Panaceia or Hygeia

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Posts Tagged ‘coronary bypass’

Effectively treating atherosclerosis without angioplasty or bypass

Posted by Colin Rose on September 17, 2008

Below is a example of the issues involved in treating chronic coronary atherosclerosis presented by an intelligent patient who asked questions about treatment and did not accept the mainstream opinion without good evidence.

The vast majority of patients with chronic coronary artery atherosclerosis can be treated as the patient described here. Most cardiologists still believe the profitable myth that heart attacks can be prevented by “treating” those blockages seen on a coronary angiogram. We now have good evidence that such blockages are composed of older, harder plaques that are less likely to rupture and cause a sudden total blockage and a heart attack. Angioplasty, stent or not, and coronary bypass are PALLIATIVE procedures indicated only for intractable symptoms related to decreased coronary blood flow reserve.

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From ProCor

From the patient’s perspective: Effectively treating heart disease through diet, exercise, lifestyle and medication

In the late 1960s, Professor G. S. H. Lock was engaged in the development of the artificial heart to address cardiac conditions for which other alternatives were not available. Forty years later he writes, “Today it is difficult to argue that technological intervention on such a scale is really necessary on a routine basis. Even intervention through angioplasty and the insertion of a stent may offer little more than temporary relief.”

In this article, adapted from a longer feature in The Lown Forum, Professor Lock shares his experiences as a cardiac patient and his observations on the use of medical technology in cardiovascular care. The Lown Forum is a publication of the Lown Cardiovascular Research Foundation; ProCor is one of its programs.

Vikas Saini
President, Lown Cardiovascular Research Foundation
 
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From the patient’s perspective: Effectively treating heart disease through diet, exercise, lifestyle and medication

G.S.H. Lock, Professor Emeritus and former Dean of Interdisciplinary Studies, University of Alberta, Edmonton, Alberta, Canada

My story begins, as it often does, with the onset of mysterious chest pains. My family physician immediately diagnosed it as angina, meriting further investigation. After numerous tests on treadmills and in machines whose operations are still a mystery to me, I was confirmed as a high-risk patient with a plumbing problem, usually described as coronary arterial occlusion. An angiogram was recommended and scheduled within two weeks. However, this seemingly routine procedure created a special problem for me because three of my colleagues had failed to recover from that very procedure. With apprehension, I listened to the consulting physician explain that the risk of complication was minimal (about 1%). I asked if there was an alternative. I shall never forget his answer: “Death.”

Needless to say, I was not reassured by this response from a very able doctor who was obviously bound by prescribed procedure. Even though he was careful enough to prescribe appropriate medication while I waited for the angiogram procedure, I sought a second opinion, at another hospital. This proved to be an equal waste of time. The physician simply described the use of angiography as a “no brainer” because he viewed it as the natural prelude to intervention. No other possibility was even considered.

These experiences led me to conduct my own extensive research on heart disease, its diagnosis, and treatment. The majority of cardiologists seem to favor intervention, with all of the technology that accompanies, if not drives, it. I, however, could not support such an approach except in emergencies or when surgery was clearly the only means by which a patient’s life could be improved if not saved. Through the Lown Cardiovascular Center I was able to confirm that a healthy minority of cardiologists are not interventionists, but believe instead that in the majority of cases, heart disease may be treated more effectively using medical therapy with its four components: diet, exercise, lifestyle, and medication.

At first glance, I thought that each of these would prove to be distasteful – something that would destroy the quality of life – but I found instead the very opposite.

Luckily for me, my wife is an excellent cook – dare I say chef? – and has developed the standard Mediterranean diet into such a variety of dishes that I eat better now than I did two years ago. This alone took my cholesterol level down well below the established safe limit.

Exercise, too, has improved my quality of life. My cardiologist at the Lown Center, Dr. Vinch, is himself and athlete and he reminded me that the heart is a muscle that needs to be nourished and exercised like any other muscle. Under his guidance, I began various walking exercises. At first, using a nitroglycerine spray to decrease the resistance of the peripheral vascular system, I took my daily walks in the river valley where I live. Gradually, the walks became longer and steeper. Today, I can briskly walk up and out of the river valley and then jog up 12 flights of stairs without any angina, and without using the nitroglycerine. 

Clinical Encounter 
Date Posted: 9 April 2008

Posted in atherosclerosis, cardiology, coronary artery disease, diet, drugs, professionalism, surgery | Tagged: , , , , , , , , , | Leave a Comment »

Medical Terrorism – The Chaoulli Decision

Posted by Colin Rose on July 20, 2008

Another example of medical terrorism and the big lie, this time from the surgical contingent. The Chaoulli  decision by the Supreme Court of Canada is misnamed. It should have been called the Doyle decision. Dr. Daniel Doyle, a cardiovascular surgeon, testified that patients waiting for a coronary bypass are “sitting on a bomb” and could “die at any moment”.

Where he got the figure of 0.45% per month mortality on the “waiting list” is a mystery. Mortality on the waiting list for elective coronary bypass is at most 1% per year, about the same as the general population of the same age group. He didn’t say and wasn’t asked about the mortality for a bypass operation, about 3%!

The judges seem to have been struck dumb by terror and lost their cool at hearing this. They forgot the old adage, “you don’t ask a barber if you need a haircut”. They didn’t even think to ask Dr. Doyle if surgery would actually prevent the rare deaths on the waiting list. As we know from the MASS-II trial mortality is the same for surgically and medically treated patients with stable coronary disease who, by definition, comprise the “waiting list”. So, a basic principal of Canadian medicare system, that all citizens should have equal access to disease care regardless of ability to pay, was instantly destroyed by the terrorist statements of a surgeon and irrational fear of death. Remind you of Ancient Egypt?

Medical terrorism. This was almost a full page size on the front page of the National Post the day after the decision. Note the ECG tracings at top and bottom. Implication? Your ECG will flat-line and you will die of heart attack because of public health care.

We look down on the Ancient Egyptians for their believe in the afterlife and the huge waste of resources that went into preparing for it. Are we really that much different? We might not believe in the afterlife but we put even more wasted resources into the futile attempt to live forever on Earth. The drug dealers and surgeons are only too happy to oblige.

Open Heart Surgery

Coronary Bypass Operation

Here is the Ancient Egyptian version of the "coronary bypass", a means of living forever administered by a secretive, priestly class. The heart was removed to be weighed against a feather representing Ma'at to determine moral righteousness. The brain was sucked out of the cranial cavity and thrown away because the Egyptian's thought it was useless. Personal belongings were usually placed in the tomb to make the Ka more at home and to assist the dead in their journey into the afterlife

Posted in atherosclerosis, coronary artery disease, law, medical terrorism, professionalism, surgery | Tagged: , , , , , , , , | Leave a Comment »