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Is medication a lifelong affair after bypass surgery.?
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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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907968_tn?1292625804
I sure hope so!  Prier to this I took maybe one aspirin a year, then suddenly I had to number each pill bottle (15 in all) and constantly check to see how many of each I needed to take and how often.  Not too long ago I got rid of most (mostly pain killers I never needed in the first place) and ended up with...
Coreg x2/day
Lisinopril x1/day
Simvastatin x1/day
Now I'm back up a few for related problems, they wont be around all the time but the three listed I'm told will be.
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Avatar_m_tn
Thanks dear. I am running 5th week after bypass surgery. I am taking the prescribed medicines.I have no other problem whatsoever.So I was thinking if a day will come when no medication will be needed. The surgery in fact has pepped up my urge to keep every subsystem of the body well regulated.Thanks dear.
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Avatar_m_tn
By and large,is this an irrelevant question in this community?
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907968_tn?1292625804
No, it's not an irrelevant question!  In fact it can become very informative. If you're asking for other opinions, just wait a while and others will jump in with their information.
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Avatar_m_tn
Thanks dear
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907968_tn?1292625804
Jogeshwar, where does this "dear" come from?  Where I come from Men don't call each other "dear".
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Avatar_f_tn
No, a bypass operation certainly does not remove the requirement for medication. A bypass is exactly what it says, it bypasses a blockage and does not remove it. 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. The only difference is that a better blood flow has been supplied to the deficit area. Aspirin will be required for life to lower the risk of clotting. If your blood pressure has not improved post cabg, then this medication will also continue. A bypass operation will not lower cholesterol, so if your cholesterol is high, statins will always be a requirement. Beta blockers will also be required for a while until the heart has fully recovered from the trauma of surgery. This time limit seems to differ with different cardiologists. Some never seem to like you kicking the drugs, while others can't wait to get you off it. Some people still feel some angina when they kick beta blockers and decide they feel better if they carry on taking it. So, I'm afraid a bypass operation is not the status quo with regards to medication.
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Avatar_m_tn
Dear RadioAstronomyObserver,
I am an Indian. Indians are fond of further sweetening the already sweet ingredients.

Have you heard about a liquid preparation called "panchamrita"?This is a mixture of 5 sweet ingredients and offered to gods and then enjoy the 'prasad"/residual.

Well, if cross cultural.divergence still irks you then I withdraw the word 'dear'.

   Well again British political imperialism ended in India in 1947 but imperialism of English language is growing very fast in India.It appears that it is a matter of time that all Indian languages will extinguish but then the English in India will not be the same as the English in Britain or America today.Language is dynamic and not static
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Avatar_m_tn
"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."

thanks.Very very vivid description of the process and more particularly the above portion.The above quote makes me rather euphoric and I feel there is cogent reason for my euphoria.Thanks again.
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328381_tn?1269367702
i agree with cath911 i  didnt have bypass but had multiple stents and have to be on my meds for life but that depends on your body and your cardioligst good luck and take care
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Avatar_m_tn
"but that depends on your body and your cardioligst good luck and take care "

