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Is medication a lifelong affair after bypass surgery.?
I think medication becomes less and less gradually in case of persons improving steadily after bypass surgery. Ultimately no medication may be necessary after a particular point of time. Am I right?
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Yes. I had much more severe problem in 1999 than what I was having in 2009
In    1999 repeated ECG tracing did not show problem though I was having dying pain. Had I known it as problem of atherosclerosis, probably I would not have undergone bypass surgery in 2009.  
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Temporary relief is no cure.One must pass through stages of suffering to relief, relief to cure and cure to ailment free ness. This will make sense of healing.
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Regarding type A personality,  I have already mentioned.Let them de-emergencize their lives. As long as they do not realize that they are type A and most of the challenges to them are their own creations,they can not transform their personality to a smooth sailing one.
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" I keep looking for patterns which I think is something we all do to try and make some kind of sense of these things."ed34.
These lines are ed34.Conceptually my sense of healing is:
1.suffering to relief;
2.relief to cure and
3.cure to ailment free ness.

What do you think?

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http://articles.timesofindia.indiatimes.com/2011-09-29/allahabad/30217661_1_heart-diseases-heart-ailments-risk-factors

Keep yourself hale and hearty on World Heart Day
Rajiv Mani, TNN Sep 29, 2011, 01.29pm IST
Tags:
World Heart Day|World Health Organization
ALLAHABAD: The increasing number of heart ailments in India raises serious concerns. Doctors say precaution is the best cure and people need to make changes in their lifestyle and eating habits to keep heart diseases at bay. The theme for this year's World Heart Day is 'One world, one home, one heart'.

Throwing light on heart care, Dr Rajesh Srivastava, consultant cardiologist at MLN divisional hospital (Colvin) said about 100 to 150 patients come for treatment of hypertension and heart diseases at the OPD. The incidence is increasing in younger generation and cardiovascular diseases set to be India's number one killer. Across the world, more than 17.2 million people die from cardiovascular diseases. Experts say that by 2020 one out of every three deaths in India could be due to cardiovascular diseases; most of the victims will be below 45 years. Doctors advise regular check up for those having one or multiple risk factors.
    Dr Srivastava said said 80 per cent of premature deaths due to heart ailments can be avoided by avoiding tobacco use and unhealthy diet.

According to WHO, by 2015 India would have lost $237 million in income because of decline in productivity and rising medical costs.

There are many risk factors associated with heart diseases like tobacco use alcohol use high blood pressure obesity physical inactivity unhealthy diet. Simplest solution is to change to healthy diet, exercise regularly, lose excess weight and give up smoking and take prescribed medicines, Dr Srivastava said.

City-based cardiologist Dr DK Agrawal says the incidence of artery ailments is increasing in Indians. Common risk factors include diabetes, hypertension, passive and active smoking, premature family history of heart disease, lack of exercise, more alcohol consumption, stress, poor oral hygiene, junk food and low consumption of fruits and vegetables etc. "Early onset of coronary artery disease is more prevalent in Indians due to our genetic predisposition and heart attack strikes in Indians at an early age as compared to westerns," he added.

Heart attack, which occurs in persons under the age of 40, is always severe, making it more pertinent that prevention is better than cure, says cardiologist Dr Alok Singh. "After the age of 30, one should go for regular check up in form of fasting blood sugar, lipid profile, CRP, homocysteine levels, uric acid and computerised stress test or Multislice CT Angio. If they are normal, then one should follow a healthy lifestyle in form of healthy food, regular exercise for at least 30 minutes, keeping diabetes and blood pressure in control and give up smoking," the doctor said.

About post treatment follow-up that is required, Dr Agarwal said that apart from medication and regular checkups, dietary and lifestyle changes are important in maintaining health after a heart attack.
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He said that one should avoid eating large amounts of fat and cholesterol in your diet because these can accelerate the progression of hardening and clogging of coronary arteries. A well-balanced diet helps to control cholesterol level as well as weight.

Dr Agarwal said quitting smoking and physical activities help to lower the blood pressure and control excess weight. Walking, swimming, and aerobics are also good for a healthy heart.

Likewise, while talking on alcohol, the doctor said that studies have shown that the risk of heart disease in people who drink moderate amounts of alcohol is lower than in nondrinkers. But drinking more than a moderate amount of alcohol can cause heart-related problems such as high blood pressure, stroke, irregular heartbeats, and cardiomyopathy (disease of the heart muscle).

