As a service to my readers here is my take on the impact of ObamaCare on the future of health care delivery in this country. The following synopsis is based on objective evidence. The impact of cardiology and other chronic illnesses will be profound.

It is my hope the following post serve as a resource that outlines the issues with the new law, the problems Canada and Britain are facing with their current systems, and why ObamaCare should be repealed in its entirety. If you want to jump straight to the socialized health care horror stories, feel free to do so. It is highly recommended reading. But first I would like to start with one from right here in the US, just so the reader is fully aware it not only can happen here, it has happened here (emphasis mine):

The powerful story of Barbara Wagner demonstrates why this discussion is of utmost importance. When Barbara’s lung cancer reappeared during the spring of 2008 her oncologist recommended aggressive treatment with Tarceva, a new chemotherapy. However, Oregon’s state run health plan denied the potentially life altering drug because they did not feel it was “cost-effective.” Instead, the State plan offered to pay for either hospice care or physician-assisted suicide.

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Heart disease covers several conditions which affect the heart. This includes ischemic heart disease, heart failure, heart arrhythmias, heart valve issues – this list is not exhaustive. Causes of heart disease often include a history of high blood pressure, smoking, high levels of bad cholesterol, low levels of good cholesterol, a sedentary lifestyle, drug abuse, genetics, and other diseases. For my wife’s father, a virus attacked his heart leading to heart failure and eventually death. The list of causes in developing heart disease are long. Knowing the warning signs can be the difference between life and death, affect the quality of your life and impact family members as well. From the CDC:

Heart disease and stroke are the most common cardiovascular diseases. They are the first and third leading causes of death for both men and women in the United States, accounting for more than 35% of all deaths. More than 870,000 Americans die of heart disease and stroke every year, which is about 2,400 people dying every day. Although these largely preventable conditions are more common among older adults, more than 148,000 (17%) of Americans who died of cardiovascular diseases in 2004 were younger than age 65 years. Heart disease and stroke also are among the leading causes of disability in the U.S. workforce. Nearly one million people are disabled from strokes alone.

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Wow, what a difference a year makes. As many of my readers will notice, I have been given a top blog award from disease.com. I am pleased this blog is recognized as helpful for those suffering from heart disease. That is my goal and continues to be my goal.

Updating has been sparse of late, partially due to other demands on my time. However, I actually do plan to begin paying this blog more attention and although I believe the current information to be quite comprehensive, there is always the latest news and breakthroughs that I would like to begin covering once again.

My last appointment with my cardiologist was last week. It has now been 18 months since my last stent, and 6 months since my last stress test. I am overdue some blood work and I intend on addressing that issue after the holidays when I get a chance to lose some of the weight I know will gather about my waste. Until then, have yourself a wonderful Thanksgiving, merry Christmas, and a happy New Year.

As I stated in My Story I am a proud member of Shepherd of the Hills Presbyterian Church.

I consider the pastor, Larry Coulter, an influential, inspiring and entertaining speaker. His presence can lift even the lowest of spirits and his sense of humor hints at the possibility that had he not chosen being a pastor, he could have ranked among the best of comedians.

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From the Associated Press:

Heart attack survivors are again being enrolled in a controversial federal study of an alternative treatment while the government investigates whether they were told enough about possible health risks.

The $30 million study, with 1,500 participants so far, is one of the largest alternative medicine experiments ever launched. It tests high doses of vitamin and mineral supplements and chelation, a treatment used for lead poisoning that has not been proved safe or effective for heart disease.

Researchers suspended enrollment last August, when the federal Office of Human Research Protections began a probe into whether the people in the study were being fully informed of risks and adequately protected.

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From PTCA.org comes an excellent article converning the use of IVUS (emphasis mine):

A study, published in the current issue of JACC Interventions, details 120 drug-eluting stent cases as viewed by intravascular ultrasound (IVUS) in order to examine characteristics that may lead to in-stent restenosis (ISR) or stent thrombosis.

Underexpansion of stents, both drug-eluting and bare metal, has been long identified as a significant predictor of adverse clinical events. Prominently discussed by Dr. Antonio Colombo in the early days of stenting, inadequate expansion of the stent struts is known to increase these problems.

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Fractional Flow Reserve, or FFR, is a guide wire-based procedure. Its utilility is that it can accurately measure blood pressure and flow rate through a specific part of the coronary artery. Is is performed through a standard diagnostic catheter during the actual coronary cathaterization. Using Fractional Flow Reserve, the interventinalist can assess whether or not to perform angioplasty or stenting on “intermediate” blockages – blocakges that may or may not cause angina symptoms or lead to serious ischemic events.

The entire point of using a stent in the coronary arteries is to increase blood flow to the heart. However, a number of studies have shown that if a “functional measurement”, such as Fractional Flow Reserve, indicates the flow is not significantly obstructed, the blockage or lesion does not need to be revascularized (angioplasty) and the patient can be treated safely with medical therapy.

The Interventinalist’s tendency to stent is well documented. Some more aggressive than others. In the case of my cardiologist, if he notices a blockage of 75% or greater, he will stent it. Some cardiologists will stent a 50% blockage. But what if FFR indicated that an intervention won’t have a significant impact on a particular blockage? Being able to better select cases not only saves health care costs, but contributes to more appropriate patient care.

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