An offer too good....

This received from Dennis Graham:

"ByPass Club" Gym, is held at the Old Mutual Sports Hall, at top of Francois Road, (Gate 9) Our numbers have dwindled in the past year due to members moving away to Ramsgat, Ballito, plus three emigrated to Europe and Australia, an of course people away overseas on extended hollidays.

We do not "Pump Iron", all exercising is to promote general fitness, static cycles, manual treadmills rowing machines use of steps, and walking all promote a healthy pulse rate.

The Gymnasium is large and for the one hour we have the place to ourselves, so we do not have to compete with young fit "Tigers" -- we are all of mature age,and of course are receipiants of either By Passes or Transplants. We are looked after by Professor Maurice Maars of the Natal School of Medicine. We meet on Monday Mornings and Thursday Mornings, at 6.00 am for one hour or as long up to one hour you feel yiou can manage. and IT'S FREE.!!!

We desperately need new members -- How about it ?

Contact Des Graham either on 031 467 0133 during office hours and 031 2058761 after 5.30 pm. Car Parking is excellent, has boom security, and 24 hour guards, such a pleasure to feel safe and at ease. Look forward to hearing from you.

Under Way

First response to my general email to members was most gratifying - see below. The second was tongue in cheek (I think?). Also repeated below.

Just as a matter of interest, I had to visit my GP recently for a minor problem and he happened to mention that a generic substitute for Lipitor is due to be released in September. Does that explain the collect the bar codes campaign being run by the manufacturers of Lipitor at the moment? Does it mean that they will reduce the price?

Here's Johns's email:

Dear geoff, it was so wonderful to go on to your web page, I am now living in the U.K and will soon be cancelling my south African e.mail address (jsutton@saol.com) my new address is johnandsadie@blueyounder.co.uk and postal is 97 Kent Avenue, Sittingbourne ME10 1HB Kent England.

I had my double bypass January 19th 2004 at Westville hospital and I made a good recovery but my blood pressure was always on the high side after a few months, my medication was changed twice and the blood pressure came under control.

Then later the medical aid said I must change my medication or pay a large levy, my Doctor changed my tablets .

Slowly my pulse became irregular also the blood pressure, my doctor prescribed more tablets and then more as I started to get headaches and my vision was suffering slightly.

When I arrived in England not at all very fit, I registered with a doctor and he stopped one of the tablets saying it was not needed as one of the tablets did the same work also my pulse was only 33 and I should to see him in 2 weeks time.

On the next visit he stopped another 4 tablets as my pulse was still low on 40 and to see him in another 2 weeks.

On the last visit I felt better then I had for a long time and my blood pressure more steady and my pulse at 70, I am now taking 4 tablets plus 1 disprin per day and to see him in 3 weeks time.

In amanzimtoi I found it was not always a good time to walk, either too hot or not safe and the fumes from the car exhaust made me fill ill.

Now I am able to take long walk at any time of the day and when ever returning from visiting at 11pm, also could not detect the car fumes at any time

( I am not knocking South Africa, just stating a fact.)

I would again like to thank you again for the web page and if I am one of the people who still need to pay please let me know.

thank you

John Sutton

and this from Les:

Geoff,

I connected to "The Blog" !!!!

I tried to connect to the members page to place an advert for a "With it Treasurer" but I got onto an international news page .

How do I get into our "general page"??

Les

Introduction

A hearty (ha, ha) welcome to this blog which is a desperate attempt to overcome the problems being experienced with bulk emailing. In an attempt to defeat the scourge of spam my service provider has made it impossible to send an email to more than 5 or 6 addresses at the same time, which makes sending out a newsletter a real pain.

I plan to post agendas and minutes as soon as they become available, usually at least two weeks before the next meeting, but quite often much sooner. This will mean that all members will be able to access the info at their own convenience, and it will also serve as an archive of past minutes.

