Doctor insights on:
Eighty Four Year Old Quarduple Bypass Paitent
Is transcranial Direct Current Stimulation (tDCS) an option for a four (4) year old patient with Williams-Biuren syndrome?
Unlikely: TDCS is experimental and has shown some benefit in individuals after brain injury either from trauma or stroke, it has also been tried in individuals with parkinsons disease. These are all cases where the brain was normal at one time and the therapy is used in attempt to re-establish connections via memory. ...Read more
My father is a heart patient who had 4 bypasses September last year. Last week he developed dry cough which is so irritable.
See doctor...: There are many possible causes for a cough. If it is of recent onset, it could be due to acute bronchitis, post-nasal drip, etc. A more chronic cough could be due to bronchospasm, GERD, post-nasal drip, etc. In this case, heart failure would be a concern as well especially if he is also complaining of shortness of breath, leg swelling, coughing pink sputum, etc. Take him to a doc for diagnosis. ...Read more
If it's true that patient stops losing weight after one year of gastric bypass surgery, can she still lose weight with diet and simple sports?
Yes: Diet and exercise are the mainstay for weight loss. As long as the balance of calories in vs calories out is negative, then there will be weight loss. A gastric bypass surgery is only a tool to jumpstart a weight loss program. Any tool can be beaten. Continue for a lifetime with prudent, low-carb diet and daily exercise for ongoing weight loss and weight maintenance. ...Read more
My father is a heart patient who had 4 bypasses do e last year around September. Lately he has had dry cough which is so irritable. I worry about him.
On an ACE-I: Is your father on an Angiotensin Converting Enzyme-Inhibitor drug? (there are many and the names used in New Guinea will differ from the USA). This class is regularly prescribed after heart surgery and causes cough in 10% - if so, he must stop it. Also, ask for a chest x-ray to rule out heart failure and many other causes of cough. ...Read more
My father is a heart patient, he had 4 bypasses done last year on September. Since last week he has had dry cough which bis irritable which is a worry?
See doctor...: There are many possible causes for a cough. If it is of recent onset, it could be due to acute bronchitis, post-nasal drip, etc. A more chronic cough could be due to bronchospasm, GERD, post-nasal drip, etc. In this case, heart failure would be a concern as well especially if he is also complaining of shortness of breath, leg swelling, coughing pink sputum, etc. Take him to his doc for diagnosis. ...Read more
Is dabigatron suitable for a patient who has had a rriple bypass many years ago and has recently had a stroke?
Anticoagulant: When dabigatran is appropriate for an individual relates to a number of factors. It is a 'blood thinner' and used to minimize the risk of stroke in patients with atrial fibrillation and no valvular heart disease. There are other situaltions when it may be appropriate. You should discuss the question with the dr. That knows you best. ...Read more
Should a triple bypass patient do pushups? And if so, is two years long enough before attempting? Don't want to compromise the wires inside. Wt. 240
Male 80 years elderly diabetic patient angioplasty or bypass, both are possible. Which is safer/better?
Copd patient aged 71. Triple bypass 4 years ago in inhalers. Moderate copd stage. What is prognosis like?
I have a question on pseudo moya moya on the left side 4 years ago. Patient has had both stent and bypass operations. Can it repeat to the right side?
Stents: Moya moya can occur on both sides and that is really based on he primary cause - with a history of stent placement and bypass surgery I would certainly closely monitor for possible development of the disorder on the opposite side. ...Read more
I am a patient of essential hypertension for last 20 years. Had coronary bypass in 1994 and angioplasty (2 stents)). In 2010. My systoic BP reading150?
A behavioral help: For your high BP is cardiologist herbert benson's book, the relaxation response. It is a little meditation that helps calm the fight flight freeze response. Congrats on your good health. Peace and good health sir. ...Read more
Depends: The answer depends on several factors mainly having to do with how healthy the heart muscle is and how healthy the other organs are such as kidneys, lungs and blood vessels to other organs. It could range from low (2 -3%) to high (>25%). ...Read more
What is the best way to treat anemia for a pregnant patient with gastric bypass surgery 7 years ago?
