Shock to your body after open heart surgery

[3mm]

I had my open heart surgery 5 weeks ago. I feel good, no sternum pain, my cardiac rehab is going well, I'm stronger every day, my endurance is improving, etc. I am wondering when it will be safe to absorb shock in my upper body. Shock can come from: recoil of my arm or knee when I strike a heavy bag; getting struck by a training partner in a martial arts class; or shooting a large caliber rifle/shotgun. My cardiologist and other medical people suggest waiting until 10-12 weeks after surgery, starting easy, stopping if it hurts, etc. Does anyone have relevant experience they can share? Thanks!

 

[Chuck C]

I also do martial arts. I was given the clearance by my cardiologist to push myself physically after 3 months and pretty much do anyting I wanted. By then I started to push myself harder in some of my cardio workouts. I did wait until about 4 months after surgery to hit the heavy bag, as I did not see any reason to rush things. I started doing Jiu Jitsu about 10 months after surgery, but I'm sure I would have been fine to get back to it sooner.

Make sure to check with your cardiologist to get clearance first. I would suggest erring on the side of waiting a little longer to get back, rather than be too eager to start back at it. The time will pass before you know it, and you will be back to all your activities.

 

[pellicle]

r shooting a large caliber rifle/shotgun. My cardiologist and other medical people suggest waiting until 10-12 weeks after surgery,

I'd concur with the risks

Really, you do NOT want to stuff up your sternum, need to be opened up again and that abraded and restitched and repeat another 8 weeks if you cause it to fracture.

Of course its entirely up to you, but to me the risk reward just isn't there

 

[3mm]

Thank you all very much for your insights. I will continue to wait a few months...... But after i wait a few more months, how do I know if the sternum has healed well?

My cardiologist was very reluctant to give guidance on this topic, which I understand since she does not cut bones, repair bones, or otherwise work on them. I will contact my surgeon's team and ask them about this in more detail. When I left Mayo Clinic after surgery the surgeon's team just gave the general purpose answer in terms of waiting 12 weeks for lifting weights over 10 lbs, start easy, stop when it hurts, etc. Can't a surgeon (or a radiologist) look at a chest x-ray and see if the sternum has healed? Won't they be able to see that the cut is being filled in with new bone?

 

[pellicle]

Can't a surgeon (or a radiologist) look at a chest x-ray and see if the sternum has healed?

Not really, frequently resolving a crack is impossible without getting exactly the right angle

 

[Woodcutter]

Here's a study with some relevant information on this subject. Interestingly, valve patients were excluded from the study population! What jumped out to me in a quick read is the tremendous variability in healing times.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333848/

Methods​

This study enrolled 197 patients who underwent isolated CABG using skeletonized bilateral internal thoracic arteries (sBITA) from 2006 through 2009. Postoperative computed tomography (CT) angiography was performed on all patients at monthly intervals for three to six months after surgery. In 108 patients, an additional CT study was performed 24 to 48 months after surgery. The axial CT images were used to score sternal fusion at the manubrium, the upper sternum, and the lower sternum. These scores were added to evaluate overall healing: a score of 0 to 1 reflected poor healing, a score of 2 to 4 was defined as fair healing, and a score of 5 to 6 indicated complete healing. Medical records were also retrospectively reviewed to identify perioperative variables associated with poor early sternal healing.

Results​

Three to six months after surgery, the average total score of sternal healing was 2.07±1.52 and 68 patients (34.5%) showed poor healing. Poor healing was most frequently found in the manubrium, which was scored as zero in 72.6% of patients. In multivariate analysis, the factors associated with poor early healing were shorter post-surgery time, older age, diabetes mellitus, and postoperative renal dysfunction. In later CT images, the average sternal healing score improved to 5.88±0.38 and complete healing was observed in 98.2% of patients.

Conclusion​

Complete sternal healing takes more than three months after a median sternotomy for CABG using sBITA. Healing is most delayed in the manubrium.

 

[pellicle]

Here's a study with some relevant information on this subject. Interestingly,

Indeed interesting, personally I looked at this

In multivariate analysis, the factors associated with poor early healing were shorter post-surgery time, older age, diabetes mellitus, and postoperative renal dysfunction.​

 

[Timmay]

I wanted to give my experience.

I did cardiac rehab and graduated with flying colors. During this time period I didn’t do anything sketchy at home. At home, all I did was walk a lot.

4-1/2 months after surgery I was shooting again. This includes 458 SOCOM, 338 Lapua Magnum, and shotguns. I took it easy. Didn’t overdo it. Not huge round counts. I was fine.

I started lifting weights again around 4 months. I started slow. My goal was to benchpress 135lb for 10 super clean and slow reps with perfect form at 6 months. I only weighed 165 lbs at the time. I did this and reached my goal. Things were looking great!!

However, shortly after I achieved my goal things went downhill a bit. And I have never been able to get back to that point. I’m still shooting a fair amount. But my workouts are crap and I’m only benching like 45lbs.

I’ve had X-rays, Ct scans, etc. they can’t find anything wrong. But, I really feel like me pushing myself for that 6-month goal did something to me. Maybe one day they’ll figure it out.

Don’t get me wrong, I’m doing great, but having my workouts limited because of something that can’t be detected is difficult. I really enjoy working out.

