Agenda January 11th 2006

AGENDA

DATE Wednesday 11 January 2006

TIME 5.00 for 5.30 p.m.

VENUE Entabeni Conference Room

PARKING In grounds (car guards)

REFRESHMENTS Available at no charge from 5.00 to 5.30 p.m.

A G E N D A

1) Welcome

2) Apologies

3) Testimonies from first timers

4) Visitation reports

a) St Augustines – Ken Monckton & Zed Tomes

b) Westville - Les Bolt & Tony Ries

c) Entabeni – Chris O’Flaherty & Jack Piek

5) Raffle draw

6) Membership – Les Bolt

7) Finance – Les Bolt

8) Guest Speaker

As this evenings meeting is too close to the Festive Season to arrange for a guest speaker, we will review extracts from a number of videos which we received from the British Heart Foundation.

The content and quality are excellent and cover such subjects as :

“Better than Before – Life after Surgery”

“Heart Surgery – What’s going to Happen”

“Sex and Heart Disease”

“Angina – A Patient’s Guide”

“Cholesterol – On the Level”

Please give us your usual support and try to be there. If you can’t, please let Jack know on 031 563 3200

JACK PIEK

Chairman

November Minutes

MINUTES OF THE NATAL BYPASS CLUB HELD IN THE CONFERENCE ROOM OF THE ENTABENI HOSPITAL, DURBAN ON WEDNESDAY 2 NOVEMBER 2005.

1. WELCOME

90 As per attendance register. An excellent attendance for the last meeting of the year. Noted that Jack arrived five minutes late due to traffic congestion (more than 1 hour from Glenashley to Entabeni).

2. APOLOGIES

Neil Davis, The Holloway’s’, Faye Miller, Les & June Bolt, Des Sutherland, Peter Deightons, Dave & Carol Parry.

3. GUEST SPEAKERS

Due to their busy schedules, Drs David Gillmer and Stewart Kidgell requested that we should allow their presentations before proceeding with our usual domestic programme.

In introducing Stewart, David, who is the cardiologist to many of us, gave a brief address of the progress that has been made in the treatment of cardiac artery disease (CAD). He confirmed that angioplasties and stents are more frequently used and longer lasting. He urged us to have our blood pressures and cholesterol regularly monitored as these were often referred to as the silent killers. He spoke of the benefits of exercise and weight control. The exercise stress test on a treadmill reflected abnormal e.c.g.’s when arteries were severely blocked. However as this did not always provide an accurate e.c.g. and when symptoms persisted, an angiogram was the most accurate diagnostic procedure and although invasive, very reliable.

However, CT scanning (Computerized Tomography) was making rapid strides and he introduced us to Dr Stewart Kidgell, a radiologist and an experienced, and a pioneer, in this relatively modern diagnostic technology.

STEWART KIDGELL C.T. Scanning has come a long way since its early days in 1972 when the first prototype was commissioned. Essentially, it comprised an x-ray tube and a device to read and store information. Initially it took 45 minutes to read ten scans.

It was developed by the EMI record company.

In 1979 Dr Cormack, an ex Capetonian and his partner were awarded the Nobel Prize for their pioneering work in this rapidly progressing technique and today it is possible to capture 64 images in 640 seconds and indeed is so fast that it is more rapid than the flow of blood.

Stewart supported his outstanding address with a Power Point computerized presentation, which is difficult to describe in writing.

He used the slicing of bread into very thin slices to find a foreign object lodged within. The CT scans slices a fraction of a millimetre in thickness and is able to detect abnormalities in every human organ or material even the thickness of dye on material!

The procedure is usually preceded by injecting a dye into the area under investigation. The scanner usually rotates in order to view the area through 360°.

Many slides were then displayed showing, in the smallest detail, organs such as the bones in the ear and an implant to improve hearing which measured 3 mm.

Slides of kidneys, brain aneurism and a bypass, which had failed and had to be ‘redone”. Also calcification nodules in coronary arteries.

Then followed a rotating scan of the heart to show the veins, arteries, chambers, valves, muscles etc – very impressive.

We were shown scans of bypass grafts and how internal mammary arteries were used as conduits for bypassing blockages.

Also the consequences of C A D and heart attack with the resultant scarring.

Following this outstanding and dramatic presentation, David and Stewart agreed to field questions.

Q to S. Does CT replace cardiac angiograms as diagnostic procedures?

