NATAL BYPASS MEETING 02/2008 held on
WEDNESDAY 7 MAy 2008
AT ENTaBENI HOSPITAL
at 17:30
PRESENT:
Shane Newman (Chairperson)
Shirley Piek (Secretary)
Chris O’Flaherty (Member)
As per attendance register
1. OPENING AND WELCOME
Shane Newman welcomed all present.
2. APOLOGIES:
The following people had given their apologies:
Dr Piet Schabort, Doug Geiling, Mike & Shirley Attridge, George Barns, Neville Nicholson, Danny Naidoo, Carol & Stuart MacKay, Ron Masters, Gerd Ackermann, Sam Wallace, Athol & Shirley Willett, Enid & Don & Fiona Phillips, Sam Wallace, Muriel Adams, Neal & Jenny Mc Innes, Jackie Miller & Harold Milan.
There had been an improvement with numbers and Shane apologized for no agenda going out for the March 2008 meeting. Numerous adverts had been placed in newspapers around KZN & on ECR.
3. TESTIMONIES FROM NEW VISITORS
Jim Brown (64)
Jim had a triple bypass in March 2006. His symptoms where that while walking to get his newspaper, he thought he had developed tennis elbow. After ECG & Angio tests he was advised that he needed possible stents or a possible bypass, but there was a waiting period of 3 to 5 months. In Bristol however, a private doctor was prepared to do the operation & wanted to know from Jim when he would like it done. The biggest problem Jim had after the operation was his leg (grafting) and his observation skills – memory. He was very thankful that there was a support club like the Bypass Club – welcome Jim !
Richard Hope
Richard has always been very fit – keen runner & squash player. He started getting breathless in the garden & started to get body warnings that there was something not right while playing squash. While walking in Lisbon, he started to feel weird and in Oct 2007 consulted a cardiologist, when an angiogram revealed that he needed bypass surgery. Richard 4 CABG done and now feels limited & frustrated with regards to what he can now do with his body.
4. IN ATTENDANCE:
Peter & Julien Rogan – PACE (Prevent Arrhythmic Cardiac Events) - Guest speakers.
5. VISITATION REPORTS
Shane mentioned that he had looked back at the previous minutes of the club and ascertained that Mr Ron Masters had volunteered to do the St Augustines & Entabeni hospital visits. Mr Ron Masters had also discussed the matter telephonically with Shane & Mr Masters could not be in a position to carry out the visitations. If there are any volunteers who would like to represent the Bypass club at either or both of these hospitals, please contact Shane.
5.1. St Augustines
There was no representative to give a report.
5.2. Entabeni
Chris O’Flaherty said that he had visited some patients downstairs and that when he was available he would do some rounds at Entabeni. Many thanks Chris.
5.3. Westville
Shane said that he had carried out visits at hospital and there was a report available if anybody wished to look at it. Shane said that one of the reasons, that he took on this task of visiting the hospitals, was to give back to society and all the nursing staff, what was given to him when he had his bypass in 2005. He found it a very rewarding, by being able to explain to patients who find themselves in the same position as he was & now is able to give some advice and encouragement to patients.
Shane made a plea for any members of the club, who could make themselves available to give support at the Westville Hospital Heart & Health day on the 28th of May 2008, at the Westville Bowling Club.
Mr Basanth Bodasing mentioned that St Annes hospital in PMB had recently started a cardiac section and that as he lived in PMB, he would be prepared to do hospital visits there. Thank you Basanth, and we thank you for your time in being prepared to do this for the patients at St Annes.
6. RAFFEL DRAW
The raffel, was won Bernard Bryers.
7. GUEST SPEAKER
Shane introduced Peter & Julien Rogen from PACE (Prevent Arrhythmic Cardiac Events) and thanked them for attending.
PACE is a support group founded by Lusan Luscombe in 2004 after her collapsed after athletics, as a result of her heart having stopped. She sadly also lost her son, Dane to the disease.
There has previously been no awareness of this problem in SA & PACE is now the first support group.
A PACE awareness meeting was attended by some bypass members on the 4th of April this year, when Dr AO, as he is know & who describes himself as a “heart electrician”, gave a very interesting talk. If anybody is interested in the notes taken by Shane at the meeting, they can contact him for a copy.
