Triple, Quad, Quint - does it matter?

[trvlgrl64]

We live in an area where the medical care is pretty limited (we were hit hard by Katrina).  My father has been told that he needs CABG.  He likes his cardiologist and accepts anything he tells him.  The surgeon told him that he'll need a quad bypass - one of the arteries is 65% blocked and it is close to the heart (left side?) and they say that angioplasy won't take care of it.  The others vary from 12% to 35% (from what I remember).  Now the surgeon says he wants to do a quintuple bypass because "we mine as well do 5 while we're in there" (which doesn't inspire confidence for me!).

How much of a difference does it make 3 vs 4 vs 5?  Is it actually better to have them all done?  It seems some of his blockages are quite small, couldn't those be done by angioplasty?

Anything you have to add would be helpful.  My Dad is of the school of acceptance and doesn't want to ask any questions.  I just want him to be OK.

Thanks,

Barri

PS - He survived a AAA surgery years back so perhaps he has a lucky "star" over him!

[Awake and Unafraid]

I left you a comment in the other thread you posted in.  You say you live in the area affected by Katrina.  I also am in an area affected by Katrina.  May I ask what area you are in?  Just curious, as I know how limited our medical has been since then specially when it comes to specialists.  Again I wish your dad the best.  

Penny
Mississippi Gulf Coast

[jim62]

Something don't sound right about this.  I don't think a doctor would concern himself at all over blockages of 12 to 35 %.  I've always heard that the guideline for intervention is 70%, so even the 65% would be marginal.  And, I can't see doing bypasses where they are really not necessary, just cause of "while we're in there".  Maybe he's looking to get some practice ??

[Momto3]

I agree, something doesn't sound right.  I'd definitely get a second opinion.  Afterall, this is major surgery. Your dad can get copies of all of his pertinent medical records (includes tapes, x-ray,etc) and take them for a second opinion.

Like jim62 said, I've always heard CABG isn't really considered until there is 70% blockage.  Also, the "while we are in there" comment doesn't set quite right.  I'd at least want clarification as to WHY on that one.

All that said, maybe your dad's doctor is right on the mark.  But, I'd want to be a bit more confident before heading to the OR.  Best wishes.

[Thatch]

I ran across this yesterday and emailed it to my aunt who is taking Lipitor.   I have had high chloresterol for over 20 years and have been taking Lecithin daily for most of it. I was struck with myopericarditis (inflamation (inflammation) of the sack around the heart from a viral infection) last December, thought I had a heart attack which also showed in my bloodwork, and was catherized, injected with dye and have no plaque at all. I have also heard of Vitamin C Chelation which is supposed to remove plaque from arteries. I think that runs around $3K.  Unless your dad is in danger of having a heart attack yesterday I would do some research on options. Getting cut hurts.
Thatch

[Thatch]

The link didn't show. Google the word Lipiflow. It sounds like it is claiming to be a way to chelate plaque orally. I never heard of till yesterday, but it does sound interesting.
Thatch

[Awake and Unafraid]

Something about this doesn't sound right.  Please, please get a second oppinion.

[surfgirl]

Ask him if he could throw in an appendectomy while he is at it.  No, wait, don't, unless you "fire" him.

[trvlgrl64]

So, the answer truly seems to be that he needs another opinion.  I don't think I can get him to do that - I wish I could.  The left artery that is clogged at 65% is really the big thing and from what the dr said the only option is CABG surgery.  My father figures if that is true then there are no other options.  I'm riding a very fine line here because I don't want to upset him (or stress him out and he says I am doing).  Thanks for your thoughts on this!

[FLBrat]

Look, just tell him "Daddy, I love you, I am concerned about your health.  I would like to see you get a second opinion before you undergo major surgery."  

My mother had 80-90% blockages all over the place and she was saying..."I'm fine, reallly I am.  I dont need surgery."  She had her 4x bypass because her children banded together about it and pushed.  Now she refuses to do anything about 75%R and 60%L blockages in her carotids.  What a stubborn wonderful woman she is.  

[Awake and Unafraid]

Bypass surgery is very serious and very painful to recover from.  I've seen it with my own dad but his blocakges were 90% when he landed in the ER with a heart attack.  

What we are discussing here is very serious.  If you can't persuade him by talking with him then put cold hard facts in front of him.  Do your homework on the internet and print information he can read for himself about how, when and under what circumstances by pass surgery is needed.  Information is power and both are at your fingertips with the information available to us on the internet.  You said in one of your post that you dad is due to have surgery in two weeks so you must get busy on your mission to provide him with all the facts he needs to make an informed decision.  

[va_tony]

I've enjoyed reading your posts.  I'm sure the Forum will benefit from your extensive reading/research on alternative therapies, diets and supplements. As a coumadin user, I especially found your suggestion of nattokinase intriguing. I'll have to look into it.

Having said that, I'm afraid I have to disagree with you on the subject of chelation therapy to remove arterial plaque (with or w/o vitamin C). This is a controversial subject in the medical community. Certainly, chelation therapy has its uses, for example as a treatment for lead poisoning. The controversy involves treatment of CAD. Since we can't give links on this board, I suggest you google QUACKWATCH CHELATION THERAPY to reach an article by Saul Green, Ph.D. with an update by Stephen Barrett, M.D, which debunks many of the claims of the American College for the Advancement of Medicine (ACAM), the principal proponent of chelation therapy. In particular, Barrett points out that in 1998, the U.S. Federal Trade Commission charged that ACAM's Web site and a brochure had made false or unsubstantiated claims. Here are two of the half dozen or so claims that the US Federal Trade Commission objected to:

"Chelation therapy is a safe, effective and relatively inexpensive treatment to restore blood flow in victims of atherosclerosis without surgery."
"Chelation therapy is used to reverse symptoms of hardening of the arteries, also known as atherosclerosis or arteriosclerosis."

Dr. Barrett concludes by pointing out: "The National Council Against Health Fraud believes that chelation therapy is unethical and should be banned ...."

Also there is another site authored by Wallace Sampson, MD  (reached by googling SKEPTICALLY CHELATION THERAPY) that, based on chemistry first principles, calculates how much calcium can be removed per chelating treatment (i.e., x moles of EDTA removing x moles of calcium) and shows it is negligibly small.

Regards

Tony

[trvlgrl64]

I have had a little success.  Dad has agreed to go for a 2nd opinion, but not until the day before his surgery.  I do know that he needs bypass as the major blockage (65%) is in the left main artery.  My concern is how many bypasses he needs and if they should do them all while in there or leave them if they aren't very blocked.

I do wish he would consider going somewhere other than our area - we've lost so many dr's since Katrina and I worry about the workload of what is left.

[Pepperliveson]

The National Institutes of Health is currently conducting a large clinical trial on chelation therapy for the treatment of coronary artery disease.  So the jury is till out - data will come start to come in in 2008.  But if the NIH is investing substantial resources to conduct this trial, I don't think we can rule it out just yet.

[jim62]

I thought that chelation therapy had long ago been relegated to the recycle bin.  Seems there were many studies done on it that found that the only effect of it was to separate the patient from his money and give some false hope to believers.

Beats me.......