But this does not mean that nondrinkers start using alcohol or that drinkers increase the amount that they drink, cautioned the cardiologist.
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976897 tn?1379171202
Personally I think too much emphasis is placed on diet. When Atherosclerosis was first observed during a post mortem, the fatty substance was taken as being caused by too much fat in the diet. I know a lot of people with normal/low cholesterol and yet have severe disease. I did a little bit of research, just out of interest, to see how the fattest people on the planet are surviving without CAD. If high fat consumption is the main cause, these people should have blood thicker than soup, but this is not the case. There are very thin people who have the disease, and there are some fat people.
I still think the exact cause is unknown and is going to take a lot more research. Why do you think it is increasing in India?
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The "streaks of sticky fats" that you mention are not fat at all.
From Wikipedia:
"The streaks are not actually fat but small collections of monocyte-derived macrophages located beneath the inner, endothelial layer of arteries. The fatty streak mainly consists of foamy appearing macrophage cells, sometimes with some additional T lymphocytes, aggregated platelets, localized smooth muscle cells, etc. Fatty streaks may be precursor of atheromas and not all fatty streaks are destined to become fibrous plaques."
there is very little fat in there.

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976897 tn?1379171202
I'm not a big fan of wiki. It seems to contradict itself in the article too. First it says how fat isn't involved, it's macrophages, but then it says how the macrophages engulf LDL lipids. This seems to be saying that white cells are in the area, and these gobble up trapped LDL lipids, making them macrophages, which then die and become foam cells. This is far from what I have read in some very interesting papers. What I have read is...
All arteries, in all ages, form tiny fractures from time to time through stress loads. In normal circumstances, the body heals them very quickly before any real harm can be done. There maybe genetics involved, but usually the higher the blood pressure the more fractures appear. When an artery is damaged, HDL triggers Monocytes to accumulate in the area. These are a white cell, part of the immune system. HDL then changes the protein code on the Monocyte membrane, which attracts LDL lipids and these bond to the Monocytes. The LDL passes its fat content into the Macrophage enabling it to grow. The Macrophage then looks for infection or material which shouldn't be there to consume it. Of course, there is no infection, but there could be some trapped blood cells of different varieties. In normal circumstances the Macrophage would alter its protein code so HDL retrieves the fat from inside, reducing it to a bag of rubbish material. The Macrophage would then float in the blood to be filtered out of the body. Now this is the part that research cannot establish. The macrophages become damaged somehow and cannot change their protein code. This means that HDL never retrieves the fat. Instead, the Macrophage dies, and when it dies it becomes a sack of fat from the LDL with some mopped up rubbish, a foam cell. Other Macrophages attempt to gobble them up, but these too become damaged and the whole process continues, growing vulnerable plaque. If they figure out why the damage to the Macrophages is occurring, then they will hopefully be able to find a way to prevent it. This would let our Macrophages get rid of all the foam cells in the arteries. The big thought for many years was free radicals. But this has been shown to be wrong. Anyway, free radicals are a natural atomic function and always have been. There's no way to stop this, we even breathe in atoms which are trying to steal electrons. So all this therapy about cleansing the body of free radicals is impossible. Anyway, that's what I have read. I'm kicking myself for not keeping the links because it took me days to find them.
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This is what I have read:
"The "response-to-injury" theory is most widely accepted explanation for atherogenesis. Endothelial injury causes vascular inflammation and a fibroproliferative response ensues. Probable causes of endothelial injury include oxidized low-density lipoprotein (LDL) cholesterol; infectious agents; toxins, including the byproducts of cigarette smoking; hyperglycemia; and hyperhomocystinemia.
Circulating monocytes infiltrate the intima of the vessel wall, and these tissue macrophages act as scavenger cells, taking up LDL cholesterol and forming the characteristic foam cell of early atherosclerosis. These activated macrophages produce numerous factors that are injurious to the
endothelium."
I wasn't actually referring to arterial plaque, but rather didn't like the term "fatty streaks" used for the precursor of actual plaque. I guess the operative term form the above would be "fibroproliferative response"
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Does this process take place in all blood vessels? We hear most about coronery arteries. Are coronery arteries more vulnerable to this process, as explained by ed34 and Occupant?
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976897 tn?1379171202
Brilliant question. It does or it can occur in all arteries, but does seem most common in the heart. I have wondered for years why this would be the case, and the only conclusion I can come up with is the sheer stress those arteries have to handle. I know arteries are elastic, but on the heart they will be pushed and pulled every second of our lives.
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ed34 is right, it can  and does happen in most of the arteries. Interestingly, I used to have a doctor (he is retired now) who told me, when I asked about Cholesterol: "I don't care about it. In Pathology, when we were disecting corpses, we would find plaque only in the carotid and the arteries of the heart. As long as nobody can explain this to my satisfaction, I just forget about Cholesterol."
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"I have wondered for years why this would be the case, and the only conclusion I can come up with is the sheer stress those arteries have to handle. "Ed34.
A brilliant answer as well.