If I could give one piece of advice it would be to take it way slower than you think. Take your time. Don’t ever compare your progress to anyone else’s here. Ever. At the time I was 50 and comparing my recovery to other guys who were in their 30’s. That was a bad call … but I thought it was fine because I worked out a lot. I was wrong.

Go slower than you think.

 

[Chuck C]

If I could give one piece of advice it would be to take it way slower than you think. Take your time

I agree with this. My cardiologist told me at 3 months that I really didn't have any physical restrictions, but to just be sensible as I train. To me, that meant taking more time to heal before I started to really push things. And, even now, about 2.5 years out, I choose to not go 100% in lifting or pushing cardio, compared to how hard I use to push myself before surgery.

While I do challenge myself physically, I'm more mindful about it. For example, I still climb Mt Monserrate from time to time. Prior to surgery, I would push myself occasionally, trying to beat my previous best time. To do this requires sustaining my heart rate at 150 to 170 bpm for 20 to 30 minutes. Now, post surgery, I don't like to sustain that kind of cardio stress for that period of time. I still get a good work out, but I don't worry about timing myself and trying for a new PR. While I did enjoy the challenge of trying to do better and better, I don't believe that it necessarily is the most healthy thing for me, especially in that I have a few replaced parts in there- my valve and part of my aorta. I have to weigh the benefits of that good feeling of setting a new PR, against the concern that I might put too much strain on things.

 

[carolinemc]

I wanted to give my experience.

I did cardiac rehab and graduated with flying colors. During this time period I didn’t do anything sketchy at home. At home, all I did was walk a lot.

4-1/2 months after surgery I was shooting again. This includes 458 SOCOM, 338 Lapua Magnum, and shotguns. I took it easy. Didn’t overdo it. Not huge round counts. I was fine.

I started lifting weights again around 4 months. I started slow. My goal was to benchpress 135lb for 10 super clean and slow reps with perfect form at 6 months. I only weighed 165 lbs at the time. I did this and reached my goal. Things were looking great!!

However, shortly after I achieved my goal things went downhill a bit. And I have never been able to get back to that point. I’m still shooting a fair amount. But my workouts are crap and I’m only benching like 45lbs.

I’ve had X-rays, Ct scans, etc. they can’t find anything wrong. But, I really feel like me pushing myself for that 6-month goal did something to me. Maybe one day they’ll figure it out.

Don’t get me wrong, I’m doing great, but having my workouts limited because of something that can’t be detected is difficult. I really enjoy working out.

If I could give one piece of advice it would be to take it way slower than you think. Take your time. Don’t ever compare your progress to anyone else’s here. Ever. At the time I was 50 and comparing my recovery to other guys who were in their 30’s. That was a bad call … but I thought it was fine because I worked out a lot. I was wrong.

Go slower than you think.

Good wisdom of advice. For many try to rush the healing and it does not fare well when it is soon after. They do not get it that the chest muscles have to heal first and takes a year. They feel better and think they are ready to push it, but they do not realize rushing does more harm than good. You did great at first. And the advice, listen to the experts, the doctors, for they know how long everything takes in the healing of the body. It does not matter the age of the person who has bypass, they have to be patient and let the body heal, for bypass is major surgery and evrything has to be allowed to heal in its own time. You did great and learned a lot.

 

[3mm]

Again, I thank everyone for sharing their information and experiences. The study that Woodcutter referenced above is ... informative and sobering. But I appreciate the harsh reality. My cardiac rehab team have told me 3 months after surgery before I do a standing pushup leaning against a wall. That is certainly a prerequisite for absorbing any shock to the upper body.

Timmay, I'm sorry to hear about your unsatisfactory workouts. I appreciate how frustrating that can be; I used to run multiple 7 minute miles, but now my left knee does not allow me to run across the street. I hope things start to improve for you!

I'm starting to realize I must carefully obey the limits cardiac rehab has given me. Meanwhile this question of shock to the body can wait. A higher priority is to replace my left knee, which suffers from severe arthritis, and worn out Cartlidge.

 

[Timmay]

Again, I thank everyone for sharing their information and experiences. The study that Woodcutter referenced above is ... informative and sobering. But I appreciate the harsh reality. My cardiac rehab team have told me 3 months after surgery before I do a standing pushup leaning against a wall. That is certainly a prerequisite for absorbing any shock to the upper body.

Timmay, I'm sorry to hear about your unsatisfactory workouts. I appreciate how frustrating that can be; I used to run multiple 7 minute miles, but now my left knee does not allow me to run across the street. I hope things start to improve for you!

I'm starting to realize I must carefully obey the limits cardiac rehab has given me. Meanwhile this question of shock to the body can wait. A higher priority is to replace my left knee, which suffers from severe arthritis, and worn out Cartlidge.

If I could do things all over again, I would wait a year before lifting weights again. This is coming from a guy who could perfectly and slowly benchpress their own body weight 10 times prior to surgery. Instead, I would focus more on my walking and jogging. At the end of my cardiac rehab I was doing interval running. I should have just kept that going and worked back up to slow jogging 2 miles at a time.

I know you can’t do the jogging thing - because of your knee - but if anybody else reads this I’d like them to hear someone like me say “Put the weights down and walk away. You cannot predict how your body is going to handle this and it’s better to be safe”.