Why am I still sore a year after quintuple bypass on my heart?

JUST over a year ago, I had a quintuple heart bypass. In the months since, the numbness in my chest has been replaced by tenderness and soreness. I also dread coughing, as this is painful too. Is all this normal?

QUINTUPLE heart bypass is just about one of the biggest operations you can have on the heart. It involves removing and replacing five major blood vessels that supply the heart because they’ve become diseased, inflamed and blocked by fatty deposits known as plaque.

A bypass is open-heart surgery, and involves taking blood vessels from elsewhere in the body and ‘plumbing’ them into the heart, helping re-establish a healthy blood supply.

After the operation, patients usually feel massively better, but it takes time to recover. Typically, people are back at work in eight weeks and fully recovered in three months.

Numbness is common around the site of the wound, as nerves can be damaged when the chest is opened. As these nerves recover, it’s common to feel odd sensations, including intermittent discomfort and pain, and coughing after this operation can indeed be painful.

In the first few weeks, patients are advised to firmly hug a small pillow to brace their chest when they cough to avoid damaging or pulling apart the incision. This will be fully healed within a few months, so in the longer term you should see gentle coughing as a sort of rehab in itself.

Although rare, it is possible to develop problems in one or more of the grafts, or in other arteries. If you’re worried, see the GP or get in touch directly with your cardiologist. Pandemic or not, heart concerns are something that the NHS will prioritise.

Hospital tests will be able to rule out anything sinister. Call 999 if you experience any sudden unusual pain, palpitations, dizziness or shortness of breath.

TWO years ago, I discovered a tiny, pea-sized lump in my breast and, on my GP’s recommendation, booked a mammogram. I was told the results showed there was nothing wrong, so I assumed it must be a cyst. The lump hasn’t grown, but it’s started to feel a little painful. Should I worry?

A NEW lump – anywhere – should never be ignored. The vast majority do turn out to be nothing to worry about, but it’s important to let the GP or specialist decide on that.

A common type of lump is a fibroadenoma – little clusters of tissue that form in the lobules, the milk-producing glands. They’re smooth to the touch and move easily under the skin.

They’re usually painless, but can be tender or even painful, particularly just before a period. Most get no bigger than a large grape, but they can grow larger. Most will stay the same size or shrink and disappear of their own accord.

In teenage girls, they’re usually diagnosed via an examination and breast ultrasound alone, but in older women, breast tissue is denser, so ultrasounds won’t work as well, and an X-ray – a mammogram – is needed. A biopsy, in which a needle is used to take a small bit of tissue from the lump, might also be offered.

Cysts are little pockets of fluid that can build up in the lobules, and again these can fluctuate in size. Cysts are often painful, and discomfort is linked to the hormonal cycle. Again, these can be diagnosed through an ultrasound or mammogram, and most don’t require treatment. Being on HRT increases the risk of them occurring.

Our advice to women now is to be breast-aware: get to know how your breasts feel, so you know what’s normal, and if you notice a change, don’t delay in getting a doctor to take a look.

I HAVE suffered from dry, flaky skin all my life. I’ve tried everything. Moisturisers, gunk you pour into the bath, ointments to slather on at night, even fishoil capsules. Nothing seems to help for long. What can I do?

DRY, flaky skin is one of the problems we GPs see the most, and it can be a symptom of a whole range of things – even being stuck indoors with the central heating on, and washing with soap.

Switching to a soap-free wash, particularly an oat-based one, can often have miraculous effects.

Another extremely common cause of crusty, flaky skin is seborrheic dermatitis. This affects the scalp and face and is the cause of dandruff, but is also seen on the chest, armpits, groin and around the breasts.

The skin can be uncomfortably itchy and, as with other skin problems such as eczema and psoriasis, scratching can cause damage and risk infections.

It’s thought to be linked to an irregular immune-system response to yeasts that normally live harmlessly on the skin.

With all of these conditions, there’s no cure and rarely a quick fix. It’s usually a case of learning to manage the worst discomfort – and there is a vast array of treatments to work through. It’s worth finding an understanding pharmacist or doctor who can help you with this process of trial and error.

We do have prescription drugs too, depending on the problem. But I’d strongly advise against self-prescribing over-the-counter hydrocortisone. It can provide relief but causes skin damage in the long term if misused.

Try the British Association of Dermatologists website, skinsupport.org.uk, for information, self-help materials and details of support services.