A. Not quite yet, but we’re getting there. However, we are successfully using it instead of angiograms to the brain and legs.

Q to S Is it cheaper than angiograms?

A. Yes, by about 25-30% because it is non-invasive and does not require an overnight stay in hospital.

Q to S Can you detect faulty heart valves?

A Not as accurately as a cardiologist can using a Doppler Echo diagnosis. David then verbally made the sounds he associated with leaking valves, heart murmurs, etc.

Q to D Many of us had bypasses when only veins were used and had to have the grafts redone this time using internal mammary arteries. Are these longer lasting?

A. Undoubtedly yes. Arteries are stronger as they have to withstand the pressure of the pumping heart. Veins are the return conduits and need not be as resilient or robust. Their walls are thinner.

Q to D Should we have a cardiologist check up every year after bypass surgery?

A (After a long pause) I don’t think so. If your blood pressure and your cholesterol are normal and you can exercise without undue breathlessness, I would say you’re ok.

A final word from David was that sometimes a little knowledge can be dangerous. For example, he knows of someone very wealthy who decided to have a cat-scan and overreacted when he saw the calcified modules on a coronary artery. They were quite harmless but the man took a lot of convincing.

Q to S Can CT diagnose whether a tumour is benign or malignant.

A Well I believe it can but oncologists prefer to play safe by insisting on further investigations such as biopsies.

Understandably, the remainder of the meeting which had been put on hold took an abbreviated form.

4. RAFFLE

Won by Roy Saunders.

5. ANNUAL SUBS

Many thanks to the majority of members who renewed their annual subs (R25) this evening. A reminder to the remaining members to please send theirs to:

Natal Bypass Club

c/o Mr L Bolt

P O Box 1805

New Germany 3620

Please do not send your remittances to me as I do not have the banking facilities. Thank you.

6. ANNUAL DINNER

55 Members and guests attended the annual lunch at the Durban Country Club where special arrangements were made for us. All agreed that R55 was good value and have requested a repeat next year.

7. NEXT MEETING

As the first Wednesday in January 2006 is too close to New year, our next meeting will be held on the 11 January, same, time, same place, and while about it, please diarise the dates for 2006.

March 1

May 3

July 5

September 6

Annual Lunch September 17

November 1

8. CLOSURE

The very well attended and final meeting of the year concluded with the beautiful rendering of a song made famous during WWII by Vera Lynn and co., and sung so beautifully by the charming daughter of our two staunch supporters Ray & Gill Robinson, Sandy Doherty-Bigara. Songs with audience participation included “Yours”, We’ll Meet Again” and finally “Auf Wiederzein”

I understand that this was to express the member’s appreciation to Jack and his committee for another successful year. I am deeply touched. Thank you for your loyal support and with Richest Blessings to you and yours over the Festive Season.

Above all, here’s wishing you a Healthy Heart!

Thank you

Jack Piek

Tel 031 563 3200

November Agenda

NATAL BY-PASS CLUB

DATE Wednesday 2 November 2005

TIME 5.00 for 5.30 p.m.

VENUE Entabeni Conference Room

PARKING In grounds (car guards)

REFRESHMENTS Available at no charge from 5.00 to 5.30 p.m.

A G E N D A

1) Welcome

2) Apologies

3) Testimonies from first timers

4) Visitation reports

a) St Augustines – Ken Monckton & Zed Tomes

b) Westville - Les Bolt & Tony Ries

c) Entabeni – Chris O’Flaherty & Jack Piek

5) Bypass Booklet – Les Bolt

6) Raffle draw

7) Annual Dinner – Durban Country Club September 25^th

8) Membership & Finance

a) Subscriptions due for 2006

b) Election of Treasurer

9) Guest Speaker

By coincidence the very interesting talk given to us on Scans which was given to us by NARGI BARMANIA, was succeeded by two comprehensive articles; first in the September issue of Readers Digest and then the 5^th September issue of Time Magazine. As this has whet our appetites for more information, Jack contacted Cardiologist David Gillmer to expand on our knowledge. He has accepted the invitation with alacrity and will bring a renowned cardiologist, Dr Stuart Kidgell, to give us an illustrated talk on this latest diagnostic procedure.

This will be the last meeting of the year so please be there, but if you can’t, please let Jack know on 031 563 3200

JACK PIEK

Chairman

September Minutes

MINUTES OF THE NATAL BYPASS CLUB HELD IN THE CONFERENCE ROOM OF THE ENTABENI HOSPITAL, DURBAN ON WEDNESDAY 7 SEPTEMBER 2005.

