Cardiovascular of Southern Nevada

1. What has caused me to have heart or vascular disease, such as disease in the arteries of my neck or the arteries in my leg?

Usually atherosclerosis is the cause of the problem. Atherosclerosis is hardening of the arteries which is caused by five major risk factors which include: high blood pressure, diabetes, smoking, high cholesterol, and your family tendencies toward development of atherosclerosis, meaning genetics. Each of these factors can be controlled, except for the genetic problem. We recommend that your blood pressure be maintained by your primary care physician, diabetes kept under good control with a good diet and medications as needed, your cholesterol be checked frequently and kept under control with medications, if needed, as well as a healthy diet, and smoking, of course, can be discontinued.

There are programs that assist people to stop smoking such as Nicotine patches or Nicotine gum, acupuncture, or even hypnosis. However, the single best way to stop smoking is to convince yourself that it is a good thing to do for yourself and to avoid any temptation to smoke when you normally would smoke such as after meals. Plan on doing something different to change your lifestyle so the craving to smoke is diminished. Of course, you will want your family members to also stop smoking, as it is difficult to stop smoking in a house where others smoke.

Many of the operations can be found on the Internet, but also prior to operation your surgeon will be glad to discuss the technical portions of the operation. Some patients want to know exactly how each stitch is placed and others do not want to know much about the technical portions of the operation. Please feel free to discuss this with your surgeon.

All of the surgeons in our group are qualified to do all heart, thoracic and vascular procedures. Sometimes one surgeon has done many more procedures than another and (s)he might even ask a surgeon with more experience to help with the case. None of the surgeons, however, will do a case they do not feel comfortable doing or feel they do not have enough experience doing. Our surgeons will refer to another more experienced surgeon in our group if (s)he feels it will better meet the patient’s needs.

Pain after surgery is something we like to minimize. However, after any type of operation we cannot totally eliminate pain. Pain medications will be ordered for you in appropriate doses. While in the hospital if you do not feel the pain medication is adequate, please feel free to speak to the hospital nurse or the surgeon when he/she makes rounds. If you have been discharged from the hospital and experience pain please contact our office. Pain medications can be adjusted.

Chances are good you will get through surgery without complications. Of course complications can occur with any type of surgery and depend on the risk factors that you have before going into surgery. Your surgeon can discuss this with you prior to surgery. Different types of risk factors include: decreased heart function, significant problems with diabetes, lung or kidney problems, and obesity.

We measure your lung function before surgery to determine just how much lung we can remove. You may be somewhat more winded when you do heavy exercises after lung surgery such as mowing the grass or vacuuming the floor, but generally speaking, most people do not miss the amount of lung we remove. If you have severe lung disease before surgery, of course, lung surgery will not improve the situation whatsoever.

It is the desire of the physicians taking care of you that you will resume a better life than what you had before surgery. Hopefully, the pain that you had in your chest will disappear after your heart surgery or the pain that you had in your legs should disappear after a vascular surgery. However, each person is different, and disability may occur depending on the amount of problems you are having before surgery.

8. Can I have this problem again, such as heart blockage, peripheral vascular disease, or carotid disease?

Yes you certainly can. The surgery that we do is a palliative type of procedure. In other words, we are just fixing the problem as it exists today. Unlike having your appendix taken out when you have appendicitis, which is a curative operation, doing vascular surgery is mainly bypassing the blockages in the artery or cleaning out the arteries that are diseased. However, the risk factors that were mentioned above i.e., high blood pressure, diabetes, smoking, high cholesterol, and your genetic tendency all hasten the development of future atherosclerosis or hardening arteries, which can block up the arteries that have been repaired. Careful maintenance of a diet, stop smoking and good exercise are the best preventatives to having this problem reoccur.

It is of utmost importance that you clarify this before surgery if you have any questions. Our office will get the procedure approved by your insurance carrier before we schedule surgery to minimize any problems that may occur. However, if you have any questions, please feel free to call our billing office.

The answer is no in most cases. For most surgeries, you will go to the hospital two days before surgery to be pre-admitted. Labs and special x-rays may be taken at that time. The night before surgery, we ask that you do not eat or drink anything unless you have been given special instructions by the nurse or the surgeon. On the morning of surgery, you will be instructed to take some of your regular medications with just a sip of water before you arrive at the hospital. You will be instructed as to what time to arrive at the hospital to be prepared for surgery.

The first thing is to relax. This will be a difficult time for you and your family. A light meal is appropriate and a good night's rest is important. Again, after midnight you should not eat or drink anything except to take your morning medications with a sip of water, unless told otherwise. A shower with regular soap is important before you go to bed, and also when you get up before going to the hospital.

You will be instructed to go to admissions for check-in and then the hospital staff will direct you to the appropriate area for the preoperative assessment by the hospital nurses. More tests may be required if something unusual was found from the previous days test. The surgeon’s anesthesiologist will usually meet with you in the preoperative area to answer any other questions. The anesthesiologist will go over the types of anesthesia (s)he is going to use and the expected outcome.

You will either see the surgeon in the office or in the hospital before surgery to answer any questions prior to surgery. On occasion, because of an urgent or emergent situation, you might meet the surgeon just before surgery, but this is not our general practice. We like to meet with you before surgery and discuss the problems you have and how we intend to fix them as well as the risks involved. In most instances, we will meet with you beforehand and also meet with you just before surgery to answer any other questions that might have come to mind. Please feel free to ask any questions, as any question that you have is important for us to answer. Additionally, you will probably not meet the anesthesiologist until just before surgery. If you have any concerns about the anesthesia, please feel free to tell your surgeon so the Anesthesiologist can meet with you to answer your questions long before surgery.