Thanks.This knowledge I was looking for. Our bodies are predisposed to eject out or repair the anomalies. In a point of time the body was incapable of repairing/ejecting out the anomalies resulting in CAD and consequently bypass surgery. It may not mean that the body will remain incapable in repairing/ejecting out the anomalies through out life. Can this capability of the body of repairing/ejecting out the anomalies be pepped up?
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328381_tn?1269367702
im not a dr but from what i have read you can help out yourself alot with proper diet and excercise
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Avatar_f_tn
The problem is, there is nothing to remove the fats stuck against the artery lining. We all know that fat will not dissolve in water, so that fat cannot return to the blood for removal. It can be forced along arteries as a Lump, causing a clot, but will never dissolve. Blood is mostly made up from water and so this is the big problem.
The Liver makes tiny submarines called Lipids and these are packed with fat and sent out into the blood. There are many types of submarines, but we are told that the LDL submarines are the bad guys. HDL are called the good submarines. LDL subs travel around the blood stream and are grabbed by cells which are damaged or multiplying because extra fat is required, as a building material. The excess fats from cells are put into the empty HDL subs and returned to the Liver.
Now the crunch. A damaged artery lining will cause the submarines to become trapped. This is because they are very small. Along comes the immune system and this attempts to remove the subs, so the artery can get on with repairing itself. However, the Macrophages (immune system large cells) demolish the subs but cannot do anything with the fat. The Macrophages die and turn into foam cells which are squashed along the artery lining by the bloods pressure. Streaks of sticky fats now line the artery. The subs that were trapped would have been a mixture of LDL and HDL (with fat on way back to liver). Other cells now get stuck to the sticky fats. This will continue to happen until a coating is formed over the fat to try and hold it away from the blood. This is plaque and is mainly calcium based. Now, if the body removes the plaque (which it wont because there's no process for that), then this would release the dangerous fat clumps which can cause strokes etc. So Plaque is basically there for good.
I have read some articles 'claiming' that plaque is removed in some people by Statins, but there is no explanation as to how this happens, chemically. Without scientific understanding I am unable to simply accept the words "statins have been shown to lessen plaque". No matter how much I put pen to paper and look at the chemistry at molecular level, I cannot see how a statin drug can reduce existing plaque. All it does is tell the Liver not to make so many submarines.
In reality the only way to clean coronary arteries is to fill them with descaler, then detergent to break down the fats. Then scrub them clean and refill them with blood.
Now there's a good project for someone.
So, as you stated, the body does have many built in mechanisms to make repairs, but it has already attempted this with coronary artery disease but made a bigger problem. If the immune system left the lipids alone and new artery tissue grew over these quickly, then we wouldn't have such a problem.
It's the same with many lung infections. It isn't the virus which kills people by attacking the lungs, it's the lungs being virtually covered inside with our own white cells, trying to remove the viruses. A virus doesn't want to kill anything alive, it needs cells to multiply and then to leave and find a new host. A virus is unable to reproduce without the use of other living cells.
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367994_tn?1304957193
The available therapy for coronary vessel disease treats the symptoms and is not a cure.  The only medication that may discontinued is medication for chest pains, etc.  
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Avatar_m_tn
Thanks for taking care.

"I have read some articles 'claiming' that plaque is removed in some people by Statins, but there is no explanation as to how this happens, chemically. Without scientific understanding I am unable to simply accept the words "statins have been shown to lessen plaque". No matter how much I put pen to paper and look at the chemistry at molecular level, I cannot see how a statin drug can reduce existing plaque. All it does is tell the Liver not to make so many submarines."

Science has explained just a few microphenomenon of which many are subject to revision. There is no verdict in science.Macrophenomen like eros/life instinct or Thanatos/death instinct are far above any scientific explanation. No science can explain how a tassar larva makes a cocoon exactly of the same type as its parents or members of species do without even having an opportunity to meet any member its species till then.Life is larger than science and so intuition may be larger than scientific explanation.

"In reality the only way to clean coronary arteries is to fill them with descaler, then detergent to break down the fats. Then scrub them clean and refill them with blood.
Now there's a good project for someone. "

Yes. breaking and not dissolving. In nature nothing seems to be permanent.So fat too may not be permanent. Please inform if you find any information about he  breakability of arterial fat.Thanks.
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Avatar_m_tn
There is a retired person who had undergone bypass surgery when he was 80.Now he is 85.He said that he had taken medicine only for about 3 months after surgery. He is fit even at 85. Can it be  explained?
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976897_tn?1379171202
You are asking me a question like "without looking at my car, why did it break down". To have any clue whatsoever we would need to see details of his condition before the procedure, what vessels were bypassed and his vital signs after surgery.
I would be very surprised if a cardiologist doesn't at least have him on aspirin. Maybe the patient decided he wanted to go against medical advice and chose not to take any medication.
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976897_tn?1379171202
sorry I forgot to say "dear "   :)
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315318_tn?1353255400
What a wonderful way you  demystified the plaque forming process. Absolutely loved it.
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315318_tn?1353255400
Dear Mr. Jogeshwar,

As others have stated, your requirement for medications will go down as time passes after your bypass procedure. However your doctor will keep you on a few medications to keep your heart disease in check.These in my opinion will be:
1. Aspirin to reduce chances of clot formation
2. Beta-blocker or related drugs to regulate blood pressure and
3. Statin or other cholesterol reducing medication.