1. WELCOME

84 As per attendance register.

A special welcome to Geoff Stuart who lives near Port Edward. Members applauded Geoff for the invaluable work he does to ensure that we all receive minutes and notices. He is in charge of printing, stationery and postage.

A warm welcome also to Dave Parry from Port Shepstone.

Jack suggested a lift club to assist members from the South Coast.

2. APOLOGIES

Stuart MacKay; Sandy & Colin Herbst; Mary Leslie (Matatiele); Roy Saunders; Brian Kidd; Tony Arnott; Mavis Brune; Tony & Barbara Thomas; Christine & Alex Jeffrey; Muriel Flowers; Meryl Seymour; Doug Jones; Muriel Adams; Des Sutherland; Piet & Betty Schabort.

We are shocked and saddened by the sudden death of Bishop Mansuet Biyase who gave us such an interesting testimony on 4 May. In recognition of all his achievements for church and country, he received an honorary doctorate of Divinity. Mansuet was the Bishop of Eshowe. He died of a stroke on June 26^th. He was 71.

3. TESTIMONIES FROM FIRST TIMERS

a. LEN WITHERS (67) Len’s father died at 50 and his two sisters and three brothers all died within five years. His wife has been in a home for a year suffering from Alzheimer’s. In January this year he went to Mexico on holiday and returned feeling depressed and out of sorts. An examination by Rob Dyer was followed by two angiograms and ultimately a double bypass by Robbie Kleinloog.

4. RAFFLE

Whisky won by John Rider

5. BOOKLET FOR BYPASS PATIENTS

Jack has perused the excellent booklet published by St Augustines and asked their management whether the same format could be used for Entabeni. This was refused and we will have to prepare and publish our own. The St Augustine’s booklet has been given to Les Bolt whose brainchild the project was. He will take action.

6. VISITATION REPORTS

Brief reports from Counsellors at the three hospitals confirmed that the regular visits were appreciated by staff and patients on the cardiac wards. The Bypass Club is indebted to the members who voluntarily give of their time to visit patients to put their minds at rest and to encourage them in their rehabilitation.

7. MEMBERSHIP & FINANCE

The response from the naming of members who were behind in their subscriptions did not meet with the anticipated payments. There were a few exceptions from grateful members who not only paid theirs, but made generous donations.

Rather than pursue the lack of subscriptions, any further this year, we have decided to wait until next year when failure to pay before the end of February 2006 will result in members’ names being removed from the circulation list.

Currently 132 out of 230 members have paid the R25 per annum subscription with approx 20 free membership for doctors.

8. ANNUAL LUNCH

As a result of the success of last year’s lunch at the Durban Country Club, a similar arrangement has been made for Sunday 25 September. This was announced at the last meeting and to date approximately 50 bookings have been made.

Jack will invite VIP’s to join us as our guests. We hope that this years’ response will be an improvement on last year.

9. GUEST SPEAKER

Due to a misunderstanding about the time of our meeting, plus an 8 hour emergency operation, Mr Robbie Kleinloog was an hour late for his presentation, This period was used for ad lib testimonies from members and proved to be most interesting, informative and amusing.

Thus we heard from GILES AUDIBERT who suffered from sleep apnea which resulted in sleeping for 20 minutes and staying awake for hours afterwards. One hours’ sleep was all he had for driving non stop through the night etc. The lack of sleep however caused rattiness and squabbling. He had severe complications after Robbie Kleinloog did his bypass operation.

Ultimately, he went to a sleep clinic and is now totally dependent on a feedback machine which does his breathing for him at night.

MERRIL PIKE (75) gave us a comprehensive testimony two meetings ago and this evening he was encouraged to tell us more.

He suffered a heart attack during a 70km cycle race last year resulting in broken bones and concussion. After a triple bypass and a prosthetic mitral valve, he started riding again and gaining confidence on his cycle. So much so, that he decided to train for this years Argus but had a bad turn during training. The problem appeared to be associated with his heart rate and valve replacement. Once he had recognized this, his cycling proceeded successfully and this year he entered the same race (‘Toti 70km) in which he had his heart event last year. He finished well and now cycles socially as opposed to competitively.