14. Who will do my anesthesia?

A group of highly trained cardiac anesthesiologists will provide safe anesthesia for your surgery. These anesthesiologists are well trained and do all of our procedures, vascular, thoracic and heart surgery. Each of them is specially trained in doing this type of surgery which helps minimize the anesthetic risk you might have with your particular surgery.

Occasionally, the hospital runs into an emergency or the surgeon responsible for your care will have an emergency, possibly even at another hospital. This will delay your surgery. Sometimes, although very unusual, the surgeon who is responsible for your surgery will not be able to do it on that particular day. When your surgeon is not able to do your surgery as scheduled, one of his/her partners may be asked to do the surgery, but the decision on who does your surgery is up to you. If you wish to have the surgery performed without delay by another of our surgeons he/she will speak with you about the procedure before your surgery. If you decide you would rather wait for the surgeon who has already talked to you, then the case may be delayed until later in the day or rescheduled. Occasionally, because of overload at the hospitals surgery is also delayed or cancelled. We have minimal control over hospital delays and cancellations. However, once we take the responsibility for your surgery, we will follow through with appropriate care.

You will see the surgeon who has performed your surgery or one of his/her partners each day after surgery until all of your surgical problems are taken care of. Because we have a busy practice, one surgeon is assigned to each hospital to make rounds. We feel by having one surgeon assigned to each hospital it enables the surgeon to know the patients well and to better establish a plan if problems occur. Even if you don’t see your surgeon, (s)he will know about your progress and any problems you may have.

Generally speaking, the time varies from patient to patient and procedure to procedure, but hopefully within 5-7 days after surgery one is discharged. There is coordination between the Cardiologist, the Internist, and the Surgeons as to when you can go home, but we certainly do not want you to go home until you feel that it is appropriate as well. Going home can be discussed with your doctor at any time as you recover in the hospital.

Prescriptions will be given to you before you are discharged from the hospital. Follow up instructions pertaining to your surgery will also be provided either at the hospital prior to your discharge or mailed to your home. In addition to follow up instructions a follow up appointment with your surgeon will also be made; this appointment will be documented on your follow up instructions. Our office makes every effort to call and check on you after surgery. At this time the post operative instructions and follow up appointment with your surgeon will be reviewed.

Generally speaking, your limitations are set by yourself. Other than no heavy lifting for about 6 weeks until your breastbone is completely healed, there are no limitations. We suggest you exercise daily by walking, and increase the amount of exercise you do each day so that you are making progress.

In most instances, we have patients come back to the office to be seen anywhere from 2-4 weeks after they are discharged from the hospital, depending on the magnitude of the surgery and the problems you might have had in the hospital. Of course, you are always able to call the office if you have a question or a problem and you will be worked in to see someone before your scheduled time if necessary.

Going back to work depends on what type of work you do. Jobs in which there is no lifting and/or significant moving about can go back to work sooner than those with heavy labor or significant movement. We would like for your breastbone to heal for about 6 weeks before we allow you to do any heavy lifting.

Generally speaking, we do not want anyone to drive until approximately 30 days after surgery, just to let you get over some of the soreness from surgery without depending on your reaction time while turning the steering wheel or having to brake. Sometimes people can start driving earlier, but we certainly do not want patients who are on narcotics or pain pills to drive. We suggest when you start to drive, you drive in an area that is very quiet so you can get your "driving legs" back.

Most patients after heart, thoracic or vascular surgery should be on a low-fat, low-cholesterol diet. Your primary care physician can help you with one of these diets, but generally speaking, a “heart healthy” diet is a good one to be on. Occasionally, you can “cheat”, but usually a change in your lifestyle eating habits is warranted after heart, thoracic or vascular surgery.

Generally speaking, when the urge or feelings to have sex come to your mind, it is okay.

25. Why am I having trouble sleeping and when will my appetite return after surgery?

Most of the time people will have trouble getting their sleeping cycle regulated and have a poor appetite after heart, thoracic and vascular surgery. Sleeping problems usually are improved as the number of naps you take during the day decrease. Occasionally a sleeping medicine will be ordered, but the best sleeping medicine is Benadryl, which is an over-the-counter medication. You can take up to 50mg (2 pills) to help you sleep.

Most people complain of some numbness around their incisions especially in the leg incisions around the ankle. This comes from disturbing the nerves. In the chest, you can often have numbness where the internal mammary artery is used for heart surgery, which would usually be in the left side of your chest and breast area. This numbness becomes insignificant after a while and you will not notice it. However, occasionally patients have a particular hypersensitivity to their incision in which even a short rubbing of the incision is quite uncomfortable. There are medications to prevent this, but most of these symptoms resolve with time as well.

Cardiac Rehabilitation is just what it says it is, rehabilitating your heart muscle after heart, thoracic or vascular surgery. It is basically a very good fitness program that is organized at established Cardiac Rehab Centers, but also can be individualized to you and done at home thereby eliminating travel. Rehabilitation can start in the hospital, but generally speaking the outpatient rehabilitation starts 2-3 weeks after you have gone home.

To save you time we have included our new patient forms on the website so you may fill out at home and bring in with you on your next visit.

HOME - PHYSICIANS - PROCEDURES - FAQs - ASK QUESTION - PATIENT FORMS - CONTACT US - PRIVACY POLICY
3131 La Canada, Suite 217 - Las Vegas, NV 89169

Frequently Asked Questions

Do you have a question you would like answered?