In my experience, Indians are reluctant either to start taking a medicine or continue taking it. In addition to taking medicines for my heart condition, I also take insulin for diabetes. I have lost count of the number of times I have been advised to come off insulin because it is "addictive" or use ayurvedic (Indian traditional) medicine to treat the condition. Some of these "advisers" were diabetic patients themselves who must have listened to their own advice because they are either no more or suffering terrible complications of diabetes.

I wish you all the best.
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Th
Here is an opinion on the medicines for me.Do you confirm?
"1.Pantocid/pantoprazole : This is a proton pump inhibitor. It destroy the ability of the G-cells in the stomach to produce HCl (Hydrochloric acid), so that the stomach content is less acid. One important side effect is that your own enzymes (in particular pepsin and proteases) no lunger function well, and food may remain undigested.
But at the same time it has an effect similar to a meal, which would serve to neutralize some of the HCl during the digestive process. Continuing this drug during a fast will "protect" your stomach to the possible side effects of the others, making it in general terms safe to take them all during a fast.

2.Amifru-s/Fusemide IP +spironolactone IP

Both frusemide (Furosemide) and spironolactone are diuretics. They destroy the ability of the tubular cells in the kidney, to re-absorb water from the "primary filtrate". Thus you lose water that the body would normally have re-absorbed. Personally I find it rather difficult to appreciate the rationale of this class of drug as its entire effect is negated simply by drinking another glass or 2 of water. BUT they have been found quite effective in improving the signs and symptoms of heart failure and are totally safe to use during a fast. Frusemide cause loss of potassium but spironolactone (a steroid) cause potassium retention so theoretically their side effects balance out.

3.Deplatt A 75/clopidogrel+asprin

Both Clopidrogel and Aspirin reduce the "stickiness" of blood platelets, so you are considerably less prone to form blood clots. You are then of course also more prone to bleed. Theoretically large doses of Aspirin can contribute to stomach ulcers, but not
- for a short period of fasting (less than say 2 weeks)
- in the low dosages used here (75 milligrams- see my previous entry) and
- In the presence of Pantoprazole.

4.B complex forte +Vitamin C

I am on record as almost blankly opposing the idea of "supplements". There are no scientifically verified data that they do anything more than swell the bank accounts of the "manufacturers". Vitamins, once removed from their natural "ambience" often do more harm than good. You should get them from your diet.

5.Cordarone/Amiodarone

Amiodarone (as mentioned before) is quite safe on an empty stomach, particularly under the circumstances mentioned under (3) above.

6-ATORLIP-EZ Atorvastatin+Ezetimibe

Atorvastatin is a chemical that poisons one of the enzymes your body employ to produce cholesterol. Thus the liver cannot make as much clolesterol as it tried to. In this way the measured blood levels of cholesterol is reduced. It is often prescribed to be taken on an empty stomach anyway. In some people it causes severe muscle inflammation, even "rhabdomyolysis" or breakdown of muscles. But in most people it is quite safe.

Ezetemibe blocks the ability of the cells in your gut to absorb the cholesterol you have eaten. Not necessary to use when you don't eat!

7.Combiflam/ibuprofen+paracetamol[/quote]

Paracetamol is universally safe in fasting people. Americans tend to call it Acetaminophen, jut to be different from the rest of the world. It blocks the effect of certain Prostaglandins, so that the nerves does not send as many pain messages.