RON ROSENTHAL After a valve replacement two years ago he was aware that on an occasion he spoke “verbal garbage” on his way home and then collapsed on the ground and bled from his nose and eyes. A bystander who could detect no discernable pulse, thumped Ron on his chest which resulted in weak heart beat until the paramedics arrived to stabilise him. He has fully recovered.

ROBBIE KLEINLOOG arrived amidst an arousing welcome and proceeded to address us.

He used a PowerPoint computerised presentation to illustrate his interesting talk.

This showed the appearance of so-called cholesterol (atheroma) in coronary arteries and surprised us all by the length of it in certain cases and the difficulty at times to find a suitable conduit to bypass the obstruction.

We saw a catscan in colour which showed thin sections through the heart and illustrated the heart disease.

There were pictures of a young and normal heart as opposed to a diseased organ. Also illustrated were coronary arteries supplying blood to the left coronary muscle. Then there was shown the left and right coronary arteries and branches which are 2½ mm in diameter, the same as the internal mammary arteries often used as bypass conduits. Robbie dwelt on modern possibilities in the field of coronary repair and spoke of the potential of stem cells for the brain, bones and heart and other parts of the body.

Interesting that, unlike any other muscle, when a heart muscle dies, it stays dead. A technique involving the punching of holes into the heart muscle and filling them with good heart cells was mentioned.

The progress of combating Alzheimer’s, torn cartilage, etc was covered. It is estimated that in 12 – 24 months dramatic breakthroughs will be made.

Robbie introduced us to “My Very Special Guest – FRANCOIS KING”

She suffered from an ailment found more in females than in males and consisting of the pressure in her lungs being too high which often results in death.

She appealed to Robbie to please save her and help her to fulfil her life’s’ ambition ‘just to see her children go to school’.

A donor lung was found and transplanted into Francois. Six years later, this started to fail and she desperately needed a lung and heart transplant due to the pressure caused by the failure of her transplanted lung. Whilst waiting for this operation called a bilateral transplant, she suffered from brain meningitis, leukaemia and eventually a coma. Her husband phoned Robbie and pleaded to please do something. She was admitted to hospital where she waited for six months for organs. Her weight dropped to 33 kg and we were shown slides of her pathetic body. In her own words, “I lost my calves, boobs and bum!”

She was admitted on Christmas Day 2003 and on 3 June 2004 she successfully received new lungs and a heart.

But after the prolonged stay in hospital she found it difficult to fit back in her home environment and couldn’t cope with her children who wanted her back at hospital and to stop laying down the law.

This was happily only transitory and now she has adjusted completely to a normal life. One of her joys is being able to shout words of encouragement to her children at sports events.

Emotionally she pointed to her husband in the audience and thanked him for the 14 years of marriage and never giving up hope and then to Robbie and said “Thank you Robbie, the most wonderful man in the world who gave me back my life.” Finally she said, “You don’t realize how valuable your organs are until you lose them!”

We bade her an emotional thanks for her heart-rending testimony and Robbie for bringing her to us.

Thank you

Jack Piek

Tel 031 563 3200

MINUTES OF THE NATAL BYPASS CLUB HELD IN THE CONFERENCE ROOM OF THE ENTABENI HOSPITAL, DURBAN ON WEDNESDAY 7 SEPTEMBER 2005.

1. WELCOME

84 As per attendance register.

A special welcome to Geoff Stuart who lives near Port Edward. Members applauded Geoff for the invaluable work he does to ensure that we all receive minutes and notices. He is in charge of printing, stationery and postage.

A warm welcome also to Dave Parry from Port Shepstone.

Jack suggested a lift club to assist members from the South Coast.

2. APOLOGIES

Stuart MacKay; Sandy & Colin Herbst; Mary Leslie (Matatiele); Roy Saunders; Brian Kidd; Tony Arnott; Mavis Brune; Tony & Barbara Thomas; Christine & Alex Jeffrey; Muriel Flowers; Meryl Seymour; Doug Jones; Muriel Adams; Des Sutherland; Piet & Betty Schabort.

We are shocked and saddened by the sudden death of Bishop Mansuet Biyase who gave us such an interesting testimony on 4 May. In recognition of all his achievements for church and country, he received an honorary doctorate of Divinity. Mansuet was the Bishop of Eshowe. He died of a stroke on June 26^th. He was 71.

3. TESTIMONIES FROM FIRST TIMERS

a. LEN WITHERS (67) Len’s father died at 50 and his two sisters and three brothers all died within five years. His wife has been in a home for a year suffering from Alzheimer’s. In January this year he went to Mexico on holiday and returned feeling depressed and out of sorts. An examination by Rob Dyer was followed by two angiograms and ultimately a double bypass by Robbie Kleinloog.

