builder.

    • Hi Alexander,
      Thank you for your comment. I cannot give you specific recommendations because I am not aware of your entire medical history. Considering you had your surgery last July (likely 2013), your sternum should be pretty well healed up by now. Assuming you have been to your cardiologist and have had a full check up with high intensity stress test (on the treadmill), you might be able to get back to doing some heavy lifting again. We do know that weight lifting is acceptable for people after they’ve had bypass surgery, but again, you must be sure that you have safety clearance from your cardiologist who will be most familiar with not just your heart condition, but any other conditions which might be present. Also bear in mind that certain medications can drag you down a notch and make you feel a bit tired, such as beta blockers. Feel free to post a comment again and let me know how you got on at the doctor’s office. Good luck!

  8. I was 62 in 2011 whenI had a 5 way heart bypass surgery. Didn’t have a heart attack, just a little burning in my breast bone area. The the Dr. said I might need a couple of stints, but when I woke up after surgery I was in awe, I had wires & tubes coming out of everywhere. My Dr. only said I had to walk 30 mins. a day, that to me is a little mickey mouse. He did say 30 days after in had my open heart surgery that I could play tennis. My question is, is this enough exercise to keep my heart strong enough so my heart doesn’t get plug up again? Oh yea, one other thing my whole heart was 90 to 95% blocked. Yea, I’m lucky to be alive!

    • Hi David, Thank you for your comment. Depending on how active you were before your heart surgery, that 30 minutes the doc recommended might not sound like much. Based on what I can gather from the context of your post, you seem to be a pretty active guy. Docs generally tend to recommend a generic program which will cover most people. Given that your surgery was around 3 years ago, you clearly would be well healed up and probably able to tolerate most activities. However, if you’ve had blockages once, then it is possible they could pop up again somewhere else in the heart. Not a guarantee, but I have seen it happen. If you were looking to do very strenuous, demanding, and longer duration exercise, then you might be well advised to have a proper stress test done to ensure that your body can handle it.

      To ensure your heart doesn’t get plugged up again, the best available evidence still suggests that you get in regular exercise (see above) and, of course, eating all the good stuff (fruits, veggies, fiber etc). There is a lot of stuff popping up on the media radar these days that says you can eat all the saturated fat you want and it won’t affect your heart, but I’m not convinced the preponderance of evidence is there yet to support this. Everyone’s looking for short-cuts to health, but in the near 25 years I’ve been in the health business, I can tell you that the advice to simply “eat less, move more, don’t smoke” is still your best medicine to keep the doctor (and his scalpel) away! Hope this helps. Let me know how you go. All the best, Bill

  9. At age 60 I had aortic valve replacement and coronary bypass surgery (4/14). I was in reasonably good shape prior to rapid onset of high blood pressure symptoms which lead to surgery on an emergency basis – discovered that I had a congenital heart defect which contributed to BP problem. Post surgery I experienced visible atrophy of chest muscles near my arms. I’ve been following a work out regimen of weight training with emphasis on chest, arms, and back. I see visible results and feel like I’ve got about 60% of my total strength back, but I am concerned that my chest muscles may never recover. I’m taking medication to maintain my blood pressure – my sense is that it keeps my heart rate down even when I exercise. Any suggestions for building back normal chest musculature?

    • Hi Russell,
      Thank you very much for your comment. I can empathise with you, as I’ve worked with many people who’ve had open heart surgery and had similar problems with their chest muscles getting back into shape. It’s one of those darn side effects of splitting you down the middle like a salmon. Nevertheless, there is hope. First, I would say that you need to be patient. If your surgery was on April 14th of this year, then you’ve still got some healing happening. Your sternum itself may take a while, anywhere from six months up to a year to strengthen up. The sternum doesn’t like saws anywhere near it unless it’s just cutting wood. Also remember that you may have some adhesions which can make you feel quite stiff. Stretching might help bring back some of your range of motion in your chest and shoulders. I think that you will find that as your sternum heals back and becomes stronger, along with your muscles, then you should be able to tolerate higher weights (with your doc’s clearance, of course) which will help you build up your muscles again. It is very much a case of being patient and letting your body run its natural course through the healing process.

      Regarding exercises, you will find that both compound and isolation exercises for your chest will help bring back some development. For example, bench press or dumbbell press are good all around compound movements and chest flyes or cable cross overs will provide a bit more isolation work. You might also find that incline dumbbell press will help work your upper pec muscles and bring about some development.

      Best wishes and please be sure to come back and leave a comment regarding your progress.
      Cheers
      Bill

  10. Hi Dr. Bill,
    I had mitral valve repair surgery on Oct 20, was released from the hospital on Oct 24. It was standard open heart surgery where they cut right down the middle of the sternum. My question is, does this cut through the pectoral muscles or connecting cartilage or something? It has been almost 3 weeks since my surgery and my pectoral muscles are still extremely weak, and seem to get strained/hurt so easily. I lifted a small laundry basket and the pain from that persists for 3 days now in my right chest. So I switched to trying to use my left arm for everything and being careful not to strain it, and the next day it was feeling strained as well. So yesterday, with both arms feeling strained/injured, I started trying to use my feet for anything i could think of to minimize use of either arm. 3 weeks seems like plenty of time to me for these to heal, I am 44 and was pretty healthy before the surgery. I know I’m not going to be doing push ups or anything for a year but my chest muscles get hurt doing things like gently pulling a towel down from the shower rod. Rarely certain movements cause a little pain in my chest bone, and I was told to expect that. But the pec muscle thing is very frustrating I don’t know what to do that would help besides minimizing the use of my arms.

