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Angioplasty and stent

Where stopping the blood-thinning tablet can kill

First things firstYour discharge sheet and your surgeon's instructions come before this page. What follows is food, rest, what the medicines do, and the warning signs. Wound dressing, lifting limits and when to go back to work differ by operation and by surgeon — ask them, not a web page.

1Before the operation

The preparation that changes the outcome.

Specific to this operation
Carry a list of every medicine you take, diabetes ones especially — some are stopped for a few days because of the contrast dye.
Applies after any operation
What your doctor must be told
Your surgeon and the anaesthetist need to know everything you are taking — medicines, Ayurvedic powders, vitamins, home decoctions, all of it.
What to do: People often do not count Ayurvedic and home preparations as medicines and leave them out. That is the commonest and most important omission. Carry the packets, or photograph them on your phone — better than trying to remember names.
Practical preparation
Small things that make the hospital day easier and are hard to remember at the last minute.
What to do: Follow the hospital's fasting instructions, not the internet's. Cut your nails and take off nail polish — the oxygen probe clips onto a finger. Leave all jewellery at home. Loose clothes. Carry your medicine list and old reports. Arrange for someone to be with you for the first week back. Clear the path to the toilet, and put water and essentials within reach of the bed.

2After the operation

What to expect in the first days and weeks.

This is the most important line on this page: never stop either blood-thinning tablet — aspirin and clopidogrel, say — without your doctor's say-so, not even for a day. A clot in the stent is fatal. Even before other surgery or a tooth extraction, the decision goes through your cardiologist.
The entry site at the wrist or groin stays bruised for days. Show it if the swelling grows or a lump forms.
If it was through the groin, go easy on lifting and stairs for a few days.
If a cardiac rehabilitation programme is offered, go — it genuinely lowers the risk of another attack.

3What to eat

The raw material for repair — and what is different after this operation.

Specific to this operation
Less salt, less fried food, less food from outside. Whole grains, dal, vegetables, fruit.
Stop smoking completely — after a stent it is the single biggest decision you make.
Grapefruit does not go with some heart medicines — ask about yours.
Applies after any operation
Protein, for the repair
Healing a wound means building new tissue, and the raw material for that is protein. The body needs more than usual after surgery — at exactly the time appetite is lowest.
What to do: Something at every meal: dal, rajma, chana, curd, paneer, egg, fish, chicken soup, moong, sattu, milk. If you are vegetarian, eat dal with rice — together they make a complete protein. If you have kidney disease, ask your doctor before increasing protein.
Low Weight / WeaknessGeneral DebilityProtein & muscle
Iron, to rebuild the blood
Every operation loses some blood. Rebuilding it needs iron, and absorbing iron needs vitamin C.
What to do: Green leafy vegetables, beetroot, pomegranate, dates, jaggery, til, rajma. With something sour alongside — lemon, amla, orange — which multiplies how much iron is absorbed. Do not drink tea straight after a meal; it blocks iron. Leave an hour.
AnaemiaWeakness & Anaemia
Fibre and water
Painkillers, moving less and a changed diet all push towards constipation. After abdominal surgery, straining does the most harm.
What to do: Water through the day, a little at a time rather than all at once. Soaked figs, raisins, munakka at night. Papaya, guava, apple with the skin. Isabgol with a full glass — with too little water it does the opposite. Build fibre up slowly or it brings gas.
ConstipationGas & Bloating
Little and often
A full plate in front of you kills what appetite there is. Six small plates get far more into you over a day.
What to do: Something every two or three hours. A share of protein each time. Liquids count — dal water, soup, buttermilk, milk, sattu. When eating is hard, drinks are the easiest way in.
Poor AppetiteWeak Digestion
What to keep away from
A few things work against both a healing wound and a digestion that is only just coming back.
What to do: Deep-fried and heavily spiced food — the stomach cannot handle it in the first weeks. Alcohol — it slows healing and is dangerous alongside painkillers. Smoking — it cuts the oxygen reaching the wound, and is the single most avoidable cause of a wound going wrong. Cut, open street food until your strength is back.
GastritisAcidity

4What the medicines do

What follows the anaesthetic, the painkillers and the antibiotics.

