Minutes - Sep 2007

MINUTES OF THE NATAL BYPASS CLUB HELD AT THE ENTABENI HOSPITAL
ON WEDNESDAY THE 12 SEPTEMBER 2007

PRESENT:
62 as per attendance register.

APOLOGIES:
Joan Perkins, Barnie Barnard, Pat Draper, Neville & Cissie Farr, Glen Bruton, Marie Leslie, Piet Schabort, Doug Tomes, Herman Davidson, Tony Schultz and G. Moodley.

ACKNOWLEDGEMENTS:
(a) Our sincere thanks to Leon & the Catering Staff of the Entabeni to once again stock the fridge with a comprehensive assortment of refreshments and also the snacks which were most welcome at this time of the day.
(b) Also to Chris O’Flaherty for the supply of red wine which helps us to operate within budget?

SPECIAL BIRTHDAYS:
To Doug Paul & Enid Phillips who celebrated their 80th birthdays on the 9th August. Welcome to the O.B.E. Club (Over Bloody Eighty!)

ANNUAL CLUB LUNCH:
Venue: Durban Country Club
Date: 18 November
Time From 12 noon
Dress: Casual, men no ties or shorts
Cost: R60 payable IN ADVANCE to: Natal Bypass Club and posted to:
J. Piek, 14 Furn Ridge, 1 Burne Crescent, GLENASHLEY 4051

Regret that only paid up reservations will be made.
From the list that was circulated it was clear that at least 90% of the members present would participate in the buffet lunch. As customary, members of the surgical, medical and catering staff will be invited. Guests of members are very welcome.

TESTIMONIES FROM FIRST-TIMERS:

JOAN GREGORY (74)
An enthusiastic Tennis player but engaged in a highly stressful occupation suffered cramping in her chest and breathlessness. Refused to accept that it could be heart-related and thought that physio would cure her problem particularly when an e.c.g. appeared normal. Nevertheless she was referred to a cardiologist when an angiogram revealed 4 partial blockages. These were successfully bypassed and Joan is taking Lipitor, Sectral and a diuretic post operatively.

“ISH” DURSEN (62)
Thought that his discomfort was due to ulcers but he also suffered pains across his chest which became progressively worse and culminated in a mild heart attack and from Parklands he was transferred to St. Augustine where he had a 4 way bypass in 1999 Very well now.

ENID PHILLIPS (80)
Suffered from severe hypertension at aged 76 and was consulted by Kevin O’Connell on a Friday and had a double bypass on the Monday. Unfortunately Enid also suffered a benign brain tumour which required 20 days altogether in hospital. She’s bright, chirpy and grateful now that it’s all behind her.
VISITATION REPORTS:
(a) St. Augustine’s: The bad news from our consultant Doug Tomes is that he has serious circulation problems in his one leg and has to withdraw from his duty at St. Augustine’s. PLEASE if any member is prepared to sacrifice one hour of his/her time per week please contact Jack and help him with this necessary and very rewarding dedication. Without a volunteer, Jack will have to attend to both hospitals which are not very close to Jack’s home. Thank you.
(b) Westville: Once again Shane Newman has been very very busy and has submitted a detailed written report to Jack. His devotion to his responsibility is most touching.
(c) Entabeni: Chris O’Flaherty has seen patients before their operation and this has been highly appreciated. Jack has received warm welcome from staff and patients.

GUEST SPEAKER: Dr. Kevin O’Connell.
As a well known cardiologist Kevin required no formal introduction and has addressed our club on several previous occasions. By way of introduction Kevin said that whereas there have been relatively few innovations, research with heart disease is still higher than any other.
As regards surgery probably the most dramatic recent innovation is Robotic surgery which can be performed by an operator many miles away from the bypass patient. The down side however is that it takes longer and that the system is too expensive to be affordable by most countries. Kevin described it as “gimmicky”.
There have been fairly dramatic improvements in valve replacements which can now be done sub-cutaneously i.e. through the groin as per angiograms and stents.
Kevin conceded that modern medical technology has had a marked effect on the Population Pyramid which has gone from the recognized pyramid shape with the maximum population of young people at the base leading to the apex comprising the elderly. This has changed to a “pyramid” with the sides sloping outwards! This has been caused in certain countries with negative population increases (growth).
Returning to surgery, the mid-cab operation where bypass surgery is performed on a beating heart with the incision made between the ribs, has fallen from favour due to the high level of pain compared to the sternum incision which however is considerably shorter than previously. Furthermore, the long incisions for the harvesting of the leg (saphenous) veins has made way for smaller and les drastic incisions.
Cardiology: There have been marked improvements in the use of stents. Years ago the solid stents tend to promote PLAQUE deposits. To a large extent these have been superseded by “chicken wire mesh” stents which have been further improved by locking in an anti-plaquing agent with a polymer which dissolves when in contact with bodily fluid. This has been extremely effective in prolonging the efficiency of stents in favour of invasive bypass surgery. It has also reduced the dosage of the anti-clotting agent Plavix from life-time to a much shorter period.
The cardio-vascular surgeon and cardiologist are a team and work very closely to decide on the best method to use in the case of cardio-artery disease.
Stents are being very successful in releasing blockages in other arteries such as in the legs and the carotid arteries leading to the brain.
Medicinal: Statins are widely used and have been proved to promote the best safety profile in the world. They are very safe and the most effective preventative in the reduction of cardio-vascular disease.
There is no validation that other preparations such as flaxseed oil have any benefits.
Heart disease per se is not genetically motivated but can influence the distribution of arterial disease.
50 – 60% of patients who have cardio or arterial disease have normal cholesterol.
C.T. Scans cannot possibly support the claim that they prevent heart attacks. The problem seems to be that hospitals try to justify their enormous capital cost (R1million) & R8000 per procedure, by promoting their use as a diagnostic tool. They cannot replace the tried and tested diagnosis resulting from stress tests (treadmill) and angiograms.
This concluded a most informative and entertaining presentation by Kevin O’Connell who was thanked by our usual prolonged applause.
The club is indebted to the very busy medical specialists who give of their valuable time graciously.
Jack Piek
(Chairman)