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Friday, February 15, 2013

Friday Q&A: Bypass Surgery

Q: I have a 65 year old male student who is having open heart surgery in a couple of days. He will be having a triple bypass with valve repair/replacement. How long (approximately) will his recovery be before he can come back to a Yoga Basics type class where we do basic postures and sun salutes? What will be the main cautions for me to be aware of as a teacher? Will his breathing be impaired? Thank you for your guidance.

A: As you might imagine, there are a lot a factors that will play into how quickly your student might return to a typical yoga asana practice after such a major surgery. So, his clearance to return to yoga will be entirely up to your student’s heart surgeon and post-operative care team. In all likelihood, he will have some physical therapy to guide him back to activities, as he will have a major chest scar that will take a while to heal. In addition to the chest scar, your student is also having a valve in the heart replaced, and will likely be on blood thinning medications for at least the short term. This can lead to bruising easily.

Cow-Face Pose Arms
 As for main cautions to be aware of as a yoga teacher, as with most situations, you want to meet your student where he is at on any given day. It would be helpful to meet with your student for at least one private session to try out some very beginner, basic movements that would likely show up on class. Keep in mind that anything that engages the muscles of the front chest, either contracting or stretching, will affect the healing breastbone area. So go slowly with things like arms overhead, out to the sides, or behind the torso. Be very mindful of more advanced positions for the arms, such as Eagle pose or Cow-Face pose arms. Lying on the chest may not be possible for a while, so keep that in mind when doing prone poses like Locust or Cobra. He may have to do a seated or standing variation of such poses. And back-bending postures will likely need to be much shallower then pre-operatively.

And for the possibility of bruising easily, you will want to mindful of poses where you are placing body parts on to one another, like the modified version Extended Side Angle pose (Utthita Parsvokanasana), when the elbow is placed on the distal thigh of the front leg. If the student does this pose without mindfulness, he could get a big bruise there, and although this is mostly of cosmetic concern, preventing it from happening will probably be much appreciated.  Stacking the legs, such as in Fire Log pose (a preparation for Lotus pose) is another one to watch out for, and you can probably come up with others as well.

On the positive side of the ledger, if the surgery is successful and the student’s heart is working more efficiently, it will not only positively impact his cardio-vascular fitness, but also should have a beneficial effect on his respiratory status as well. Gentle breath work, taking into account that the stretch of the rib cage area could trigger some pain, can be introduced pretty early on, if his surgeon gives the green light. In fact, pranayama and meditation practices could likely be started pretty soon after surgery, as they primrily require mental focus and concentration rather than physical demands. Good luck, and feel free to let us know how his return to yoga progresses!

—Baxter
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