As this will mean an update only every two months I would like to expand the thing to include stuff which would be of general interest to members and so I’m making an appeal to all of you to email me (geoffs@telkomsa.net) anything you feel might be relevant, or even irrelevant. Useful articles, dietary information, problems with medication that other members might be able to help with, news and views would all be grist to the mill. When the Bypass Booklet project gets under way perhaps we can include some of that material for reference. Please feel free to make suggestions, and to let me know what you think about this means of communication. The Agenda for the next meeting follows:

Agenda July 2005

NATAL BY-PASS CLUB

DATE Wednesday 6 July 2005

TIME 5.00 for 5.30 p.m.

VENUE Entabeni Conference Room

PARKING In grounds (car guards)

REFRESHMENTS Available at no cost 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 & Doug Tomes

b) Westville - Les Bolt & Tony Ries

c) Entabeni – Chris O’Flaherty & Jack Piek

5) Membership & Finance

6) Bypass Booklet

7) Raffle draw

8) Guest Speaker

Nargis Barmania by special request following her brief explanation of her profession at the last meeting. See Minutes Item4.

If unable to attend please phone

JACK PIEK

563 3200

Minutes May 2005

MINUTES OF THE NATAL BYPASS CLUB HELD IN THE CONFERENCE ROOM OF THE ENTABENI HOSPITAL, DURBAN ON WEDNESDAY 4 MAY 2005.

1. WELCOME

95 As per attendance register. Apologies to members who were inconvenienced due to a lack of chairs.

2. APOLOGIES

Jennifer McInnes, Ken Howell, Ron Masters, Chris O‘Flaherty, Stewart & Carol McKay Jill Thomas Herman Davidson Brian Kidd Geoff Stuart

3. TESTIMONIES FROM FIRST TIMERS

a. MERRILL PIKE (75) Led a very active outdoor life including many sports in particular cycling (Cape Argus several times, Tour D’Urban, etc) and has cycled from Durban to Johannesburg in 2½ weeks. He suffered no symptoms to indicate heart disease, but on the 18 March last year, he blacked out during a cycle race near 'Toti causing him to fall heavily and crack his helmet plus fracture two ribs. The diagnosis was a mild heart attack which was confirmed at St Augustine’s where he had a triple bypass, plus a valve replacement. Merrill was back on his bike after three months and started walking briskly. Determined to cycle the Argus once more, he flew to Cape Town but during a practise run, he blacked out again which put paid to his Argus. Undaunted, Merrill is exercising regularly again and is determined to enter next year’s Argus.

b. SAM WALLACE (63) Like Merrill, Sam has been a keen sportsman and has run six Comrades. Recently he suffered pains in his arms, shoulders and back and became fatigued which led to a visit to a cardiologist who tested him on the treadmill but due to his fitness, it was only with severe effort that an e.c.g. revealed heart disease. At first it was felt that a stent would suffice, but this was followed by a double bypass. Unfortunately, Sam suffered serious complications with his pulse racing at 200 and serious internal cardiac bleeding and a B.P. of 70/50 which necessitated an open-heart operation being performed again.

Happily, the news now is good with his pulse and blood pressure back to normal. He has lost 10 kg and is trying to run next years Comrades.

c. RONALD NAIDOO (52) Apologised for not being as fit as the previous two new members. He plays tennis and golf. He suffered a pain in his neck and his doctor prescribed an anti-inflammatory (Voltaren). As the pain persisted, Ronald was consulted by a Cardiologist who did an angiogram (after the treadmill) and found two partially blocked coronary arteries. Mr Kleinloog bypassed these. Ronald is currently studying for a degree in theology and told us that he believes that God has asked him to “slow down”.

d. MANSUET BIYASE (72) Is the Catholic Bishop of Eshowe. He was a clergyman at Ixopo from 1960-1975 and a keen soccer player, but his transfer to his present position resulted in a deterioration of his health. Whilst on a visit to Germany, the bishop started having trouble with his breathing and he as diagnosed as suffering from high blood pressure and diabetes. His first heart attack followed and on returning to Natal he saw David Gillmer followed by a triple bypass. Later he started feeling very tired and Dr Gillmer fitted a pacemaker.

e. BERYL DRAPER Showed symptoms of heart disease seven years ago, but it was not considered necessary to have surgery until recently when it was discovered that she had excessively high blood pressure and a faulty heart valve. At the end of last year Beryl’s G.P. referred her to David Gillmer who found that bypass surgery plus valve replacement were necessary. Fine now after the operation.