    • Hi Eric,
      You are still very fresh out of your surgery. Open heart surgery is very hard on the body and requires at least a good 2-3 months before you start feeling “good” again. The sternum can take a year or so to fully heal. If you are still feeling soreness just one month post op, then this is quite normal. You should not be doing any lifting precisely for the reasons you mentioned in your comment. I would recommend speaking with your cardiac rehab team at the hospital where they did the surgery and discuss your concerns with them. They should recommend just range of motion exercises which will help keep you from stiffening up too much. I agree that it is very frustrating but I can assure you that in the next month or two, you should be feeling considerably better. Best wishes.

  11. Hi Bill, I’m in a unique situation as I was a bodybuilder prior to the op so I was weight training seriously for over 10 years. It’s been exactly six months since my surgery and I still can’t quite do heavy bench pressing, push ups, or pull ups without stressing the chest and it feels scary when I try. I haven’t lifted any weights on any bodyparts because I wanted to be 100% before going back full tilt. How much longer do you think I will have to wait to do this, and is there anything I can do to speed up the process (lifting around the chest for example)? On a side note, I am regularly doing HIIT cardio and my cardiovascular endurance is the best it’s been in a very long time.

    • Hi Luke,
      Thanks for your comment. If you’re six months post-op, then you have to remember that your sternum is still healing. You might find that it could take a good year for the bone to get its strength back. I could certainly imagine that any kind of pressing motion at this stage might be uncomfortable. Lighter weights might not be too much of an issue, but again, remember that there is still healing happening on the inside!

      Regarding speeding up the healing process, I don’t think there’s any magic bullet for this. I would, however, suggest doing mobilisation (stretching) exercises to maintain mobility around your collective shoulder girdle. This can sometimes get a bit tight/stiff with scar tissue/adhesions forming around the sternal incision site. If you’re stretching and find yourself saying “OUCH! THAT HURTS!” then (obviously) don’t do that, or at least don’t push it to the red line!

      Have you been back to your cardiologist for a proper treadmill stress test? This might be a good idea to ensure that your ticker is working properly and there are no hidden surprises lurking which might be awakened/worsened by doing heavy lifting. Just a prudent suggestion that I tend to recommend to very active/fit people like yourself.

      Also, I would recommend discussing your specific situation re: your sternum with your surgeon and/or cardiologist since the human body is not always a one-size fits all (when it comes to open heart surgery). My mantra is always the same: safety first.

      Keep me posted on how you get along. Good luck!

  12. Thanks for getting back to me. I just realized I forgot to mention two very key points.
    1) I am only 29 years old.
    2) I had an aortic root aneurysm and NOT a bypass or even a valve replacement.

    Does that change anything? I would think being younger and not having any artery clogging problems would be on my side when it comes to healing (my recent echo shows my heart is perfectly fine now).

    I also just started doing some light chest work with dumbbells and the hammer strength machine, as well as variations of lat pulldowns for my back.

    • Hi Luke,
      Thanks for the additional information. Considering you are younger and do not have any coronary artery disease, this does put you in a better situation. I say this because I’ve seen many patients after a bypass procedure end up going back in for a stent or follow up bypass for other clogged arteries. I often suggest to active people like yourself that they discuss having a stress test with their cardiologist if you’re going to be pushing higher intensities (either weight training or cardio). But if you’ve been given the all clear regarding the heart itself, then you’re probably just playing a waiting game for the sternum to get a bit stronger. I wish there was a way to speed it up, but a little bit of patience will probably be your best bet for the time being! Best wishes

    • Hi luke,i am just interested with your case,as I have ascending aortic aneurysm,4.8cm. I am scheduled for an open heart surgery with in this month. I hope I can still live a normal and active life after my surgery.

      • Hi Chelly I am 37 years old female I was born with a bicuspid aortic valve which has never caused an issue but in May it was detected that I and had an ascending aortic aneurysm of 6.2cm. I had open heart surgery 6 weeks ago to repair it and am starting to feel really really great. Hardly any pain left in my chest plate. Mainly muscular and nerve discomfort. My biggest problem is remembering that it takes time to recover completely and to no push myself too hard too soon.

  13. Well I have been doing HIIT cardio on the treadmill for several months now but I’ll ask about the stress test anyway. I’ll just have to be patient I guess! Thanks Dr!

    • Good onya Luke. I’m sure you’ll be fine given all the factors in your favour. To be honest, I’m just like you. I’m not a very good patient when I’m injured and can’t go surfing! I’ve had two knee blowouts over the years and that kept me dry-docked for a while. It sucks, but good news is that it’s just temporary! Stay healthy amigo!

  14. Greetings

    Dr. Sukala

    In May 2014 I had OHS, and my chest hurts like…. Your comments to Russell was very helpful. I have no feeling in my breast my chest hurts so terribly bad. Where my incision is, and surrounding even inside my chest feels like a Tens Unit, sore, and is so darn painful off the rector scale. What I am experiencing with pain and pressure is 10+++

    Days after my surgery I kept telling my family that I feel metal in my chest it honestly feels hard, cold, and I can feel steel and metal rubbing or sliding. When I went for my check up I informed my surgeon, and he said you do have a plate in your chest. He was like in shock by me describing what I can feel, and this feeling has not left. My comfort level is poor their are times it feels like it is shifting. Somewhat like a door hinge that is broken and you know it needs to be repaired because every time you open the door you have to adjust the plate in order to close it. There are times it feels like its swinging, and times I ‘SCREAM’
    My movement is tight chested I do minimal exercises, and stretches. As much as I want to believe this will go away I’m convinced, and fully persuaded that this pain is not going anywhere nor the metal, and abundance of pressure, and hot at times.
    I have many allergies therefore I have to endure this pain without pain meds. Perhaps you may have some encouraging words or suggestions that I can share with my physician so I can have some type of relief. Thank You