4. RAFFLE

Whisky won by John Rider

5. BOOKLET FOR BYPASS PATIENTS

Jack has perused the excellent booklet published by St Augustines and asked their management whether the same format could be used for Entabeni. This was refused and we will have to prepare and publish our own. The St Augustine’s booklet has been given to Les Bolt whose brainchild the project was. He will take action.

6. VISITATION REPORTS

Brief reports from Counsellors at the three hospitals confirmed that the regular visits were appreciated by staff and patients on the cardiac wards. The Bypass Club is indebted to the members who voluntarily give of their time to visit patients to put their minds at rest and to encourage them in their rehabilitation.

7. MEMBERSHIP & FINANCE

The response from the naming of members who were behind in their subscriptions did not meet with the anticipated payments. There were a few exceptions from grateful members who not only paid theirs, but made generous donations.

Rather than pursue the lack of subscriptions, any further this year, we have decided to wait until next year when failure to pay before the end of February 2006 will result in members’ names being removed from the circulation list.

Currently 132 out of 230 members have paid the R25 per annum subscription with approx 20 free membership for doctors.

8. ANNUAL LUNCH

As a result of the success of last year’s lunch at the Durban Country Club, a similar arrangement has been made for Sunday 25 September. This was announced at the last meeting and to date approximately 50 bookings have been made.

Jack will invite VIP’s to join us as our guests. We hope that this years’ response will be an improvement on last year.

9. GUEST SPEAKER

Due to a misunderstanding about the time of our meeting, plus an 8 hour emergency operation, Mr Robbie Kleinloog was an hour late for his presentation, This period was used for ad lib testimonies from members and proved to be most interesting, informative and amusing.

Thus we heard from GILES AUDIBERT who suffered from sleep apnea which resulted in sleeping for 20 minutes and staying awake for hours afterwards. One hours’ sleep was all he had for driving non stop through the night etc. The lack of sleep however caused rattiness and squabbling. He had severe complications after Robbie Kleinloog did his bypass operation.

Ultimately, he went to a sleep clinic and is now totally dependent on a feedback machine which does his breathing for him at night.

MERRIL PIKE (75) gave us a comprehensive testimony two meetings ago and this evening he was encouraged to tell us more.

He suffered a heart attack during a 70km cycle race last year resulting in broken bones and concussion. After a triple bypass and a prosthetic mitral valve, he started riding again and gaining confidence on his cycle. So much so, that he decided to train for this years Argus but had a bad turn during training. The problem appeared to be associated with his heart rate and valve replacement. Once he had recognized this, his cycling proceeded successfully and this year he entered the same race (‘Toti 70km) in which he had his heart event last year. He finished well and now cycles socially as opposed to competitively.

RON ROSENTHAL After a valve replacement two years ago he was aware that on an occasion he spoke “verbal garbage” on his way home and then collapsed on the ground and bled from his nose and eyes. A bystander who could detect no discernable pulse, thumped Ron on his chest which resulted in weak heart beat until the paramedics arrived to stabilise him. He has fully recovered.

ROBBIE KLEINLOOG arrived amidst an arousing welcome and proceeded to address us.

He used a PowerPoint computerised presentation to illustrate his interesting talk.

This showed the appearance of so-called cholesterol (atheroma) in coronary arteries and surprised us all by the length of it in certain cases and the difficulty at times to find a suitable conduit to bypass the obstruction.

We saw a catscan in colour which showed thin sections through the heart and illustrated the heart disease.

There were pictures of a young and normal heart as opposed to a diseased organ. Also illustrated were coronary arteries supplying blood to the left coronary muscle. Then there was shown the left and right coronary arteries and branches which are 2½ mm in diameter, the same as the internal mammary arteries often used as bypass conduits. Robbie dwelt on modern possibilities in the field of coronary repair and spoke of the potential of stem cells for the brain, bones and heart and other parts of the body.

Interesting that, unlike any other muscle, when a heart muscle dies, it stays dead. A technique involving the punching of holes into the heart muscle and filling them with good heart cells was mentioned.

The progress of combating Alzheimer’s, torn cartilage, etc was covered. It is estimated that in 12 – 24 months dramatic breakthroughs will be made.

