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 – 1st 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
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