    Lisa S — Houston, TX

    • Dear Lisa,
      Thank you for taking the time to leave a comment. I am not happy to hear you’re having such a hard time. This is generally not the norm, but I have seen cases in cardiac rehab where some people had a more difficult recovery than others. Considering that your surgery was back in May of 2014, I would imagine that by now (under normal circumstances) that the bulk of your discomfort would have subsided. I don’t have any magic solution to make it go away, nor do I make any representation that I’m an expert on pain science. I would suggest the following: 1) Perhaps have another talk with either your surgeon or cardiologist to discuss this in greater depth. Perhaps they’ll be able to present some options for you; and 2) if appropriate, perhaps you could get referred to a pain clinic where they might be able to work with you on some strategies for minimising your discomfort. You have to remember that pain, although you feel it in your chest, ultimately originates in certain regions of the brain. There have been cases of people who lost limbs in wars, accidents, etc and had excruciating pain in their non-existent phantom limb (the one that’s gone). So you might ask, “how the heck can you have pain in a limb that’s not even there?!” They were able to use a mirror box to trick the brain to treat the pain. Have a look at this video here—>

      Mirror Box Pain Therapy

      Point is, pain has its origins upstairs in the noggin. I’m not saying that this will be a solution for you, but if they’re worth their salt at the pain clinic, they may have some creative strategies like the mirror box to fool your brain into letting go of the pain. I’m sorry I can’t offer any specific suggestions, but I think having a consult with your docs and possible referral to a pain clinic might be a good start. No one should have to live with this kind of pain your describing, and I agree that going straight to pain medications is not necessarily the answer. Please leave another comment after your consults and let me know how you’re progressing. Warm regards, Bill

  15. Hi Dr Sukala.
    I had my open Heart operation ( AVR) done on 1st April 2014,I went through hell of a time ,while my recovery ,I am feeling better now , I have strated going to Gym ,.can you please advice me what exercise I can do..
    Thanking you
    Prakash.

  16. Hi Dr. Bill,
    I am 36 years old, last March I was diagnosed with aortic aneurysm both ascending and descending,and my doctor advised me to undergo open heart surgery. My question is can I still go back to gym after my open heart surgery? is it still possible for me to get pregnant via normal delivery?

    • Hi Chelly, I’ll respond in depth when able, but the short answer is yes. You’ll need to work with your cardiologist and team. Better the aneurysm you know than the one you don’t, especially a surgically repaired one!

    • Hi Chelly,
      Message 2 here. As I said above, any diagnosed aneurysm is better than an undiagnosed one that ruptures unexpectedly. So whilst I’m not happy to hear you have to undergo open heart surgery, I am glad to know that, at your young age, it has been diagnosed and will be properly treated. Just for clarity, I am a clinical exercise physiologist by profession (not a cardiologist), but worked in cardiac rehab for many years. I have seen a lot of abdominal aortic aneurysm patients come through and perform very well through the cardiac rehab process. In your case, I’d guess that you probably have clean coronary arteries so that is a positive. Provided your valves are in good working order, then really, all things considered, you don’t have a heart problem per se. You just have a bad pipe that needs some aggressive plumbing work to repair it. Surgery is surgery though, so if it’s for a AAA repair or bypass surgery, there will be some trauma on the body and you may feel a bit worn out and tired after the procedure. Just know that it’s quite normal to feel that way. I used to explain surgery to people by saying it’s like you had a car accident and had some trauma to the body. You have to expect you’re going to be a little sore and worn out for a while. It’s just the nature of the beast.

      Regarding exercise, I think that provided you are medically stable and cleared by your cardiologist and surgeon to resume exercise, then you should be fine. Your sternum will be a bit tender for a bit so just know that going in. You will need to avoid any heavy exertion and/or pressure on the chest until that bone starts to heal up properly and the pain goes away (i.e., there could be some nerve damage from the surgery, but talk to your docs about it).

      As for the pregnancy, my short answer is, I don’t know. Plus this would depend on your particular condition. No two people are exactly alike, so my recommendation is simply to discuss this in depth with your docs and work on getting the best outcome. I hope you find this helpful and reassuring. Leave a comment down the road after your procedure and I’ll be happy to help where I’m able. Kind regards, Bill

  17. Hi Dr.Bill,
    Thanks for your reply. I’m looking forward to a healthier me after the operation. More power to you!

  18. Hi Dr Bill,
    I had open heart surgery on 2nd Nov 2014 as a result of attack which happened at my place of work. I was stabbed in the chest which had pierced my right ventricle. This was repaired and was six months on the 2nd of May 2015 since i had the surgery. I am looking to start exercising because i have gained weight since after the surgery.

    I am wondering if it is safe for me now to start exercising.

    Your expert advise on this will be appreciated

    • Hi Peter,
      Wow, that’s an incredible story. I haven’t had that kind of comment on my blog before! I’m glad that they saved you and were able to fix your ventricle. I’m guessing that you put on weight because the post-surgery recovery process really knocked down your energy levels. If so, then congratulations, you’re normal. If you feel like a train ran over you, it kinda did. Surgery is a trauma to the body (as I explained to Chelly in a different comment) and you have to be nice to yourself and give yourself permission to be a little out of shape after something so profoundly life-altering like a knife attack and surgery.

      In answer to your question of whether or not it’s safe to exercise, I would suggest the following:
      Speak with your cardiologist and surgeon to make sure they give you the all-clear to exercise. You might request that they do a treadmill stress test on you in order to see what kinds of exercise intensities your body can withstand without any signs, symptoms, or abnormal changes in your ECG from rest to peak exercise. Provided that’s all in order, then they will probably give you the green light to get back into your exercise groove.

      Even with clearance, make sure you ease back into it and don’t try to do too much too soon. And that’s prudent advice for anyone, whether you’ve had surgery or not. If you have a cardiac rehabilitation program at your hospital, I would advise you to do it for at least a month in order for them to check out your ticker on the ECG under different exercise intensities. If after a month or so they’re not seeing anything too out of the ordinary, then with reasonable confidence you should be able to get back to living life to the fullest.

