Tuesday, February 06, 2007

We Get Questions


So, what is the medication regimen prescribed for you by Dr. Wayne. Also what are the "three specific locations of blockages that are fairly rare" that may need CABG surgery? The latter was mentioned in your Blog of 6Dec2006 at 0138 hrs.

Jeff's Reply

I'm sorry I took so long to respond. I work on an oil rig in Nigeria and I don't get to check my email daily. Let me tell you about a website where a lot of questions you have may be answered. It is the late Howard Wayne's website: Dr. Wayne is no longer with us, however, his wife has kept his website up. I don't know if all of his books are available, but if they are, you can buy them through the website.

Dr. Wayne started me on three medications back in May 2004. Metapropolol, Fosinopril, and Modiuretic. He titrated my dosages until my blood pressure at rest became the lowest it could be without me having lightheadness as a side effect. That amounted to 100mg of Metapropolol twice a day, 20mg of Modiuretic in the morning and 10 mg. of Fosinopril at bedtime. It took about six weeks to accomplish this. Back then, Dr. Wayne had given me a prescription for Isosorbide but he told me to stop titrating and not use the prescription.

I went from May 2004 to November 2006 without one incident of angina. While traveling home from Nigeria just after Halloween, I had to run through Charles De Gaulle Airport in Paris to make my connection. I then experienced my first angina in over two years. Since that time, I have had angina a few times a week. In January 2007, I visited a new noninvasive cardiologist I called after learning that Dr. Wayne passed away in October 2006 while vactioning in the mountains around Lake Tahoe. He would have been 83 in three weeks and lived a good and productive life.

The new physican added Isosorbide Long Acting 60mg in the morning to my regimen and gave me Nitroglycerin .04 sublingual as needed. The Isosorbide caused my blood pressure to crash too much so, I started cutting them in half and taking it with my Metepropol in the morning and at night. The angina is once again controlled.

I will see my doctor when I return from West Africa the end of February.

Regarding what types of CAD usually require surgical intervention. The main one is a significant blockage that is of the large left atrial vessel. If there is any evidence of cardiac ischemia with new onset of chest pain, and finally, any CAD that doesn't respond to medication. In other words, if the first two conditions do not exist and the doctor has not tried to treat you with medication but wants you to have a CABG, you probably want to get a second opinion.

I am not a doctor and do not pretend to be one. I would never be so bold as to tell you what to do with your health. But I do think we all should take charge of our own bodies and not let doctors with less than altruistic motives scare and coerce us into surgery we do not need.

I wish you great health and prosperity.


I enjoy answering questions and wish we would get more. Feel free to ask anything you like. I especially enjoy sparring with interventional and invasive cardiologists. If any of you want to (and I know you are out there) spar a little bit with me, feel free. I like nothing better than to try to turn you guys and gals into proper cardiologists. So if you can defend the huge amount of CABGs performed in the USA, drop me a line.


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