4. SPECIAL GUEST NARGI BARMANIA introduced herself as an Echo Cardiographer and explained the technology based on a similar basis as MRI scanning but conducted on the heart to determine damage or the success of bypass surgery. It detects blockages and areas of the heart which are starved of blood. It determines the difference between a normal and a diseased heart. Her brief introduction resulted in an enthusiastic request from members to address us with a fuller explanation with illustrations.

We have invited her to comply by talking to us at our next meeting on 6 July. Should be interesting.

5. INVITATION BY PFIZER FOR LIPITOR USERS

Jack displayed the handsome folders and informative bulletins which Pfizer are offering on an ongoing routine basis to all Lipitor users. Many members took application forms with them for enrolment. The programme is entitled “An Exciting free programme that aims to help you lower your risk of heart Disease”.

6. RAFFLE

Once again very well supported and the whisky was won by W.Merle a member for 15 years. Congratulations!

7. MEMBERSHIP & FINANCE

We have 225 members of which only 106 have paid their annual subscriptions. These were due on 1 January 2005 and we will have to review the continuation of the membership of the defaulters.

A further reminder that R25 subs should not be posted to Jack but to :

· Les Bolt

Natal Bypass Club

P O Box 1805

New Germany 3610

Or to be deposited into bank account :

· Standard Bank Savings Account

Pinetown Branch

Account No 257360549

But please follow this up with a fax or phone call to Les on 7013435 giving details of your name and deposit. Thank you.

Thank you also to the two members who very generously sent cheques for R250 as donations.

This brings us to Item

8. BYPASS BULLETIN

At the last meeting the suggestion of a booklet for patients and families was discussed. A sub-committee comprising Les Bolt, Chris O’Flaherty and Jack Piek has met and resulted in the following decisions.

a. Chris who is in London will approach the British Heart Foundation for a complete list of all their publications and establish whether a copyright obtains re duplication.

b. Jack will peruse the envisaged publication currently being printed for the benefit of patients at St Augustine’s.

c. Les will co-ordinate all information presently and pending available and investigate the feasibility of condensing this into our publication. The costs, number of copies, etc.

9. VISITATION REPORTS

a. St Augustines – We are grateful to Doug Tomes who has volunteered to assist Ken Monckton. Doug reported that the ward has been fairly quiet.

b. Westville - Les Bolt and Tony Ries are making sure that two visits per week are arranged as nowadays patients are often discharged within 5 or 6 days after ICU.

c. Entabeni – With Chris O’Flaherty in London, Jack has increased the frequency of his visits.

10. GUEST SPEAKER

Dr Alan Hold’s association with the Bypass Club goes back to its inception some 21 years ago when Jack and his team were counselling adult patients at Wentworth (the only hospital where bypass surgery was performed). Alan was looking after the babies and children by visiting, providing toys and giving them hope and encouragement. These unfortunate little ones often came to the hospital for open-heart surgery by ambulance from a clinic closest to the homes of their parents. Very often they only saw their parents again after their operation and convalescence. Alan did a wonderful job of playing a parental role during this period.

Alan has been the anaesthetist at many of the bypass and transplant operations and this included the only heart and lung transplant performed in South Africa by Robbie Kleinloog.

His presentation was supported by a power point presentation which was highly entertaining, amusing and risqué.

These cartoons were used to provide the analogy to the work of an anaesthetist.

Alan has assisted in 17 -1800 bypass operations and can therefore talk with many years of experience and knowledge.

Up to 1850 in the absence of anaesthetics, patients had to “bite the bullet”. Pain from operations, amputations and dentistry was excruciating and often was followed by bacterial infection. Mortality was very high.

Nitrous Oxide (laughing gas) and ether were introduced in 1850 and chloroform in 1890.

