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You’ll Get the Truth Only If There Is Money To Be Made
A
letter from the Cardiovascular Center of St. Helena Hospital
reminded me of how patients learn the truth. (St. Helena
Hospital in Napa Valley California was the location of my
clinic for 16 years from 1986 to 2002.)
Here
is what the letter said:
“Question: Are you seeing patients with post-operative CABG
cognitive dysfunction?
Answer: At St. Helena Hospital, we decrease the incidence of
stroke and changes in cognitive function by performing
beating heart surgery…”
In
other words, your patients’ brains will be less damaged
(cognitive dysfunction) by our new procedure (beating heart
surgery) compared to the traditional bypass surgery (CABG =
Coronary Artery Bypass Grafting). Patients who see this
letter should be asking, “What brain damage? How come I
never knew bypass surgery caused brain damage?
The
first time I wrote about the brain damage caused by the
heart-lung machine (the bypass pump) used in all traditional
bypass operations was in my book McDougall’s Medicine—A
Challenging Second Opinion, published over 20 years ago
(1985). I would estimate that since then more than 7
million people in the US alone have suffered brain damage—and hardly a
single one of them was ever informed of this universal
complication prior to having the operation.
For
more than 20 years I have been talking on radio and TV, and
writing about this closely guarded medical secret. In that
time I have never met a patient who had been informed that
he or she was likely to never be the same after spending
time on the pump. Over the years I have confronted many
heart surgeons and cardiologists—all have minimized the
importance of this damage and many have denied it even
occurs—denied it to me and to their patients. The deception
ends now with the introduction of a new medical business,
“off-pump” beating heart surgery. This surgery repairs the
heart arteries without stopping the heart and without
placing the patient on the bypass pump.
Research Compares Procedures
The
December 20/27, 2005 issue of the American Heart Association
journal Circulation published the most recent
findings on the brain-damaging complications of bypass
surgery.1 Researchers compared the brain after
the traditional bypass (which uses the pump) with the brain
after the “off-pump” (beating heart) surgery by examining
the blood vessels in the back of the patients’ eyes
(retinas) for damage (emboli, leaks, hemorrhages, etc.). Of
those who were on the pump, 5 of 9 patients had damage,
whereas none of those undergoing heart surgeries without the
use of the pump had eye damage.
The
eye is an extension of the brain; therefore these findings
reflect injury that occurs throughout the brain. This
damage is caused by embolization of bits of debris (emboli)
released during the bypass surgery. Examining an artery that
supplies the brain (the middle cerebral artery) with an
ultrasound machine, doctors could “see” this debris 20.3
times more frequently during “on-pump” bypass surgery than
during the “off-pump” procedure.
Is Heart Surgery Worth It?
The
July 18, 2005 issue of Business Week magazine ran an
article, “Is Heart Surgery Worth It?” that should be
required reading before anyone is allowed to agree to heart
surgery for blocked heart arteries (coronary artery
disease). This article talks about the failure of
bypass surgery to save lives in most cases, and about
complications, including the brain damage.
Dr. Nortin M. Hadler, professor of
medicine at the University of North Carolina at Chapel Hill
and author of The Last Well Person, is quoted in this
article as saying, “Bypass surgery…should have been
relegated to the archives 15 years ago."
You
can find this article online at the Business Week web site:
http://www.businessweek.com/@@EIDaaoQQMOesihsA/magazine/content/05_29/b3943037_mz011.htm
Follow the Money
Brain damage from bypass surgery is just one example of how
people usually learn medical information. Count on some
business making lots of money before you hear about it. The
importance of cholesterol became well known in order to sell
billions of dollars worth of “statin” drugs. The marketing
of dairy products, calcium pills, and HRT (hormones) led to
osteoporosis becoming a household word. GERD (gastroesophageal
reflux disease) is a familiar word thanks to the antacid
industry—now we are all too well acquainted with our
refluxing stomach acids. The list is endless.
You
need to protect yourself and your family by following the
money trail. Next time you hear something new, at least
ask, who benefits by me knowing this information? And always
be asking, “How do I really solve my health problems and
avoid the medical businesses?” The bottom line is
self-care—diet and lifestyle.