Robbie introduced us to “My Very Special Guest – FRANCOIS KING”

She suffered from an ailment found more in females than in males and consisting of the pressure in her lungs being too high which often results in death.

She appealed to Robbie to please save her and help her to fulfil her life’s’ ambition ‘just to see her children go to school’.

A donor lung was found and transplanted into Francois. Six years later, this started to fail and she desperately needed a lung and heart transplant due to the pressure caused by the failure of her transplanted lung. Whilst waiting for this operation called a bilateral transplant, she suffered from brain meningitis, leukaemia and eventually a coma. Her husband phoned Robbie and pleaded to please do something. She was admitted to hospital where she waited for six months for organs. Her weight dropped to 33 kg and we were shown slides of her pathetic body. In her own words, “I lost my calves, boobs and bum!”

She was admitted on Christmas Day 2003 and on 3 June 2004 she successfully received new lungs and a heart.

But after the prolonged stay in hospital she found it difficult to fit back in her home environment and couldn’t cope with her children who wanted her back at hospital and to stop laying down the law.

This was happily only transitory and now she has adjusted completely to a normal life. One of her joys is being able to shout words of encouragement to her children at sports events.

Emotionally she pointed to her husband in the audience and thanked him for the 14 years of marriage and never giving up hope and then to Robbie and said “Thank you Robbie, the most wonderful man in the world who gave me back my life.” Finally she said, “You don’t realize how valuable your organs are until you lose them!”

We bade her an emotional thanks for her heart-rending testimony and Robbie for bringing her to us.

Thank you

Jack Piek

Tel 031 563 3200

Does this happen to you??

Our intrepid Treasurer has taken the plunge and dived into the world of Blog only to find that random bits of code are displayed when a page comes up on the screen. I suspect that this may be due to the version of Internet Explorer that he is using, and am investigating this. I would be grateful to hear from any of you who are experiencing the same problem, and if so what version of what browser you are using.

Personally I use Mozilla Firefox which is extremely simple and less vulnerable than Microsoft IE. It is available as a free download at http://www.mozilla.org/products/firefox/

Agenda September 2005

NATAL BY-PASS CLUB

DATE Wednesday 7 September 2005

TIME 5.00 for 5.30 p.m.

VENUE Entabeni Conference Room

PARKING In grounds (car guards)

REFRESHMENTS Available at no charge from 5.00 to 5.30 p.m.

A G E N D A

1) Welcome

2) Apologies

3) Testimonies from first timers

4) Visitation reports

a) St Augustines – Ken Monckton & Zed Tomes

b) Westville - Les Bolt & Tony Ries

c) Entabeni – Chris O’Flaherty & Jack Piek

5) Membership & Finance – result of publishing names of members in arrears

6) Bypass Booklet – Les, Chris, Jack

7) Raffle draw

8) Annual Dinner – Durban Country Club September 25th

9) Guest Speaker

By popular demand – Mr Robert Kleinloog

(as a result, please come early to secure a seat)

If unable to attend please phone

JACK PIEK

563 3200

Minutes July 2005

MINUTES OF THE NATAL BYPASS CLUB HELD IN THE CONFERENCE ROOM OF THE ENTABENI HOSPITAL, DURBAN ON WEDNESDAY 6 JULY 2005.

1. WELCOME

52 As per attendance register.

2. APOLOGIES

Cissy & Neville Farr, Piet Schabort; Gerd Ockers, Des Sutherland, Len Withers, John Machel, Peter & Maggie Saunders, Les Bolt, Herman Davidson, Dave Parry and Geoff Stuart

3. TESTIMONIES FROM FIRST TIMERS

a. TONY HUMAN (60) Is a school teacher and visited us purely out of interest. Welcome!

b. DOUG GELLING (76) His wife died in April 2004 and eight months later, his daughter was diagnosed with leukaemia and so he went to visit her in Australia. On his return he decided to see Rodney Matisson, the cardio, for a check up, and a stress test (treadmill) showed an abnormal e.c.g., which ultimately led to a double bypass. Fine now.

c. TONY ARNOTT (67) Very active. Both his mother and father died at a relatively early age. Tony suffered a pain in his right shoulder which was diagnosed as a pulled muscle and treated by a physiotherapist. As the pain persisted, he saw a doctor who referred him to a cardiologist on the 15 November 2004.