Interesting that Queen Victoria was given chloroform when she gave birth to one of her many sons – Leopold.

The second world war resulted in many new developments such as Pentothal used during the Pearl Harbour attack

Included in anaesthetics is the drug used for epidurals which is used in back or leg operations etc, and during labour.

40% of the anaesthetics are administered outside the operating theatre.

The patient’s lifestyle before and after an operation is of utmost importance. This would include drug users, asthmatics, alcoholics, smokers.

Even obesity is taken into account to determine the anaesthetic. “Fat babies make fat adults make fat corpses.”

Patients are graded between low and high risks. Often patients are reluctant to divulge their true personal details. This has partially been taken care of by completing a detailed questionnaire which is to ensure defence against litigation.

Interesting that certain herbs also react adversely with specific anaesthetics.

There have been massive improvements and developments which have reduced the risks and recovery rates of surgery such as cataracts, dentistry and above all, cardiac operations. Now it is even possible to do bypass surgery on a beating heart. (A technology which was presented to us in an illustrated talk by Robbie Kleinloog. He called it the mid-cab operation.)

During an open-heart operation, copious doses of oxygen are administered to reduce the workload of the heart. Also lots of Warfarin to reduce the risk of clotting.

The perfusionist operates the heart /lung machine once the patient is anaesthetized so that the surgeon can perform bypass surgery on a still heart.

The body is cooled down to further facilitate the operation. This must be carefully controlled to about 30° C because below this, the heart goes into ventricular fibrillation. This danger is however reduced due to the patient’s connection to the heart /lung machine.

After the operation, the patient is gradually warmed up and drugs are administered to counteract those used to put the patient to sleep. This recovery is a critical stage of the operation.

Adrenalin is also used.

Interesting to note that the heart is the only muscle that beats spontaneously after it has been stopped. This even applies to a heart transported over thousands of kilometre for a transplant. Only seldom is it necessary to shock the heart back into beating.

There are hundreds of drugs which are used to balance the important triad of sleep, pain and relaxation.

It is important to get the patient up and about as soon as possible and not to practise the old Wentworth regime which was 1½ to 3 days.

A monitor is used to test the patient for pain or paralysis, known as the BIS monitor, it has only been in use for five years and has removed the previous “talking to the patient” method.

There has been a tremendous advance in the development of gadgets to assist the operating team. A small example is to use scented masks for children.

Anaesthetics are administered by either or a combination of intravenous injection, inhalation or epidural (into the spinal chord).

Drugs are used to prepare patients before going to the theatre, and these too have undergone vast improvements.

Apart from operating the heart /lung machine, the perfusionist must carefully monitor the cardiac output and waste disposal. These are even more important than blood pressure.

HIV/AIDS are always a major danger for the use and disposal of needles, masks and other materials must be disposed of with due care.

Finally, the technology of anaesthetics has come a long way in recent years and rapid advances are still pending.

In the treatment of ischaemic heart disease (IHD) research into mechanical hearts, the injection of foetus cells into the heart and drugs which will dissolve cholesterol and atheroma blockages are but a few.

Alan was bombarded with questions all of which have been incorporated in this report on his outstanding presentation. He certainly deserved the full house here this evening. Even the fridge ran out of refreshments!

Thank you

Jack Piek

Tel 031 563 3200

Minutes March 2005

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

1. WELCOME

52 As per attendance register.

2. APOLOGIES

Ian & Margaret Smith (their daughter has suddenly contracted Guilame Barré disease) Herman Davidson, Cyril Edwards, Hendrick van Rooyen, Muriel Adams, Dave Parry, Krish Moodley, Ken & Norma Monckton, Wenwood Harris, Willie van Rooyen, Bishop M.D. Biyase and Des Sutherland.