      I should also point out that since you had a trauma to the heart (stab wound) and not coronary artery disease (CAD), then this changes the landscape of things. Provided your ventricle is all healed up and your arteries are clean, then it’s highly unlikely you’re going to have a heart attack due to atherosclerotic plaque. To be honest, the cardiac patients that keep me awake at night are the ones with CAD since, even if they’ve had an angioplasty/stent or bypass surgery, there is always a chance that a treated artery can block up again or another artery could plug up and cause problems.

      Thanks for leaving a comment Peter. Best wishes to you and please feel free to leave a comment after you’ve started your exercise. Cheers, Bill

      • Hi Dr Bill,

        Thanks for replying my question. t is been 7 months since my surgery. I met with the cardiologist yesterday 8-6-15 and he gave me all clear. He told me to start exercising but i should do it slowly. 30 mins everyday and slowly build it up.

        Also the ECG done March this year came out good and the consultant was happy with my progress. He equally said i do not need Cardiac Rehabilitation Exercise as my breathing is normal and my recovery is going on good

        I must say that heart surgery is the most painful thing i have ever experienced in my life. I felt like i was hit by a train but am very happy with my progress. I wish everyone out there who has going through this painful process quick and swift recovery…

  19. Hi Dr. BILL,
    I AM ALMOST 5 MONTHS POST-OP CABG for diffuse coronary artery disease (12 blockages) and 7 by pass grafts.

    QUESTION? I feel as if a section of my sternal incision, approx 2 inches long and just between my breasts, is ? FORMING ADHESIONS OR?. After sitting for a short time, say an hour watching TV, when I stand up I feel as if the inside of my chest wall is sticking to my sternum, or grabbing onto the wires? Do you know if this is a common occurrence or should I be concerned? Will this eventually fade? As my cardiologist says he is not familiar with post op sternal pain such as I am describing, is it worthwile to see my surgeon re this problem? Also, will myofa fascial massage at the incision site be helpful?

    Thank you so much for taking the time to answer concerns here, very much appreciated.

    Audrey

    • Hi Audrey,
      I’m sorry to hear you’re having some prolonged pain five months after surgery. In my experience, everyone responds a bit differently to the surgery. Some people come out of it fresh as a daisy and others have a difficult time where it’s the gift that keeps on giving. In your case, I think the most prudent course of action at this time is to have a talk with your surgeon. If you try massage and this helps, then all the better, but just make sure that whatever course of action you take that it’s not worsening things. Again, best bet is to have a talk with your surgeon and see if you can get a bit more information specific to your condition.
      Kind regards
      Bill

  20. Dr. Sukala,

    How to begin to restore range of motion of right arm, following less invasive robotic mitral valve repair with annuloplasty ring? Surgery was 5/26. I am up to walking one easy mile, three times a day, but my right arm is tight as a drum and still hurts to raise. I’m an avid dog walker. I have an option to begin a local hospital rehab program Tuesday. I am also a distance swimmer. Thanks for help.

    • Hi Bernie,
      Considering you’re less than one month post op, I think patience will be your best friend for a while. You sound like an active guy and, to be honest, active people that have heart surgery are often “bad patients” because they often want to get straight back to high intensity weight training, marathon training, etc. It’s often easy to do too much too soon when what you need is a bit of patience and just keeping up with some light exercise. I would encourage you to do the cardiac rehab program since they can hook you up to a telemetry monitor and see how your ticker is doing under exercise stress. If nothing that exciting (i.e., arrhythmias etc) then you can probably get back to your regular routine without too much worry. As for your range of motion, you’ll probably find that over the next several months it will start to improve naturally. Remember that surgery is a trauma to the body and it does take time to heal. In our cardiac rehab program, we’d often encourage people after open heart surgery to do light to moderate exercise for the first 6-8 weeks and then after approval from the cardiologist they can graduate to higher intensities. Bottom line: just be nice to yourself and give yourself permission to be human and heal properly. Kind regards, Bill

  21. No, nothing like that 🙂 Just swimming and walking the dog. I got a go-ahead from my surgeon today to attend my rehab orientation and will progress slowly from there. Thanks! My main question was things I can do to be able to raise my right arm full extension again.

    • Hi Bernie,
      Good choice to enter into the cardiac rehab program. I’m sure it’ll help give you a boost of confidence to make sure everything is running smoothly with the ticker. As for your arm, I think you’ll gain mobility with it naturally as you progress through the healing process. Speak with the cardiac rehab team to get you doing movements like “wall walks” with your fingertips where you slowly walk your fingers up the wall until you feel pain (as in “ouch that hurts” kind of pain). Make a note of how far you got and then progress gradually. They might also give you some stretches which may help your mobility around the collective shoulder girdle. Again, just be patient and you’ll get there. Best wishes to you.

  22. hi Dr Bill Sukala
    i underwent CABG for triple vessel blockage20 days back,i am 56,i was in gym and while running at 5.5 km treadmil i observed the stress in my chest and net day been to check the heart status.now i got discharged
    8 days back and started walking 6-10 mts and with target of 1.5-2.0 km per day
    but i am very tired and heart beat goes upto 115 from 102 normal after surgery,i use to have 60-65 pre surgery
    shall i stop the walking target and concentrate after six weeks
    pl guide the best suitabale excercise for whole body,i am 66 kg with 166cm height

    thanks and regards
    Dr srinivas

    • Hi Dr Srinivas
      I see you were very recently released from the hospital. You still have a lot of healing taking place on the inside and at the sternal incision site. At this stage, as I wrote in my article, it is important that you continue with light workloads and just try to make sure you’re not overdoing it. After 6-8 weeks, then you might consider higher intensity exercise. If you can work with a clinical exercise physiologist in your area with experience in cardiac clients then I think that would be a big help. Also talk to your cardiologist about doing a treadmill stress test on you in a month or so to ensure you do not have any rhythm abnormalities before you get into higher exercise intensities. Regarding your heart rate, it is difficult to say what’s going on there without knowing your entire medical history. Moreover, I’m legally unable to give anyone specific advice on my website. In the meantime, just be patient and keep doing your low level exercise until you’ve healed a bit more. Hope this helps. Cheers, Bill

