Yes, Lynne what I am looking for is different from other kinds of surgery.  I am actually interested in approaches that help keep arteries open and disminish the plaque that develops the need for heart surgery.  There is so much "hype" out there with a sales pitch that one could die trying all of them. I like Dr. Weil's  approach because he looks at the available research ( which is not always available to the lay person) and gives an opinion as whether the product can help.  I ask a question on the board about his opinion  about grapefruit pectin which is   advertised as something that will help clear plaque from arteries.  My brother age 61 just had  open heart surgery ( four by-passes),  and I have already had one angioplasty  (some heredity I'm sure). Thus, my interest in finding the best approach.  We are following the diet suggestions, exercise, etc. that are recommended in Dr. Weil's library-  also take the newsletter.  Thanks so much for your help and concern. I will appreciate any info. you may be able to get concerning grapefruit pectin, etc. I doubt that the question will make it through the board.

i'm a critical care nurse, and my area's of specialization are cardiovascular care and trauma surgery. i spent two years recently working in the interventional cardiology unit working with people much like your self. part of my practice was to lead a "heart health" class three days a week for people who had heart attacks, recovering from bypass surgery and people that had angioplasty. it's been a year now since i led these classed but the basic tenets of recovering and maintaining cardiovascular health after an insult involves beginning a low impact exercise plan, invesitgating and implementing a low fat heart healthy diet and unfortunately there are always prescription medications that are prescribed for about 6-8 months after the event.

as far as exercise is concerned, i worked with a physical therapist to describe actual exercises, but i do recall that it was standard to encourage a walking program that begins with walking three days a week for roughly 15-30 minutes and advancing to your comfort level over time. i always advised that initially after discharge from the hospital one must start slowly, if fifteen minutes feels like too much then start out doing less and increase as you feel comfortable.

once again, as diet goes, i worked with an expert dietitian that had meal plans prepared. i know enough about nutrition to follow a healthy diet myself, but i'm afraid i wouldn't feel comfortable making recommendations to others (beyond avoiding the fast food and foods that are unquestionably unhealthy).

in terms of medications, you have an expert here. it depends of course what from you are recovering but each event/procedure utilizes a standard therapy almost universally, no matter which doctor you see or which facility you go to. questions regarding the surgery/procedures/ and post-care or therapy i can address. if you have questions in that arena.

oh, and i have a particulary strong opinion against the use of statin medications (you know, Lipitor, Zocor, ect.) except in some extreme cases, if you are interested.

Thanks so much for your input.  I am very interested especially in your opinion of the statin drugs.  I have recently seen much research coming from the Cleveland Clinic and the Harvard Medical Center indicating that they are helpful  in more ways than just cholesterol.  My brother is the one who has recently (ten days ago) had heart surgery-  four by-passes.  He had angioplasty three years ago with one stent.  I had angioplasty with one stent five years ago, and am trying to avoid as much more damage as possible for both of us.  I have been on atenolol and plavix since the angioplasty.  My brother opted to take no medication other than some oral chelation stuff that had been recommended to him by someone selling it and aspirin.  It did not work.  We have both followed a "heart healthy" diet and an exercise program.  There is, of course, a genetic factor here.  I appreciate your information.

i'm sorry to hear about the difficulties you two have had, especially since it sounds like you have made all the recommended lifestyle changes. in light of that, i'm afraid that my opinion, and it is just that an opinion, will probably be little consolation for you.

anyway, it was a few years back when we first started using these drugs widely, the statins. i don't even remember which one came first (Zocor or Pravachol, i think, but don't quote me). they were costly as i recall and then all of sudden Lipitor hit the market and everybody was on it. the research showed that we were getting an excellent response lowering cholesterol and reducing a major risk factor for heart disease and heart attack. i'm not a mainstream type person, i never have the latest products first, and although i try to keep an open mind i was skeptical about this miracle treatment.

as i said, for a few years i was leading a cardiac health education program and historically all the research concluded that diet, exercise and stress reduction significantly reduced risks. we always emphasized risk factors as two tiered, those you can change and those you cannot. you cannot change a family history (or a genetic predisposition) and you cannot change being a diabetic. however, you can quit smoking, eat healthy, exercise, keep your blood sugar well controlled, reduce the stress in your life and learn to deal with stress more effectively. the research indicates that these are effective ways to reduce the risk of heart attack, and other cardiovascular disease states. i believe this, and i was absolutely stunned one day when a young man in his late twenties was admitted for chest pain and automatically ordered a statin. there is documentation out there that explains how these drugs work, and if memory serves me the block the body's production of cholesterol rather than eliminating dietary intake of cholesterol. so, if you're on a statin you need to modify your diet as well.

the body is an amazing organism, it has all manner of regulatory systems and when you manipulate them extrinsically the body tries to compensate. so, if if you're taking a statin, your liver can't produce cholesterol; but guess what happens when you stop taking the drugs. your liver begins synthesizing cholesterol, in fact it works overtime producing it. i have frequently heard doctors and patients alike say that this would be a temporary treatment to bring cholesterol under control. but, again my numbers are from memory, there is something like an 86% increased risk of cardiac insult if a statin is discontinued abruptly. to my mind that means this becomes a lifelong therapy, and i was appalled that we would consider putting a young healthy person on this type of therapeutic regimen. my opinion is that lifestyle changes should be the first prescription for anyone that has the ability to make them.

there are people that cannot make these changes, for example there are people with cardiovascular disease so advanced that they wouldn't survive the surgery they need, others that have such bad heart failure that the only exercise they get is breathing. these are good candidates for statin therapy. additionally, there appears to be a certain cross section of the population that hyper-produce cholesterol and no matter what lifestyle changes they make they cannot reduce their levels, and statin therapy then becomes necessary once this is identified. there are other candidates as well.

sorry, i tend to get long winded discussing topics like this, especially when it's so onesided like this, because i argue these points frequently in the clinical arena and usually with physicians that aren't listening. regarding the recent report from Mayo, they stumbled upon a new use for the statins in treating aortic stenosis (AS). AS is a narrowing of the valve in your heart that blood is ejected through to circulate through the body (i won't lead an anatomy lesson, i promise). AS has two treatments, valve replacement and valve revision, but this isn't the type of surgery you have until it presents a problem, again the body has amazing adaptive capacity. this study indicates that statin therapy may provide an alternative therapy to people with AS if it is identified early enough to prevent the need for surgery. i think this is a valid application of statin therapy as well, but i have to qualify that by saying that age and overall health should be considered when choosing to initiate statin therapy.

again, sorry to blab on and on, and i hope this was informative or at least entertaining.

be well