Ibuprofen is a more potent prostaglandin antagonist, which also reduces inflammation. Theoretically it can predispose you to the development of stomach ulcers, but this has not been observed to happen in the real world like it does with most other drugs in this class."
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Avatar_m_tn
Thank you all.

'"Maybe the patient decided he wanted to go against medical advice and chose not to take any medication."

Dear Ed34,
Who is under this  sun who can go with medical advice in letter and spirit.?It depends upon the extent of faith and circumstances.On the contrary,science never gives any verdict.So medical advice not necessarily can be the gospel of truth. Confounding facts may alter the medical advice itself. At the moment, while complying with medical advice I am exploring the best possible life style for years to come.
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Avatar_f_tn
Does anyone know how medication is processed in the stomach after gastro by pass.  I know that any medication that is extended relief does not work, but what about Psychotropic drugs like zoloff, namenda, aricept, etc?  Anyone know how the stomach processes medication?
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976897_tn?1379171202
Medications are not absorbed by the stomach obviously, nothing is. Medications are coated with other substances to help them get through the stomach so they can be broken down and absorbed by the small intestine. For example, gastric resistant Aspirin has a coating which gives the stomach a tough time attacking it, so the actual medication isn't presented to the stomach lining. Many drug companies make their medications in a variety of coatings. I've had plavix range in size from about 5mm to 10mm. The amount of medication is the same, just the coating alters. Your Doctor should be able to find out if your medication is available in a smaller coating and prescribe it. I believe you still have a small stomach in the form of a pouch connected directly to your small intestine, but obviously far less acid?
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Avatar_m_tn
In any case I have taken a conscious decision with certain life style amendments to discontinue medication with effect from June 15,2010.I have no complication  till date.
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976897_tn?1379171202
A decision you have made, but not one I personally would advise to anyone else. In my opinion you are running on luck and taking unnecessary risks. I have to ask if the body is so good at managing such diseases, why do millions die all over the world every year from it.
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Avatar_m_tn
"I have to ask if the body is so good at managing such diseases, why do millions die all over the world every year from it."


      Many thanks dear,You have rightly raised a very pertinent question.In India the average life span is in 40syears+. I have already got the bonus more than 20 years.So I will have no regret if I continue without medication dependency for some more years

     The other part of your question is more baffling. For African countries life expectancy is in 30syears+ whereas in Japan it is 80syears+ and India is 60syears+.This wide variation can be attributed to lifestyle *** natural environment.Right?
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976897_tn?1379171202
Well, to assume it's related to lifestyle could be a big misconception without a lot of research. It could be a genetic thing, it could be how different people in different countries due to genetics react to stress, it could be many things.
It is interesting that when Indian families come to the UK to live, and have no medical conditions on arrival, they soon find themselves with artery disease. So moving from one country to another seems to have a big impact. It was assumed that the cause was change of diet, but in fact you cook your home foods here in the UK and all the ingredients are available too. The only difference I can see that is left, is stress. I remember reading a research study many many years ago which investigated what stressed people the most. The top cause for high stress levels was moving home. This was moving home within the same country. So goodness knows how much stress there must be for moving home across nations.
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Avatar_m_tn
Many thanks dear to bring another vital factor,that is,stress.The point is my discontinuation of medication. I do not think my cardiologist's prescription  contains any anti-stress medication.

  Stress again mostly depends upon attitude towards own life.If one thinks that emergency condition in his life is unavoidable then what medication can do? So as far as possible one must de-emergecize life.