A further talk by Dr AO, who is from Cape Town, will be held on the 5th of June at Westville. For further info you can contact Juliet on 084 205 9737.
Peter Rogan introduced himself as a very keen over 35 soccer player & surfer for over 20 years, ate well and was enjoying life to the fullest.
While working on the North Coast, after a semi final soccer match the evening before, he was not well and advised Juliet that he just needed to sleep – started vomiting, falling in & out of consciousness. His cardiologist had picked up that his heart rate was in excess of 250 beats per minute, which is the equivalent of sprinting a Comrades Marathon. As there was no Electro Cardiologist in Durban he was flown to JHB. Peter received a local anesthetic and some “short circuiting” was preformed on him to try and establish, what & where the problem was of this excess heart rate.
One & half years later, Peter once again had to be cardio inverted (shocked) at work, where there was no recordable heart beat as it was “off the graph” and his body collapsed again.
Peter eventually was introduced to Dr A. Okreglicki (AO) in Cape Town (Groote Schuur), whereby after numerous tests, a ICD (Implantable cardioverter defibrillator) was inserted, which is a miniature “hospital” for sufferers, whereby it shocks the heart and is triggered when the heart is going to go out of rhythm. ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy) is genetic & is the replacement of normal right ventricular muscles cells by fibrous tissue and fat, which can disturb the electrical pathways in the heart & lead to life threatening chaotic heart beats.
Peter has been seen amongst other surfers to leap a foot out of the water, when this ICD has had to work, not that this is a common occurrence and after such a shock from the ICD Peter needs to go to hospital to be checked. Peter has on one occasion, in the presence of his wife, had the ICD shock him 10 times within 15 minutes. He is on numerous medication for his disease.
Peter went on to say that his 11 year old daughter is a ARVC sufferer, and would need to be watched.
Peter has had to stop all his sport and went on to say that we take life for granted & when something like this happens to ones life, you realize just what we have been given.
The testimony by Peter was well received by all present and we thank Peter and Juliet Rogan for coming to share with the club and wish them all the success with PACE.
8. GENERAL
8.1. Blog Site
There is a blog site were the minutes and agenda of the meetings can be viewed. The address is http://natalbypass.blogspot.com/
8.2. Members contact details
It was requested that each member check that their personal particulars were up to date and changed accordingly, on the lists that were provided.
8.3. Distribution of Minutes
As it was becoming more costly to send minutes by post, it was requested that if people have e-mail addresses or are able to access e-mail that they please provide this information, so that the database can be updated.
8.4. Membership fees
Shane requested that if any members still have fees outstanding for 2008, that they please pay Shirley. The fee for 2008 is still R30 per person.
8.5. Committee
Nil
9. NEXT MEETING
The next meeting would be on Wednesday the 2nd of July 2008 at the Executive Conference suite at the Entabeni Hospital at 17:00 for 17:30.
Complimentary drinks and snacks will be available, to club members.
The Impilo tablets will continue to be on sale at the meeting, but should you wish to secure an order, you can place your order with Shirley Piek.
A guest speaker will be invited to come and share with the club in July, so please try & be there.
Issued by Shane Newman – 084 510 8738 or 031 708 5629 (after hours)
Chairman – Natal Bypass Club
……………………………………………………………..
Date : …………………………..
Saturday, June 7, 2008
Minutes - March 2008
NATAL BYPASS MEETING 01/2008 held on
WEDNESDAY 5 MARCH 2008
AT ENTaBENI HOSPITAL
at 17:30
PRESENT:
Shane Newman (Chairperson)
Shirley Piek (Secretary)
As per attendance register
1. OPENING AND WELCOME
Shane Newman welcomed all present and asked everybody to stand for a minutes silence in remembrance of the late Chairman of the Natal Bypass Club Jack Piek who had passed away on the 22nd of February 2008, after a short illness.
2. APOLOGIES:
Chris O Flatery – departing for overseas on holiday/business
Neville & Sissy Farr – Sissy is recovering from a hip operation
John & Pat Rider
It was noted that the turn out to the meeting was poor, but also encouraging to note that Mr Dave Perry had traveled form Port Shepstone to attend the meeting – well done Dave on your commitment & enthusiasm shown.