In my 1999 attack I was having dying pain.I met general physicians,medicine specialist,cardiologist and orthopedician in quick sequence.Their doses had very short effect.Apart from prescribing interalia muscle relaxants the orthopaedician referred me to physio therapists. There was no anomalous ECG tracing.I was advised further investigations too.But I felt that I would die by the time I go for the investigations.So I had to take a decision at midnight. Muscle relaxants and then physio therapists_____>Progressive Muscle Relaxation(PMR). Yes.4 times at night with short intervals. By the morning I became fit for my office.

      Then I was doing PMR but not so regularly.When there was pain I was repeating PMR and was getting relieved.But in in one occasion in 2009 pain did not stop.So I had to be hospitalized and underwent bypass surgery. Then studied life after open heart surgery and discontinued medications with effect from June 15,2010. Now interalia I am regular and rigorous in PMR. Iam OK
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I agree there is certainly an underlying process probably restricted to hydraulics of blood supply to heart. If it was blood chemistry, we would have blockages everywhere.

There are people who get several heart attacks even after being on medications and there are people who do not even come to know that they had a heart attack and continue to live for years (with no medications).

I know people who live very discplined life in terms of diet and life style and  get heart attacks and others who eat and do whatever they feel like and abuse their body but continue to live without heart problems.


I wonder if our scientific community has understood this process, fully. If we would have known, this disease may not have taken such magnitude as explained by Jogeshwar. The medications we are put on, appear to be based more on the statistics (which is at times manipulated by vested interests) rather than understanding of correct underlying process.
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Thanks.A sufferer is least bothered about statistics.He/she needs insight to the problem above all. Let me repeat.

  At midnight I was suffering from dying pain. By the time I would have found laboratories probably I could have died. So more than one prescription had prescribed muscle relaxants.One had referred to physio therapist. These information trigerred my insight-probably muscle relaxation is the need of the moment.I repeated progressive muscle  relaxation at short intervals interspersed by brief periods of sleep. The insight worked
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"The medications we are put on, appear to be based more on the statistics (which is at times manipulated by vested interests) rather than understanding of correct underlying process."nspower

It is very very vital issue.Are there statistics revealing what percentage of patients(?) medicated needlessly/unduly?
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976897 tn?1379171202
Without statistics we wouldn't know the effectiveness of any medication, or indeed the effectiveness of any surgical intervention. For example, if you are in hospital expecting surgery, you would feel better knowing the odds because it is natural to feel everything is stacked against you. Without statistics they couldn't say "over 90% of patients survive".
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Yes.You are right. So my query is "Are there statistics revealing what percentage of patients(?) medicated needlessly/unduly?"

2.Statistics Vs.insight.In academy statistics is an inevitable asset but in problem solving there is no substitute to insight.
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976897 tn?1379171202
I would say that statistics from research show how medications 'benefit' patients. It would soon become very apparent if they didn't.
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Thanks.The sufferer takes medicines with the belief as you mentioned but needless medication error is also a matter of concern in the area of medicine management. May like to visit the following links.
http://www.fda.gov/drugs/drugsafety/medicationerrors/default.htm
http://ezinearticles.com/?Causes-of-Medication-Errors&id=5111546
http://www.patientsafetyfederation.nhs.uk/workstreams/no-needless-medication-errors.aspx
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"Enough is enough.

In 1999 the Institute of Medicine (IOM) published a report which stated that nearly 98,000 people die needlessly each year because of medical mistakes. In 2009 the Consumers Union published a follow up to the IOM report basically stating that absolutely nothing had changed in the past ten years. The Consumers Union concluded that "There is little evidence to suggest that the number of people dying from medical harm has dropped since the IOM first warned about these deadly mistakes a decade ago." The Consumers Union projects that preventable, medical mistakes account for more than 100,000 deaths each year- or as many as one million lives over the past decade."



Article Source: http://EzineArticles.com/3674653
http://ezinearticles.com/?Preventing-Medical-Mistakes&id=3674653
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Now it is 16 months since when I am detached from cardiologist/medication and I am fine
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Now it is 22 months since when I am detached from cardiologist/medication and I am fine
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976897 tn?1379171202
I have to ask, how do you know? do you have a ct scanner at home? It's obviously one thing to say you feel fine, but that's very different from being fine.
Anyway, I'm glad you feel like you are doing well.
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Thanks.
" that's very different from being fine." Will you please elaborate what is really "being fine"?
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976897 tn?1379171202
"well"
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The World Health Organisation(WHO)definition of health is physical,mental and social well being. Who is that healthy man then? No body knows.So one bird in hand is better than two in the bushes.