3. TESTIMONIES FROM FIRST TIMERS

a. DOUGLAS JONES (64) His annual medical check-up indicated a slightly abnormal ecg and he was referred to Dr Rob Dyer. A treadmill test followed by an angiogram revealed four blocked coronary arteries resulting in bypass surgery. Fine now but emphasized the importance of an annual check-up. Also interesting to note that his father and brother had died of heart attacks at a young age.

b. DOUG PAUL (77) A staunch member of the Club now becomes qualified as a full member having had a triple bypass on the 11 January. This is co-incidental to his wife’s’ bypass operation on the same date last year! Doug’s operation lasted three hours and was witnessed by his daughter who is a fourth year medical student. Doug has lost a lot of weight for no apparent reason.

c. RON MASTERS (71) Another long standing member had to have a repeat following surgery some years ago. One of the three grafts had blocked plus another two new grafts and a valve replacement (metal). He has recovered fully.

4. VISITATION REPORTS

a. St Augustines - Unfortunately Zed Tones who has assisted Ken Monckton has been transferred away from Durban. Ken is also finding difficulty in attending to his visitation duties. We are fortunate in having our new member Doug Jones volunteer to fill the gap. He will be inducted by Jack very soon. Many thanks Doug! A very rewarding commitment.

b. Westville - Les Bolt reported that they had visited 300 patients last year. He is ably assisted by Tony Ries & Des Sutherland.

c. Entabeni – Chris O’Flaherty & Jack are being encouraged and appreciated by the courteous nursing staff and continue with their bi-weekly visits.

5. MEMBERSHIP AND FINANCE

The increased subs to R25 per annum are being paid but there are still many outstanding subscriptions. These were due on the 1^st January.

Please do not send cheques to Jack, but to:

The Natal Bypass Club

P O Box 1805

New Germany 3620

Alternatively, deposit into the following bank account:

Standard Bank – Savings Account

Pinetown Branch

Account No 257360549

But please follow this with a phone call or fax to Les Bolt 031 7013435. This is most important. Thank you.

Les took Jack to task for his bad reporting following the last meeting. R769 was not a balance at the end of last year but a carry over. In fact, our present balance is R8079, which is remarkable considering the costs of our printing and postages, refreshments, etc.

This leads us to a recommendation by Les that we should use R6000 for the compilation, publication and distribution of a booklet for the benefit of patients and families and which will cover and answer the repetitive queries we have had over the years during our hospital visits and at our meetings. This proposal led to a lengthy discussion. Some members felt that we should not delve into our healthy bank balance but rather seek sponsorship from say Hudson & Knight.

The final decision was that Les will chair a sub-committee of which Jack and Chris and others will assist in the content and compilation before approaching sponsors. The ball is now firmly in Les’s court but Jack must apologise for the increase in subs, which, with hindsight, was not necessary. Nevertheless, there have been no complaints. Indeed the subs plus donations have been forthcoming. Thank you.

6. GUEST SPEAKER – JENNI RIVETT

Because the electronic equipment was incompatible with Jenni’s program at the November 2004 meeting, we made a point of rectifying this at this evenings’ meeting. We set up the hospitals equipment comprising laptop computer and projector which seemed fine, but when Jenni tried to project her program it didn’t work! Then we tried to connect Jenni’s laptop to the projector but the patch cord didn’t fit. So once again, Jenni had to give her presentation without visuals. How very frustrating!

Unfazed, Jenni spoke to us thus:

Nutrition

We are all different and respond differently to certain foodstuffs. Some will be allergic, others not. Our digestive systems differ from person to person.

Best way to eat is to keep it simple. Jenni hopes that by the end of her talk, she will give us better choices for dieting.

Dieting Disasters

1. We try to diet 100% of the time and when we fail, we go into a slump.

2. It is impossible to adopt an “all or nothing” approach. We say, “From Monday, I am going to go on a strict diet” and the good resolution is soon broken and then another and another is made.

3. We succumb to the gimmicky promotions and when we come off them, our weight goes up to more than it was before.

4. We become bored with exercise because we don’t do them correctly.

South Africans have become lazy. They use cars because there is a lack of public transport which would entail walking to railway stations, bus stops, etc.

We lead a very social life and our level of activity is not high enough to sustain it.

Keeping active is better than one hour in the gym.

Thus there is a cumulative effect of the big picture.