3. IN ATTENDANCE:
Mrs Gillian Adams – Physiotherapist & guest speaker for the evening.
4. VISITATION REPORTS
4.1. St Augustines
There was no representative to give a report.
4.2. Entabeni
There was no representative to give a report.
4.3. Westville
Shane to make enquires from both St Augustines & Entabeni representatives to ensure that visits are being made and that there be some form of report back at the Bypass club meetings.
5. RAFFEL DRAW
The bottle of whiskey, which was donated by Shirley Piek, was won by George Barnes. Thank you Shirley.
6. GENERAL
6.1. Subs
Shane requested that if any members still have fees outstanding for 2008, that they please pay Shirley. The fee for 2008 is still R30 per person.
6.2. Election of Members
Shane mentioned that Jack Piek had requested before passing on that Shane take over the running of the club. Shane mentioned that Chris O’ Flattery (member) & Shirley Piek (secretary/treasurer) have made themselves available to assist him – thank you to both of these members. If there are any other members who feel that they would be available to contribute in the running of the club or have any concerns, they can please contact Shane.
6.3. Updating Membership Details
It was requested that each member check that their personal particulars were up to date and change accordingly, on the lists that were provided.
6.4. Election of Members
Those present were asked if the same venue as last year function (viz: Durban Country Club) should be booked again for November/December 2008. It was agreed and Shirley would make contact with DCC and make a booking.
7. GUEST SPEAKER
Gillian Adams is a UK Charted & SA Registered Physiotherapist with a special interest in hydrotherapy & fitness rehabilitation. She was awarded an honorary certificate in Aquasize Instruction by the SA Water Fitness Association in 1983 for her contribution to the promotion of water fitness in South Africa. Gillian has assisted with Cardiac rehabilitation Phase IV at two of NHS hospitals & attended 4 post graduate courses in hydrotherapy. She received her masters degree in Sports Medicine at RAU in 2004 & the subject of her research was the feasibility of cardiac rehabilitation in water, which she also presented at the International Society of Medical Hydrology Conference in Istanbul in June 2006.
Gillian proceeded to show two PowerPoint presentations, one being of particular interest to the members on hydrotherapy.
Some of the salient points from her presentation on Cardiac Considerations with Immersion were as follows :
… Pressure increases with depth. At 1 metre depth, pressure on ankles is 10% more than on the surface = double layer of tubigrip - Useful for those swollen ankles as this pressure assists blood back to the heart = Preload
… How does this affect exercise in water?
o The relevance concerns how the heart handles Preload
o Preload lying down = standing in water up to the waist, 130ml
o Immersion: 700ml fluid moves upwards in 6 seconds= approx 7 heartbeats: ¼ stored by the heart, the rest in the large thoracic veins and pulmonary circulation.
o The heart rate decreases
o The heart beats smarter, not harder
o Cardiac output increases 30%
… Guidelines for exercise in water:
o Heart condition must be STABLE
o Low & medium risk patients, ejection fraction >30%
o Chest depth is generally safe - (Severe MI and CHF can exercise UPRIGHT, no deeper than the xiphoid if sleeping flat can be tolerated)
o Gradual entry, don’t leap in or out!
o Rather not use step-up and down exercises (fluctuating preload and heart volume)
o Be aware of ‘masked’ angina
o Keep meds next to pool
o Talk test useful, exercise at 60-75%MHR (THT…)
o Swim if previously a swimmer, not alone
o Don’t swim underwater
o Avoid extreme water temperatures - below 16˚C Absolute Contra-Indication
o Rest in sight afterwards for 15 mins, recovery rate NB - Adrenal hormones are raised during vigorous exercise and take a little while to go back to normal. If the person with heart problems does not rest he may experience some irregularity of the heart beat and become distressed
… Calculation of Heart Rate - 4 methods:
o % true HRmax
o Karvonen: calculates Heart Rate Reserve and should use the true HRmax * tables available - (HRR = HRmax - HRrest)
o Age adjusted method: 220-age
§ 20-30 beats above RHR = require an actual measurement of Hrmax from your doctor
o Talk test is practical
… Recovery rate is still the best way to measure how well a heart is doing
o Return 10 beats from resting heart rate within 5 minutes after exercise - can take a little longer in older people
… Check with your doctor, listen to your body, relax and enjoy !
