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