  23. Hello Doc,
    I have underwent cabg surgery for the blockage of 2 arteries.i’m discharged from the hospital 5days back after the surgery & i’m 52.
    Now i’m felling a rod like structure in between my breast bone when i’m moving my neck around which is causing me a lot of pain.i also can’t sleep on my left hand because of the pain in the hand.It is insane for me to get up from the bed without a person’s help.I also can’t walk.More than all this i’m having cough which is causing me a severe pain in the heart.So i sincerely will be waiting for your advice.
    best wishes & regards
    venkateswar

    • Hi Venkateswar,
      Thank you for your comment. First and foremost, I would advise you to bring this to the attention of your surgeon and/or cardiologist. Though I will say, in my experience, it’s quite common to feel a bit of discomfort in the breast bone after open heart surgery. Your surgery was very recent, so it’s important to remember that you will need to give yourself some time to heal from this. You’re not going to be up and running a marathon in the next week or two, so just remember that you’ll need some down time. Please refer to my article where I mentioned that it can take a good two months before you start feeling a bit normal again, and your breast bone can take a good year for it to heal up properly. I know it’s not a fast process, but you should be ok. If you’re alarmed by this, I would strongly encourage you to speak to your surgeon. Best wishes, Bill

      • Thanks Dr bill for your advice.It’s a bit better today.But,can you tell me how to stop my cough.cough is the only thing which is making me suffer.I am also using medicines for cough,But no use.So please tell me how to stop my cough.

        • Hi Venkateswar,
          I couldn’t help you with that. You need to get that checked out by your doctor and properly diagnosed/treated. Sorry I can’t be of further help.
          Kind regards

  24. dear doc,

    i am prakash cardiorespiratory physiotherapist, i am working in a cardiac rehabilitation dept,in india

    plz answer my two question
    1)whether i am fit for cardiac rehab
    2)when we have to start cardiac rehab after cardiac surgery
    plz answer me

    • Hi Prakash,
      Thank you for your comment. In answer to your questions:
      1) I’m not sure if you’re asking this for yourself as a patient or on behalf of your patients.
      2) As for when a patient starts cardiac rehab after cardiac surgery, this will depend on the individual patient, their condition, comorbidities, if they had post-surgery complications, the medications they’re taking. There are a LOT of factors that contribute to when exercise can begin.

      But as a general guide, you can mobilise a patient within 48 hours after surgery by getting them out of bed, having them walk around the nurses station. They just need to be upright and gravity bearing in order to get their bodies functioning normally under normal orthostatic load. Keep close to the patient in case they feel light-headed and dizzy.

      Once the patient is discharged from the hospital after 4-7 days, then they can continue to do light walking around the house and neighbourhood on level surfaces (no hills). After two to three weeks, if feeling well, they can come back into the hospital cardiac rehabilitation program as an outpatient and work with you and your physiotherapy team doing structured exercise, checking heart rates, blood pressures, etc.

      I am available for consulting to hospital cardiac rehabilitation programs. If you’d like to discuss this, please email me.

      Kind regards
      Bill

      • thank you for your reply answers
        my question is i am a Master of physiotherapy graduate,am i eligible to work in cardiac rehab as a exercise instructor

        • Hi Prakash, the answer to that will depend on your country’s professional guidelines and scopes of practice. In Australia and New Zealand, you can be a physiotherapist and work in cardiac rehab. As long as you have the clinical skills to work with cardiac clients then I imagine you will be fine.

  25. Dr,
    My husband had a triple by pass last week he is recovering very well. His legs and feet are extremely swollen. He is taking 20mg of Lasix two times a day. Is it safe to massage his legs at this point in his recovery?

    • Hi Adele,
      You’d have to ask your husband’s cardiologist if this is appropriate at this point. I would imagine they should still have him in compression stockings to help improve return blood flow and minimise swelling. Ask his doc if this is appropriate, as each case is unique. It’s still early days into his recovery so patience will be key at this point. In the next month I’m sure you’ll see him improve significantly. Keep me posted. Kind regards, Bill

  26. hi doctor .myself nagamani. on aug 22nd 2015 ,my mother had cabg bypass surgery .
    because of the double vessel disease. they made incisions to both legs and for the chest also. it is very terrible to me. she is suffering with diabetes also. how long it will take to heal the incisions and when can she begin her activities by herself? when can she get up by her own ? and so many doubts are there.
    but please reply me for these questions now……. please iam waiting for ur reply

    SIR IAM FROM INDIA

    • Hi Nagamani,
      It’s hard to say exactly when your mother’s wounds will heal after her surgery. Wound healing can take longer in diabetic people. Wounds heal slowly and can worsen rapidly, so you should be very watchful over your mother while she’s healing from her surgery. There are several factors that influence wound healing in a diabetic patient, and may include: high blood sugar levels, poor circulation, nerve problems related to diabetes (neuropathy), immune system deficiency, and infection.

      You should work very closely with your mother’s doctors and find out as much as you can to ensure that her incision site remains clean. Without knowing anything about your mother’s detailed medical history or her current situation, it’s hard to say exactly when she can get back to exercise. However, if you’re able to help her around the house by just getting her up on her feet, that is a step in the right direction. She must not be bed-ridden all the time as this can lead to muscle wasting. After about 2-3 months, I would imagine that her chest incision should be healed and she should be feeling considerably better after her surgery.

      Again, I suggest working closely with her doctors to make a plan that is right for her.

      Kind regards,
      Bill

      • Thanks for ur reply sir.but iam scaring about her wounds ? what should i do? and she had an emergency cabg . but why can’t they do by stunt? they said that left main coronary atery means compulsory bypass has to do, is it true? and coming to her health condition .her blood sugar level is under control itself. but the incision of the chest has littile gap between the skin. her wounds are dressing by me only dialy. can you give me any suggestions in doing dressing?