General comments from Gillian :
o Heart & other conditions must be stable and your doctor’s permission is essential before any exercise.
o We as bypass patients must not get complacent, after the operation
o People are more comfortable in water than in a gym
o Water walking (moving of arms and legs under water, as if walking) is sufficient exercise for cardiac patients.
o Get to know your body of what it can do, your resting heart beat, maximum & how quickly your heart beat returns to normal after exercise – any anomalies should be pointed out to your cardiologist or doctor.
o Don’t hold your breath when you pick up things.
o Remember with all exercise to warm up all your muscles, which includes your heart muscles.
o A program of two sets of 10 minutes three times a week is sufficient
o The pressure under the water pushes you Blood Pressure (BP) up.
o In order to realize what your maximum & minimum BP is subtract your age from 220 & multiple by 60% for the minimum and 75% for the maximum i.e. 220 – 60 = 160 * 75% = 120
o Don’t swim alone & not under water
o Rest, re-hydrate and rest.
Questions were raised by those present and the meeting was closed.
8. NEXT MEETING
The next meeting would be on Wednesday the 7th of May 2008 at the Executive Conference suite at the Entabeni Hospital at 17:00 for 17:30.
Complimentary drinks and snacks will be available, to club members.
The Impilo tablets will continue to be on sale at the meeting, but should you wish to secure an order, you can place your order with Shirley Piek. Thanks Shirley for providing this service to the members.
A guest speaker will be invited to come and share with the club in May, so please try & be there.
Issued by Shane Newman – 084 510 8738 or 031 708 5629 (after hours)
Chairman – Natal Bypass Club
……………………………………………………………..
Date : …………………………..
WEDNESDAY 5 MARCH 2008
AT ENTaBENI HOSPITAL
at 17:30
PRESENT:
Shane Newman (Chairperson)
Shirley Piek (Secretary)
As per attendance register
1. OPENING AND WELCOME
Shane Newman welcomed all present and asked everybody to stand for a minutes silence in remembrance of the late Chairman of the Natal Bypass Club Jack Piek who had passed away on the 22nd of February 2008, after a short illness.
2. APOLOGIES:
Chris O Flatery – departing for overseas on holiday/business
Neville & Sissy Farr – Sissy is recovering from a hip operation
John & Pat Rider
It was noted that the turn out to the meeting was poor, but also encouraging to note that Mr Dave Perry had traveled form Port Shepstone to attend the meeting – well done Dave on your commitment & enthusiasm shown.
3. IN ATTENDANCE:
Mrs Gillian Adams – Physiotherapist & guest speaker for the evening.
4. VISITATION REPORTS
4.1. St Augustines
There was no representative to give a report.
4.2. Entabeni
There was no representative to give a report.
4.3. Westville
Shane to make enquires from both St Augustines & Entabeni representatives to ensure that visits are being made and that there be some form of report back at the Bypass club meetings.
5. RAFFEL DRAW
The bottle of whiskey, which was donated by Shirley Piek, was won by George Barnes. Thank you Shirley.
6. GENERAL
6.1. Subs
Shane requested that if any members still have fees outstanding for 2008, that they please pay Shirley. The fee for 2008 is still R30 per person.
6.2. Election of Members
Shane mentioned that Jack Piek had requested before passing on that Shane take over the running of the club. Shane mentioned that Chris O’ Flattery (member) & Shirley Piek (secretary/treasurer) have made themselves available to assist him – thank you to both of these members. If there are any other members who feel that they would be available to contribute in the running of the club or have any concerns, they can please contact Shane.
6.3. Updating Membership Details
It was requested that each member check that their personal particulars were up to date and change accordingly, on the lists that were provided.
6.4. Election of Members
Those present were asked if the same venue as last year function (viz: Durban Country Club) should be booked again for November/December 2008. It was agreed and Shirley would make contact with DCC and make a booking.