  In my case the condition was such that I was forced to enter into prolonged litigation.After tremendous loss I won the battle against government.I could have claimed damages but I did not want to re-impose emergency in life. Another individual opponent died. Then  I burnt the litigation papers. Life became de-emegecized by the grace of God. So my pursuit now is BE FITTER THAN FITTEST.
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976897_tn?1379171202
There are medications which can help the heart with stress. For example, beta blockers. These block the beta receptors on the heart which react to adrenaline, a substance high in stress related times and increases the work load of the heart.
If you are able to reduce cholesterol levels without statins/ezetimibe, then that's great. However, I suffer familial hypercholesterolemia. Without those medications, my cholesterol is off the chart. Problems with statins are very rare, and they do have an added bonus, they have anti-inflammatory properties for arteries, making atherosclerosis less likely.
To change as a person, from a type A who becomes stressed very easily to someone far more relaxed is a huge task and not as simple as it seems. I went to a relaxation therapist who asked me to sit in a chair and totally relax. I did as I was asked and believed I was relaxed. She pointed out 10, yes TEN reasons that I was not relaxed. After a few sessions I began to realise what she meant. When I thought I was relaxed, I was probably 10-15% of the way there only. You get so used to being stressed, that you no longer recognise it. Your body is in stress mode all the time and you don't even realise it. Our emotional makeup is conditioned by life from quite an early age.
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Avatar_m_tn
Although, I generally agree with you, there is more to it than that, based on my own personal experiences. I had a CT-Scan 11 years ago, my Calcium Score was negligible. They scored it different then, it was 25% in one artery. A year ago I had another one and the Score became 1217. The thing is, in both cases I was already retired. One would think the stress was much higher when I still had an active working life (and lots of fights with my then boss), but the scans don't reflect that at all. It could be, of course, not doing anything is the greatest stress of them all.
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976897_tn?1379171202
It's very interesting that you say that. When my wife was diagnosed with cancer, I became flooded with stress. I had to balance a job, visit/nurse my wife, feed and clothe 3 children and do all the housework etc. It was a very tough time but I felt physically fine all through that time. When my wife returned home and was back on her feet, I was able to relax more and it was a few months after that when my first MI appeared. So, it didn't seem to be at the time of stress, but once I could relax again. Then in late 2009 my wife had the bad news her cancer had returned. She underwent very traumatic surgery, ended up on life support, and suffered a large stroke which paralysed her completely down one side of her body. Again, no problems physically while nursing her to recovery and rehabilitating her through her stroke, but when she was about 99% recovered (Dec 2010), I started to relax more and found I was having chest pains. Then 3 months later, another MI. It seems that while you are pumped up with adrenaline, you don't notice the effects the stress is having? but once you relax, WHAM. Maybe this is when, for whatever the reason, it takes a hold of some people. I wish I knew the answers. I know a number of people who have retired in the last 3-5 years and have had to succumb to bypass surgery or stents. I keep looking for patterns which I think is something we all do to try and make some kind of sense of these things.
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Avatar_m_tn
The discussion is really becoming very very lively.
There are anti-stess medications and there are psychiatrists to prescribe those.But the difficulty is that the effect of such medications is temporary and you will have to repeat.With repeatition habituation dawns and the medicines become less and less effective.On the other hand, one can not be called healed as long as he/she is under medication. Alternatively, there are several relaxation exercises. To me the best ones are Progresssive Muscle Relaxation and Ujjai pranayama.
   Regarding type A personality,  I have already mentioned.Let then de-emergencize their lives. As long as the 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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Avatar_m_tn
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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Avatar_m_tn
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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Avatar_m_tn
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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Avatar_m_tn
" 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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Avatar_m_tn
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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Avatar_m_tn
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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Avatar_m_tn
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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Avatar_n_tn
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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Avatar_m_tn
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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Avatar_m_tn
"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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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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Avatar_m_tn
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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Avatar_m_tn
"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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Avatar_m_tn
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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Avatar_m_tn
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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Avatar_m_tn
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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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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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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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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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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Avatar_m_tn
No ditto as yet. Let collective wisdom evolve and prevail.
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Avatar_m_tn
Now it is 25 months since when I am detached from cardiologist/medication and I am fine
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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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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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Avatar_m_tn
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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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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Thank you :)   You understood me completely.
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Avatar_m_tn
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?1318997813
Erijon's belief is this thread should go away.
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Avatar_m_tn
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?1318997813
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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************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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