### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
It s been 6 months since my significant other received a double bypass. He has complained about pain in his left arm and shoulder which seems to be getting worse. He is only able to lift his arm chest high without pain. The pain wakes him up at night. His cardiologist says it s most likely nerve damage from the way they positioned him during the long surgery or a pinched nerve.He never went to any physical rehab after surgery, they kept telling him he wasn t ready yet but then we moved from NY to Texas and the new cardiologist made it sound that after 6 mnths it wouldn t help him anyway. Should he see a neurologist for this ? Thank you for your reply. Joyce Fagan

### output:

Hello, My opinion is Its better late than never. Let's come to the discussion where we can find some possible solution for the patient.  It is true that after any cardiac surgery one needs to undergo a proper cardiac rehabilitation program under an expert physiotherapist. Now, you are saying that the patient has Complaints in his left arm and is not able to lift the arm.  Please make it assure that the cardiac routine diagnostic procedures are done before we come to a neurological point of view.  Is the pain he felt is due to cardiac of not that is the first thing we have to keep in mind. If there is no cardiac issue and is ruled out that one needs to not worry, and we can jump over the surgery part. Now, let us make it clear, that due to bypass surgery there will be shortening of the pectoral muscles, and it needs a good stretching, so the shoulder stays in a normal position wherein the biomechanics of the shoulder do not get disturbed and the functionality of the shoulder remains intact. Coming to the neurological point of view, I don't think he will have any nerve compression. Because if it is nerve compression then the symptoms will be like tingling, burning, numbness etc. Now, let's assume that he doesn't have any cardiac or neurological issue then it is straight the job of the physiotherapist to help him out. Undergoing a proper rehabilitation program should definitely help him lift his arm up. Also, a good strength in the muscles of the arm is needed to acquire the optimum functional ability.  Besides breathing exercises should be made a part of the overall exercise program as it has got to do a lot with the overall well-being of the patient. Please take the call based on the guidelines. First the heart needs to be assessed. Then the surgical part if any muscle is shortened and leading to change in the posture which is changing the biomechanics of the joint.  And lastly, the neurological point of view if we rule our step by step all things then definitely we can come to a proper diagnosis and help the patient to have a good lifestyle change. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In Chat Doctor. 