Nausea after anaesthesia
Feeling sick for the first day or two after a general anaesthetic is very common.
What to do: Sips, not glasses. Dry roti, khichdi, plain rice. Once you are allowed, a slice of ginger or dry ginger in warm water. Stay off fried and strong-smelling food for a day. If vomiting keeps up and even water will not stay down, tell your doctor.
Nausea / VomitingVomitingAcidity & Nausea
No appetite after the medicines
Anaesthesia, painkillers and antibiotics together flatten the appetite for a week or two — at exactly the time the body needs the most food to repair itself.
What to do: Less at a time, six times a day. Something with protein each time — dal, curd, paneer, egg, sattu. Jeera or ajwain water before eating. A sour taste opens the appetite — lemon, amla, pomegranate. Six small plates beat one forced large one.
Poor AppetiteLoss of AppetiteWeak Digestion
Constipation from painkillers
Strong painkillers — tramadol, codeine, morphine — slow the bowel down. After surgery this happens to almost everyone; it is not a sign that something has gone wrong.
What to do: Sip water through the day. Soaked raisins, figs or munakka at night. Warm water first thing. Isabgol with a full glass of water. And walk as soon as you are allowed — movement wakes the bowel faster than anything else. Ask your doctor for a stool softener early, rather than once it has set in.
ConstipationStubborn Constipation

5Changes in the body

Skin, hair, and the changes nobody warns you about.

Swelling that builds through the day
Swelling around the site, and in the limb below it, is normal for weeks. It is least in the morning and most by evening.
What to do: Keep the part above heart level as much as you can. Keep working the ankle up and down. Go easy on salt. But note the difference — swelling in one calf with pain and warmth points to a clot; do not massage or apply heat, go straight to a doctor.
Ankle swellingFor standing jobsAnkle exercises
Weakness that lasts for weeks
Even a small operation costs several weeks of strength. People expect to feel normal as soon as the stitches come out, and are alarmed when they do not.
What to do: Protein at every meal. Get checked for anaemia. Some sunlight daily. Start walking short and add a little each week — judge it by weeks, not days. On a day you overdo it, do less the next day rather than stopping.
General DebilityChronic FatigueGeneral Weakness / TonicAnaemia
Rash from tape and dressings
Surgical tape and adhesive dressings often leave an itchy red square on the skin.
What to do: Tell the nurse or doctor so a different dressing is used next time. Keep the area dry. Plain coconut oil once the skin is intact. Do not scratch — a scratched rash can get infected. Blisters or any pus need to be looked at.
Itchy SkinSkin Health & Glow

6Days in bed

Lying still carries its own risks — these are what prevent them.

Keep the ankles moving — to prevent clots
Lying still slows the blood in the leg veins and raises the risk of a clot. After surgery that risk is already higher than usual.
What to do: Every waking hour: pull both feet towards you and point them away, twenty times. Do not keep a pillow permanently under the knees. Whenever you are allowed, get out of bed and take a few steps — that beats any medicine for this. If compression stockings were given, keep them on.
Ankle exercisesFor standing jobs
Deep breathing — to keep the chest clear
Anaesthesia and pain make the breathing shallow, the lower parts of the lungs do not open fully, and infection settles there. The risk is highest after abdominal or chest surgery.
What to do: Ten deep breaths every hour — in through the nose, hold for two, slowly out through the mouth. Then one huff — mouth open, push the air out fast, not a cough. Press a pillow against the wound while coughing or huffing; it cuts the pain a great deal. If you were given a spirometer, use it as often as instructed.
Breathing exercises
Not a home remedy — see a doctor

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