B12 and Fe: Gastric bypass is associated with vit B12 deficiency which is secondary to loss of intrinsic factor secreted by the stomach along with fe (iron) deficiency which is absorbed by the duodenum. Moreover during pregnancy the blood volume increase to support the fetal circulation thus lead to dilutional anemia. The best approach is to receive vit B12 and fe replacements. Good luck. ...Read more
Nothing specific: I like to put the patients I operate on a significantly reduced sugar diet. A balanced diet of lean protein, complex carbohydrates and vegetables. Also some fruits and nuts. I think sugar and corn syrup should be eliminated or reduced as much as possible. That being said, my patients over 80 - I often tell them to eat whatever they want. I figure it's not going to make a huge difference. ...Read more
Heart-lung machine: The patient is placed on a heart-lung machine. ...Read more
How long it will take to recover after bypass surgery? Is saying any bad news bad for the health of the patient?
Everyone is different. A lot depends on age, severity of illness and degree of vigor vs. Frailty. On average younger people can expect to be back at full strength in 2-3 months. Over age 70, it is more like 3-4 months. The stronger you are going in to surgery, the quicker the recovery.
It varies from person to person. ...Read more
Depends: If the bypass is done before there is a lot of damage and if there are no complications, the patient should do well. Pain should improve and the patient should be able to recover. ...Read more
Seriously?: Tatib5, in medicine, as in life, there are never any guarantees. I tell my patients that I guarantee that I will do my best to help them and i'll be there for them if things go wrong. Bypass surgery is a routine operation with a low operative mortality in most patients guarantees are not possible. ...Read more
CABG: No surgeon in his right mind would guarantee a surgical result to a patient. In general coronary bypass patients have over a 90% chance of signficant improvement of their symptoms. In some situations that number won't be realistic and the patient is generally made to understand what they can hope for. ...Read more
Why induce coma:
33F asks why put a pt in a medical induced coma after triple bypass surgery.
Many reasons but first would be suspect brain injury due to low BP during surgery and want to protect brain. First ask the person's team why? And go to ScientificAmerican. Com and look at What is a Medically induced Come and why is it use? B David Biello Jan 10, 2011. ...Read more
Post Bariatric Surg: Yes. That is the simple answer. But, if with that dose you feel any burning or acid or increase of pain then in your case it may not be so safe. ...Read more
No push ups 3 mo.: Given that there are no medical issues, healing of the sternum as with any bone in the body, occurs slow. It takes 6 weeks post sternotomy for new bone to start forming. During that time maneuvers that can result in sternal malunion or non union should be avoided. Like falling with outstretched hands, push ups, pushing a car or refrigerator, you may put if you golf but no swinging a bat or club. ...Read more
Need docs answers! What guarantee does a heart bypass procedure give to a stricken heart patient?
The: Guarantee that if the pipes are not cleaned, the stricken heart could get much worse, and even still stop working! ...Read more
What reasons would a person not be able to have bypass surgery perform on 3 arteries blocked over 90%? Patient is 36, 6'1", 200 lbs.
Anatomy: It would largely depend on the coronary anatomy and location of the target vessel/s and the surgeon -- not the patient criteria. ...Read more
Since the gastric sleeve can cause complication with a sarcoidosis patient. Is the gastric bypass better to have done with sarcoidosis?
Sleeve ; sarcoidosis: Neither one (bypass or sleeve) is better than the other with respect to sarcoidosis. Studies have shown that people on immunosuppressive therapy can safely undergo either operation. I would just decide which operation is best for you. In a healthy ; moderately obese person, either operation is fine. If you have gerd, diabetes, or have a bmi over 50, bypass is preferred. ...Read more
How long after cardiac bypass surgery should a patient expect to feel as well as prior to the surgery?
It varies: If the bypass was done after a heart attack it may take a lot longer to recover, whereas if it was an elective procedure then recovery may be possible in 4-6 weeks, especially if followed by good cardiac rehab program. ...Read more
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