We are becoming duped into joining gyms, buying machines, etc.

Cutting Out Dietary Fats

It is a fallacy to believe that cutting out all fats will reduce, e.g. Heart disease. A very low fat diet results in powerful craving and binges.

All carbohydrates that we eat result in an increase in blood sugar levels and an increase in insulin secretion. When the resultant blood sugar drops as a result of this secretion we are subject to peaks and valleys of blood sugar and this must be broken. Moderation in everything you eat is the answer.

Here are a few tips on healthy eating:

We are eating too many processed foods and our systems cannot cope particularly because our activity levels have dropped.

We should consciously make an effort to eat less. Here are a few ways to do this.

Eat Nature’s Source mixed berry muesli and also orange & cinnamon & banana with skim or 2% milk.

Oat porridge and rye bread are good,

Eat low glycemic index foods as per food labels. For comprehensive information on this, try to buy “The Holford Diet” book which is the best publication on health and dieting.

Don’t eat bread, pasta, potatoes and rice at night as this causes lethargy the next morning. (They cause high secretion of insulin).

Eat carbohydrates early in the day.

Don’t skip meals as this causes fluctuations in blood sugar levels.

Always have breakfast.

Always have snacks handy. Best is almonds which cost R59.99 at the Hypermarket. Very good. Also an apple in the morning will boost magnesium. Other nuts tend to have a high fat content.

At 5 p.m. eat a red grapefruit.

Try to have 4 to 5 alcohol free nights per week or 1 to 2 glasses of wine maximum.

Do not exceed one cup of coffee or two cups of tea per day. They cause dehydration which should be avoided and can be evidenced to dark urine, small volumes of urine, elevated heart rate and headaches.

Water is the only medium with which to combat dehydration.

Note dehydration caused by too much blood sugar results in an afternoon slump.

Aim at 2 litre of water per day, but very gradually move to this level by starting at ½ litre per day and increasing this by ½ litre per day each week until the desired goal is reached.

The body is unable to digest the chemicals in canned drinks.

Fruit juices have a high glycemic index.

We are victims of our taste buds.

Consistency in eating the correct foods is the answer. Adopt the 80/20 principle, i.e. the right food 80% of the time. If you binge today and go back to your diet tomorrow, that’s ok. The occasional treat will not harm you.

Try to eat 3 to 4 different fruits per day but beware of acid fruits which cause you to be edgy.

Alkaline fruits and salads are good.

Very important for bypass survivors is Omega 3 daily – taken in capsule form.

Jenni was thanked in our usual warm sincere way for giving us so much “Food for Thought”.

Jack added his personal thanks with a kiss and a hug. “Eat your heart out guys!”

Finally here are two stories to share with those who were unable to attend the meeting:

JENNI’S JOKES:

A wife who is very concerned about her husbands’ weight and fitness tells him that walking is the answer so she tells him: “I want you to walk 2 km in the morning and 3 km in the evening.”

After seven days he phones and says “I am now 35 kms from home and I’m tired and hungry, how much further must I walk?”

Then there was the women very dissatisfied with her figure when she looked in the mirror and said to her husband. “Just look at me, I have no waistline, my bottom is big and sagging, my thighs are flabby and my boobs are facing south. Is there nothing about me that hasn’t changed since we married?”

“Yes there is” answered hubby, “your eyesight!”

FOOTNOTE:

To all Lipitor users

Enclosed with previous minutes you received an application to join Pfizer’s Wellness program. I have just received my first package with comprehensive notes and a handsome folder in which to file future literature. Many aspects of how to combat heart disease, risk factors, etc. etc. are covered. Do think of joining, you won’t regret it. I still have forms if you’ve lost yours.

Thank you

Jack Piek

Tel 031 563 3200

Minutes January 2005

MINUTES OF THE NATAL BYPASS CLUB HELD IN THE CONFERENCE ROOM OF THE ENTABENI HOSPITAL, DURBAN ON WEDNESDAY 12 JANUARY 2005.