A treadmill resulted in angina and he was admitted to St Augustines with a serious and urgent problem. (If it was left, he could die within two days.) After bypass surgery on the 26 April 2005, he fully recovered and is walking 4 kms every day.

d. THEO FREEZE (63) Had never had an operation or been sick his whole life but recently he suffered a pain across his chest and down one arm. He was admitted to the Umhlanga Hospital sweating profusely and after two days was transferred to St Augustines where it was diagnosed that his heart was only 47% functional. An angiogram revealed three blocked arteries and these were bypassed by Mr Kleinloog. Theo is an unfortunate asthma sufferer.

e. DEVAN MARI (52) A very fit gold medal ballroom dancer. Twelve yeas ago an e.c.g. for an insurance policy indicated a heart abnormality and one blocked artery was diagnosed. Admitted first to Addington and then to Wentworth where an angiogram confirmed that there was one blocked artery. He was put on medication for 12 years, but this year decided on another opinion. Dr Deena the cardiologist, performed an angiogram and diagnosed three blocked arteries. These were bypassed and Devan is fine now.

4. VISITATION REPORTS

a. St Augustines Zed Tones has seen 20 patients but has been forbidden to see Dr Y.T. Singh’s patients. The hospital has published a comprehensive 24 page booklet entitled “Your Guide to Cardiac Bypass Surgery” which was handed to Jack.

b. Westville As there were no counsellors at this evenings’ meeting there was no report.

c. Entabeni As Chris O’Flaherty was overseas for a month, Jack did a “double shift” . Nothing to report, save a cordial welcome by staff and appreciative patients. Visitations vary from nil to eight per call.

5. BYPASS BOOKLET

Chris O’Flaherty‘s attempt to gain knowledge from the British Heart Foundation during his recent visit to London was frustrating and he did not receive the co-operation for which he had hoped. Nevertheless, he has handed Jack brochures, literature and application forms for perusal and consideration with the St Augustines booklet for us to take the next decision regarding a publication.

6. MEMBERSHIP & FINANCE

Only 115 members out of 226 have paid their subscriptions. It was suggested that due to the over whelming success we achieved in reminding defaulters of their commitment, we should repeat the exercise this year. Jack agreed on condition that the members who are named should appreciate that it was not an indictment but merely a reminder. Most members have simply, unwittingly, forgotten that subs are due.

Here are the surnames of members who are receiving notices, but have not paid their subscriptions this year: Bailey, Balkissoon, Basckin, Benn, Biggar, Billson, Booyse, Brett, Clover, Docrat, Dos Santos, Duvel, Dyer, Geddes, B.Govender, R.Govender, Graham, Greenspan, Hargovind, Harvey, Hipkin, Jackson, Kinnear, Kinnaird, Kinsman, Kirstensamy, Larsen, Leach, Lezard, Lombard, Manilall, Martin, Master, Mathews, Maud, Middendorp, Minnaar, Moodley, Moola, Morgan, Naicker, Nash, Nathoo, Nellnampius, Pascoe, Pinto, Pollock, Potgieter, Rencken, Renton, Root, Rorke, Rosenthal, Sanders, Seeck, Sherriff, Smith J., Sprong, Sutherland, Sutton, van Niekerk, van Rooyen, van Zyl, Vermaak, Walker, Walters, Whitehorn, Will.

Please do not post cheques to Jack, but send your R25 to

The Natal Bypass Club

P O Box 1805

New Germany 3620

Or deposit into the following bank account making sure that Les Bolt on 031 7013435 is advised:

Standard Bank Savings account

Pinetown Branch

Account No 257360549.

This being August, we will assume that if no payments are made by September 30, you no longer wish to receive further minutes and have terminated your membership.

7. RAFFLE DRAW

Won by Norma Monckton.

8. ANNUAL LUNCH

Due to the success of last year’s lunch at the Country Club, Jack was urged to make a similar arrangement this year. This he has done and here are the details.

DATE Sunday 25 September 2005

VENUE Durban Country Club – 1^st floor

TIME 12 noon

COST R55 per person

DRESS No jacket or ties for men (Smart Casual)

We will use the main dining facility, as a separate venue will cost us R85 for the same menu.

Our number is limited to 40 and so it must be on a first paid, first booked system.