        • Hi Nagamani, yes, a CABG is commonly required for the left main artery since it feeds two other major arteries. Regarding the incision and dressings, you really need to work closely with one of your doctor’s nurses to ensure you’re doing it right. I cannot advise you on this on the internet. Kind regards

  27. What are your thoughts on heavy weight training for someone whose had open heart surgery to get his aortic root aneurysm fixed? Any extra risk doing damage to the valve or causing a leakage?

    • Hi Luke, thanks for your email. If it’s been repaired and you’re medically stable, then speak to your doc about first doing light to moderate resistance training and, if no issues, then you might be able to tolerate higher workloads. Ask your doc to do a high intensity treadmill stress test. If you can tolerate the higher workloads at higher blood pressures, then that is also a good indicator. To be clear, I legally cannot tell you yes or no, but I would run my suggestions by your cardiologist and get the green light before you start pushing around the heavy stuff. Kind regards, Bill

  28. ok sir as you said i will be in close to the doctor. and after healing of wounds can she do all of her works ?
    how long she need help to do her activities by own? and is there any chance of getting heart problem again in future? what are the precautions must take?

    • Hi Nagamani
      Once her chest incision site has healed and she has clearance from her doctor, she should be ok to get back to normal. There is always the possibility she could have heart problems again in the future, but she can minimise her risk by taking good care of her blood sugar levels through healthy eating and exercise. If she smokes cigarettes, then she must quit. Overall, a healthy lifestyle is the key to minimising her chances of future heart problems.

  29. Hello doc I am Aman Mishra ,I want to build muscular body in gym. By birth I was suffering from heart disease (T.O.F) and in June 2006 underwent an open heart surgery. I have been playing sports like badminton since then. After 10 years of operation how much weight can I lift in gym?

    • Hi Aman,
      Thank you for your comment. As I’m sure you can appreciate, I do not give specific advice to anyone in the comments section since I am unfamiliar with your entire medical history. Your best bet would be to discuss with your cardiologist if there are any specific limitations that would keep you from lifting heavier weights. I presume your operation was to correct the TOF and, provided it was a success, then that would help support your case in discussing this with your cardiologist. Please appreciate that no one’s condition is identical, so there is no way that I can provide an individualised consultation without knowing your full medical history. Best wishes. Bill

  30. Hello doctor
    My 14 years old son did an open heart surgery for aortic valve replacement four months ago. He gained some weight and he’s not exercising. I’m afraid to let him start exercising because he takes medication ‘ sintrom’ since the valve is metallic. What do you advice? Can he start exercising and what’s the best way to avoid any bleeding?? Thanks in advance..

    • Hello Jihan,
      Thank you for your comment. Sintrom is an anticoagulant so your main concern will be contact sports or activities. By four months post-surgery, he should be well enough to do exercise like walking, jogging, riding a bicycle, or other continuous activities (that do not put him at high risk for impact).

      Does he have a medic bracelet where if he does have an accident, the paramedics or doctors will know he is taking Sintrom? If not, this would be a good idea.

      Without being fully aware of your son’s medical history, I can’t give you any specific recommendations but I would suggest you discuss your concerns with your son’s cardiologist. I’m sure that if there are no other significant medical issues, then his doctors should be ok to clear him for exercise.

      Hope this helps.
      Kind regards,
      Bill

  31. Hi Doc,

    I am 30 and had my aortic root (but not the valve) replaced via surgery 1.5 years ago (I still have mild MR and PR). I’m a very active guy who bodybuilds and does very intense (HIIT) cardio where the hand sensors on the treadmill say my heart rate gets as high as 175bpm (don’t know whether accurate or not). My resting heart rate is 60-65. Am I causing myself any danger by elevating my heart rate that much during cardio?

    • Hi Luke,
      Theoretically, the high blood pressures induced by high intensity exercise “could” add more wear and tear on your ticker, but it is a good sign that you appear to be tolerating these high workloads with no adverse effects. As I say in most of my responses, I cannot give any specific yes/no, right/wrong answers since I’m not familiar with your entire medical history. I would strongly suggest discussing these concerns with your cardiologist who will (obviously) know more about your specific situation. To your advantage, you are still reasonably young and healthy and this will add support to your case. Cheers, Bill

  32. Hi Dr Bill:
    Thanks for sharing your knowledge with us … much appreciated!

    I had a triple bypass Jan 1996 and have been seeing my cardiologist every 6 months. I am 61-1/2 years old. In August 2015 I’ve had a personal trainer at a local gym (never had one before nor lasted very long at a gym on my own). At the time of surgery, I was 160 pounds. I probably reached 180 pounds after 3 years (going up & down over the years. I was 165 pounds in August 2015 & am currently 155 pounds (I have a “stocky” body type). I started with 2 times per week and in October 2015 increased in to 4 times per week (1 day arms, 1 day legs, 2 days full body cardio). From the start, my trainer noticed good muscle definition when I was pulling the weights. He asked me if I’d every consider bodybuilding. I said no I hadn’t. He asked again 2 weeks ago & I’m more on board with it now, but with some hesitancy. My last radioactive stress test was September 2015 — results normal. I told my cardiologist about my weight training. He advised to go slowly. My next appointment is April 2016. In November 2005, my cardiologist mentioned that the average graft last 10 years, there is no warning of “malfunction” … they just collapse.

