Welcome to Dr. Warrick's podcast channel. Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. Hi, my name's Dr Warrick Bishop and I'd like to welcome you to my podcast and videocast station and I'd like to welcome you to part four of Dan's journey. So welcome back, Dan. Thanks, Warrick, and happy to be here. Look, for those of my missed part one, two and three, in a nutshell, Dan is a man who was 44 years of age when he came to see me. We found he had significant chronic artery disease. He ended up having bypass grafting. And we've just got to the end of his hospital stay at the end of part three. So I'd really like to talk about getting out of hospital and getting into rehab and returning to normal life. So, Dan, about how many or how long after the surgery would you say you started to feel normal again? I'd say the first four weeks I felt definitely abnormal. And as I alluded to earlier... I had the leg infection, so I was immobile. I had the liver issues, so I was on a lot of medication. And that was a challenging four weeks. And it was somewhere closer to the six to seven weeks in that I suddenly felt, or not suddenly, but I felt that I could sit up and get out of bed without using a rope and I could walk to the beach. And I'd say my rehab and my return to, I guess you'd say normality. started from about six weeks onwards. So the first four to six weeks was just absolute recovery and really no rehab. And then after the six weeks, that's when I was like, that was the next stage, the next stage of recovery, which was going from, you know, surgery and immobility to return to normal. In that four-week period, are there any hints or tips that you'd offer someone who might have that ahead of them? You mentioned sort of in a humorous way the constipation that can be associated with pain control and surgery. So obviously having a close eye to making sure you're regular in that department. But were there anything that you'd advise people to be aware of? I think the biggest thing is it will get better. That's what I found. And I didn't know at the time just how long it would be or the recovery. And I must admit, it was going slower than I had planned and projected. Having the liver issue and the leg infection meant that I was kind of recovering from three things rather than just the actual chest surgery. And looking back now, because there wasn't a lot of progression in that period that I felt. It did get better and I would say that from six weeks on and I have heard that from six weeks on that's kind of when the bypass has kind of recovered. So internally my physical recovery from the actual heart surgery was progressing and it progressed well. That's when I suddenly felt able physically and motivated to start. certainly wasn't intensive but to start the rehabilitation program progress. Well at what stage because you went to a formal rehab program which was run through the hospital where you had your surgery at what stage post surgery did you start that program? It was probably six to eight weeks that I did that and that was that was a really good it was a really good program that they offered. that I'd strongly encourage anyone to do. Did your wife attend for any of those sessions or are the partners invited to those? Partners are invited. Katie didn't come to any of those. It wasn't really because she didn't need to or any particular reason. I went to the first one on my own and she was back at work and it coincided that she was at work so she couldn't make the first one. And I think I felt and we both felt that For my personal journey and our journey together, I was getting enough out of that on my own and she didn't need to come to that one. There were other partners that did attend it and obviously there's benefits from them attending, but we didn't feel that was necessary in our way. What I got out of that, there's two parts of that rehab program, they do an exercise. structured exercise regime which lasts just under an hour and then there's a group discussion and a little bit of theory on recovery from heart disease and lifestyle and medications and things like that so it's kind of a bit of a theory and a practical. I got a really good program off them for just basic heart recovery exercises and because I have a gym at home, not a great gym but let's call it a room with a couple of weights. That gave me a structured kind of exercise regime that I could then do every day. So I could walk every day for an hour, and I'd walk about 10k a day, nice and slow on the beach, and then I'd spend an hour in the gym just doing really low weights, low intensity, just slightly increasing it every week. That, as I said, started from about six to eight weeks on, and once I did that... Every day was better than the day before. My recommendation to people is to be very cautious about the sternal wound or the chest wound where the bones are, as you said before, cobbled together with a bit of fencing wire. I often advise my patients to do as little as possible until they've hit about 90 days to allow that bone to knit as well as possible. Presumably there were some precautions that they advised you around the same space? Oh, absolutely. And so, yeah, the exercise regime, I should say, is like using one kilo. One kilo weights with the arms. There's absolutely no movement of