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How To Bypass Bypass Surgery

I first saw Herman Ablon in June of 1983, when he was 52-years-old. He had been having chest pain while exercising. An angiogram revealed three blockages in his coronary arteries, and two cardiologists told him that he needed immediate coronary artery bypass. He was quickly scheduled for surgery.

Just before Herman checked into the hospital, he asked me for a third opinion. After evaluating Herman, it was clear that he was no more a candidate for bypass surgery than I was. First, he had never had a heart attack, so his heart muscle was undamaged. Second, his heart was functioning well, as shown by the results of his exercise stress test. And third, he had never even tried medical or lifestyle therapy to reduce his angina.

Herman bypassed bypass and chose a program of regular exercise, a low-fat diet, and targeted nutritional supplements. Within a few months he was back in form, exercising daily, pain free, off all drugs, and living a robust and vigorous lifestyle.

"Deja Vu All Over Again"

In June 2001, at the age of 70, it was, to quote Yogi Berra "deja vu all over again." Herman had been having trouble keeping his blood pressure down, and when it reached a dangerous 213/139, he was sent to the hospital. Another angiogram was ordered, despite the fact that he had no symptoms of coronary artery disease. A significant blockage was found, and immediate bypass surgery was recommended.

Again, he came to me for a second opinion. A comprehensive evaluation convinced me that the recommendation for bypass was even more flimsy this time around. His only problem was high blood pressure, and hypertension per se is no reason for bypass surgery—or for an angiogram, for that matter.

Herman was again advised to forego surgery and intensify the diet, exercise, and supplement program that he had more or less followed for the past 18 years. (He had slacked off in recent years.) Once he got back on track, he responded rapidly, just as he had before.

When I saw Herman after that, he was using a treadmill daily, following his diet to a tee, and had been able to lower his blood pressure medication by two-thirds. Just as he had in 1983, Herman avoided the dangerous, high-tech approach to heart disease. If you ever find yourself in Herman's shoes, I suggest you do the same thing. Here's why.

Bypass Surgery Is Unproven and Ineffective

The first coronary artery bypass surgery was performed in 1967, but this procedure was not evaluated by the scientific community until a decade later, when it was already being done on tens of thousands of patients each year. This first study—in which 596 patients with heart disease were assigned bypass surgery or drug therapy—found that surgery conferred no benefit at all. After three years, the rates of heart attack and death from heart disease were virtually the same for both groups.

Normally, such a poor showing would have landed bypass in the rubbish bin of failed therapies. But other factors were at work. As Eugene Braunwald, MD, Chief of Cardiology at Harvard Medical School, stated in the New England Journal of Medicine 25 years ago, "An industry is being built around this operation...[it] is developing a momentum and constituency of its own, and as time passes it will be progressively more difficult and costly to curtail it..." As you will see, Dr. Braunwald's prediction has come true in spades.

The Other Shoe Drops

Six years later, the other shoe dropped when a second study was published, providing even more conclusive evidence that bypass surgery just doesn't wor

k. This meticulously controlled study involved 780 patients with angina and known coronary artery blockages. Half of the patients underwent surgery, while the other half were treated with medications.

Again, results ran 180 degrees counter to expectations. The death rate of the nonsurgical group was less than 2 out of 100 patients per year—virtually the same as the surgical group.

Folks, surgery won't save your life if you're not dying anyway. However, you can be scared into a useless operation by being told you're "at death's door," or "a walking time bomb." If you're scared into bypass with manipulative statements such as these, of course you'll believe you're alive because of the surgery. In reality, your chances of survival would have been the same without surgery.

A Monster That Must Be Fed

Between 1979 and 1998, the number of cardiovascular procedures grew by 384 percent. Today more than a million bypass surgeries and angioplasties are performed every year. This has nothing to do with patient needs or scientific evidence.

You know the old saying, if you only have a hammer, everything looks like a nail. As more and more surgeons train to do heart surgery, more and more unnecessary surgeries will be performed…just to keep them busy.

There will always be grist for the heart surgery mill. It isn't difficult to convince trusting patients that bypass is needed. Yet, as the studies mentioned above and at least a dozen subsequent studies have proven, the basic presumption of bypass surgery is just plain wrong.

Bypass Attacks the Wrong Enemy

Research conducted over the past few years suggests that the most important determinant in whether or not a blockage in a coronary artery will cause a heart attack is not its size but its composition. We now know the vast majority of heart attacks are caused not by the large plaques picked up on angiography but by far smaller, yet much more deadly lesions.

Instead of ordering an angiogram—which is the gateway to invasive procedures—cardiologists should consider other factors. Has the heart been severely damaged? Does exercise bring on skipped beats? Does angina come on unpredictably? These are far more significant and predictive risk factors for future cardiac events than the presence or absence of arterial blockages, and a positive response to these questions might indicate a need for an invasive procedure.

However, an estimated 90 percent of all patients who are funneled into bypass or angioplasty do not fall into this category. I feel like the AFLAC duck, singing the same song for more than 30 years: People don't need this operation. Like Herman Ablon, most patients do much better with lifestyle changes and, if necessary, appropriate drugs.

Recommendations

The best time to educate yourself about bypass is now, before you have a problem. Pick up the updated version of my book Reversing Heart Disease, first published in 1985. It is one of the few books available on the downside of bypass surgery.

If you are recommended to have bypass surgery, get a second opinion, and get it from someone who is not vested in this procedure.

References:

Braunwald E. Coronary-artery surgery at the crossroads (editorial). N Engl J Med 1977;297(12): 661-3.

Murphy M et al. Treatment of chronic stable angina a preliminary report of survival data of the randomized Veterans Administration Cooperative study. N Engl J Med 1977;297(12): 621-7.

For more information visit http://www.searchhearthealth.com

Dr. Whitaker is Director of the Whitaker Wellness Institute and Editor of Health and Healing newsletter that provides important health advice for more than 500,000 people nationwide. Dr. Whitaker graduated from Dartmouth College in 1966 and received his MD in 1970 from Emory University Medical School. He completed his surgical internship at Grady Memorial Hospital in 1971, and continued at the University of California in San Francisco in orthopedic surgery. In 1974, Dr. Whitaker founded the California Orthomolecular Medical Society, along with four other physicians and the Nobel prize-winning scientist Dr. Linus Pauling. Dr. Whitaker is the author of several books including the best-selling Shed 10 Years in 10 Weeks.

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