    So, my issues is … it will be 20 years next month since my bypass. I have never had any issues If I should consider training for a bodybuilding show, what issues should I be considering? Will I be putting myself in “wreckless risk”? Is there a risk of “blowing apart” my grafts? I would be training under the supervision of a trainer. My trainer is aware of my prior surgery. My trainer has never “pushed” me to the point of concern. What questions should I ask my cardiologist? What “scenario” about bodybuilding training do I present to my cardiologist? etc …

    Thank you in advance for your advise …

    Bill B

    • Hi Bill,
      Thanks for your comment. The bottom line is that bodybuilding will increase your heart rate and blood pressure and this will place stress on your heart and blood vessels. You’ll need to speak to your doc about this and perhaps discuss with him/her any ways to assess your grafts and their current status. With exercise, there are always risks even if you have the greatest trainer on Earth. Best to discuss with your doc that you’d like to do bodybuilding and the intended program regarding frequency, intensity, and duration. Best wishes and good luck with everything!

      Kind regards,
      Bill

      • Hi Dr Bill:

        Thanks for your quick response … much appreciated. Also, thanks for the guidelines on what to inform my cardiologist about. I’ll consult with my personal trainer to get the info for my cardiologist.

        Thanks for your service, your availability & your advise.

        With much gratitude and appreciation!!!
        … Merry Christmas & Happy New Year!!!

        Bill B

  33. Good Evening,

    I had an extended septal myectomy for HOCM on Oct. 20 this past year. I went back to work about 3 weeks ago, but there’s been delays in getting my Cardiac Rehab program started. My initial appt is in just a few days, but they don’t plan to start me until Feb 1. I was never very active prior to surgery, and up until going back to work, I was doing ok walking a mile or so daily on my own…very little shortness of breathe, etc… It did take some time but I saw progress. Since returning to my sedentary office work, I’ve noticed increased feelings of shortness of breath just walking , all day. I’m not completely winded, but I feel sent at ions of not enough oxygen. It’s been especially bad this past week, not to mention I was in a vehicle accident and rear-ended just 7 days ago.

    My question is could feeling worse be due to decreased exercise these last few weeks? I’m so nervous it’s something else. My cardiologist for HCM seems to think it’s more from the accident, but everything looked fine when I was checked out. I’m truly hoping it’s just excercise related and will be better once I begin to get conditioned.

    Thank you kindly.

    • Dear Jessica,
      Thank you for taking the time to leave a comment. My apologies for the delay but for some reason your comment ended up in the spam sin bin. However, I have rescued it from purgatory and am now getting back to you.

      Regarding feeling winded, it’s difficult to say exactly what is causing this since there are a few competing possibilities. First, having open heart surgery is rough business no matter how you slice it (bad unintentional pun) and it does take time to heal. Each person is a bit different in that regard in that some people zip through their recovery and for others it takes a bit longer. I don’t know if this applies to you. Second, you also mentioned you had a car accident. This is not beyond the realm of possibility (as your cardiologist suggested). Third, you may find that it’s just a case of regaining your conditioning since you’re just getting back into the groove again. It looks like you’re still about 10 days away from beginning your cardiac rehabilitation program but I think that if you are able to carry on with your walking program in the meantime then you can have more detailed conversations with the rehab staff as they will be more familiar with your specific condition and any other considerations which might impact your ability to exercise.

      Feel free to leave another comment as you go through your rehab program. Many of these comments are helpful to other readers.

      Warm regards,
      Bill

  34. Hi Doc, I am 58 yrs old and had a very successful OHS with mitral valve repair 2 1/2 month ago. This month I returned to the gym, lifting light weights, walking on the treadmill, etc. I enjoy surfing very much and I am wondering when I can possibly resume surfing, first in small waves and then progressively back to normal (due to the MVP I had before, I didin’t use to surf when the waves were big and now I really enjoy small/middle size waves). BTW, I live in Brazil where the weather and the sea temperature are mild.
    PS: I ve been seaching the web a lot to find pages resuming sport ativities after OHS and it is very difficult to find them. I think your website ie the best I found so far, congratulations

    • Ola Jose, Muito obrigado pela sua mensagem. Sou surfista também e entendo que o surfing é uma paixão! Eu falo português mas acho que seria mais fácil escrever em inglês porque a terminologia medica e um pouco complicado pra mim. The most important thing you can do is speak with your cardiologist and make sure that you are medically-stable and able to resume your normal activities. Provided the surgery was a success and you are healing well, your doc might give you the all clear. You will also need to consider that your sternum might need a bit more time to heal. If you are on blood thinning medications, then you’d have the concern of getting hit by your board or someone else’s board which could plausibly result in internal bleeding. I have had a number of patients and clients who were surfers and once they were healed and given the final clearance from their doctors, they were able to get back on the board. But as I said, I cannot give you my final approval, as I am not familiar with your entire medical history. I do think that since you are at the gym, lifting weights, and walking on the treadmill that this will lend extra support to your request for clearance from your doctor. I hope this helps. Kind regards, Bill (tambem conhecido como Guilherme no Brasil)

  35. Hello dr sukala

    Great article. Was very easy to understand unlike most of the other articles i have read. I am 35 and have had 2 aortic repaires this year at the Ottawa heart institute (july and dec.) second was supposed to be a Ross procedure but a repair was decided on due to sutres had come undone on the first patch. Doing rehab at hospital and gym following same guidelines. Will definatly be sharing this article.
    Thank you
    Greg

    • G’Day Greg, Thanks so much for your comment and for sharing your story. I really appreciate your feedback too. I purposely wrote all my cardiac articles without all the technical jargon so that most people could understand it. I’m always open to ways I can improve them, so feel free to leave any suggestions. Keep up the good work and feel free to report back with any information you think can help other readers.

      Kind regards,
      Bill

  36. I’m in the medical marketing/communications business and must say that this the best article I’ve read on CABG/surgery recovery. kudos!

