Diet and Exercise

This morning I spoke with an old friend who is doing well after his CABG a year ago.
In fact he is doing so well, that he is back to his pre-operative weight of 200 lbs (about 25  lbs too heavy).

So what? He feels wells, is busy, physically as active as before he became ill  (probably more active than most other people), and has no symptoms of fatigue or angina as before his surgery.

His situation is typical of patients who have had a successful intervention such as PCI (Stent), or bypass surgery. Even though he had been warned that a procedure does not treat the underlying disease, but only improves the blood supply to the heart temporarily, this was long forgotten.

It is also typical that there has been little or no supervision of his illness: his cardiac surgeon and his cardiologist are no longer be involved and his local doctor hasn't seen him since his recovery because he is doing so well.

So what needs to happen? Improving the blood flow is of course vital, but also just the beginning of other treatments that are vital to prevent his underlying disease of atherosclerosis from progressing:

  • Diet: Eating a diet that is low in calories and "bad" cholesterol in moderate amounts is essential. Most older patients and their families have never been educated in eating a proper diet. A study just released has shown the benefit of low Glycemic Index carbohydrates.
  • Reduce weight: Most studies will point out that this is one of the most difficult things to achieve
  • Exercise: Don't for a moment believe those ads that promise easy weight loss with just a little exercise. You can bet that those pretty ladies on television do a lot more than following a simple diet. While better than nothing, a little exercise will not even begin to address the issue. In fact a new study has shown, that pretty intense, moderate exercise is necessary to achieve effective and lasting weight loss.
  • Use medications to protect your bypasses or Stents with Aspirin and other medications.
  • Treat high blood pressure, cholesterol etc,

I believe this is why patients develop recurrent blockages: the underlying problem was never treated, or only for a short period of time. Taking care of yourself is hard work, pills and procedures alone will not do it for you!

Let me know what you think,
Dr T


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