1. WELCOME

52 As per attendance register.

2. APOLOGIES

Muriel Flowers, Ken Monckton, Piet & Betty Schabort, Mavis Brune, Peter Perott, Roy Buckland, Peter & Jacqui Lezard, Athol Morris, Christine & Alex Jeffrey, Stewart & Carol McKay, Malcolm Fraser.

3. TESTIMONIES FROM FIRST TIMERS

a. NIGEL ATKINSON (75) Showed no symptoms but during a routine check up his pulse behaved “strangely”. A visit to David Gillmer resulted in a treadmill test and an angiogram which revealed 3 blocked arteries and an immediate triple bypass. After this his pulse raced up to 140 and was stabilized with shock treatment. He is fine now.

4. VISITATION REPORTS

a. St Augustines - Zed Tones is kindly assisting Ken Monckton and reported that in 17 weeks he has visited 18 patients of which two were females.

b. Westville - Tony Ries & Les Bolt reported a quiet festive season and that as usual they had full co-operation from the hospital staff.

c. Entabeni – Chris O’Flaherty & Jack had very much the same to report about the Entabeni except that Jack had regularly visited Gaeton Bax one of our earliest members who required a heart transplant which however was not forthcoming and he died on the day after Jack’s last visit on Monday. Jack attended the Requiem Mass and Chantal (Gaeton’s widow) expressed her appreciation for what the Bypass Club did for Gaeton.

This brings us to two special long-standing members who are in the audience Doug Paul and Ron Masters were both admitted to the Entabeni today and have been prepared for surgery tomorrow. Robert Kleinloog told them in the ward that they should attend our meeting and chased them upstairs! Doug Paul has to have a triple bypass (he had angioplasty and a stent some time ago). Ron Masters has to have a “re-do” following bypass surgery some time ago. He also had to have a valve replacement.

(Jack visited them four days later and they were both doing well.)

5. RAFFLE

As usual very well supported by all and won by Vernon Wilson (a member for 20 years!)

6. LIPITOR

Included in the minutes of last meeting, all members have received an application form from Pfizer which you are invited to complete if you are taking Lipitor. The benefits will be:

a. Free Quarterly educational and support materials to promote healthy heart living.

b. Quarterly News Bulletins

c. Compliance rewards, including a free Lipogram

Members are urged to avail themselves of this free offer.

7. VENUE

Jack was advised that the cost of hiring the conference room was R500, but in appreciation of our support to patients, this would be waived. However, the refreshments in future would have to be paid for.

In accepting this arrangement, we are sorry to increase our annual subs by R5 to R25 per annum. As this is the first increase in 21 years since the Clubs formation, members were very understanding and supportive. Please, please note that all subs are payable on 1 January 2005.

8. MEMBERSHIP AND FINANCE

In his usual inimitable and entertaining presentation, Les reported on:

Membership

a. He has been our treasurer for 19 years and is looking for a successor (Fat chance!!)

b. We have 200 members comprising 191 paying and 9 complimentary or honorary members by virtue of their professions such as specialists, cardiac high care sisters, etc.

c. Last year we had a big “clear out” of members who had not paid for two years.

d. All members are requested to please pay their subs which are due on 1 January 2005.

Finances

Our income from subs, donations, raffles and sale of anti-oxidants was R7433 and our expenditure which comprises stationery, postage, complimentary lunches for V I P guests and the whisky for raffling was R6664.

This gave us a balance of R769 with which to start our new year.

(For interest, the refreshment bill for this evenings meeting was R350, which will justify the R5 increase in subs. Thank you)

Les reminded us that Geoff Stuart does not charge for his service in printing our minutes, cards, envelopes etc., only for materials. We applaud Geoff in his absence.

9. GUEST SPEAKER

Dr “Mac” Robertson corrected Jack by reminding us that he was not a specialist “but just a G.P.” who has a keen interest in Diabetes and Sexual Problems which will be the main focus of tonight’s’ address.

This is what Dr Mac Robertson covered:

In commenting on Jack’s reference to Lipitor, there is no generic for Lipitor but there is for Zocor, which is also a statin.