  37. I am 56 yrs old I had mitral valve repair 4 weeks ago. I experienced mild annoying pain just left of chest in the area of mitral valve from day one. Doctor said this is normal. I can press on the chest and no pain. After gardening and lite digging I feel pain in same area as described only it goes all the way to my back I’ve tested for four days but pain has not subsided. Can this be serious or am I being overly concerned

    • Hi David,
      It’s not uncommon to have pain in your chest after open heart surgery, but having said that, each person is unique. I can’t speak as to whether or not it’s serious in your case since I’m not familiar with your entire medical history. I would recommend you speak with your doctor about these concerns. Over time these pains “should” go away or diminish, but it is best to run these up the flagpole with your doc. Kind regards, Bill

  38. Hi, I am 39 years old and I had valve sparing open heart surgery 9 months ago after being diagnosed with Marfan syndrome including an aortic root anuryseum only a year earlier.

    The top section of my incision site is still very tender (I have a very slight pidgeon chest)and I still need to use a cushion to roll or get up if laying down. I can only lay on my side for a short period of time and this is only if I am hugging a cushion against my chest. How long will this last before my chest is pain free.

    Also I’m wondering if at any stage will I be able to do any strength training as there a mixed thoughts on weight lifting when you have Marfans syndrome. Thanks

    • Hi Narelle,
      My apologies for the delayed response. I always try to respond in a timely manner, so I don’t know how I didn’t see your comment until now!

      Regarding your pain at the incision site, this is one of those things that, in my experience, tends to vary from person to person and can depend on an individual’s pain threshold as well as the surgery itself. It’s difficult to say exactly how long your pain will last, but I would suggest speaking to your surgeon about this for more specific information relevant to your operation. I have generally found that most post-open heart surgery patients feel reasonably well by around 6 months but may have some lingering discomfort for longer duration in some cases.

      Regarding strength training with Marfans syndrome, most of what you’ll read will recommend that you can’t engage in high intensity exercise, but I think ultimately, it would depend on your individual condition as well as working closely with your cardiologist and/or cardiac rehabilitation team to find what weights are most appropriate for you (particularly the effect it has on your individual blood pressure response).

      Hope this helps.
      Kind regards,
      Bill

  39. Hi Doc

    Good article thank you. I am physical therapist. I would like to know if you know of patients who did ultra marathons like the comrades after bypass surgery. I know each case differs and important to consult their doctor, but is it really possible and ok for the heart?

    • Hi Ancois,
      I do not know of any patients who’ve done ultra endurance marathons (like multiple day marathons of 100+ km), but I am familiar with people running normal marathons after surgery. I think provided a patient is medically stable and there are no other significant contraindications (and the cardiologist has given his/her approval), then it could be done, but as you rightfully pointed out, each case is different and will depend on the individual and their particular condition.
      Cheers,
      Bill

  40. Hi doc. There are some great tips there. this article is very helpful for me for my father. he got bypass surgery last month. So much thank you for coming up with this. GRATEFUL !!

  41. Hi. I’m 14 years of age and in April, I had an open heart surgery for mitral valve repair. The surgery was amazing, thank god for that :). However, I’ve got a few questions. I’ve been really down and depressed since my operation. I’ve had nightmares, I also had 2 of the same nightmares. And I don’t feel happy at all, always stressed or down. In my normal life I was much happier than I am now. My scar makes me unhappy and self conscious with myself. Is this normal after open heart surgery? I’ve asked on other websites but no answers :(. I just need help on my emotional issues

    • Hi Sev,
      I’m very sorry to hear you’re having a difficult time after your surgery. While I can’t provide you with any specific medical advice, I can offer some suggestions and reassurances which might put your mind at ease. Overall, rest assured, much of what you’re describing is common after open heart surgery.

      Here are some key things to bear in mind:

      1) Depression after open heart surgery is something I’ve seen a lot of in my experience working in cardiac rehab. Remember that the surgery itself is a trauma on your body and after the surgery is done, it takes your body some time to heal and get back to normal. I have also been told by surgeon friends of mine that when they put you on the heart and lung bypass machine during surgery that it can sometimes have the effect of making things go a little haywire in the brain for a while after the surgery. I have heard from numerous patients stating the same as you, that they had very bad nightmares after their heart surgery.

      I would strongly recommend that you visit a health counsellor or psychologist if you are feeling very tormented by all this. PLEASE KNOW THIS: Reaching out and asking for help is a SIGN OF STRENGTH, NOT WEAKNESS. As I stated above, it’s not uncharted territory to feel down and blue after heart surgery, but rest assured you are NOT alone. Remember to give yourself permission to be human during this journey and know that it’s not always going to be this way. You don’t necessarily have to APPROVE of how you’re feeling, but it can be helpful to just ACCEPT what is for the right here and now. As I said above, a smart option is to ask for help and feel good about that decision. You’re not crazy. You’re just human and you’ve been through a lot. Surgery is a rough ride for anyone, let alone still being a young 14 years old.

      2) I’ll be honest. Surgery sucks and it can be a rough ride afterwards. No doubt about it. But when it comes to a decision like that, it’s a case of “if I don’t get the surgery, I might die. If I do get the surgery, then there might be after effects from it.” So obviously most people choose life. But remember that in your case, you’re only a few months post-surgery, so your body still has some healing on the inside to do and this can take some time. Many of my patients I’ve worked with did not feel “back to normal” for up to a year. Especially the sternal incision site.

      3) Regarding your scar, you will probably find it will remain a bit red and prominent in these early healing stages, but over time it will fade. My best friend in the world had open heart surgery when he was younger than you. Yes, he has a scar, BUT the good news is that the colouring of the scar has long since faded and now with his chest hair, it’s barely noticeable. I know that’s not helping you right here and now, but it’s going to be a patience thing in your case. If it is still an issue for you in the next year or two, perhaps discuss it with your doctor and ask if there are any cosmetic procedures that might help minimise the scar’s appearance.

      Ok Sev, I hope this all helps you a bit and puts you on a better mindset. Feel free to check in and let me know how you’re doing in your recovery. Your comments can help others who are experiencing the same effects after their heart surgery.

      Best wishes,
      Bill

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