Deadline is 8 September and cheques are to be posted to Jack, crossed and made payable to J.C.L. Piek, address – 14 Furn Ridge 1 Burne Crescent Glenashley 4051, or pay at the meeting on 7 September 2005. Thank you

9. BYASS CLUB’S OWN WEBSITE

Geoff Stuart who is responsible for the printing and posting of our minutes and notices and has experienced difficulties in sending emails. Consequently, at no charge, he has applied for a website which is http://bypassnatal.blogspot.com

Members previously receiving notices by email are requested to download on our new website. Thank you. (Note from Geoff: Please send an email to geoffs@telkomsa.net if I can remove you from the postal list.)

10. GUEST SPEAKER

NARGI BARMANIA is an Echo Cardiographer and her brief presentation at our last meeting resulted in a request from members to give a comprehensive address. Here is a synopsis of her talk, which was superbly supported by a power point presentation.

When asked how many members present had experienced echo cardiography, only four hands were raised.

What is this recent technology?

It is based on the same principle as ultra sound used on pregnant women. It is safe and painless. It is a diagnostic procedure and is used to confirm abnormal e.c.g.’s on a treadmill. It pinpoints areas where problems exist. It is a diagnostic procedure and used to confirm initial clinical diagnosis.

It uses high frequency ultra sound waves and takes moving pictures of the heart.

A transducer produces the sound waves which are aimed at the heart. Thus, signals are transmitted and received. These will show heart walls, valves and blood flow and an overall picture of the heart. However, it is not bone friendly and ribs do interfere with the picture.

Range of Ultra sound techniques:

Two dimensional echo

Pulsed wave Doppler

Continuous wave Doppler

Colour Doppler showing blood flow images.

Doppler uses sound waves which measure speed and direction of blood flow.

Colour flow Doppler shows regurgitation indicating faulty heart valves. Red flows away and blue flows toward the heart.

MRI is used when there is a suspicion of lesions and when you want a 100% diagram.

Scans are used to determine the degree of diminution or an increase in the diameter of vessels and blood flow.

INFORMATION FROM IMAGES

The sizes of the four heart chambers are measured.

A study can be made of the motion and appearance of the heart.

It examines heart valves for stenosis and regurgitation.

It concluded how forcefully the heart muscle contracts.

It excludes congenital abnormalities

It can detect calcification of the four heart valves.

“Holes in the heart” caused by blood shunting between heart chambers due to faulty valves can be detected. If this abnormality is not detected timeously, death can result.

WHAT INFORMTION IS PROVIDED BY THE DOPPLER PROCEDURE?

Sound waves are used to judge :

Speed

Amount (volume)

Direction of blood cells flowing through parts f your heart and greater vessels.

They are used to determine how healthy vessels are before bypass surgery.

Doppler provides quantitative data such as pressure gradient.

Valve areas

Valve regurgitation estimates and other comprehensive information to promote diagnosis.

TRANSOESOPHAGEL ECHO CARDIOGRAPHY (TOE)

This process enhances the diagnostic capabilities of cardio ultra sound and provides detailed visualization of heart function from a small oesophageal transducer. It is reliable and simple. Interalia, it picks up abnormalities of the aorta, clots and atrial masses.

APPLICATION OF ECHOCARDIOGRAPHY

It confirms initial diagnosis

It helps with the clinical management of the patient.

It assists the cardiologist with the diagnosis of a wide variety of heart diseases

WHERE IS ECHO USED?

Coronary care unit

Intensive care unit

Emergency department

Cardio Catheratisation laboratory

Diagnosis and Monitoring effect of therapeutic examinations.

SUMMARY

It is non-invasive

It is a very useful clinical diagnostic tool.

The results are immediate

It needs no special patient preparation.

It can be used for outpatients

Soon it will be able to give results in 3D.

CONCLUSION

Nadia showed several slides illustrating the chambers and valves of the heart and a valve suffering from calcification which restricted the valve opening.

Also shown was the regurgitation of the mitral valve and a leaking of the tricuspid valve also due to calcification and restricting the blood flow to the aorta.

We also saw echo sounds of babies in utero with front and side views.

Pictures of babies’ hand, ear, spine at 19 weeks and a ‘baby’ with a club foot at 12 weeks. The umbilical chord and placenta very clearly visable.

FINAL QUESTION FROM THE CHAIR

Can echo sound diagnose when there is stenosis (narrowing) of coronary arteries. Can it be used instead of an angiogram?

Answer No, not at present, but progress is being made in that direction.

Nargis was warmly thanked for her excellent presentation on a technology, which was hitherto unknown to us. The comprehensive visual support helped us to follow the somewhat technical address and we have learnt a lot.

Thank you

Jack Piek

Tel 031 563 3200