Heart Disease Forum
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My Dad just had 4-way by-pass surgery Mon Nov. 19.  He is 70 year old and ended up staying in OHR 4 days, instead of the average 24 to 48 hours.  Was able to get off of the Butamene? to help heart beat, and blood pressure seems to be ok, considering his anxiety about being on the respirator,but unable to get off of respirator.  Now he has Pneumonia, and Friday nite moved him to ICU.  It seems the heart surgery is not so much a concern now as his pulomnary  problem.  They put tubes into lungs to drain fluid and an air pocket, and have him heavily sedated. He just lays there and is not conscious. of course they are treating with two antibiotics, and trying to keep him comfortable. What sort of recovery time should we expect, what percentage of patients die from this sort of complication?  Should we expect him to be quite disoriented from all the time he has passed unconscious and on medication?  What kind of thrapy will they want to do or what should we ask about?  I feel very frustrated with his doctors.  We feel like they do not wish to be bothered with our questions or spend time wxplaining things to us.  We have no experience with these types of medical issues.  I don't even know what to ask or be concerned about.
I will appreciate any input.  I need to have some idea as to what to expect.  I am a single working mom of 5 children, and my Mother is not able to care for Dad or to drive.  I need to gear up for whatever is coming.
2 Responses
Avatar universal
Dear holly,
I'm sorry to hear of your father's complicated post-operative course.  In a small percentage of persons undergoing heart surgery coming off the ventilator can be a problem. If there is a history of smoking or lung problems pre-op this can make it harder.  Probably in some part due to the difficultly with the breathing post-op he has now contracted pneumonia.  Pneumonia is usually quite easy to treat but in an elderly person who has just undergone major surgery it can be quite difficult to cure and may even be deadly.  The percentage of individuals dying would depend on the person's overall health and what type of bacteria was present in the lungs but could be upwards of 5%.

In general for someone who is critically ill post-op a recovery time of 2-3 weeks in the hospital is not uncommon with sometimes an additional several weeks in a rehab unit.  Regaining strength is important and may take awhile.  

Questions to ask his doctors:  Has the type of pneumonia been isolated?  Is an Infectious disease doctor (someone who specializes in the care of pneumonias) seeing him?  If not could you please consult one?  How is his heart functioning?  Is he being weaned from the ventilator?  If not, when do we need to consider placing a tracheostomy (breathing tube)?  Is he requiring pressors to maintain his blood pressure? (a bad sign if he is). Should we consider transfering him to a tertiary medical care center (large medical center used to taking care of critically ill patients)?

Hope all turns out OK with him.  Let us know how he does.
Avatar universal
dear ccf-md-crc:
Thankyou for your prompt response.  Your suggestions will be very helpful.  I have jsut returned from hosp. where Dad is still on ventilator, they tried to wean him off of it.  He was initiating his own breaths, but with extra help from the machine.  His rate was between 45 and 51 bpm.  Not good.He has also spiked a new fever this am of 102 degrees, 101 at 4pm, and at 10:00 it was 101.8. He is very restless and seems agitated squirms around in the bed.  They took him off of the fentalyn and ativan yesterday, but still not able to open his eyes, although he did seem to barely respond with a nod tonite when I told him I was there.  He does not respond when I say, "Squeeze my hand"..  So, because his breathing was so fast and shallow, they again gave him ativan and stepped the ventilator back up to 12 bpm, assisted, the machine is now doing the work again.  I think this is the 3rd time they have done this.  I have asked for a list of all meds he is on and what they are for , along with a list of several other questions.  I had to take my list and give it to the head of nursing, and also had it taped to the front of his chart.  The doctors just don't call us.  He is moving his extremities, but is it possible he has had a stroke of some sort, or is cong heart failure a concern?  
Thank you again for your answer to my letter.
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