Chronic stress, glucocorticoid receptor resistance,inﬂammation, and disease riskSheldon Cohena,1, Denise Janicki-Devertsa, William J. Doyleb, Gregory E. Millerc, Ellen Frankd, Bruce S. Rabine,and Ronald B. TurnerfaDepartment of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213; bDepartment of Otolaryngology/ENT, Children’s Hospital of Pittsburgh,Pittsburgh, PA 15224; cDepartment
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Lower Extremity Bypass Surgery
No lifting over 5 pounds (1/2 gallon of milk) for 2 weeks. Slowing increase activity. Walk short distances on flat surfaces at first then increase distance as tolerated. Avoid exercising in extreme temperatures. Leg swelling after bypass surgery is common and may occur for a few months after the surgery. When you are sitting or resting elevate your legs above the level of your heart. If you have been asked to wear compression stockings, put them on first thing in the morning and remove them at night. Limit stair climbing to 2 times a day for the week after your surgery.
Do NOT perform any strenuous activity such as yard work, sports, running, swinging a
golf club, pushing or pulling type activities until instructed by your surgeon. You may ride in a car. No driving until after the first post-op visit. For most people this is about 2 weeks, but depends on each person’s recovery. Before driving, make sure you can firmly extend your foot to the brake without pain, for some people this may be longer than 2 weeks. You should not be taking prescription pain medication when you start driving again. Sexual intercourse should be avoided for 2 weeks, avoid positions that will cause strain If you smoke, please quit. Smoking increases your chances of developing heart disease, carotid artery disease, lung cancer, and peripheral artery disease. It can also delay wound healing. Personal Hygiene/Shower
You may shower on the second day after your surgery. Do NOT sit down in water for a
tub bath, whirlpool, hot tub or swimming pool for at least 4 weeks or until the incision is completely healed. Gently wash the incisions with soap and water daily when you are in the shower. Pat dry with a clean towel. Do NOT scrub the incision. Make sure the incisions are kept clean
and dry. Do NOT apply lotion, ointments or creams to the incisions.
You may resume your normal diet when you return home unless otherwise directed. If you have diabetes, keeping your glucose level in good control with help with wound It will be important for you to get an adequate amount of protein and calories for the next 6-8 weeks to promote healing of your incisions, unless otherwise directed by your physician. For most people a low saturated fat and low cholesterol diet which is high in fruits, vegetables and whole grains is a good healthy diet, unless a specific diet plan has been otherwise provided for you to follow. Medications
You have been prescribed
Aspirin 81 mg daily
Plavix 75 mg daily
575 First Street | Macon, GA 31210 | Phone: 478-743-9762 Fax: 478-743-9465 | maconcvi.org
It is VERY important that you take these medications as directed. They help keep the bypass graft open.
You will be given a prescription for pain medication. Take it as directed. Pain medication causes drowsiness and you should not drive while taking prescription pain medication. Your incisional discomfort may not require a prescription pain medication. If you want you can take over-the-counter pain medications such as Acetaminophen (Tylenol). Take these as directed on
the manufacturers packaging. Do NOT take Tylenol at the same time as prescription pain
A side effect of prescription pain medication is constipation and nausea. To help with constipation you may take Docusate Sodium (Colace) once or twice a day while on pain medication. This is an over-the-counter stool softener and can be purchased at a pharmacy or grocery store. If constipation persists you can take an over-the-counter laxative, such as Dulcolax tablets. If the constipation is not relieved please contact the nurse practitioner or physician assistant for further instructions. To avoid nausea take prescription pain medication with a small snack or meal. Incision
It is normal for there to be some redness or swelling for the first week after the procedure. There will be a raised ridge along the incision line for several weeks. This is normal. Many incisions are closed with staples or sutures. These will be removed in your surgeon’s office Dermabond is adhesive glue that is sometimes used to close incisions. There are sutures under the skin. These will dissolve over time. The glue will appear shiny at first and then become sticky,
darken and begin to peel away. Do NOT scrub the incision, the glue will dissolve and come off in
1-2 weeks after the procedure on its own.
Call Your Surgeon for Any of These Symptoms @ (478) 743-9762
Leg swelling does not improve with frequent elevation above the level of the heart.
(Reminder: Lower leg and foot swelling is common after this procedure. If this happens
elevate your legs when you are reclining above the level of your heart. The swelling may last
for several weeks.
There is bleeding from the incision that does not stop when pressure is applied. The incision has increasing pain, redness, swelling or draining pus. Leaking of fluid from the incision. Your leg becomes cold, painful or numb. You have chest pain or shortness of breath. You have chills or a fever over 101 degrees F. Follow-up appointment
A follow-up appointment will be made for you before you leave the hospital with your surgeon. It will be 2-3 weeks from your surgery. Make every effort to make this appointment. We will check
your incisions for healing, remove sutures or staples, and make important follow-up ultrasounds
appointments. It is EXTREMELY important that these follow-up ultrasounds are scheduled and
kept to make sure your new bypass graft is functioning properly.
Returning to Work
This is generally discussed at the first post-operative visit after your procedure. If you have a job that does not require physical labor you may be able to return to work in 4-6 weeks as long as you are not sitting for long periods and can move around frequently. If your job requires physical labor you will be off from work up to 12 weeks. 575 First Street | Macon, GA 31210 | Phone: 478-743-9762 Fax: 478-743-9465 | maconcvi.org
15 de Septiembre Hace tiempo, un día como hoy ocurría. - Día Internacional de la Paz "La paz, el desarrollo y la protección del medio ambienteson interdependientes e inseparables." (Principio 25 de la Declaración de Río sobre el- Guatemala ? Independencia (1821) ? Fiesta Nacional. - Nicaragua ? Independencia (1821) ? Fiesta Nacional. - Honduras ? Independencia (1821) ? Fies