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Brain Damage from Bypass Surgery -
The Untold Story |
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During
the typical coronary artery bypass operation the
patient's heart must be stopped in order to sew the
new vessels around the large, "rock-hard,"
blockages.1-3
During these death-like minutes to hours, a
marvelous "cardiopulmonary bypass machine" takes
over the function of the heart and lungs and keeps
the patient's vital tissues alive. Blood is
pumped through the plastic tubes and membranes of
this heart-lung machine, where carbon dioxide is
removed and oxygen is added. However, this
machine is far from perfect. |
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Tiny
fragments of plastic break off the tubes and
membranes, blood cells and platelets are injured
(causing them to form clumps), fat particles are
sucked into the patient's circulatory system, and
gas (air) bubbles enter the bloodstream. All
of this matter is then dumped back into the patient
causing diffuse microembolization (delivery of tiny,
occluding particles) throughout the person's body.
When this debris enters the small vessels it stops
the flow of blood to the patient's tissues - causing
them injury and often death. Most tissues can
regenerate themselves after such injury, but the
brain cannot; therefore, permanent damage, with its
subsequent deficits, results.2-4
After
surgery employing the heart-lung machine, nearly all
patients show evidence of brain damage based on the
release of products of brain tissue injury
into the patient's spinal fluid and bloodstream, and
other changes in brain physiology.5-10
Decline in mental function is most severe right
after surgery. At the time of discharge from
the hospital, between 50% and 80% of patients are
having troubles.4
Five years after surgery a 20% decline in mental
function has been found in 42% of patients.4
Most of the difficulty perceived by the patient is
with subtly tasks, like remembering names and
numbers. Family members commonly notice
personality changes, like "Dad used to be so kind
and understanding, and now the slightest irritation
sends him into a rage."
All this
loss of mental function might be worthwhile for the
one million people worldwide (300,000 in the USA)
who have bypass surgery annually if not for two
undeniable facts:
1) Bypass surgery does not save lives in the vast
majority of cases;
2) The patient and family are almost never informed
about the true impact of this common consequence of
surgery. |
References:
1)
Ascione R,
Ghosh
A,
Reeves BC,
Arnold J,
Potts
M,
Shah
A,
Angelini GD. Retinal and cerebral
microembolization during coronary artery bypass surgery: a
randomized, controlled trial. Circulation. 2005 Dec
20;112(25):3833-8.
2)
Ahonen J, Salmenpera M. Brain injury after adult cardiac
surgery. Acta Anaesthesiol Scand. 2004
Jan;48(1):4-19.
3)
Zimpfer D, Czerny M, Vogt F, Schuch P, Kramer L, Wolner E,
Grimm M. Neurocognitive deficit following coronary artery
bypass grafting: a prospective study of surgical patients
and nonsurgical controls. Ann Thorac Surg. 2004
Aug;78(2):513-8.
4)
Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H,
Jones RH, Mark DB, Reves JG, Blumenthal JA. Longitudinal
assessment of neurocognitive function after coronary-artery
bypass surgery. N Engl J Med. 2001 Feb
8;344(6):395-402.
5)
Aberg T, Ronquist G, Tyden H, Ahlund P, Bergstrom K.
Release of adenylate kinase into cerebrospinal fluid during
open-heart surgery and its relation to postoperative
intellectual function. Lancet. 1982 May
22;1(8282):1139-42.
6)
Snyder-Ramos SA, Gruhlke T, Bauer H, Bauer M, Luntz AP,
Motsch J, Martin E, Vahl CF, Missler U, Wiesmann M, Bottiger
BW. Cerebral and extracerebral release of protein S100B in
cardiac surgical patients. Anaesthesia. 2004
Apr;59(4):344-9.
7)
Henriksen L.. Evidence suggestive of diffuse brain damage
following cardiac operations. Lancet. 1984 Apr
14;1(8381):816-20.
8)
Henriksen L, Hjelms E, Lindeburgh T. Brain hyperperfusion
during cardiac operations. Cerebral blood flow measured in
man by intra-arterial injection of xenon 133: evidence
suggestive of intraoperative microembolism. J Thorac
Cardiovasc Surg. 1983 Aug;86(2):202-8.
9)
Herrmann M, Ebert AD, Galazky I, Wunderlich MT, Kunz WS,
Huth C. Neurobehavioral outcome prediction after cardiac
surgery: role of neurobiochemical markers of damage to
neuronal and glial brain tissue. Stroke. 2000
Mar;31(3):645-50.
10)
Snyder-Ramos SA, Gruhlke T, Bauer H, Bauer M, Luntz AP,
Motsch J, Martin E, Vahl CF, Missler U, Wiesmann M, Bottiger
BW. Cerebral and extracerebral release of protein S100B in
cardiac surgical patients. Anaesthesia. 2004
Apr;59(4):344-9. |