the chest. It's a very low speed on an exercise bike or walking on a treadmill. So definitely not an elite kind of program or a CrossFit style. conditioning it was um very low intensity it was really just to just to even get the heart rate up to 100 110 beats nothing significant at all um and a huge focus on um keeping the chest um stable stable yeah absolutely so the rehab went for several weeks yeah their their rehab um The rehab I did, I believe I went to four or five sessions, but for me it was over eight weeks. I returned to work for a little bit and there was also an Easter break, so I missed a couple over that. They were really flexible in how they offered it. It wasn't like you must come one, two, three, four weeks in a row. So mine with them was the four or five sessions, but it was over an eight-week period. So by the end of it, by my last rehab session, I was, I think, 12, 13 weeks in, which is where they start saying you can start to put a little bit of pressure on your chest. Yeah, 12 weeks is that 90-odd day mark. Yeah, that's right. Or thereabouts, definitely. Yeah, and that's when I thought, yeah, I can start going for jogging again and start going surfing again. Certainly not in the big ways, but... paddling around a little bit. So you've been surfing again? I have been surfing again. I haven't ventured anywhere too scary or anything like that. But did the chest feel clicky? No, I've got rock solid. Yeah, I've got rock solid now. That's fantastic. The only thing I feel in my chest is a little bit of the nerve damage from the surgery. Which would be unavoidable. It's unavoidable and it will be there for a long time, maybe forever. But physically now... And like as I went for a run with you today, I don't feel any physical concerns or issues from the surgery. And what are we now? It must be mid-February is when I had the surgery. Okay, so February, March, April, May, June, July. Five months later and I'm... Leaving me behind running. Well, I'm physically now and emotionally feel like I'm... like at the very latter stages of my recovery. You feel like you're through it now? I do. Yeah, it's fantastic. How have you been with the tablets? All good? I have no issues with the tablets. I have no noticeable side effects. Clearly from the blood tests I had and when I reintroduced them, they weren't involved with any of the liver issues I had. So I take them daily, every evening, diligently. Yeah, no. I would say I don't have any positive effects or negative effects from them. They really have no side effects that I'm aware of. I think that's an interesting comment, no positive effects, no negative effects. The reality is that a lot of our preventative medications don't make you feel any different. They actually just prevent something that you wouldn't know would occur. They've prevented it from happening. Well, that's right. That's right. So the fact that nothing happens can actually be that the tablets are working. That's exactly it. I know that they're having a positive effect. But it's an important space because I get people back year after year after year after year complaining about taking their tablets. And I say, well, they're clearly working because you're coming back year after year. So it's great that you got through the rehab. It's really good that the tablets are well tolerated because they do work. They do. And it's great that you feel like you're through this whole process. I mean, this has been an extraordinary journey. And actually, if you haven't heard all four parts of this journey of Dan's, then I really encourage you to go back and have a listen because it's... through thin threads that we can find an alternate universe, and your alternate universe may not have been quite as good. No. No, I have no, or I'm 100% sure that at some stage in this calendar year, if I had none of the prevention or preventative measures, I'd have suffered a heart attack, and who knows where that would have left me. Just reflecting on your own journey and the opportunity to share with people who are listening, what advice, what comments would you make to people based on your own experience? And I'll mention again that Dan was 44 years of age, turned 45 during the time he was doing rehab. A proactive approach. And I was very fortunate to receive that from pretty much every medical practitioner along the way, a proactive approach from getting my bloods tested, cholesterol, seeing a cardiologist doing the scanning, like not being blasé about it, just doing all the scanning and everything will save your life. And that's what it did for me. Yeah. It's extraordinary, really. It is. Before I get all emotional, I'm going to thank Dan again for sharing. Thank you so much. Thank you. I'm so appreciative of everyone along the way that's helped me because I'm here having a run today and having a conversation with you and it could have been vastly different. So thank you. All right. Thank you again, Dan. For those listening, I really do hope you got a lot out of Dan's journey as I did. Till next time, keep well from the Healthy Heart Network, hoping you live as well as possible for as long as possible. Take care and bye for now. You have been listening to another podcast from Dr. Warrick. Visit his website at drWarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.