By and large all statins are the same i.e. have the same action in lowering cholesterol.

Also, he corrected Jack about the pharmacy chain Sparkport (Jack had told members that because Sparkport was a wholesaler their pharmaceuticals were much cheaper than other pharmacies and that many of his A.R.P. & P. members had changed.) Dr Mac told us that the secret of Sparkports’ success is that they operate on a Pick & Pay principal and have branches everywhere and buy in bulk and are able to waive admin and other charges levied by pharmacies.

DIABETES

The incidence and magnitude is far greater than HIV/AIDS but the main difference is that it is treatable. However, in spite of this, very many patients are not receiving the treatment that they should.

As a striking example, the members of the RSA parliament agreed to be tested and 35% were found to be diabetic without their knowledge!

There are two types of diabetes:

TYPE 1 generally affects youngsters. They eat and drink “like a horse” and still lose weight. They can lose 10 kg from a weight of 26 in two weeks and are easy to diagnose early. They do not have a high blood sugar contents and need insulin injections for their whole life.

Type 1 is fundamentally a Caucasian disease and not found much in the Black population.

There is a marked decrease in the incidence from Europe towards the Equator.

It is important to realise that sugar does not cause diabetes.

TYPE 2

This is very different to Type 1.

It is a silent disease, which has no obvious symptoms, but after many years, the patient will have a high blood sugar content and start suffering from thirstiness and lassitude.

Very often by the time it is diagnosed, complications have already set in.

All diabetics have complications viz., strokes, deafness, blindness and hearing damage.

It affects male sex organs in causing erectile dysfunction. The mechanism which causes this is similar to what causes cardiac disease. Therefore diabetics should be examined by cardiologists.

Doctors should be suspicious if the patient has one or more parents which is diabetic. If one parent, the likelihood is 25% and if both parents, then as high as 100%!

Women are sometimes protected until menopause but if diabetic they have a higher risk of heart disease than males.

As heart disease is often silent, i.e. asymptomatic, Mac often insists on an angiogram when his patient is diagnosed as diabetic. He is always on the lookout, particularly if the parents were diabetic.

There is a strong association between sexual problems and cardiac artery disease (CAD)

Diabetics are very badly managed.

What precipitates diabetics?

You start putting on weight at middle age which is caused by eating the same amount of food when you were younger or more active.

The danger symptoms for a women is when she starts putting on weight around her tummy like a man and not around her bottom. Intra abdominal fat predisposes diabetics to heart disease. Recommendation is to walk 20 minutes each day.

Chinese women walk a lot and have a much lower incidence of diabetics than the people of many Western countries.

Instant management of diabetics is a change in lifestyle.

Many sportsmen become diabetics because of the change on their exercising intensity.

When a diabetic is diagnosed a doctor should not prescribe medication but send the patient to an ophthalmologist and if necessary to a cardiologist who alas, often have patients referred to them only after they have shown symptoms of heart disease.

The prevalence of diabetics should be between 3 & 5% but in certain older people it is as high as 68%.

The carotid arteries take blood and therefore oxygen to the brain and blood sugar is as essential.

At 18, the carotid arteries are 100% open and take the required 5 milli-mols of sugar to the brain per second.

However, at 70, the carotid arteries are only 50% open and therefore there is a shortage of blood sugar to the brain. This often causes dementia (“patient becomes ga-ga”)

But this can be aggravated by a patient given the wrong treatment for his diabetes causing an acute starvation of blood sugar to the brain and increased dementia.

Finally, Glycomen should never be prescribed for diabetics who are overweight (We had a member with us who conformed to this dangerous situation).

The diagnosis at chemists are unreliable and diabetes should be diagnosed by a blood test. The normal sugar in urine should be from 4 to 6 milli-mols where 11 and over is high.

The meeting ended with an enthusiastic applause to thank Mac for his fine thought provoking address.

For interest, several members phoned Jack to asks for Dr. Mac Robertson’ telephone number, Obviously, he sowed the seed at the meeting.

Thank you

Jack Piek

Tel 031 563 3200