  According to you your elaboration of what is really "being fine" is just "well".

Let it satisfy you. But I continue to promote feeling fine in me perpetually.

I am not going to beat around the bushes.
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159619 tn?1499916784
I think the issue is a little deeper. Your comment here that since you have been "detached from cardiologist/medicine" you are "fine" would suggest that you are better now than when you were under medical treatment. If that works for you, great. However, this is not the kind of recommendation that should be made to others on the forum, it is a bit reckless to say that since you are "fine" without medical intervention, others will be as well. In reality, all you know is your perception of fine and not necessarily the actual state of your health.

Jon
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" this is not the kind of recommendation that should be made to others on the forum,"

Certainly I am not recommending to any body.

Every one is the best judge of himself/herself but if he/she errs then he/she will be ditched and no body can help him/her.
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According to ed34 elaboration of what is really "being fine" is just "well". .

Do you ditto it?
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159619 tn?1499916784
In the context of this forum, well is subjective. Most would agree it means free of disease. My definition is mine and mine alone and not really important to this discussion.
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976897 tn?1379171202
Probably a cultural thing. In the UK most people just say 'fine' when asked how they are feeling. It just generally means you feel ok.
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Thanks.
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976897 tn?1379171202
Having stopped all your medication and decided not to take the advice of medical professionals, I am wondering what you believe caused your artery disease? Obviously medication can slow the progression, sometimes stop it, but not cure it. But if you have no medication and no knowledge of the cause for the disease, the outcome will be inevitable.
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Does any one else ditto this view?
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976897 tn?1379171202
it was a question
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No ditto as yet. Let collective wisdom evolve and prevail.
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Now it is 25 months since when I am detached from cardiologist/medication and I am fine
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976897 tn?1379171202
I'm not so sure this is a good thing to advertise. Personally I think it could mislead a lot of people and produce doubts. You do know for example that most people have no symptoms of heart failure until the late stages? you do realise that blockages up to 50-60% are unlikely to cause problems until they increase more in size? I would be living in fear not knowing if something bad was happening with my heart. I think it's a bit like flying a plane without ever doing any maintenance. Sure it will fly, possibly for quite some time, but eventually something will fail and cause it to crash.
Just my opinion.
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"This means there is plaque/fats in the Coronary arteries still posing a risk of rupture or fracture. The risk of stroke or heart attack is still there, the same as it was before the surgery."

What is the maximum probable time by which the rupture or fracture likely to occur?
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976897 tn?1379171202
There is no time restriction. You could reach 10 years and believe it will never happen, and then it does. It could be an hour, a day, weeks, months, years. At least with medication you stand a better chance of losing less heart muscle should a clot form.
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Beliefs, opinions and apprehensions of ed34 are already well explicit.Now let others give their scientific views if at all.
2.I do not earn my bread and butter from the pockets of heart patients. So I have no need to advertise.
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159619 tn?1499916784
You misunderstand Ed, he is not saying you are advertising for gain. His concern is that making statements like yours may encourage others to do the same. Everyone is different, what works for one may not work for another so if another forum member were to take your advice it could put them at risk.

I don't see any sense in debating this here. Anyone with existing heart disease is better off under a doctor's care, period. It is reckless to have a known disease and to ignore it and assume you are well because you have not had any issues. I had a cousin who had a heart attack and got over confident in his health after being symptom free for a couple years. He died of a massive heart attack while racing his truck in the desert. You just don't know how well you are just because you are symptom free.

Jon
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976897 tn?1379171202
Thank you :)   You understood me completely.
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Beliefs, opinions and apprehensions of enjon too are already well explicit.Now let others give their scientific views if at all.
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159619 tn?1499916784
Erijon's belief is this thread should go away.
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To prevent others' scientific views? There is no need for apprehension. No one else is going to reply the question above.
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159619 tn?1499916784
If just one of our members takes your advice or gives up his medical treatment because a seed has been planted in his mind due to any post on this thread, the results could be tragic. I don't think we should allow that.

I have no apprehension and you have no scientific proof to share so what's the point?

I think we're done here.

Jon
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More than another four and half years have elapsed.Despite expert wisdom my heart is trouble free, reliable and dependable without medication/expert opinion.
/
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************THIS THREAD IS CLOSED TO NEW POSTS************

As a reminder, always see your doctor regarding your medical condition.  This thread has run its course and several perspectives have been thoroughly discussed.  As it is beginning to get off topic it is being closed to new posts.  Please do not post on this thread anymore.
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Facts remaining the same interpretation can be anything as the interpreter pleases, may be even a crying need to deny the truth.
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