7. GUEST SPEAKER
Gillian Adams is a UK Charted & SA Registered Physiotherapist with a special interest in hydrotherapy & fitness rehabilitation. She was awarded an honorary certificate in Aquasize Instruction by the SA Water Fitness Association in 1983 for her contribution to the promotion of water fitness in South Africa. Gillian has assisted with Cardiac rehabilitation Phase IV at two of NHS hospitals & attended 4 post graduate courses in hydrotherapy. She received her masters degree in Sports Medicine at RAU in 2004 & the subject of her research was the feasibility of cardiac rehabilitation in water, which she also presented at the International Society of Medical Hydrology Conference in Istanbul in June 2006.
Gillian proceeded to show two PowerPoint presentations, one being of particular interest to the members on hydrotherapy.
Some of the salient points from her presentation on Cardiac Considerations with Immersion were as follows :
… Pressure increases with depth. At 1 metre depth, pressure on ankles is 10% more than on the surface = double layer of tubigrip - Useful for those swollen ankles as this pressure assists blood back to the heart = Preload
… How does this affect exercise in water?
o The relevance concerns how the heart handles Preload
o Preload lying down = standing in water up to the waist, 130ml
o Immersion: 700ml fluid moves upwards in 6 seconds= approx 7 heartbeats: ¼ stored by the heart, the rest in the large thoracic veins and pulmonary circulation.
o The heart rate decreases
o The heart beats smarter, not harder
o Cardiac output increases 30%
… Guidelines for exercise in water:
o Heart condition must be STABLE
o Low & medium risk patients, ejection fraction >30%
o Chest depth is generally safe - (Severe MI and CHF can exercise UPRIGHT, no deeper than the xiphoid if sleeping flat can be tolerated)
o Gradual entry, don’t leap in or out!
o Rather not use step-up and down exercises (fluctuating preload and heart volume)
o Be aware of ‘masked’ angina
o Keep meds next to pool
o Talk test useful, exercise at 60-75%MHR (THT…)
o Swim if previously a swimmer, not alone
o Don’t swim underwater
o Avoid extreme water temperatures - below 16˚C Absolute Contra-Indication
o Rest in sight afterwards for 15 mins, recovery rate NB - Adrenal hormones are raised during vigorous exercise and take a little while to go back to normal. If the person with heart problems does not rest he may experience some irregularity of the heart beat and become distressed
… Calculation of Heart Rate - 4 methods:
o % true HRmax
o Karvonen: calculates Heart Rate Reserve and should use the true HRmax * tables available - (HRR = HRmax - HRrest)
o Age adjusted method: 220-age
§ 20-30 beats above RHR = require an actual measurement of Hrmax from your doctor
o Talk test is practical
… Recovery rate is still the best way to measure how well a heart is doing
o Return 10 beats from resting heart rate within 5 minutes after exercise - can take a little longer in older people
… Check with your doctor, listen to your body, relax and enjoy !
General comments from Gillian :
o Heart & other conditions must be stable and your doctor’s permission is essential before any exercise.
o We as bypass patients must not get complacent, after the operation
o People are more comfortable in water than in a gym
o Water walking (moving of arms and legs under water, as if walking) is sufficient exercise for cardiac patients.
o Get to know your body of what it can do, your resting heart beat, maximum & how quickly your heart beat returns to normal after exercise – any anomalies should be pointed out to your cardiologist or doctor.
o Don’t hold your breath when you pick up things.
o Remember with all exercise to warm up all your muscles, which includes your heart muscles.
o A program of two sets of 10 minutes three times a week is sufficient
o The pressure under the water pushes you Blood Pressure (BP) up.
o In order to realize what your maximum & minimum BP is subtract your age from 220 & multiple by 60% for the minimum and 75% for the maximum i.e. 220 – 60 = 160 * 75% = 120
o Don’t swim alone & not under water
o Rest, re-hydrate and rest.
Questions were raised by those present and the meeting was closed.
8. NEXT MEETING
The next meeting would be on Wednesday the 7th of May 2008 at the Executive Conference suite at the Entabeni Hospital at 17:00 for 17:30.
Complimentary drinks and snacks will be available, to club members.
The Impilo tablets will continue to be on sale at the meeting, but should you wish to secure an order, you can place your order with Shirley Piek. Thanks Shirley for providing this service to the members.
A guest speaker will be invited to come and share with the club in May, so please try & be there.
Issued by Shane Newman – 084 510 8738 or 031 708 5629 (after hours)
Chairman – Natal Bypass Club
……………………………………………………………..
Date : …………………………..
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